Haryana

Fatehabad

CC/262/2018

Gurpreet Maan - Complainant(s)

Versus

The New India Assurance Company - Opp.Party(s)

M.S Godara

21 Aug 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION; FATEHABAD

          C.C.No.262 of 2018.               Date of Instt.:12.09.2018 Date of Order: 21.08.2023.

Gurpreet Maan daughter of Manjeet Singh (wife of Anil Kumar) resident of Geeta Colony, Tohana Tehsil Tohana District Fatehabad.

..Complainant.

          Versus

1. The New India Assurance Company Limited 1215, 12^th Floor, Naurang House, 21-Kasturba Gandhi Marg, New Dehli-11001 through its Manager.

2.The New India Assurance Company Limited, Branch Chandigarh Road Tohana District Fatehabad through its Branch Manager.

3.Dhanda Motors, Mauti Authorized Service Dealer, 1 K.Stone, Ratia Road, Tohana Tehsil Tohana District Fatehabad through its Proprietor/Partner.

          ..Opposite parties.

Complaint under Section 12 of the Consumer Protection Act, 1986

Before:        Sh. Rajbir Singh, President.                                                               Smt.Harisha Mehta, Member.                                                             Sh.K.S.Nirania, Member

Present:       Sh.M.S.Godara, counsel for the complainant.                                    Sh.U.K.Gera, counsel for the Ops No.1 & 2.                                       OP No.3 exparte Vide order dated 08.04.2019.

 

ORDER

SH.RAJBIR SINGH, PRESIDENT;

                   By way of this complaint, the complainant has submitted that he is owner of vehicle bearing registration No.PB-13AW-0110 which was insured with OPs No.1 & 2 vide policy No.98000031160304766377 having validity for the period from 27.12.2016 to 26.12.2017; that on 17.12.2017, the vehicle in question met with an accident and regarding this DDR No.18 dated 18.12.2017 was entered and recorded with the concerned police station Sadar, Tohana District Fatehabad; that the complainant intimated about the accident to the insurance company; that the surveyor inspected the vehicle and further obtained the estimate of Rs.8,51,156/- from Op No.3 as the vehicle was totally damaged; that the complainant requested the Ops to make the compensation and on this it was assured to him that an amount of Rs.6,73,951/- would be paid to the complainant shortly but till today not even a single penny has been paid to the complainant, and further repudiated his claim, despite several. The act and conduct of the OPs clearly amounts to deficiency in service. In evidence, the complainant has tendered affidavit and documents Annexure CW1/A, Annexure C1 to Annexure C45.

2.                          On notice, only Ops No.1 & 2 have appeared and filed their joint reply. However, Op No.3 did not appear before this Commission despite issuance of notice through registered cover, therefore, it was proceeded against exparte vide order dated 08.04.2019. Ops No.1 & 2 in their joint reply have submitted that the present complaint is not maintainable and the complainant has no cause of action to file the present complaint. It has been further submitted that the complainant has violated the condition No.1 of the policy in question as the intimation was given to the Ops No.1 & 2 after a gap of 5 days of allegedly, therefore, the claim was rightly repudiated; that the story put-forth by the complainant creates a doubt on the manner of accident; that due to delayed intimation the insurance company was deprived of their valuable right of investigating the facts as per terms and conditions of the policy; that the approved surveyor had assessed the loss to the tune of Rs.5,97,951/- subject to terms and conditions of the policy; that the complainant himself has violated the terms and conditions of the policy, therefore, the answering Ops are not liable to pay any claim to the complainant. There is no deficiency in service on the part of answering OPs. In the end, prayer for dismissing the complaint has been made.  OPs No.1 & 2, in evidence have tendered affidavits of K.S.Chaudhary, as Annexure R1 and affidavit of Sh.Suresh Kumar Vashisth, as Annexure R2 with documents Annexure RW1,2/1 to Annexure RW1,2/10.

3.                          Heard. The counsel for the complainant reiterated the averments made in the complaint and prayed for its acceptance whereas the counsel for appearing OPs reiterated the averments made in the reply and prayed for its dismissal.

5.                          Undisputedly, the complainant is registered owner of vehicle bearing registration No.PB13AW-0110 (Annexure C1) and the same was insured with Ops No.1 & 2 (Annexure C3). The complainant has come with the plea that her vehicle met with an accident during the subsistence of the policy; therefore, it is the boundened duty of the Ops No.1 & 2 to pay the loss suffered by her on account of damage of the vehicle but the Ops did not do so.  

6.                          Learned counsel for the appearing Ops has stressed hard that the complainant himself has violated the condition no.1 of the policy as there is delay of 5 days in intimating the insurance company with regard to alleged accident, and further the complainant has not submitted the demanded documents mentioned in Annexure RW1,2/4 therefore, the Ops No.1 & 2 cannot be held liable for any liability on account of damage of the vehicle.  

7.                          DDR (Annexure C6) was registered on the statement of the complainant wherein it has been specifically mentioned that due to sudden appearance of Neel Cow, his vehicle got uncontrolled and further in the process of saving the cow, the vehicle dashed into a big stone and further fell in the river. It has been further mentioned in the said DDR that due to sudden death in the relations, the complainant could not get the report with regard to said accident in the police station on 18 & 19, therefore, the DDR was entered and registered on 20.12.2017. Learned counsel for the complainant has submitted that the delayed intimation, if any, was not intentional rather due to circumstances arising out at that time.

8.                          Learned counsel for the Ops No.1 & 2 in the joint written statement has submitted that the insurance company was deprived of their valuable right of investigation/spot survey as per the terms and conditions of the policy due to late intimation. The fact regarding delaying intimation is not disputed because the alleged accident had happened on 17.12.2017 and the intimation was given to the Ops No.1 & 2 only on 22.12.2017.  Learned counsel for the Ops nO.1 & 2 has mentioned that due to violation of condition No.1 of the policy, the claim was rightly rejected. The fact regarding accident of the insured vehicle during the subsistence of the policy is clearly established. Though there may be delayed in intimation but there is no justification for the Op for denying the claim of complainant in its entirety only for such violation of term and condition.  In this regard, reliance can be made to authority titled as United India Insurance Co. Ltd. Vs. Gian Singh reported in II(2006) CPJ page 83 (NC), wherein it has been held by Hon’ble National Commission that in case of violation of condition of policy as to nature of use of the vehicle, the claim ought to be settled on non-standard basis.  In the authority titled as Mohammad Ejaj Vs.UII, 2014(4) CLT page 161 (Hon’ble State Commission, Haryana), it has been held that Insurance Claim-Repudiation-On the ground that there was delay of 15 days in lodging the F.I.R. and 36 days in giving intimation to the Insurance Company-IRDA have given direction to the Insurance Companies not to reject genuine claims simply because of late registration of F.I.R. and late intimation to the Insurance Company-Held-IRDA is the controlling authority of all Insurance Companies and being a statutory body, is competent to frame guidelines and issue instructions to Insurance Companies which are binding upon them-Appeal accepted.  In the authority cited in 2016(2) CLT page 434 (Hon’ble State Commission, Haryana) titled as Future General India Insurance Co. Ltd. Vs. Satbir, where in the head-note, it is mentioned that Insurance claim-Theft of insured tractor-Prompt FIR-Delay of 66 days in intimation to insurance company-Held-In the Circular Ref:IRDA/HLTH/MISC/CIR/216/09/2011 dated September 20, 2011 issued by ‘IRDA’, it has been mentioned that genuine claims should not be rejected on account of delay in intimation, and that, the insurer’s decision to reject a claim must be based on “sound logic” and “valid grounds”-Insurance company is liable to indemnify the loss suffered by the complainant-Appeal dismissed. Hence, we are of the considered view that the claim in respect of vehicle in question should have been settled by the Ops No.1 & 2 on the basis of the guidelines of non-standard settlement.         

9.                          Thus, in view of above discussion, we allow the complaint partly and direct the Ops No.1 & 2 to settle the claim of complainant on non-standard basis and to pay Rs.505464/- i.e. 75% of Rs.6,73,951/- (insured value of the vehicle as mentioned in Annexure C3), subject to furnishing of subrogation letter and transfer the ownership of vehicle in the name of Ops No.1 & 2 by the complainant within 30 days.  However, it is made clear that the wreck of the vehicle in question will be kept by the insurance company and if it is returned to the complainant, in that eventuality, complainant is directed to return the same to the Ops No.1 & 2 within a period of 30 days, failing which the insurance company is directed to make the payment of awarded amount after deducting the value of wreck to the tune of Rs.75,000/- as assessed by the surveyor in its report  Annexure RW 1,2 /9.  The compliance of the awarded amount be made within a period of 30 days by the Ops No.1 & 2 after doing the needful by the complainant as per direction given above, failing which the awarded amount would carry interest  @ 9 % per annum from the date of filing of the compliant till its realization.  The complaint against Op No.3 stands dismissed.

10.                        In default of compliance of this order, proceedings against respondents shall be initiated under Section 72 of Consumer Protection Act, 2019 as non-compliance of court order shall be punishable with imprisonment for a term which shall not be less than one month, but which may extend to three years, or with fine, which shall not be less than twenty five thousand rupees, but which may extend to one lakh rupees, or with both. A copy of this order be sent to the parties free of cost. File be consigned to the record room after due compliance.     

Announced in open Commission.                                                           Dated: 21.08.2023

                  

          (K.S.Nirania)               (Harisha Mehta)                     (Rajbir Singh)                      Member                                 Member                               President