Brief fact of this case is that, the petitioner is the Consumer, the OP.No.1 is the insurer, OP.No.2 whoissued Insurance policy to the petitioner & OP.No.3 in whose jurisdiction the claim amount be disposed of. That the petitioner purchased one car(TATA ZWST) bearing Regd.No.JH05CK-6545,Chassis No.MAT624031JPK14371 from ASL Motors,Adityapur,Jamsedpur in the year 2019 and the vehicle was duly insured before the General Insurance Co.Jamsedpur covering period from 09.05.2019 to 08.05.2020. The vehicle was not insured (renewed) till 24.11.2020 due to restrictions of Covid-19 and during the said period the vehicle was not plying on the road. Subsequently the petitioner insured his vehicle before the Op.No.2 on dt.25.01.2020 covering period from 26.11.2020 to 25.11.2021 vide policy No.55070231202000001613. On dt.09.01.2021 at about 8.15 pm while the petitioner was travelling in his vehicle from Barajamda to Nuamundi for distribution of marriage invitation card being driven by his driver, two dumpers coming from opposite direction tried to overtake the car, as a result of which the driver was compelled to turn the car towards right side and ultimately dashed against a tree. Due to such accident the front side of the car was completely damaged. The petitioner informed the fact online to the customer service of Op.No.1 at 1800-209-1415NIACL on the same day i.e on 09.01.2021 and the claim has been registered. The OP No.1 Insurance company informed that the vehicle in question be shifted to ASL Motors show room for assessment of damages and repair. So, the petitioner shifted the vehicle to ASL Motors immediately wherein it was parked. The petitioner submitted his claim letter on dt.08.02.2021 before the OP.No.3 for an amount of Rs.8,93,800/- as assessed by ASL Motors,Adityapur.The petitioner also informed the cause of submission the claim intimation letter on 08.02.2021. However, the Op.No.3 made correspondence with Op.No.2 for review and ready reference to claim documents.The Surveyor of the said Insurance Company paid visit to the parking place at ASL Motors for assessment of damages of the vehicle. But the surveyor submitted an imaginary and concocted report stating “damages do not appear consistent with the nature and cause of damages as no mark of tree bark found on the damaged vehicle and unprofessional approach towards tutelage of damaged vehicle by insured”. The Op.No.3 sent a letter to the petitioner stating “your claim No. 55070231200390000098 vide policy No. 55070231202000001613 is repudiated by competent authority as our DCC has found the following irregularities and lacuna in this claim.”(a)the damaged vehicle was left unattended for more than one month and many vital items found missing for which no FIR had been filed(b)Reason behind no requesting spot survey after the accident  and for late intimation for more than one month had been found unjustifiable (c) No valid  clarification against break-in-insurance and late renewal of previous policy(d) the damaged vehicle was also moved through one work-shop to another work-shop without written intimation to insured and Surveyor(e) No satisfactory reply found with respect to queries like tutelage damaged vehicle, accident spot and late intimation for this claim. That, such observation of DCC is baseless. It is pertinent to mention that the petitioner informed the cause of accident on the same day on dt. 09.01.2021 and online claim ref.No.1-234956101 dt.09.01.2021 has been endorsed to that effect. The surveyor has not attended the vehicle inspite of repeated requests made by the petitioner. Due to engagement of marriage ceremony of petitioner’s daughter, the petitioner could not submit the claim intimation letter during that period and submitted on dt.08.02.2021 with proper explanation. On the version of Insurance Company, the vehicle was shifted to ASL Motors,Adityapur soon after the accident. As the vehicle was completely damaged, it is unjust and improper to say that vital items are missed. That the petitioner suffered harassment and mental agony due to refusal of making payment the claim amount in spite of several correspondences. The cause of action arose within the jurisdiction of this Hon’ble Court on 09.01.2021(the date of accident) and on 15.12.2021(the date of last refusal to make payment the claim amount.) Hence, the petitioner prayed that the OPs may be directed to pay the claim amount of Rs.8,93,800/-, Parking charges of Rs.60,000/- and a sum of Rs.50,000/- towards harassment and mental agony total comes to Rs.10,03,800/-.

The complainant relies upon the following documents:

1. Photocopy of Registration Certificate bearing No.JH-05-CK6545.
2. Photocopy of Policy certificate of MAGMHD General Insurance Co.
3. Photocopy of Receipt of claim information.
4. Photocopy of Loss/ damage intimation letter.
5. Photocopy of Damage Assessment of ASL Motors.
6. Photocopy ofCertificate of Insurance agent by the New Assurance Co.Ltd.
7. Photocopy of the driving licence of LaxmidharGand.
8. Photocopy of Intimation of repudiation of the claim.

On the above complain, the case is admitted and notice issued to the Ops for filing written version. In their written version the OPs stated that the present case has been filed by the complainant to get an award of Rs.8,93,800/- with 12% interest including Rs.60,000/- towards parking charges and Rs.50,000/- towards harassment and mental agony. The case is not maintainable under Law and fact. There is no cause of action to file this case against the OPs. That the present case is bad for mis-joinder and non-joinder of party. That the averments made in complaint petition from paragraph 1 to 5 of the complaint are denied by Ops But it is false to say that the Surveyor deputed by the Insurer submitted an imaginary and concocted report.The fact is that the insurer could not get any opportunity to conduct spot survey since the vehicle in question was already shifted from the place of occurrence and the Surveyor duly deputed by the insurer after conducting final survey has clearly stated “damages do not appear consistent with the nature and cause of damages as no mark of tree bark found on the damaged vehicle and there was unprofessional approach towards tutelage of damaged vehicle by the insured”.The insured vehicle (insurance period from 26.11.2020 to 25.11.2021) met an accident on 09.01.2021 but required claim were filed on 08.02.21 by the insured, as such due to late intimation, spot survey could not be conducted. Though the nature of damage was larger size, no FIR/ Station Diary was lodged. However, the insurer had performed its duty chronologically as per the procedure with an intention to render best and expeditious service to the insured. The most significant fact is that while processing the claim of the insured, the Divisional Claims Committee(DCC) had found many irregularities and lacuna such as (i) the alleged vehicle was left unattended for more than one month and many vital items found missing for which no FIR hadfiled (ii) reason behind not requesting for spot survey after the accident and for late intimation for more than one month had not been found justifiable(iii) no valid clarification against break-in insurance and late renewal of previous policy (iv) the damaged vehicle was also moved to oneworkshop to another without written information to insurer and surveyor & (v) no satisfactory reply found with respect to queries line tutelage of damage vehicle, accident spot and late intimation, thus is claim in question was rightly repudiated.Since non-settlement of claim has been made due to the fault of the complainant, it is expedient for the ends of justice that the case be dropped with costs being devoid of any merit. In the above circumstances, the present case is liable to be dismissed with cost as prayed by Ops. Insurance Company.

The OP relies upon the following documents:-

1. Copy of final Survey report on dt.14.08.21 but not filed by Ops.
2. Letter of Repudiation to complainant dt.21.12.21.
3. DCC Noting.                                                               

On the above pleadings the following issues are framed to decide the case.

1. Whether the case is maintainable?
2. Whether any cause of action arises on this case?
3. Whether Ops have made any deficiency of service?
4. Whether the complainant is entitled to get any relief sought for?
5. Where the case is bad for mis-joinder and non-joinder of necessary parties.                                         

​FINDINGS

All the issues are inter-related to each other so they are discussed and decided para wise as follows: There is no dispute regarding the complainant is a consumer because he has availed an insurance from Ops by paying a sum of Rs.14,943/- as yearly premium vide policyNo.55070231202000001613. After accident as per instruction of Op.No.1 the vehicle bearing  Regd.No.JH05CK-6545 was shifted to Adityapur Showroom for  repair and assessment of damages. The complainant submitted his claim to OP No.3 of Rs.8,93,800/- only as assessed by ASL Motors. In this case the OP has not filed the Survey report in this case which is a valid document to decide the case. But as per the version filed by Ops the Surveyor submitted in his report “damages do not appear consistent with the nature and cause of damages as no mark of tree bark found on the damaged vehicle and unprofessional approach towards tutelage of damaged vehicle by insured”.

It is also found from the written version and arguments that Divisional Claims Committee(DCC) found many irregularities and lacuna as follows: .”(a)the damaged vehicle was left unattended for more than one month and many vital items found missing for which no FIR had been filed (b)Reason behind no requesting spot survey after the accidentand for late intimation for more than one month had been found unjustifiable (c) No validclarification against break-in-insurance and late renewal of previous policy (d) the damaged vehicle was also moved through one work-shop to another work-shop without written intimation to insured and Surveyor(e) No satisfactory reply found with respect to queries like tutelage damaged vehicle, accident spot and late intimation for this claim. The Regd.post letter on dt.21.12.2021 of Ops clearly declares repudiation cum settlement of claim No.55070231200390000098 vide policy No.55070231202000001613.

In this case the complainant filed a decision and cited the version of Hon’ble Supreme Court of India Civil Appellate jurisdiction vide civil appeal No.1069 of 2022 as highlighted that , the Insurance Company could not have repudiated the claim merely on the ground that there was a delay in intimating the Insurance company about the occurrence of the theft.

                        In the above situation this Commission feels that this matter to be taken as other purpose of General Insurance on Non-standard basis.“Surveyor’s report is only reliable document which is to be considered for settling Insurance claim-petitioner has filed to put forward any cogent reasons to dispute Surveyor’s report and there is no reason to reject it”. The complainant relied upon the decision passed by the learned Court that, the New India Insurance Co.Ltd.Vr. Prandhar Agarwal on 30.10.2008 of Chhatisgarh State Consumer Dispute Redressal Commission, Pandari Raipur passed on Appeal No.214/07 and other decision of the National Commission referred in this decision here it is held that & taken view in case breach of policy condition as to limitation of use of vehicle the insured be entitled for settlement of claim on Non-standard basis.

                        The Divisional claims Committee (DCC) found many irregularities under the basis of survey report and other documents but not investigated the matter in field. So, it is not possible to give stress on the report of the Committee.

So far as the delay in intimation is not a matter of fact as per above citation. This commission feels that the complaint case regarding Insurance claim of the vehicle should be assessed as per the report of estimate of ASL Motors on 75% of Non-standard basis. So, the case is maintainable and mis-joinder and non-joinder of parties is not a cause to discuss as it is an Insurance case.

ORDER

            The complaint petition is allowed on contest. TheOps are directed to pay Rs.6,70,350/- to complainant on 75% of Non-standard basis of Rs.8,93,800/-. The Ops are further directed to pay Rs.50,000/- for mental harassment and cost of litigation. If the Ops failed to comply this order within 45days from receipt of this order the total amount Rs.7,20,350/- shall carry 9% interest per annum from the date of this order.