Haryana

Karnal

CC/666/2019

Amandeep Singh - Complainant(s)

Versus

The Oriental Insurance Company Limited - Opp.Party(s)

Deepak Kumar

24 Aug 2022

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                       Complaint No. 666 of 2019

                                                        Date of instt.27.09.2019

                                                        Date of Decision:24.08.2022

 

Amandeep Singh son of Shri Madan Lal, resident of House no.752, Gali no.4, Kunjpura Road, R.K. Puram, Karnal. Aadhar card no.4284-2905-5559.

                                               …….Complainant.

                                              Versus

 

The Oriental Insurance Company Ltd. through its Divisional Manager, Divisional Office Karnal.

 

                                                                      …..Opposite Party.

 

Complaint Under Section 12 of the Consumer Protection Act, 1986 and after amendment Under Section 35 of Consumer Protection Act, 2019.

 

Before   Shri Jaswant Singh……President.

              Shri Vineet Kaushik……Member

      Dr. Rekha Chaudhary…….Member

                   

 Argued by: Sh. Subhash Kashyap, counsel for the complainant.

                   Smt. Saroj Bala, counsel for the opposite party.

 

                    (Jaswant Singh President)

 

ORDER:   

                

                   The complainant has filed the present complaint Under Section 12 of the Consumer Protection Act, 1986 as after amendment under Section 35 of Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that complainant got insured his car Chevrolet Beat TCDI PS BS4 bearing registration no.HR05AU-1582 with the OPS, vide policy no.261301/ 31/2018/7342, valid from 30.12.2017 to 29.12.2018. On 14.12.2018, Rakesh Verma son of Shri Raj Kumar resident of village Mator, District Kaithal alongwith his friend Pritam son of Shri Mewa, resident of Kalsar and his sister namely Kajal were coming Kalayat to Kaithal in the aforesaid car and at about 5.30 p.m. when they reached near Dera Sacha Soda, Jind Road Bye Pass in the meantime suddenly a Neel Cow came on the road and to save the cow Rakesh Verma stopped the car and car came in front of the another truck bearing registration no.HR64A-0041 which was coming from opposite side and the truck driver also in order to save the car turned the truck towards left side and the said truck struck into the car. Due to said incident, the car of complainant was badly damaged. Thereafter, complainant made a telephone call to the police helpline 100 number and also made a telephonic call to the toll free number of OP. The surveyor of the OP inspected the vehicle and advised to get repair the same and insurance company would have pay the total repaired charges to the complainant. The police of Police Station Civil Line Kaithal lodged the report dated 18.12.2018.  On the advise of the surveyor complainant got the said vehicle repaired from Lekhraj Motors Pvt. Ltd. NH 65, Ambala Road, Kaithal and also spent Rs.2,87,600/-. Thereafter, complainant approached the OP and submitted all the relevant documents and requested to settle the claim. After that complainant visited the office of OP so many times for settlement of the claim but OP did not pay any heed to the request of complainant and lingered the matter on one pretext or the other. The aforesaid car is fully insured with the OP and OP is liable to pay the total repaired charges but OP did not pay the same. Then complainant sent a legal notice dated 23.05.2019 to the OP but it also did not yield any result. In this way there is deficiency in service on the part of the OP. Hence this complaint.

2.             On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability and concealment of true and material facts. On merits, it is pleaded that the driver of the car no.HR-05-AU-1582 has got no valid driving license at the time of accident and the owner wanted to manipulate the facts by insertion of a person who got valid driving license at the time of accident to grab the money from the insurance company. It is further pleaded that complainant did not have the eye witness of the accident, so he is not conversant with the facts of accident nor he informed the police on 100 number telephone. The office at Kaithal was intimated regarding the accident, vide intimation letter dated 17.12.2018 on 20.12.2018. As per the version of complainant, alleged Rakesh Verma (relative of complainant) was driving the car, this version seems to be wrong, as Rakesh Verma had failed to lodge the FIR on the date of accident i.e. 14.12.2018 and even otherwise Rakesh Verma had lodged the DDR on 18.12.2018 of car no.HR05-AU-1585 and not of HR-05-AU-1582. As per DDR and facts mentioned in the complaint, a truck bearing no/HR-64A-0041 was coming from the opposite side and as the driver of the car stopped his car, then the tuck hit the car of complainant. So, under these circumstances, the truck must also be damaged. The photos taken by the surveyor of the damaged car shows that the accident took place between truck and car from opposite side when both the vehicles were run by both drivers rashly and negligently. As per terms and conditions of insurance policy the notice shall be given in writing to the company immediately upon the occurrence of any accident. So that surveyor for spot inspection would be appointed to confirm the reason for the accident, no spot inspection was made by the company due to lack of information. Driver as well as complainant has avoided informing the company as well as to police. The complainant had not mentioned any reason for not filing the FIR against truck and not informing the OP immediately. It is further pleaded that on 22.12.2018 OP had deputed Shri Ajay Bansal to carry out the survey, who surveyed the car at M/s Lekh Raj Motors, Pvt. Ltd., Kaithal to assess the loss and to confirm the genuineness of claim. Further, the OP had also deputed an authorized investigator, S.Gurmeet Singh to investigate the case and also confirm the genuineness of claim and also collect all the documents relating to the accident. The surveyor assessed the net liability of Rs.2,29,000/- as per his report dated 18.03.2019. The OP can make the payment, if the accident and all the documents are found genuine beyond reasonable doubt. The complainant had not been cooperating the investigator S.Gurmeet Singh to find out the genuineness of the accident regarding the injury of the occupants of car and loss to third party i.e. truck involved in the accident a well as the complainant relation with the alleged driver Rakesh Verma. But complainant failed to arrange any mutual talk with the complainant, occupants of the car and the truck driver. Registered reminders dated 25.03.2019, 23.04.2019, 17.06.2019 and 05.08.2019 were issued to complainant by Gurmeet Singh and also telephonically discussion with Rakesh Verma on 09.04.2019, 15.04.2019 and 19.04.2019 for arranging meeting with the person sitting in the car at the time of accident. But all the time he fixed the meeting but failed to meet the investigator. One registered letter dated 23.04.2019 was also issued to SHO, P.S. Civil Lines, Kaithal for confirmation of accident and injury to the occupants of the vehicles in the accident. Rukka received from the doctors and action taken by the police in the accident. FIR/DDR, if any, but no reply was received. Though S. Gurmeet Singh by the police authorities was told that Pritam and Kajal were occupying the car and both sustained injuries. On the date of accident Pritam was driving the car and having learners license on and name of the driver Rakesh Verma was lateron mentioned. The affidavit of complainant dated 24.12.2018 only mentioned the name of driver Rakesh Verma as occupant of the car and no other person and same is the position in the intimation letter dated 17.12.2018 regarding accident submitted to the insurance company, Kaithal by complainant. It is further pleaded that complainant had not cooperated with the investigator S.Gurmeet Singh in investigation and not supplied the documents as per registered reminder dated 23.04.2019. After that registered reminders dated 20.05.2019, 06.06.2019, 20.08.2019 and 30.09.2019 by the OP were given to the complainant, but to no effect. The investigator submitted his report dated 01.09.2019. So claim of the complainant was closed as no claim, vide registered letter dated 13.11.2019 and followed by last letter dated 30.09.2019. All the statements are contradictory and prove the concealment of facts and entitlement of the claim does not fulfill the terms and conditions of the insurance policy. Insured never cooperated the insurer, at all, to settle the claim. There is no deficiency in service on the part of the OP. The other allegations made in the complaint have been denied by the OP and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of insurance policy Ex.C1, copy of motor claim form Ex.C2, copy of FIR Ex.C3, copy of Bill receipt Ex.C4, copy of Registration Certificate of vehicle no. HR05AU-1582 Ex.C5, copy of letter from Insurance Company Ex.C6, copy of particulars of bills Ex.C7, copy of legal notice Ex.C8, copy of reply of legal notice Ex.C9, postal receipt Ex.C10 and closed the evidence on 31.03.2022 by suffering separate statement.

5.             On the other hand, learned counsel for OP has tendered into evidence affidavit of Sanjiv Madan, Senior Divisional Manager Ex.R/A, copy of claim form Ex.OR1, copy of claim no.26/304/31/2019/03090 Ex.OR2, copy of affidavit of complainant Ex.OR3, copy of Non-Cognizance Information Report Ex.OR4, copy of Daily Roznamcha Ex.OR5, copy of letter dated 07.01.2019 Ex.OR6, copy of reminder dated 25.03.2019 to complainant Ex.OR7,  acknowledgement Ex.OR8, postal receipt Ex.OR9, letter dated 23.04.2019 to SHO P.S.Civil Lines Kaithal Ex.OR10, postal receipts Ex.OR11 and Ex.OR12, copy of reminder dated 23.04.2019 to complainant Ex.OR13, copy of statement of complainant Ex.OR14, copy of registered letter dated 20.05.2019 to complainant Ex.OR15, copy of postal receipt Ex.OR16, copy of reminder dated 06.06.2019 to complainant Ex.OR17, copy of postal receipt Ex.OR18, letter dated 17.06.2020 Ex.OR19, postal receipt Ex.OR20, copy of last reminder dated 05.08.2019 Ex.OR21, acknowledgement Ex.OR22, postal receipt Ex.OR22, copy of reminder dated 20.08.2019 Ex.OR24, copy of letter  dated 01.09.2019 of investigator Gurmit Singh Ex. OR25, copy of letter dated 13.11.2019 Ex.OR26, copy of reply to legal notice dated 25.06.2019 Ex.OR27, postal receipts Ex.OR28 to Ex.OR32, copy of insurance policy Ex.OR33 and closed the evidence on 19.05.2022 by suffering separate statement.

6.             We have heard the learned counsel of the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for complainant, while reiterating the contents of complaint, has vehemently argued that complainant got insured his car Chevrolet Beat with the OP. On 14.12.2018 the said vehicle of complainant met with an accident and the car was badly damaged. Intimation in this regard was sent to the Police as well as to the OP. The surveyor of the OP inspected the vehicle and advised to complainant to get repair the same. On the advise of the surveyor complainant got repaired the said vehicle and spent Rs.2,87,600/-. Thereafter, complainant approached the OP so many times and requested to settle the claim but OP did not settle the claim and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for OP, while reiterating the contents of written version, has vehemently argued that the complainant has alleged that Rakesh Verma was the driver of the car, if he was the driver he would have lodged the FIR on the same day and it appears that Rakesh Verma was not the driver and the vehicle was driven by Pritam who was not having valid driving license at the time of accident.  No spot inspection was made by the company due to lack of information. The complainant had not mentioned any reason for not lodging the FIR against offending truck and not informing the OP immediately. The complainant had not been cooperating the investigator S.Gurmeet Singh to find out the genuineness of the accident regarding the injury of the occupants of car and loss to third party i.e. truck involved in the accident. Registered reminders dated 25.03.2019, 23.04.2019, 17.06.2019 and 05.08.2019 were issued to complainant by Gurmeet Singh and also telephonically discussion with Rakesh Verma on 09.04.2019, 15.04.2019 and 19.04.2019 for arranging meeting with the person sitting in the car at the time of accident, but he failed to do so. So claim of the complainant was closed as no claim and lastly prayed for dismissal of the complaint.

9.             We have duly considered the rival contentions of the parties.

10.           Admittedly, the vehicle in question met with an accident during the subsistence of the insurance policy.

11.           The claim of the complainant has been closed by the OPs vide letter Ex.OR26 dated 13.11.2019 on the grounds that accident took place on 14.12.2018 and intimation was given on 20.12.2018 after the removal of the vehicle in question  from the spot. Thus, the OP has been deprived of its right to investigate the matter and there is delay of four days in lodging the FIR and investigator has sent a bundle of letters and reminders to the complainant but he failed to reply the same. The vehicle was driven by Pritam not by Rakesh Verma and there is contradiction in the statements of witnesses and also the concealment of facts on the part of the complainant.

12.           A legal notice Ex.C8 dated 23.05.2019 was served upon the OP and said notice was duly replied by the OP, vide reply Ex.OR27 dated 25.06.2019. In the reply of said notice OP has specifically mentioned that complainant has failed to reply the queries raised by the investigator of the OP even after on receipt of telephone calls as well as registered letters and reminders. To prove its version OP placed on file letters and reminders dated 25.03.2019, 23.04.2019, 23.04.2019, 20.05.2019, 06.06.2019, 17.06.2018, 05.08.2019, 20.08.2019 Ex.OR7 to Ex.OR9, Ex.OR15, Ex.OR17, Ex.OR19, Ex.OR21, Ex.OR24 alongwith acknowledgements and postal receipts.

13.           As per the above letters, complainant has failed to reply the queries raised by the investigator of the OP and also has failed to rebut the abovesaid letters of OP by leading any cogent and convincing evidence. Moreover, the claim of the complainant has not been repudiated by the OP and the same has been closed, vide letter Ex.OR26 dated 13.11.2019. Hence, we are of the considered view that, at this stage, the present complaint is pre-mature and OP is not deficient in closing the claim of the complainant.

14.               In view of the above observation, the present complaint is disposed of with the liberty to the complainant to reply the queries raised by the investigator of the OP as mentioned in the aforesaid letters/reminders. OP is also directed to reopen the claim of the complainant if he comes forward to reply the queries raised by the OP. No order as to costs. This order shall be complied with accordingly. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:24.08.2022                                                                     

                                                                President,

                                                    District Consumer Disputes

                                                    Redressal Commission, Karnal.

 

 

 (Vineet Kaushik)       (Dr. Rekha Chaudhary)

  Member                   Member