Haryana

Yamunanagar

CC/882/2011

Deepak Kumar Saini - Complainant(s)

Versus

The Oriental Insurance Co.Ltd. - Opp.Party(s)

S.S.Saini

17 Aug 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

 

                                                                                    Complaint No. 882 of 2011.

                                                                                    Date of institution: 18.08.2011

                                                                                    Date of decision: 17.08.2016.

1. Deepak Kumar Saini, aged about 30 years,
2. Sunil Kumar Saini, aged 32 years, both sons of late Sh. Satpal Saini s/o Des Raj Saini.
3. Swarna aged about 57 years, widow of Sh. Sat Pal Saini,
4. Madhu Bala daughter of Sh. Sat Pal Saini s/o Sh. Des Raj Saini. all residents of village Shahpur, Tehsil Naraingarh, Distt. Ambala.

                                                                                                           …Complainants.

                                      Versus

 

1. The Oriental Insurance Company Ltd. Registered and Head Office at A-25/27, Asaf Ali Road, New Delhi through its Chief Manager.
2. The Oriental Insurance Co. Ltd. Branch Office: Opp. Hindu Girls Court Road, Jagadhri, through its Branch Manager.                                                                                                                                                                                                                                                     …Respondents. 

 

BEFORE:         SH. ASHOK KUMAR GARG…………….. PRESIDENT.

                        SH. S.C.SHARMA………………………….MEMBER.

 

Present:  Sh. S.S.Saini,  Advocate, counsel for complainants.  

               Sh. Amit Bansal, Advocate, counsel for OPs.             

             

ORDER

 

1.                     The present complaint has been filed by Deepak Kumar Saini and others being LRs of deceased Sh. Satpal Saini, who was the registered owner of the damaged vehicle/ tipper bearing registration No. HR-04N-0174, under section 12 of the Consumer Protection Act 1986 praying therein that respondents (hereinafter referred as OPs)  be directed to release the claim amount on account of accidental damages of Rs. 5,00,000/- alongwith compensation and litigation expenses.   

2.                     Brief facts of the complaint, as alleged by the complainants, are that deceased Satpal Saini was the registered owner of one tipper bearing registration No. HR-04N-0174  model 2006 which was comprehensively insured with the OPs insurance company vide its policy bearing No. 261701/31/2008/8628 valid from 06.03.2008 to 05.03.2009 for a sum of Rs. 10,50,000/-. The vehicle/ tipper in question met with an accident with truck bearing No. HR-58-7045 in the mid night of 04/05.07.2008 when the driver was driving the tipper in question and was going from Yamuna Nagar to Jyotisar, District Kurukshetra. In this regard a DDR No. 30 dated 05.07.2008 was lodged in the police station Thanesar, District Kurukshetra. It has been further mentioned that due to oversight clerk of the deceased Satpal Saini i.e. complainant’s father lodged the claim with the Reliance General Insurance Company Ltd. because Sh. Satpal Saini was having more than 20 vehicles and had got the same insured with different insurance companies. A surveyor and loss assessor was deputed by the abovesaid Reliance General Insurance Company Ltd. who assessed the loss to the tune of Rs. 2,30,446/- vide its report dated 14.10.2008 whereas a sum of Rs. 5,00,000/- were spent on repair of vehicle in question. However, when the Reliance General Insurance Company Ltd. processed the claim then it came to the notice of the official of the Reliance General Insurance Company that vehicle in question was not insured with their Insurance Company i.e. Reliance General Insurance Company then the official of the Reliance General Insurance Company informed to Sh. Satpal Saini father of the complainant. After that, it was found that tipper/vehicle in question was insured with the OPs Insurance Company i.e. Oriental Insurance Company, so the claim was lodged with the OPs Insurance Company. The official of the OPs Insurance Company was requested to release the claim amount as per surveyor report of Sh. A.K. Chhatwal who was deputed by the Reliance General Insurance Company and was also on the empanelment of the OPs Insurance Company but despite so many requests no claim was paid by the OPs Insurance Company so a consumer complaint was filed which was disposed off by this Forum “ vide its order dated 19.11.2010 with the direction to the complainant to lodge the claim with the OPs Insurance Company within 30 days and to submit all the documents with the OPs Insurance Company and OPs Insurance Company will settle the claim of the complainant within 30 days from the date of its lodging”.

3.                     After receiving the copy of the order, complainant sent the certified copy of that order and relevant documents through registered post vide letter dated 29.03.2011 to the Ops Insurance Company, by virtue of which the OPs Insurance Company have demanded survey report of A.K.Chhatwal  deputed by Reliance General Insurance Company Limited and in failure thereto denied the claim of the complainants. Complainants have visited so many times to the OPs Insurance Company but till date no claim has been settled by the OPs Insurance Company. Hence this complaint.

4.                     Upon notice, OPs Insurance Company appeared and filed its written statement by taking some preliminary objections and on merit it has been submitted that as per information provided by the insured the truck/tipper bearing registration No. HR-04N-0174  met with an accident  in the mid night of 04/05.07.2008 and the insured had informed the M/s Reliance General Insurance Company Limited regarding the loss to the vehicle in question and on information of the insured, a surveyor and loss assessor Sh. A.K. Chhatwal was deputed for spot survey as well as final survey of the vehicle but the vehicle was not insured with the Reliance General Insurance Company Limited and after knowing this fact insured contacted the Branch Manager of the Ops Insurance Company and requested to release the claim on the basis of survey report of Sh. A.K. Chhatwal. On this information, Sh. A.S.Vias was appointed to investigate the case who sent one registered letter to Reliance General Insurance Company Ltd. and also sent a copy of this letter to the insured Sh. Satpal Saini, requesting them to supply the original bills of parts and repair alongwith survey report of Sh. A.K. Chhatwal etc. but no reply was received from either side. A separate registered letter was also written to Sh. A.K.Chhatwal, Surveyor & Loss Assessor deputed by Reliance General Insurance Company Ltd. to send the report and other relevant documents to the OPs Insurance Company but the same was not supplied. Meanwhile, the complainant filed a consumer complaint which was disposed off on 19.11.2010 with the direction to lodge the claim with the Ops Insurance Company alongwith all the documents within a period of 30 days. As per direction of this Forum, the Ops Insurance Company entertained the claim of the complainant but the complainant failed to supply the relevant documents i.e. original surveyor report, original bills of repair and parts, photographs, intimation letter, registration certificate, driving license etc. to the OPs Insurance Company. The OPs Insurance Company wrote a letter dated 29.03.2011 to the complainants to supply the documents but all in vain. After that, OPs Insurance Company again wrote letters dated 08.04.2011, 30.04.2011 and 09.05.2011 to supply all the above noted documents but no document was received by the Ops Insurance Company either from the complainant or Reliance General Insurance Company, so finding no alternate, the claim of the complainant was closed as “No Claim” and the complainant was informed vide registered letter dated 03.06.2011(Annexure R-10). Hence, there was no deficiency in service or unfair trade practice on the part of Ops Insurance Company and lastly prayed for dismissal of the complaint.

5.                     To prove the case, counsel for the complainants tendered into evidence affidavit of all the LRs of deceased Satpal Saini as Annexure CX and documents such as Photocopies of documents i.e. Insurance policy as Annexure C-1, RC as Ann. C-2 death certificate of Sh. Satpal Saini as Annexure C-3, DDR as Ann. C-4, Builty/GR goods receipt as Ann. C-5, National permit as Ann. C-6, Driving license of Sh. Ombir as Ann. C-7, Estimate and Bills Ann. C-8 to C-26, postal receipt as Ann. C-27, Letter dated 29.03.2011 as Ann. C-28, Postal receipt Ann. C-29, Reply of legal notice as Ann. C-30, order dated 19.11.2010 as Ann. C-31, D.L. of Sh. A.K. Chhatwal as Ann. C-32, Misc. letter as Ann. C-33, Receipt of Sh. A.K. Chhatwal as Ann. C-34, License of Surveyor & Loss Assessor as Ann. C-35, Duplicate copy of surveyor report of Sh. A.K. Chhatwal dated 14.10.2008 as Ann. C-36, Duplicate copy of survey fee bill as Ann. C-37 and closed the evidence on behalf of complainant.

6.                     However, in additional evidence original surveyor report alongwith bills of repair and parts, photographs etc. containing pages 1 to 82 summoned from the Reliance General Insurance Company and the same original file was handed over to the Branch Manager claims OIC Sh. Abhas Toppo and photo copy of the same was marked as Annexure C-38 and closed the additional evidence on behalf of complainant.  

7.                     On the other hand, counsel for the OPs tendered into evidence photo copies of documents i.e. insurance policy as Ann. R-1, letter dated 20.03.2009 as Ann. R-2, letter dated 03.04.2009 as Ann. R-3, Investigator report of Sh. A.S.Vias as Ann. R-4, Letter dated 11.03.2011 as Ann. R-5, letter dated 29.03.2011 as Ann. R-6, Letter dated 08.04.2011 as Ann. R-7, Letter dated 30.04.2011 as Ann. R-8, Letter dated 09.05.2011 as Ann. R-9, Claim repudiation letter dated 03.06.2011 as Ann. R-10 and closed the evidence on behalf of Ops Insurance Company.

8.                     We have heard the counsels of both the parties and have gone through the pleadings as well as documents placed on the file carefully and minutely. The counsel for the complainant reiterated the averments mentioned in the complaint and prayed for its acceptance whereas the counsel for OPs reiterated the averments made in its reply and prayed for dismissal of complaint.

9.                     It is not disputed that deceased Satpal Saini was the registered owner of the Tipper bearing registration No. HR-04N-0174 (Anenxure C-2) which met with an accident in the mid-night of  4/5.7.2008 which is evident from DDR No.30 dated 05.07.2008 (Annexure C-4) registered in police station Thanesar, District Kurukshetra and a claim was lodged with the Reliance General Insurance Company on 14.10.2008 by the complainant not with the OPs Insurance Company i.e. Oriental Insurance Co. It is not disputed that Sh. A.K.Chhatwal, Independent Surveyor and Loss Assessor was deputed for assessing the loss who has assessed the loss to the tune of Rs. 2,30,446/- subject to the terms and conditions of insurance policy and submitted his report on 14.10.2008 (Annexure C-36).

10.                   The claim of the complainant was only repudiated as “No Claim” by the OPs Insurance Company vide its letter dated 03.06.2011 (Annexure R-10) which is reproduced here as under:

This as reference to our letter dated 11.03.2011 and its registered reminder dated 29.03.2011 regarding above. You are requested to submit us the original bill of the parts purchased/receipt/bills of repair and original survey report of Sh. A.K. Chhatwal deputed by M/s Reliance General Insurance Company Limited but till date you have not responded to our letters. Keeping in view the above we are left no other alternative but to file your claim as “No Claim”. This is for your information.”

11.                   The complainants themselves have also admitted in their complaint in para No.4 & 5 that clerk of the complainant Sh. Satpal Saini inadvertently lodged the claim with the Reliance General Insurance Company Limited because Sh. Satpal Saini was having more than 20 vehicles insured with the different insurance companies. it is also not disputed that previously complainant filed his complaint on the same cause of action and for the same grievances before this Forum which was disposed off on 19.11.2010 (Annexure C-31) with the direction to the complainants to lodge the claim with the OPs Insurance Company within 30 days alongwith all documents and respondents will decide the claim of the complainant within 30 days from the date of its lodging.

12.                   From the perusal of this order, it is clear that complainant were bound to submit all original documents and original surveyor report after getting the same from the Reliance General Insurance Company to the OPs Oriental Insurance Company but despite so many letters as well as reminders complainant failed to submit the documents with the OPs insurance company so, the Ops insurance company was not having any option except to close the file of the complainant as No Claim. However, during the penency of this case before this Forum, complainant filed an application on 23.12.2015 to summon the record i.e. original file containing original report of the surveyor and loss assessor Sh. A.K. Chhatwal , original bill of repair and parts, photographs and other documents from the Reliance General Insurance Company in additional evidence of the complainant which was allowed vide order dated 18.01.2016 by this Forum. In compliance of this order, Sh. Sunil Pathania, Claim Manager, Reliance General Insurance Company Chandigarh appeared and produced the original claim file containing original surveyor report, bills of repairs and parts and photographs on 13.07.2016. On the same day the original summoned file was handed over to the Assistant Manager, Oriental Insurance Company Limited, Divisional Office, Yamuna Nagar against proper receipt after placing photo copy of the same on the court file which was marked as Annexure C-38.

13                    We have gone through the surveyor report of Sh. A.K. Chhatwal (Anenxure C-36) and other photographs, bills of repairs as well as parts from which it is clearly evident that Surveyor and Loss Assessor has assessed the amount to the tune of Rs. 2,30,446/- and there was no violation of the terms and conditions of the insurance policy on the part of the complainant. So, in this way, the complainant was entitled to get the same amount i.e. Rs. 2,30,446/- from the OPs Insurance Company. As the complainant earlier failed to submit the required documents to the Ops Insurance Company which were later on submitted through this Forum to the OPs Insurance Company after summoning the same from the Reliance General Insurance Company on 03.07.2016, so, the ground of repudiation of the claim by the OPs Insurance Company now has been met out/ resolved because from the perusal of repudiation letter dated 03.06.2011 (Annexure R-10) which has been reproduced above in para No. 10 of this judgment it is clear that there was no other ground for closing the file of the complainant as “No Claim”.

14.                   In the circumstances noted above, we are of the considered view that as all the documents i.e. original surveyor report bills of repair and parts, photographs etc. have been handed over to the OPs Insurance Company on 13.07.2016 for want of which the claim of the complainants was repudiated as “No Claim” So, now the OPs Insurance Company have no reason to deny the claim of the complainant. As such, the complainant are entitled for relief.

15.                   Resultantly, we partly allow the complaint of complainants and direct the OPs Insurance Company to pay the assessed amount of Rs. 2,30,446/- to the complainants within a period of 30 days failing which complainants shall be entitled to recover the interest at the rate of 9% per annum for the defaulting period. OPs are also directed to pay Rs. 5,000/- as compensation on account of mental agony, harassment as well as Rs. 3000/- as litigation expenses. Order be complied within a period of 30 days failing which complainant shall be entitled to invoke the jurisdiction of this Forum as per law. Copies of this order be sent to the parties concerned free of costs as per rules. File be consigned to the record room after due compliance.

Announced: 17.08.2016.

                                                (ASHOK KUMAR GARG)

                                                              PRESIDENT.  

        

 

                                                                                     (S.C.SHARMA)          

                                                                                      MEMBER