Chandigarh

DF-I

CC/467/2022

Jaswinder Pal Singh - Complainant(s)

Versus

The New India Insurance Co. Ltd. - Opp.Party(s)

Maanvinder Singh

03 Sep 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-I,

U.T. CHANDIGARH

Jaswinder Pal Singh s/o Malik Singh Chawla r/o House No.139, Sector 38-A, Chandigarh.

… Complainant

V E R S U S

1. The New India Insurance Co. Ltd., Claim Hub, Chandigarh having its office at 4^th Floor, SCO 36-37, Sector 17-A, Chandigarh (U.T).
2. M/s Policy Bazaar Pvt. Ltd., having its office at 2^nd Floor, SCO 55-56-57, Sector 8C, Sector 9, Chandigarh 160009.
3. M/s HitekMotorz, Plot No.695, Industrial Area, Phase-1, Chandigarh.

… Opposite Parties

Per Pawanjit Singh, President

1. The present consumer complaint has been filed by Jaswinder Pal Singh, complainant against the aforesaid opposite parties (hereinafter referred to as the OPs).  The brief facts of the case are as under :-

1. It transpires from the allegations, as projected in the consumer complaint, that complainant is the registered owner of Hyundai Verna car bearing registration No.CH-01-AN-9451 (hereinafter referred to as “subject car”) and got the same insured from OP-1 through Policy Bazaar/OP-2 since the year 2019 which was finally renewed vide policy (Annexure C-1) w.e.f. 10.8.2021 to 9.8.2022 (hereinafter referred to as “subject policy”). While renewing the subject policy, complainant had to just select the policy and rest of the details were to be automatically filled up. It is further alleged that No Claim Bonus (NCB) is a discount on premium, offered by the Insurance Company if the vehicle owner has not made any single claim during the prior term and as the complainant had not raised any claim earlier, at the time of renewal of the subject policy, he was allowed to avail 50% NCB.  The complainant had paid online premium to the tune of ₹10,428/-. Unfortunately in the month of November, 2021, the subject car met with an accident and was badly damaged and it was taken to the Hyundai Service Centre of OP-3, where same was repaired and bill to the tune of ₹71,937/- was raised by the repairer.  After that, complainant raised claim with OP-1/ insurer, but, surprisingly on 3.2.2022 OP-1 had sent an email (Annexure C-2) to the complainant stating that he is only entitled to 20% NCB instead of 50%.  In fact, OP-1/insurer had sent the said email to the complainant when he had already raised claim with it. Thereafter, complainant had requested OP-1 to consider his case afresh, but, with no result, rather OP-1 had advised the complainant to pay an amount of ₹671/- towards 30% NCB.  OP-1 had again sent an email to the complainant on 21.2.2022, asking him to pay the aforesaid amount within five working days so that the claim may be settled after deduction of difference in premium amount. As OP-1 had already approved 50% NCB to the complainant, it cannot withdraw the said NCB as the same is against the terms and conditions of the subject policy. Due to the aforesaid act of the OP/insurer the subject car could not be delivered to the complainant by the repairer and finally the complainant was compelled to pay an amount of ₹45,972/- to the repairer instead of ₹35,993/- as the repairer had also charged parking charges from the complainant. In this manner, the aforesaid act of the OPs amounts to deficiency in service and unfair trade practice. OPs were requested several times to admit the claim, but, with no result.  Hence, the present consumer complaint.
2. OPs 1 & 2 resisted the consumer complaint and filed their separate written versions.
3. In its written version, OP-1 inter alia, took preliminary objections of maintainability, locus standi, jurisdiction, non-joinder and mis-joinder of necessary parties and suppression of material facts.  On merits, admitted that the subject policy was purchased by the complainant which was valid w.e.f. 10.8.2021 to 9.8.2022 for IDV of ₹2,15,775/- on payment of premium of ₹7,890/- through OP-2. After taking the policy out from the system, it was the duty of the complainant to check the correctness of the contents.  The issue of NCB entitlement is clearly defined in the procedure under the Indian Motor Tariff which was framed under the Insurance Act, 1938.  On receipt of information qua the accident, complainant was informed about the claim amount of ₹25,379/- which was ready for release, but, some formalities were required to be completed by OP-3.  However, after the completion of all the formalities an amount of ₹25,379/- (26015 – 636 TDS) was transferred on 15.7.2022 after deduction of 30% amount which was wrongly claimed by the complainant towards NCB entitlement. The complainant was also requested to deposit the difference of NCB recovery before settlement of claim, but, he did not comply the same.  It is further alleged that even as per the terms and conditions of the subject policy, NCB was granted in good faith on the declaration given by the complainant subject to the condition that in case same is not found correct, own damage cover under the policy will stand cancelled and the complainant shall not be entitled to any refund or claim under the policy. The facts as stated in the preliminary objections have been reiterated. The cause of action set up by the complainant is denied.  The consumer complaint is sought to be contested.
4. In its written version OP-2, inter alia, took preliminary objections of maintainability, cause of action and suppression of facts.  It is further alleged that, in fact, complainant was eligible for 20% NCB, but he had opted for 50% NCB in the policy.  In fact the answering OP is a platform with the domain name and url
5. OP-3 did not turn up before this Commission, despite proper service, hence it was proceeded against ex-parte vide order dated 21.2.2023.
6. Despite grant of sufficient opportunity, rejoinder was not filed by the complainant to rebut the stand of the OPs.

2. In order to prove their case, contesting parties have tendered/proved their evidence by way of respective affidavits and supporting documents.
3. We have heard the learned counsel for the contesting parties and also gone through the file carefully, including written arguments.
   1. At the very outset, it may be observed that when it is an admitted case of the parties that the complainant had obtained/got renewed the subject policy from OP-1 through OP-2, valid w.e.f. 10.8.2021 to 9.8.2022, by paying the requisite premium and the subject car met with an accident in the month of November, 2021 and thereafter the complainant had raised claim, which was partially allowed by OP-1 by holding that the complainant had wrongly claimed 50% NCB whereas he was entitled for 20% NCB, the case is reduced to a narrow compass as it is to be determined if OP-1/ insurer is unjustified in partially dis-allowing the claim of the complainant on the ground that the complainant had misrepresented facts before obtaining the subject policy and the complainant is entitled for the reliefs prayed for in the consumer complaint, as is the case of the complainant, or if OP-1/insurer has rightly settled the claim of the complainant and the consumer complaint of the complainant, being false and frivolous, is liable to be dismissed, as is the defence of the OPs.
   2. In the backdrop of the foregoing admitted and disputed facts on record, one thing is clear that the entire case of the parties is revolving around the terms and conditions of the subject policy (Annexure C-1), previous policy (Annexure R-5), NCB certificate (Annexure R-4), motor final survey report (Annexure C-6) and analysis of motor claim (Annexure R-7).
   3. Perusal of the previous policy (Annexure R-5) i.e. the policy issued to the complainant just before the subject policy clearly indicates that the same was valid w.e.f. 25.7.2020 to 24.7.2021 qua the subject car and the NCB was shown as zero, which fact otherwise has not been disputed by the complainant.
   4. Annexure C-1 is the subject policy, which indicates that the same was got renewed by the complainant through the portal of OP-2, by claiming 50% NCB.  The real dispute between the parties has arisen only due to the 50% NCB discount shown in the subject policy. 
   5. Admittedly insured is entitled to 20% NCB on renewal of policy subject to policy active for 12 months and no claim was reported/lodged upto expiry of policy, provided in the event of vehicle continuing in ownership of the insured.  In the case in hand, complainant had not reported/lodged any claim against the previous policy which was valid w.e.f. 25.7.2020 to 24.7.2021 (Annexure R-5), making clear that on the renewal of the subject policy, he was entitled for only 20% NCB.
   6. As further it is an admitted case of the parties that the complainant had obtained the subject policy (Annexure C-1) which was valid w.e.f. 10.8.2021 to 9.8.2022 by filling/claiming 50% NCB discount to the tune of ₹946.72 whereas he was entitled for 20% of the NCB discount, it is clear that the complainant himself had given wrong information while obtaining the subject policy and OP-1 has rightly deducted 30% discount while settling the claim in pursuance to the terms and conditions of the subject policy, which also finds reference in the subject policy and the relevant portion of the same is reproduced below :-

        “Important notice:

        The insured is not indemnified, if, the vehicle is used or driven otherwise than in accordance with this schedule. Any payment made by the company by reason of wider terms appearing in the certificate in order to comply with the Motor Vehicles Act, 1988 is recoverable from the insured: see clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY". It is clarified that in case the declaration regarding the ncb or other previous policy details made by the insured, is found to be incorrect, all the benefits (including claim) under section-1 of this policy, will stand forfeited.”

7. However, the motor final survey report (Annexure R-6) itself indicates that the surveyor had assessed the total loss to the tune of ₹40,952/- and in the analysis of Motor Claim (Annexure R-7), after deducting ₹2,000/- towards excess clauses, ₹652/- towards salvage value and ₹12,285/- towards excess 30% NCB, finally the claim amount was calculated at ₹26,015/- by OP-1.
8. Moreover, law is well settled on this point that in case a person has obtained NCB from the insurer for which he/she was not entitled as per the terms and conditions of the policy, the entire claim of the insured cannot be repudiated, rather the same is to be settled by the insurer/insurance company subject of course to proportionate deductions to the extent of such NCB availed by the insured.  In this regard, reliance can be placed on the order of the Hon’ble State Commission, UT, Chandigarh in case titled National Insurance Company & Anr. Vs. Mohinder Kumar, Appeal No.248 of 2017 in which the Hon’ble State Commission has decided the matter by relying upon two orders of Hon’ble National Commission in the case of National Insurance Co. Ltd. Vs Harpreet Singh, Revision Petition No.3216 of 2012 decided on 8.2.2016 and Anjani Gupta Vs Future Generally India Insurance Company, Revision Petition No.1051 of 2017 decided on 12.12.2017.  In the first order of Harpreet Singh’s case (supra) the Hon’ble National Commission observed as under :-

       “On reading of the above, it is clear that where the insured is unable to produce the evidence pertaining to his No Claim Bonus entitlement, he may be permitted to give a declaration in support of his No Claim Bonus. It is further provided in the tariff that notwithstanding the above declaration, the insurer allowing the No Claim Bonus shall be under obligation to write to the policy issuing office of the previous insurer seeking confirmation of entitlement of the insured and the rate 6 of No Claim Bonus and previous insurer shall be under obligation to respond to said query within 30 days. It is further provided that failure of the insured granting No Claim Bonus to write to the previous insurer within 21 days shall constitute the breach of tariff. In the instant case, admittedly no communication was sent by the petitioner to the previous insurer within 21 days after granting the insurance cover to the insured. This obviously amounts to breach of tariff on the part of the petitioner insurance company and disentitle the insurance company to take shelter of the plea of misrepresentation of facts on the part of the petitioner. However, the fact remains that respondent complainant on the basis of false declaration given to the petitioner paid 25% less premium. Therefore, the equity demands that bonus payable to the complainant in respect of his insurance claim should be decreased by 25%.”

9. On similar facts, another Bench of Hon’ble National Commission in Anjani Gupta’s case (supra), observed as under :-

“It would therefore be seen that if No Claim Bonus is wrongfully taken by the insured, the claim would still be payable on a non-standard basis, if the insurer had the means to verify the correctness of the declaration made by the insured, while claiming the No Claim Bonus. In the present case also, the respondent had an opportunity to verify the correctness or otherwise of the declaration made by the petitioner/complainant by making necessary inquiry from the concerned insurer. That having not been done, the complainant is entitled to reimbursement of the loss sustained by him, subject of course to proportionate deduction. Since the No Claim Bonus was availed by the complainant @ 25%, the amount payable to the complainant/petitioner has to be reduced in the same proportion.”

10. Similar proposition of law was also laid down by the Hon’ble National Commission in the cases of National Insurance Company Ltd. Vs. Jagir Kaur, 2016 (2) CPJ 459 and United India Insurance Company Ltd. Vs. M/s Jindal Poly Buttons Limited, 2017 (2) CPR 553.
11. As it is an admitted case of the parties that OP-1 has already paid an amount of ₹25,379/- to the complainant i.e. after deducting ₹636/- as TDS from ₹26,015/-, it is safe to hold that the complainant has failed to prove any deficiency in service or unfair trade practice on the part of the OPs and the present consumer complaint deserves dismissal.

4. In the light of the aforesaid discussion, the present consumer complaint, being devoid of any merit, is hereby dismissed leaving the parties to bear their own costs.
5. Pending miscellaneous application(s), if any, also stands disposed of accordingly.
6. Certified copies of this order be sent to the parties free of charge. The file be consigned.