Haryana

Karnal

CC/179/2022

Rajnish - Complainant(s)

Versus

The Reliance General Insurance Company Limited - Opp.Party(s)

Ram Chander Taya

27 Sep 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No.179 of 2022

                                                        Date of instt 30.03.2022

                                                        Date of Decision:27.09.2024

 

Rajnish son of Shri Subhash, resident of village Jamba, sub tehsil Nighdu, tehsil Nilokher, District Karnal.

 

                                                                        …….Complainant.

                                              Versus

 

1. The Reliance General Insurance Co. Ltd. SCO no.147-148, sector no.9C, Madhya Marg, Chandigarh-160009.

 

2. The Reliance General Insurance Co. Ltd. registered and Corporate office, Reliance Centre, South Wing, 4^th floor, Santacruz East near old Western Express Highway, Mumbai-400055.

                                                                   …..Opposite Parties.

 

Complaint under Section 35 of Consumer Protection Act, 2019.

 

Before   Shri Jaswant Singh……President.

              Ms. Neeru Agarwal……Member

      Ms. Sarvjeet Kaur..…..Member

 

 Argued by: Shri Ram Chander Taya, counsel for the complainant.

                 Shri A.K.Vohra, counsel for the OPs.

 

                     (Jaswant Singh, President)

ORDER:   

                

                The complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that complainant is the registered owner of TATA ACE bearing registration no.HR-045C-0208. The complainant got insured his vehicle with the OPs, vide policy no.200222123340000117, valid from 08.01.2021 to 07.01.2022 and the insured declared value (IDV) of the vehicle was Rs.3,40,000/-. OPs issued the said policy after due physical verification of the vehicle. On 08.08.2021 at about 12.30 p.m., the complainant was driving the aforesaid vehicle at a moderate speed after observing all traffic rules and the complainant was going from Nilokheri to village Jamba. When the complainant reached ahead of the bus stand of village Khawja Ahmedpur, a motorcyclist came in front of the vehicle of the complainant and the complainant tried to save the motorcyclist and in this process, a stray animal suddenly came in front of the vehicle of the complainant. The complainant also tried to save stray animals and in this process, the complainant lost the control over his vehicle and the vehicle and vehicle struck against a tree, as a result of which the vehicle was totally damaged and the complainant also sustained some injuries and thereafter the complainant was confined to bed and took rest. The intimation in this regard was sent to the OPs on the same day. On 16.08.2021, complainant went to the police post, Nilokher, Police Station, Butana and reported the matter and in this regard a DDR no.6 dated 16.08.2021 was recorded by the police. Thereafter, the complainant went to the office of OPs and submitted the copy of DDR and all other relevant papers on 16.08.2021. The complainant was advised by the OPs to shift the accidental vehicle to Bhimra Jagdamba Bus Body Maker, Pipli (Kurukshetra) and the proprietor of said workshop allowed the complainant to park the vehicle with the abovesaid workshop on garage charges of Rs.200/- per day. The said workshop prepared the estimate of Rs.3,12,750/-. The complainant submitted the said estimate to the OPs and requested to pay the total assessed value of the vehicle. The IDV of the vehicle was Rs.3,40,000/-. The Bhimra Jagdamba Bus Body Maker has given an estimate of Rs.3,12,750/- which is almost near the total assessed value of the vehicle. It is further averred that Satish Arora, surveyor of the company conducted the survey of the vehicle of the accidental vehicle and told to the complainant that only Rs.40000/- to Rs.45000/- can be given by the company to the complainant, which was a very meager amount, whereas the vehicle was totally damaged and was fully insured. Thereafter, surveyor of the OPs told the complainant that the full insurance of the vehicle is not possible, rather he can get provide Rs.85,000/- to Rs.88000/- only to the complainant, but the estimated repair cost i.e. IDV comes to Rs.3,40,000/-. Thereafter, complainant visited the office of OPs several times and requested to pay the assessed value of the vehicle but OPs did not pay any heed to the request of complainant and lingered the matter on one pretext or the other. OPs issued letter dated 28.11.2021, vide which complainant was shocked to know that OPs have issued three letters dated 23.10.2021, 06.11.2021 and 20.11.2021 but complainant never received these earlier letters. In the letter dated 28.11.2021, OPs have mentioned that the insurance claim no.3121147684 in respect of vehicle in question has been finally closed which is illegal, null and void and not binding upon the rights of the complainant. There was no lapse on the part of the complainant for not supplying the pending documents. Infact, complainant has already deposited all the relevant documents but OPs have prepared false letters allegedly sent to complainant only to avoid their legal liability and to pay the sum insured to the complainant as the vehicle of the complainant has been totally damaged. The complainant is still ready to deposit the documents, if any, and the OPs have not mentioned the details of required documents.  It is further averred that Bhimra Jagdamba Bus Body Maker is charging Rs.200/- per day as garage charges and the complainant is being unnecessarily burdened due to illegal act on the part of the OPs and since then the vehicle is lying parked with Bhimra Jagdamba Bus Body maker. OPs have illegally and arbitrarily closed the claim case of complainant knowingly, intentionally, deliberately and arbitrarily on false and frivolous ground. Due to this act and conduct of OPs, complainant has suffered mental pain, agony and harassment as well as financial loss. In this way there is deficiency in service and unfair trade practice on the part of the OPs. Hence complainant filed the present complaint seeking direction to the OPs to pay Rs.3,40,000/- the IDV of the vehicle alongwith interest @ 24% per annum from the date of accident till its realization, to pay Rs.1,00,000/- for causing mental agony, pain and sufferings and to pay Rs.31,000/- as litigations expenses.

2.             On notice, OPs appeared and filed its written version raising preliminary objections with regard to maintainability; cause of action; locus standi and concealment of true and material facts. On merits, it is pleaded that the claim of the complainant was duly processed and considered the same but it was not found payable, due to the fact that the complainant was asked vide letter dated 23.10.2021, 06.11.2021, 20.11.2021 and telephonic discussions for the supply of the following documents for the settlement of his claim;

1. Final repair bill.
2. Vehicle to be produced for re-inspection.
3. Claim discharge voucher.
4. Documents i.e. PAN Card, Voter/Aadhar/Ration card etc.
5. Cancelled cheque/pass book copy for NEFT payment etc.

                However, inspite of several reminders, the OPs have not received any revert from the complainant nor has the complainant complied with the pending documents. Therefore, the OPs presumed that the complainant is not interested in pursuing this claim further and hence the claim file of the complainant was closed, vide speaking registered letter dated 28.11.2021. Hence, the complaint filed by the complainant is pre-mature and is an abuse on the process of law. It is further pleaded that the insured vehicle in the instance is hypothecated with Financer HDFC Bank Ltd. a necessary and proper party in the matter. The insured has however, failed to implead the financer in the matter and hence, the present complaint is liable to be dismissed for want of necessary party. There is no deficiency in service and unfair trade practice on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence his affidavit Ex.CW1/A, copy of aadhar card of complainant Ex.C1, copy of insurance policy Ex.C2, copy of driving licence of complainant Ex.C3, copy of RC Ex.C4, copy of pollution certificate Ex.C5, copy of DDR Ex.C6, copy of estimate Ex.C7 and Ex.C8, loan account statement Ex.C9, postal receipt Ex.C10 and Ex.C11, copy of fitness certificate Ex.C12, copy of tax receipt Ex.C13, copy of final notice dated 20.11.2021 Ex.C14, copy of legal notice Mark-A, registered envelop Ex.C15, AD Ex.C16 and closed the evidence on 15.05.2023 by suffering separate statement.

5.             On the other hand, learned counsel for the OPs has tendered into evidence affidavit of Suryadeep Singh Thakur Ex.OP1/A, affidavit of Pankaj Bajaj Ex.OP2/A, copies of letters and reminders dated 16.08.2021, 23.10.2021, 06.11.2021 and 20.11.2021 regarding demanding the documents Ex.O1 to Ex.O4, copies of claim closure letters dated 28.11.2021 Ex.O5 and Ex.O6, copy of insurance policy Ex.O7, copy of RC Ex.O8, copy of DDR Ex.O9, copy of survey report Ex.O10 and closed the evidence on 08.05.2024 by suffering separate statement.

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

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that complainant got his vehicle insured with the OPs. On 08.08.2021, the said vehicle met with an accident and badly damaged. Intimation was given to the OPs and the concerned Police Station. The complainant lodged the claim with the OPs and submitted all the required documents for settlement of the claim but OPs did not settle the claim despite repeated request of complainant and close the claim of complainant on the false and frivolous ground and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OPs, while reiterating the contents of written version, has vehemently argued that the present complaint is pre-mature as the complainant did not provide the documents to OPs despite repeated requests for processing of the claim. Due to non-supply of documents, the claim of the complainant has been closed by the OPs, vide letter dated 28.11.2021 and lastly prayed for dismissal of the complaint.

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

10.           Admittedly, complainant got insured his vehicle with the OPs and the vehicle in question met with an accident during the subsistence of the insurance policy. It is also admitted that the Insured Declared Value (IDV) of the vehicle in question is Rs.3,40,000/-.

11.           The claim of the complainant has been closed by the OPs, vide letter Ex.O6 dated 28.11.2021 on the ground, which is reproduced as under:-

“We hereby bring to your notice that vide our letters dated 23.10.2021, 06.11.2021 and 20.11.2021 and several telephonic reminders and investigator’s letter dated 28.11.2021 where we have asked you to comply with the pending documents in order to process your claim.

However inspite of several reminders we have not received any revert from your side nor have you complied with the pending documents. Therefore, we presume that you are not interest in pursuing this claim further and hence, we are closing your claim as “final closure” in our records.”

 

12.           OPs have alleged that complainant has not submitted the documents inspite of various letters and reminders. On the other hand, complainant has alleged that he has submitted all the demanded documents to the surveyor of the OPs and also got re-inspected the vehicle in question from the surveyor of the OPs.

13.           On 08.08.2021, the surveyor of the OPs inspected the vehicle in question and prepared his report Ex.O10 on 30.09.2021 and has assessed the final liability to the tune of Rs.88,000/-. The OPs have demanded the documents i.e. KYC, consent letter, repair bill and cancel cheque. When all the above mentioned documents were available with the complainant, thus, the same would have been supplied to the OPs. Moreover, it is also unbelievable an insured whose personal interest is involved for such amount why he will not supply the documents to the insurance company for getting his claim amount and will indulge himself in unwanted litigations. Hence, we found no substance in the contentions of OPs.

14. Furthermore, now a days it has become a trend of insurance companies, they issue the policies by giving false assurances and when insured amount is claimed, they make such type of excuses. Thus, the denial of the claim of complainant is arbitrary and unjustified. In this regard, we place reliance on the judgment of Hon’ble Punjab and Haryana High Court titled as New India Assurance Company Ltd. Versus Smt. Usha Yadav & others 2008 (3) RCR (Civil) 111, has held as under:-

“It seems that the Insurance Companies are only interested in earning the premiums which are rather too stiff now a days, but are not keen and are found to be evasive to discharge their liability. In large number of cases, the Insurance companies make the effected people to fight for getting their genuine claims. The Insurance Companies in such cases rely upon clauses of the agreements, which a person is generally made to sign on dotted lines at the time of obtaining policy. This is, thus pressed into service to either repudiate the claim or to reject the same. The Insurance Companies normally build their case on such clauses of the policy, but would adopt methods which would not be governed by the strict conditions contained in the policy”.

15.           Keeping in view, the ratio of the law laid down in aforesaid judgments, facts and circumstances of the present complaint, we are of the considered view that act of the OPs while closing the claim of the complainant amounts to deficiency, which is otherwise proved genuine one. 

16.           Complainant claimed Rs.3,40,000/- the insured declared value (IDV) of the vehicle on the basis of estimate Ex.C8. The said estimate is only rough estimate and not a final invoice. The surveyor of the OPs, vide his report Ex.O10 has assessed the final liability to the tune of Rs.88,000/-.  Hence, the report of the surveyor will prevail. In this regard we relied upon the authority 2(2008) CPJ page 182 (NC), United India Insurance Co. Vs. Maya, wherein it has been held that a surveyor report should not be dismissed summarily as the surveyor is independent and qualified person under the relevant provision of Insurance Act, 1938. In view of this authority as well as the facts and circumstances of the case, we are of the considered view that the OPs are liable to pay the loss assessed by the surveyor alongwith interest, compensation for mental agony and harassment and litigation expenses.

17.           In view of the above discussion, we partly allow the present complaint and direct the OPs to pay Rs.88,000/- (Rs. eighty eight thousand only) as loss assessed by the surveyor of the OPs alongwith interest @ 9% per annum from the date of closing of the claim i.e. 28.11.2021 till its realization to the complainant. We further direct the OPs to pay Rs.25,000/- to the complainant on account of mental agony and harassment suffered by him and Rs.11,000/- for the litigation expenses. This order shall be complied within 45 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.

Announced
Dated:27.09.2024

         President,

      District Consumer Disputes                           

      Redressal Commission, Karnal

 

                   ( Neeru Agarwal)            (Sarvjeet Kaur)

                          Member                        Member