Haryana

Yamunanagar

CC/678/2011

MS.Vandana D/o Kamlesh Kumar Verma - Complainant(s)

Versus

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

S.S.Saini

19 May 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

 

                                                                                           Complaint No. 678 of 2011.

                                                                                           Date of institution: 22.06.2011

                                                                                           Date of decision: 19.05.2016.

Ms. Vandana daughter of Shri Kamlesh Kumar Verma, Verma Watch Company, Birla Mandir Chowk Kurukshetra at present r/o House No.231, Kalyan Nagar, Jagadhri, District Yamuna Nagar.     

                                                                                                                                                                                            …Complainant.

                                    Versus

 

1. The Oriental Insurance Company Limited, Opp. Hindu Girls College, 1^st Floor, Court Road, Jagadhri through its Branch Manager/authorized signatory.
2. The Oriental Insurance Company Limited, Head Office, A-25/27, Asaf Ali Road, New Delhi-110002 through its Chairman/Managing Director/Authorized Signatory.                                                                                                                                                                                                                                                                                                                                                                                                                       …Respondents.

 

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

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

 

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

                Sh. Rajiv Gupta, Advocate, counsel for respondents                

             

ORDER

 

1.                     Complainant has filed the present complaint under section 12 of the Consumer Protection Act. 1986, praying therein that respondents ( hereinafter referred as OPs) be directed to pay a sum of Rs. 9380/- alongwith interest at the rate of 18% per annum, being cost of repair of car bearing registration No. HR-07-6004 and further to pay compensation as well as litigation expenses.

2.                     Brief facts of the complaint, as alleged by the complainant, are that she is registered owner of car bearing registration No. HR-07M-6004  which was duly insured with the OPs vide policy bearing No. 261701/31/2011/8009 valid w.e.f. 29.12.2010 to 28.12.2011 for a sum insured of Rs. 160,000/- and paid a premium of Rs. 3583/-. It has been further mentioned that unfortunately on dated 14.03.2011 the said vehicle met with an accident near Bus Stand Jagadhri and the vehicle was badly damaged and complainant gave information to the OP No.1 telephonically and officials of the OP No.1 asked the complainant to bring the vehicle at authorized service station of M/s Pandit Automobiles, Jagadhri. Accordingly, the complainant brought the said vehicle to the said authorized service station on the very next day and surveyor inspected the damaged vehicle and assured the complainant that the repair charges as per bill issued by the authorized service station will be paid to the complainant very shortly. The OPs have lodged claim No. 261701/31/2011/000364 on the intimation given by the authorized service station of OPs. The authorized service station have handed over the delivery of vehicle after repair on receipt of amount of Rs. 9380 in cash as per invoice No. BR10002735 dated 16.03.2011 and thereafter the complainant sent the bills in original to Op No.1. The complainant repeatedly visited to OpNo.1 with the request to make the payment of Rs. 9380/- but they continued to prolong the matter on one pretext or the other and lastly repudiated the claim of complainant vide letter dated 06.05.2011 on the ground that the complainant has received the No Claim Bonus from her previous Insurance Company i.e. M/s ICICI Lombard General Insurance Company and stating that the declaration of the complainant found to be incorrect and hence, they wrongly and illegally forfeited the benefits of policy. It has been further mentioned that the complainant has narrated about the receipt of NCB from the said company to the authorized agent of OPs namely Rajiv Oberoi. Moreover, No claim Bonus, if any, has been received from her previous Insurance Company and the OP are legally bound to pay the claim regarding damages of the said vehicle. Hence, this complaint.

3.                     Upon notice, OPs appeared and filed its written statement by taking some preliminary objections such as complaint is not maintainable, there is no negligence or deficiency in service on the part of OP. The complainant had obtained one insurance policy for car bearing No. HR-07M-6004 bearing No. 261701/31/2011/8009 valid w.e.f. 29.12.2010 to 28.12.2011 from the OPs company by giving false declaration and by misrepresentation/ false information and obtained 25% NCB at the time of taking of insurance policy from OPs without disclosing the facts that she had already taken an Insurance Claim from the previous insurer ICICI Lombard General Insurance Company in the previous policy No.MAR10425176/09. An intimation was received by OPs Insurance Company on 14.03.2011 that car bearing registration No. HR-07-M-6004 has met with an accident on 12.03.2011 and on receipt of the said intimation the OPs Insurance Company immediately started processing the claim of complainant and Sh. Paramjot Singh Anand an independent Surveyor & Loss Assessor was deputed to survey and assess the loss and the said surveyor conducted the survey and assessed the net loss to the tune of Rs. 7380/- after applying the relevant depreciation clause on repair basis subject to terms and conditions of the Insurance Policy vide report dated 18.03.2011. On receipt of said report of surveyor, the OP Insurance Company vide its mail dated 28.04.2011 desired from the previous insurer ( i.e. ICICI Lombard General Insurance Company) the claim status under policy No. MAR 10425176 for the previous year and the said insurer vide its mail dated 03.05.2011 confirmed that a claim has been paid to the complainant under the previous policy. On receipt of the said communication, the OPs company vide its registered letter dated 30.06.2011 legally and justifiably repudiated the claim of the complainant on account of violation of terms and conditions of the insurance policy and provisions of Indian Motor Tariff and GR No.27. No claim is payable to the complainant under the policy in question. On merit reiterated the stand taken in the preliminary objections and prayed for dismissal of complaint.    

4.                     To prove the case, counsel for complainant tendered into evidence affidavit of complainant as Annexure CW/A and documents such as Photo copy of Insurance policy as Annexure C-1, Photo copy of insurance cover note as Annexure C-2, Letter dated 06.05.2011 as Annexure C-3, Invoice/Cash Memo dated 14.03.2011 as Annexure C-4 and closed the evidence on behalf of complainant. 

5.                   On the other hand, counsel for the OPs tendered into evidence affidavit of Sh. Ashok Kumar Sahni, Senior Branch Manager, Oriental Insurance Company as Annexure RW/A, Affidavit of Sh. Paramjot Singh Anand, Surveyor and Loss Assessor, as Annexure RW/B and documents such as Claim Intimation Format as Annexure R-1, Photo copy of surveyor report as Annexure R-2, Claim status report as annexure R-3, copy of letter dated 06.05.2011 as Annexure R-4, Copy of repudiation letter dated 30.06.2011 as Annexure R-5, Copy of insurance policy as Annexure R-6, Photo copy of NCB confirmation letter as Annexure R-7, Photo copy of insurance cover note as Annexure R-8. Photo copy of proposal form as Annexure R-9, Photo copy of RC as annexure R-10, Photo copy of certificate cum policy schedule of ICICI Lombard Gen. Ins. Co. Ltd. as Annexure R-11 and closed the evidence on behalf of Ops. 

6.                     We have heard the learned counsel for both the parties and have gone through the pleadings as well as documents placed on 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 OP reiterated the averments mentioned in the reply and prayed for dismissal of complaint.

7.                      It is admitted fact that the complainant is registered owner of car bearing registration No. HR07M-6004 which was insured with the OPs vide comprehensive policy bearing No. 261701/31/2011/8009 valid from 29.12.2010 to 28.12.2011 for a sum insured of Rs. 1,60,000/-(Annexure C-1/R-6) and paid a premium of Rs. 3583/-. It is further not disputed that surveyor and loss assessor Paramjot Singh Anand was deputed and Rs. 7380/- was assessed on “Net Loss on Repair Basis” after applying the relevant depreciation clause and subject to terms and conditions of the insurance policy in question as Annex. R-2.

8.                     The only version of the complainant is that claim of the complainant has been wrongly repudiated by the OPs Insurance Company on the ground that complainant has received no claim bonus from her previous insurance company i.e. ICICI Lombard General Insurance Company and has suppressed the true facts from the OPs.

9.                     On the other hand, counsel for the OPs hotly argued that at length that claim of the complainant has been rightly repudiated as the complainant gave false declaration and by misrepresentation/ false information, has obtained 25% NCB at the time of taking insurance policy from the OPs Insurance Company without disclosing the fact that she had already taken an insurance claim from her previous insurance policy. To prove this fact OPs draw our attention towards confirmation letter issued by the previous insurer ICICI Lombard on dated 03.05.2011 (Annexure R-3) and also referred the previous Insurance Policy Annexure R-11.

10.                   After hearing both the parties and perusal of the insurance policy of the Ops Annexure R-1, it is clearly evident that complainant has availed “No Claim Bonus”  under GR-27 from the OPs insurance Company at the time of taking of policy in question. Further from the perusal of proposal form (Annexure R-9) submitted by the complainant, it is evident that complainant made a declaration that “ I/we declare that the rate of NCB claimed by me/us is correct and that no claim has arisen in the expiring policy period ( copy of the policy enclosed). I/We further undertake that if this declaration is found to be incorrect, all benefits under the policy in respect of Section 1 of the policy will stand forfeited. The facts of the case law referred by the counsel for the OPs titled as National Insurance Company Limited Versus Onkar Nath Sharma, FA No. 3496 of 2007 decided on 28.05.2009, by Hon’ble State Commission, Haryana, Panchkula and case law titled as TATA AIG General Insurance Company Versus Gulzari Singh, Revision Petition No. 1255 of 2009 decided on 26.02.2010 by Hon’ble National Commission are fully applicable to the facts of the present case.

11.                   In the facts and circumstances noted above and case law referred by counsel for the OPs (supra), we are of the considered view that there is no deficiency in service or unfair trade practice on the part of OPs and claim of the complainant has been rightly repudiated by the OPs insurance company vide its letter dated 30.06.2011 (Annexure R-5).

12.                   Resultantly, we find no merit in the present complaint and the same is hereby dismissed with no order as to costs. 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: 19.05.2016

                                                             

                                                                                    (ASHOK KUMAR GARG )

                                                                                    PRESIDENT,

                                                                                     

 

                                                                                    (S.C.SHARMA )

                                                                                     MEMBER.