Haryana

Karnal

CC/377/2020

Pranav Jawa - Complainant(s)

Versus

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

Virender Bahl

02 Sep 2021

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                            Complaint No.377 of 2020

                                                             Date of instt. 18.09.2020

                                                           Date of decision 02.09.2021

 

Pranav Jawa son of Shri S.S. Jawa, resident of House no.1129, New Housing Board Colony, Karnal. Aadhar no.469270404309.

 

        …….Complainant       

                                        Versus

 

1.     The Oriental Insurance Company Ltd., Branch Office: Meera Ghati, above OBC Bank, Karnal, through its Manager.

2.     The Oriental Insurance Company Ltd. Head Office: A-25/27, ASAF Ali Road, New Delhi, through its Head Manager/Director/ Chairman/Authorized Signatory.

 

…..Opposite Parties.

 

      Complaint u/s 35 of the Consumer Protection Act, 2019.       

 

Before   Sh. Jaswant Singh……President.       

      Sh.Vineet Kaushik ………..Member

 

 Present: Shri Virender Behl Advocate for complainant.

               Shri R.M. Sharma Advocate for OPs.

 

                (Jaswant Singh President)

ORDER:                    

 

                This complaint has been filed by the complainant u/s 35 of the Consumer Protection Act, 2019 on the averments that complainant is owner of Maruti Car SX4 ZXI bearing registration no.HR-26-BR-9104. Complainant purchased the said car from Prabhat Aggarwal son of Shri KBL Aggarwal, resident of house no.14/26, First floor, DLF-PH II, Gurgaon. At the time of purchase, complainant got insured the same from OPs (hereinafter referred as to ‘OPs’), vide policy no.261301/31/2020/186, valid from 13.04.2019 to 12.04.2020 midnight. After purchase of said car the complainant had applied for transfer of the aforesaid vehicle before the concerned authority and the transfer was completed on 11.06.2019, however, the intimation and Registration Certificate of car was received by the complainant on 14.06.2019.

2.             Further, there was 14 days times to intimate to get the insurance transferred in the name of the complainant but in the meanwhile on 21.06.2019 the vehicle was coming from Gurgaon towards Dwarka, Sector-23, Delhi driven by the son of complainant namely Rishabh Jawa in normal speed by observing the traffic rules and friend of Rishabh Jawa namely Shubham was also accompanying with him in said car, then a truck coming from opposite direction slightly dashed hit the car in question and had a small touch with the said car, resulting the driver lost the balance and all of a sudden, the said car fell into a pit, adjacent to the berm of the road. The minor injuries had been received by both the occupants. The complainant did not inform the police as the accident in question had occurred all of a sudden. Thereafter, complainant on 22.06.2019 has intimated to the office of the OP no.1 regarding the accident and also informed about transfer of ownership of the said car in his name, by making his personal visit, but the official of the OP no.1 has orally instructing the complainant to submit the estimate of the loss first, then they would proceed further for granting claim in favour of the complainant.

3              Further, on the instructions of the OP no.1, complainant had got assessed the loss of the damaged occurred to the car in the accident, from concerned authorized service centre of Maruti Company. The aforesaid authorized service centre of Maruti Company had assessed the loss of said car in question to the tune of Rs.5,20,779/-. After getting the assessment of loss, the complainant had submitted the same before the office of OP no.1 alongwith receipt of Crane Co., who towed the damaged vehicle from the place of accident. Thereafter, OPs had appointed approved investigator R.N. Sharma & Associates, vide letter dated 05.10.2019. The investigator had advised the complainant to get copy of Toll Tax receipt under Right to Information Act, and as per advice of approved investigator, complainant has filed an application Right to Information Act on 10.12.2019 but Mr. Nirmal Kumar Manager, National Highway Authority of India, Ambala, has denied providing information regarding Toll Tax receipt. During such period, investigator of the OPs had recorded the statement of son of complainant on 29.12.2019 and said approved investigator had also demanded receipt of crane from the complainant, who towed the car from the place of accident. Complainant provided the receipt to the investigator. Complainant delivered all requisite documents/ information/ explanations to the approved investigator of the company of the OPs. Even after delivering all the documents to the approved investigator of the OPs, OPs instead of disbursing the claim amount had sent a registered letter dated 05.03.2020, vide which OP again sought some information/documents/ explanation. After receiving the said letter, complainant again provided requisite documents/ information and explanation to the OP, vide letter dated 13.03.2020 and requested for disbursement of claim in favour of the complainant. Thereafter, OP repudiated the claim of the complainant, vide letter dated 20.03.2020 on the false and frivolous grounds. In this way there was deficiency in service on the part of the OPs. Hence complainant filed the present complaint.

4.             Notice of the complaint was given to the OPs, who appeared and filed written version, raising preliminary objections with regard to locus standi; cause of action and concealment of true and material facts. On merits, it is pleaded that the intimation of accident was given to the OPs after delay of 27 days. It is further pleaded that the policy issued to Prabhat Aggarwal and complainant is a purchaser of insured car and the policy is still in the name of Prabhat Aggarwal. Thus, there is violation of Section 157 of Motor Vehicle Act and violation of sale of goods Act 1930. The sum insured of the policy is only Rs.2,50,000/- whereas claim of Rs.5,20,779/- is lodged by the complainant. However, surveyor has assessed the loss of Rs.2,06,500/- on net of salvage basis with R.C. cancellation. It is further pleaded that the driver of the vehicle in question was not holding a valid Driving Licence at the time of accident. The car in question was used against the terms and conditions of the policy. It is further pleaded that no explanation was given regarding not lodging of the FIR and intimation was given to the OPs. Thus, the OPs are deprived from spot survey. It is further pleaded that the NOC of the vehicle bearing no.HR-26-BR-9104 was issued from Registration Authority, Gurgaon on 30.04.2019 and the accident took place on 21.06.2019. No explanation is given by the complainant regarding delay in applying for transfer of R.C. The claim of the complainant has been rightly repudiated by the OP. 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.

5.             Complainant tendered into evidence his affidavit Ex.CW1/A, copy of Aadhar card Ex.C1, copy of Registration Certificate Ex.C2, copy of insurance policy Ex.C3, premium of Registration Certificate of car Ex.C4, copy of receipt of crane Ex.C5, National Highway Authority Letter Ex.C6, letter dated 05.03.2020 Ex.C7, email conversion Ex.C8, reputation letter Ex.C9, photographs of car Ex.C10 to Ex.C13, premium receipt Ex.C14 and closed the evidence on 09.03.2021 by suffering separate statement.

6.             On the other hand, OPs tendered into evidence affidavit of Sanjiv Madan Senior Divisional Manager Ex.OP1/A, repudiation letter Ex.O1, investigation report Ex.O2, Final Survey and Assessment Report Ex.O3, Insurance policy Ex.O4, clearance certificate Ex.O5, payment of receipt of Registration Authority Karnal Ex.O6 and closed the evidence on 30.07.2021 by suffering separate statement.

7.             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.

8.             Learned counsel for complainant while reiterating the contents of complaint, has vehemently argued that complainant is owner of a Maruti Car SX4 ZXI bearing registration No.HR-26-BR-9104 and the said car was got insured from the OPs. During subsistence of policy, the car met with an accident. In this regard,  intimation was given to the OPs. The OPs did not settle the claim of the complainant despite repeated requests, hence, prayed for allowing the present complaint alongwith heavy compensation and litigation expenses.

9.             Per-contra, learned counsel for OPs while reiterating the contents of the written version, has vehemently argued complainant sent the intimation to the OPs regarding the accident after delay of 27 days. The policy was issued to Prabhat Aggarwal and still the policy in question was in the name of said Prabhat Aggarwal. The sum insured of the policy is only Rs.2,50,000/- whereas claim of Rs.5,20,779/- is lodged by the complainant. However, surveyor has assessed the loss of Rs.2,06,500/- on net of salvage basis with R.C. cancellation. The NOC of the vehicle bearing no.HR-26-BR-9104 was issued from Registration Authority, Gurgaon on 30.04.2019 and the accident took place on 21.06.2019. No explanation is given by the complainant regarding delay in applying for transfer of R.C. The claim of the complainant has been rightly repudiated by the OPs, hence, prayed for dismissal of the present complaint with heavy cost. Learned counsel for OPs relied upon the case titled as M/s Complete Insulations (P) Ltd. Versus New India Assurance Co. Ltd., Civil Appeal No.2131 of 1994, Date of Decision 21.11.1995, National Insurance Company Limited Versus Jitendra Kumar Singh, Revision Petition No.3110 of 2014, United India Insurance Co. Ltd. Delhi Versus Jagpal Singh, Revision Petition No.2454 of 2009 and United India Insurance Co. Ltd. Versus V.C.Deenadayal & another Revision Petition No.426 of 2007.

10.           Admittedly, the vehicle of the complainant met with an accident during the subsistence of insurance policy. The vehicle in question got surveyed by the OPs. The claim of the complainant has been repudiated by the OPs, vide repudiation letter Ex.01/Ex.C9, on the following grounds:-

i)              There is no explanation that why the complainant had not lodge the FIR, whereas the vehicle in question is badly damaged and complainant lodged the claim of Rs.5,20,779/-.

ii)             As per the statement of Mr.Rishabh Jawa, he was driving the car at the time of accident, but from the perusal of his affidavit dated 18.07.2019, it reveals that he was driving the said car. This major contradiction.

iii)            No intimation of accident was given to nearest office of insurance company, due to which insurance company is deprived to conduct the spot survey.

iv)            As per statement of Mr. Rishabh Jawa he himself and Mr. Himanshu Sharma were injured in the accident and also taken treatment from hospital, but this fact is not mentioned in the claim papers, and as per the claim papers, no one is injured in the alleged accident.

v)             Complainant has not submitted the desired documents to settle the claim and also to confirm the date of accident i.e. toll tax receipt of 3 tolls, treatment documents given by hospital, Attendance record of Mr. Rishabh Jawa.

vi)            NOC of the vehicle is issued by RA Gurgaon on 30.04.2019/01.05.2019. Complainant has not explained exact date of sale/purchase of vehicle. Neither complainant submitted copy of affidavit sale/purchase agreement.

Hence, the competent authority of insurance company has no option but to repudiate the claim mainly on the ground of lack of valid contract between complainant and insurance company and keeping in view of the other facts mentioned above, the OPs have closed the claim of complainant as “no claim”.

11.           The first plea taken by the OPs is that there is no explanation that why the complainant had not lodge the FIR with regard to accident.  In this regard we are of the considered view that rejection of the claims purely on technical grounds in a mechanical manner will result in loss of confidence of policy holder of the insurance industry. In this regard we are placing reliance upon the case titled as Om Parkash Versus Reliance General Insurance and anr. in Civil Appeal no.15611 of 2017 decided on 4.10.2017 whereby Hon’ble Supreme Court of India held that the decision of the insurer to reject the claim has to be based on valid grounds and rejection of the claims purely on technical grounds in a mechanical manner will result in loss of confidence of policy holder in the insurance industry. Hence, this plea taken by the OPs has no force.

12.           The next plea taken by the OPs is that, as per the statement of Mr.Rishabh Jawa, he was driving the car at the time of accident, but from the perusal of his affidavit dated 18.07.2019, it reveals that he was driving the said car. The language of this plea is not clear and there seems no contradiction. Hence, this plea taken by the OPs has no force.  

13.           The next plea taken by the OPs is that no intimation of accident was given to nearest office of insurance company, due to which insurance company has deprived to conduct the spot survey. In this regard, we are of the considered view that no doubt, complainant removed the vehicle in question from the spot without spot inspection done by the surveyor of the OPs and thus complainant deprived the legitimate right of the OPs to ascertain the necessary facts. Hence, this contention of the OPs has force.

14.          The next plea taken by the OPs is that as per statement of Mr. Rishabh Jawa he himself and Mr. Himanshu Sharma were injured in the accident and also taken treatment from hospital, but this fact is not mentioned in the claim papers, and as per the claim papers, no one is injured in the alleged accident. The OPs has also taken a plea that complainant has not submitted the desired documents to settle the claim and NOC of the vehicle has been issued by RA Gurgaon on 30.04.2019/01.05.2019 but complainant has not explained exact date of sale/purchase of vehicle. In this regard, we are of the considered view that the complainant has failed to rebut the version of OPs by leading cogent and convincing evidence. Hence, plea taken by the OPs is having force.

 15.          The next plea taken by the OPs is that the vehicle was reported to meet with an accident on 21.06.2019 and claim is reported by the complainant to the OPs on 18.07.2019 i.e. after 27 days. As per version of the complainant, he has informed the OPs with regard to the accident on 22.06.2019. The case of the complainant is based upon the oral evidence and he has failed to place on record even a single document in order to prove his version. Hence, this plea taken by the OPs has force.

16.           The moot question involved in the present case is that whether without the insurance policy being transferred in the name of complainant, the complainant is entitled to be indemnified by the insurer or not? In the present case, admittedly, the complainant has purchased the vehicle in question from one Prabhat Aggarwal son of Shri K.B.L. Aggarwal. As per version of complainant the transfer process of the vehicle was completed on 11.06.2019 and he received the registration certificate on 14.06.2019. It is also admitted case of the complainant that there was 14 days time to get the insurance transferred in the name of complainant. As per version of complainant, the vehicle met with an accident on 21.06.2019 and on the very next day i.e. on 22.06.2019 the complainant has intimated OP no.1 regarding the accident and also informed about the transfer of ownership in his name.  On the other hand, the OPs while repudiating the claim of the complainant has mentioned that the complainant has informed the OPs with regard to the alleged accident on 18.07.2019 i.e. after the delay of 27 days. The complainant has failed to place on record any documentary proof that he has informed the OPs with regard to the accident on 22.06.2019.  The complainant has further failed to place on record any documentary proof that he has informed the OPs with regard to transfer of ownership of the vehicle in question in his name as well as he requested the OPs to get the insurance policy transferred in his name.  Further, as per Section 157 (2) of Motor Vehicle Act, the transferee shall apply within fourteen days from the date of transfer in the prescribed form to the insurer for making necessary changes in regard to the fact of transfer in the certificate of insurance and policy described in the certificate in his favour and the insurer shall make the necessary changes in the certificate and the policy of insurance in regard to the transfer of insurance. But, the complainant despite having purchased the vehicle, did not get the insurance of the vehicle transferred in his name, which he was required in view the provisions contained in Sub-Section (2) of Section 157 of Motor Vehicles Act. That having not been done so, there was no privity of contract between him and the insurance company on the date, the vehicle was met with an accident.  Moreover, it has not been proved from the registration certificate Ex.C2 that when the vehicle in question has been transferred in the name of complainant. Thus, the complainant has failed to prove his case by leading cogent, believable and convincing evidence. Therefore, the insurance company is not liable to pay any claim for the accidental car to the complainant. Thus, there is no deficiency in service on the part of OPs while repudiating the claim of the complainant mainly on the ground of lack of valid contract between the complainant and insurance company.

17.           Keeping in view the ratio of the judgments, facts and circumstances of the case, we are of the considered view that the present complaint has no force and same deserves to be dismissal.

18.           Thus, as a sequel to abovesaid discussion, we do not find any merits in the complaint and the same is hereby dismissed. No order as to costs. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:02.09.2021                                                                     

                                                                  President,

                                                       District Consumer Disputes

                                                       Redressal Commission, Karnal.

 

 

 

(Vineet Kaushik)          

                     Member