| Final Order / Judgement | CONSUMER DISPUTES REDRESSAL COMMISSION – X GOVERNMENT OF N.C.T. OF DELHI Udyog Sadan, C – 22 & 23, Institutional Area (Behind Qutub Hotel) New Delh 110016 CaseNo.162/2016 Ishwar Singh Chauhan S/o Sh. Pokhar Singh R/o H.No.20, Gali No.2 Rajeev Nagar, Near Purani Chungi OldFaridabad-121002 …………….COMPLAINANT Vs. The Oriental Insurance Company Limited Divisional Office: CBO-192, Central Road Jangpura, Neew Delhi-110014 Through its Director/Principal Office ………..…..RESPONDENTS Date of Institution-23.03.2016 Date of Order-02.02.2024 O R D E R RITU GARODIA-MEMBER - The complaint pertains to deficiency in service on the part of OP in repudiation of claim.
- Fact outlined in the complaint: The complainant got his vehicle insured from OP from 21.07.2013 to 20.07.2014 vide policy No.212703/31/2014/1667 for IDV of Rs.3,59,000/-.
- On 07.12.2013, around 1.30 a.m. the driver of the complainant, Sukhram, alongwith his helper Hari met with an accident wherein the aforementioned vehicle struck another vehicle whose driver had suddenly applied brakes. Both the driver and helper sustained injury and were taken to the hospital. Mr. Hari was declared dead by the concerned doctor. FIR was lodged on the same day.
- The complainant informed the OP. A surveyor visited the accident site for spot inspection and checked the driving license of the driver. The surveyor submitted a report. The complainant got his vehicle repaired by spending Rs.1,25,000/-. Thereafter the complainant submitted the claim but his claim was not processed by OP. Complainant prays for refund of Rs.1,25,000/-,compensation of Rs.50,000/- and litigation expense amounting to Rs.11,000/-.
- OP in its reply states that a surveyor, Vipin Kumar Gupta, conducted a spot survey of accidental vehicle and gave his Motor Spot Survey Report on 10.12.2013. Subsequently, a final survey was done of the accidental vehicle by surveyor and loss assessor, Pardeep Kumar, who gave his report on 12.02.2014 and assessed the cost of repairs/loss at Rs.47,000/- after deducting on account of depreciation, excess clause and salvage value.
- OP, on 19.02.2014, requested the complainant to submit the final bills and payment receipt for purchase of parts allowed by the final surveyor, discharge voucher duly signed with bank details and a copy of cancelled cheque for ECS transfer. OP alleges that complainant failed to supply the documents requested. Thereafter OP, as matter of goodwill, recommended the claim approval for Rs.49,380/- on 29.01.2015. OP once again requested for submission of documents. As allegedly no documents were received, the claim was closed 30.03.2015.
- The complainant submitted evidence by way of affidavit and exhibited the following documents as under :
- Copy of Insurance Policy is marked as Ex.C-1.
- Copy of F.I.R is marked as Ex.C-2.
- Copy of bills is marked as Ex.C-3.
- The OP submitted evidence by way of affidavit and has exhibited the following documents as under
- Copy of survey report is exhibited as Exhibit ‘R/A’.
- Copy of final survey report is exhibited as Exhibit ‘R/B’
- Copy of letter dated 19.2.2014 is exhibited as Exhibit ‘R/C’
- Copy of letter dated 29.1.2015 is exhibited as Exhibit ‘R/D’.
- Copy of letters dated 13.2.2015 and 12.3.2015 is exhibited as Exhibit ‘R/E’.
- Copy of letter dated 30.3.2015 is exhibited as Exhibit ‘R/F’.
- We have considered the material and documents on record. It is admitted by both the parties that vehicle of the complainant was insured from 21.07.2013 to 20.07.2014 vide policy No.212703/31/2014/1667 for IDV of Rs.3,59,000/-. The vehicle met with an accident and a FIR was registered on 07.12.2014.
- It is admitted that the spot survey was done by Mr. Vipin Kumar Gupta. The said report dated 10.12.2013 shows the nature and cause of accident as follows :
“As per FIR and Insured stated, that the insured vehicle was going on its way. Suddenly an ahead going truck applied brakes suddenly and it dashed with the truck. Causally it got damaged badly.” - The 2nd surveyor report by Mr. Pradeep Singh dated 12.02.2014 provide assessment as follows :
Summary of Assessment | Estimated (Amt. in Rs,) | Assessed (Amt.in Rs.) | Total Labour Charges | 33,600.00 | 9,500.00 | Total Cost of Parts | 1,99,300.00 | 48,528.13 | | | 53,028.13 | Less Salvage Value | | 4028.13 | Less Excess Policy Clause | | 2000.00 | | 2,32,900 | 47,000 |
“P.S.- As per spot survey report, the Radiator assy was found intact and safe and the insured demanded the replacement of the same. The same were found old at the time of Reinspection also which please note. The insured was also adamant on the demand of the second hand cabin to be reimbursed for a higher amount which was not justified in the opinion of the undersigned. The aforesaid facts were also apprised to the underwriters in the meantime.” - OP vide letter dated 23.01.2015 increased the claim amount from Rs.47,000/- to 49,380/-. The complainant has filed repair bill dated 27.01.2014 and 29.01.2019 amounting to Rs.1,27,530/-.
- The details of the broken/cut/reduced and estimate of parts in the aforementioned surveyor’s report are as follows:
Estimated Assessed Hydraulic nakka bracket | Broken | 2,400.00 | Disallowed | Dashboard Panel instrument Main Wiring electric complete | Broken cut | 9,500.00 9,500.00 | Disallowed Disallowed | RECONDITIONED PARTS | | | | PARTS 10% DEP.{I TAX PAID} | 1. Cabin assy complete (Bare only) | 85,000.00 | 30,000.00 | 2. Dash board | | 2,500.00 | 3. Speedometer assy. | | 850.00 | 4. Brake booster assy | | 2,500.00 | | 85,000.00 | 35,850.00 | Summary of Assessment | Estimated | Assessed | | (Amt. in Rs,) | (Amt.in Rs.) | Total Labour Charges | 33,600.00 | 9,500.00 | Total Cost of Parts | 1,99,300.00 | 48,528.13 | | | 53,028.13 | Less Salvage Value | | 4028.13 | Less Excess Policy Clause | | 2000.00- | | 2,32,900 | 47,000 | | | | | | |
- The assessment report has disallowed Hydraulic nakka bracket and dashboard panel instrument which was acknowledged as broken. The assessor has disallowed wiring electric which was observed as cut by the said assessor.
- The surveyor identified reconditioned parts, including Cabin assy complete (Bare only), Dash board, speedometer assy, and Brake booster assy. The surveyor's estimated cost was Rs. 85,000/-, but the approved amount was Rs. 35,850/-. The estimated labor charge was Rs. 33,600/-, yet the assessed and allowed amount was only Rs. 9,500/-. Surprisingly, neither the surveyor nor the insurance company provided reasons for disallowing broken or cut parts. Furthermore, there is no explanation for the reduction in the estimated cost of reconditioned parts. The assessment lacks clarification or justification for the calculated and reduced labor charges. Conversely, the complainant has submitted bills/receipts for the repairs already carried out on the vehicle.
- Hence the amount/disallowed is {2,400 +9,500 +9,500 + 49,150 (85,000-35,850)+24,100 (33,600-9,500)} Rs.94650/-.
- Hon’ble National Commission in Branch Manager, New India Assrance Company Ltd. Vs. Anoj Kumar Sahay MANU/CF/0807/2023 has observed:
10. As regards the quantum of loss, the OP/insurance company had contended that Surveyor has assessed the loss at Rs. 20,112/-. But District Forum, after taking note of loss assessment done by police and statements of stock, which were hypothecated to SBI, has taken the value of stock to be Rs. 2.50 lakh and concluded that value of stolen property was more than Rs. 2.50 lakh. In this regard relevant portions of District Forum's order are reproduced below:- "11 by filing Surveyor's report alongwith additional evidence on oath, the O.P. has come out with a case that the admissible amount of loss was assessed at Rs. 20,112/- (Twenty Thousand One Hundred Twelve only) by the Surveyor.The complainant has produced copy of final form submitted by the police in which the value of the stolen property has been said to be about Rs. 3,00,000/- (Three Lakhs only). Pleading also to this effect can found in Para 7 to the synopsis to the Complaint petition. In para 3 of his evidence on oath also the Complainant has stated that the police had assessed the entire theft to the tune of about Rs. 3,00,000/- (Three Lakhs only) Along with Complaint’s petition, the Complainant has filed copies of statements of stock hypothecated to State Bank of India for the months from August 2008 to October 2008. The statement with respect to October 2008 shows the total value of the stock to be Rs. 2,50,651/- (Two Lakhs Fifty Thousand Six Hundred Fifty One only). Under the circumstances as mentioned above, we have come to a conclusion that the value of the stolen away property was definitely more than Rs. 2,50,000/- (Two Lakhs fifty Thousand only) and as such the Complainant is entitled to get the sum of Rs. 2,50,000/- (Two Lakhs fifty thousand only) which is the sum insured in the Insurance policy." The National Commission has upheld the finding of District Commission in this matter. - Hon’ble Supreme Court in New India Assurance Company Limited Vs. Pradeep Kumar IV(2009)CPJ46(SC) has observed:
- The object of the aforesaid provision is that where the claim in respect of loss required to be paid by the insurer is Rs.20,000/- or more, the loss must first be assessed by an approved surveyor (or loss assessor) before it is admitted for payment or settlement by the insurer. Proviso appended thereto, however, makes it clear that insurer may settle the claim for the loss suffered by insured at any amount or pay to the insured any amount different from the amount assessed by the approved surveyor (or loss assessor). In other words although the assessment of loss by the approved surveyor is a pre-requisite for payment or settlement of claim of twenty thousand rupees or more by insurer, but surveyor's report is not the last and final word. It is not that sacrosanct that it cannot be departed from; it is not conclusive. The approved surveyor's report may be basis or foundation for settlement of a claim by the insurer in respect of the loss suffered by the insured but surely such report is neither binding upon the insurer nor insured.
- So far as the case in hand is concerned, the claim of the complainant
has been accepted by the consumer fora as it was duly supported byoriginal vouchers, bills and receipts. It has been held that the actualexpensesincurredbythecomplainantcomestoRs.1,39,438/-ingettingthetruckrepairedapartfromtheexpensesonaccountofhaulageoftruckandcarrying it to the workshop. Taking into account actual expenses incurredandtheinterestthatthecomplainanthadtopaytothebankfromwhichtheloan was obtained for that amount, the District Forum awarded a sum ofRs.1,58,409/- to the complainant and insurance company was directed tomakethatpaymentalongwithinterestattherateof12%perannum. The complainant has filed following bills: i. Bill no. 1793 dated 27.01.2014 from Yunus Automobile for Rs.92,700/-. ii. Bill no. 1330 dated 27.01.2014 from Daulat Ram Repairing for Rs.6,165/-. iii. Bill no. 10742 dated 29.01.2014 from Yunus Automobile for Rs.28,655/-. - In the light of the discussion above and observation made by Hon’ble National Commission, we find OP guilty of deficiency in service in not reimbursing the bills of repair of the complainant. Hence, we direct OP:
i. To pay Rs.1,27,520/- (Rs.92,700/- + Rs.6,165/-+ Rs.28,655/-) with 9% interest from the date of accident till its realization. ii. To pay Rs.25,000/- towards compensation for mental harassment. iii. To pay Rs.5,000/- towards litigation expenses. - Orders to be complied within 30 days of the date of order. File be consigned to record room. Order to be uploaded on website.
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