Haryana

Karnal

CC/159/2018

Naresh Kumar - Complainant(s)

Versus

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

Amit Arora

04 Feb 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

                                                          Complaint No. 159 of 2018

                                                          Date of instt. 05.07.2018

                                                          Date of Decision 04.02.2019

Naresh Kumar aged 41 years son of Shri Kashmiri Lal, resident of House no.1016, Sector-4, Urban Estate, Karnal (Adhar no.7135 5178 8320).

                                                                      …….Complainant

                                        Versus

The Oriental Insurance Company Limited, Meera Ghati Chowk, above Oriental Bank of Commerce, Karnal through its Branch Manager.

                                                                …..Opposite Party.

 

           Complaint u/s 12 of the Consumer Protection Act. 

 

Before    Sh. Jaswant Singh……President. 

      Sh.Vineet Kaushik ………..Member

                Dr. Rekha Chaudhary…….Member

 

 Present:  Shri Rishi Chalia Advocate for complainant.

                    Shri Ramesh Chaudhary Advocate for OPs.

 

                   (Jaswant Singh President)

ORDER:                    

 

                        This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986 on the averments that complainant is the registered owner of Beat Car bearing R.C. no.HR-04/E: 6880, the same was insured with the OP, vide its cover note no.261301/31/2017/9158 valid from 29.12.2016 to 28.12.2017. The policy was a comprehensive/package policy and it was insured for Rs.7,50,000/-. On 4.6.2017 the brother of the complainant named Sunil Kumar alongwith his wife named Geeta, his children Tanisha (daughter-aged 10 years) Aradhya (son-aged 6 years), Parth (nephew-10 years) Simran, aged 36 years and Devanshu  were coming from Yamuna Nagar to Karnal in the abovesaid car which was being driven by Sunil Kumar at a proper and moderate speed and on his due left hand side of the road, when the car reached near Indri, the car met with an accident and got damaged extensively. All the occupants of the car also received injuries. From the place of accident the injured was shifted to Kalpana Chawla Government Medical college Hospital, where they were admitted and treated there. The matter was reported in this regard. After the accident the car was brought to Bhatia Motors, ITI Chowk, Karnal with the help of crane for its repair, change of parts, denting painting etc. The complainant intimated the official of the OP and submitted all the relevant documents to the OP. The said vehicle is a total loss and beyond its repair. The complainant informed the OP and submitted the claim form alongwith all the relevant and required documents i.e. estimate etc. A surveyor was appointed by OP, who inspected the vehicle and also obtained all the relevant documents from the complainant, the copy of RC, insurance, driving licence and bills/estimate were submitted to the OP. The official of the OP assured the complainant that O.D. Claim of the car will be settled in time but the matter was prolonged and delayed unnecessary without any rhyme and reason. The complainant has received a letter dated 15.02.2018 in which the official of the OP has declined the claim of the complainant on the false and flimsy grounds. The complainant served a legal notice to the OP in this regard but it also did not yield any result. In this way there was deficiency in service on the part of the OP. Hence complainant filed the present complaint.

2.             Notice of the complaint was given to the OP, who appeared and filed written version raising preliminary objections with regard to maintainability; complaint is false and frivolous and concealment of true and material facts. On merits, it is pleaded that the O.D. claim filed by the complainant was duly processed, however, during investigation, it was found that there was/is clear violation of terms and conditions of the policy as at the time of accident 7 persons were travelling in the alleged car, where as the car was passed for 5 persons including driver, the main cause of loss was found over loading, hence the OD claim of the car of the complainant was repudiated and information was given in this regard to the complainant on 15.02.2018 through post. During process of OD claim the loss was assessed as Rs.1,79,000/- on total loss basis by the surveyor & loss assessor namely Shri R.S.Kohli. Hence there is no deficiency in service on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Complainant tendered into evidence his affidavit Ex.CW1/A and documents Ex.C1 to Ex.C15 and closed the evidence on 20.12.2018.

4.             On the other hand OP tendered into evidence affidavit of Manraj Virk Dy. Manager Ex.RW1/A and documents Ex.R1 to Ex.R5 and closed the evidence on 20.12.2018.

5.             We have appraised the evidence on record, the material circumstances of the case and the arguments advanced by the learned counsel for the parties.

6.             The case of the complainant is that he is owner of car bearing registration no.HR04E-6880. The same was insured with OP from 29.12.2016 to 28.12.2017. The policy was comprehensive and it was insured for Rs.7,50,000/-. On 04.06.2017, the said vehicle was met with an accident and got damaged extensively. The complainant intimated the OP regarding the accident and submitted the required documents with OP for accident claim but claim was repudiated by the OP without any reason, vide letter dated 15.02.2018

7.             On the other hand, the case of the OPs is that O.D. claim filed by the complainant was duly processed, however, during the investigation, it was found that there was/is clear violation of the terms and condition of the policy as at that time of accident 7 persons were travelling in the alleged car, whereas the car was passed for 5 persons including driver, the main cause of loss was found overloading. Hence the OD claim of the car of the complainant was repudiated. The IDV of the car was of Rs.1,80,000/- and the same was insured only for a sum of Rs.1,80,000/-.

8.             Admittedly, the accident took place during the subsistence of the policy. It is also admitted that at the time of accident 7 persons including 4 minors aged about 8 years to 14 years were sitting in the car. The claim of the complainant was repudiated by the OP only on the ground that during the investigation, it was found that there is a clear violation of terms and conditions of the policy. We are of the considered view that the repudiation of the whole claim of the complainant is not justified and the claim of the complainant is decided as per non-standard basis.

9.             In view of authority cited in Revision Petition no.1870 of 2015(NC) decided on 14.08.2018 titled as New India Assurance Co. Ltd. Versus Thirath Singh Brar and authority of our own Hon’ble State Commission in First Appeal no.717 of 2016 decided on 6.4.2017 titled as United India Insurance Company Limited and others Versus Anshul Bansal. In both judgments it was held that in case of any breach of warranty/condition of the policy the insurer is liable to pay 75% of admissible claim on non-standard basis.

10.            The proposition of law laid down by Hon’ble National Commission and Hon’ble State Commission Haryana is fully applicable to the facts of the present case. In the present case complainant violated the terms of the policy as the car was found overloaded at the time of accident. Consequently, the complainant is held entitled to get 75% of the of the insured amount.

13.            As a sequel to the foregoing discussion, we accept the  complaint partly and direct the OP to pay 75% of the sum insured amount  to the complainant with interest @ 9% per annum from the date of filing the complaint till its realization.  We further direct the OP to pay Rs.20,000/- to the complainant on account of mental agony and harassment suffered by her and for the litigation expense.  Complainant is also directed to get cancelled the RC and transfer the RC in the name of the OP and handover the car in question to the OPs. This order shall be complied within 30 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Dated: 04.02.2019

                                                                        President,

                                                           District Consumer Disputes

                                                           Redressal Forum, Karnal

 

           (Vineet Kaushik)     (Dr. Rekha Chaudhary) 

                    Member                   Member