DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SAS NAGAR

                                          Consumer Complaint No.87 of 2019                                      Date of institution: 18.01.2019

                                                Date of Decision: 10.11.2021

Roshan Lal Sharma son of Shri Basant Ram, resident of House No.435, Second Floor, Sector 12-A, Panchkula, Haryana . 

…….Complainant

Versus

2. The United India Insurance Company Limited, Branch office, SCO No.72, Phase IX, SAS Nagar, Mohali, Punjab.

3. Vipin Gulati, Authorized Service Agent, the United India Insurance Company Limited, Branch Office, SCO No.72, Phase IX, SAS Nagar, Mohali, Punjab

                                                      ……..Opposite Parties

                        Complaint under Consumer Protection Act.

Quorum:   Shri Sanjiv Dutt Sharma, President.

                Ms. Gagandeep Gosal, Member.

Present:    Complainant in person

                        Shri Harinder Kumar, Counsel for OPs No.1 & 2

                        OP No.3 ex-parte  

Order dictated by :-  Shri Sanjiv Dutt Sharma, President

ORDER

                The present order of ours will dispose of the above complaint filed under Consumer Protection Act, by the complainant (hereinafter referred to as ‘CC’ for short) against the Opposite Parties (hereinafter referred to as ‘OPs for short) on the ground that the CC is the owner of vehicle of Toyota Etios bearing registration No.CH-01-AQ-1934, Model 2012, Chassis No.200039562, Engine No.1280150. It is alleged that the CC had been subscribing the policy of OP No.1 & 2 regularly for the last three years. Accordingly, the CC was given policy No.1121003117P111595883 issued on 09.11.2017, which was valid upto 08.11.2018, by OP No.1 & 2 and the policy of the vehicle of the CC has been taken through OP No.3 The OPs had also handed over a proposal form for issuing the Depreciation Cab Policy/Bumper to Bumper Policy for the vehicle of the CC.  At the time of giving the proposal form, the CC clearly told the OPs that he had taken a claim against his vehicle in the previous year and he is not entitled to No Claim Bonus of the current year. As such the agent of  OP No.1 & 2 asked the CC to pay an amount of Rs.11,990/- as premium. It is alleged that in the proposal form also the agent did not mention anything about the No Claim Bonus taken by the CC of the previous year. After some days, the CC received the copy of the Insurance Policy and kept the same in his vehicle without verifying the details under a bonafide belief. It is alleged that the vehicle of the CC met with an accident on 03.09.2018 in Chandigarh and got damaged. The CC sent the vehicle to a workshop in Industrial Area Phase-I, Chandigarh for repairs. Thereafter, the CC also reported the accident to the OPs, who sent the surveyor and the surveyor assessed the loss of the vehicle of the CC. The CC was surprised and shocked to see that the OPs have not provided any cashless facility to the CC and was asked to pay the entire amount on account of repair of his vehicle. The CC was given assurance that the OPs will proceed with his claim and will reimburse the amount of the repair, which was Rs.10,483.12. In November 2018, the CC came to know that OP No.1 & 2 have repudiated the claim of the CC on false, frivolous and baseless plea that the CC has suppressed the true and correct facts while subscribing the policy. It was in the repudiation letter that the CC had taken the no claim bonus while suppressing this fact and as such the CC is not entitled to any claim. Because of this act of the OPs, the CC has suffered mental and physical harassment.

                  Thus, alleging deficiency in service on the part of the OPs, the CC has sought directions to the OPs to pay him the amount of Rs.10,483.12 and Rs.1,00,000/- as compensation for mental agony, harassment and humiliation along with Rs.21,000/- as litigation expenses. The complaint of the CC is signed and supported by affidavit.

          2.             In reply, which is in the shape of affidavit of Ms. Hemlata Panwar, authorized signatory, OP No.1 & 2 have denied the allegations of the CC. It is alleged that the CC concealed the factum of the claim availed by him at the time of subscription of the policy and got ‘No Claim Bonus’ at the time of submitting the proposal form and issuance of the policy. It is alleged that it is mandatory terms and condition of the policy that insured will disclose each and every fact truly and concealment of fact will lead to violation of terms and conditions of the insurance policy which will entitle the answering OPs to repudiate the claim. It is further alleged that the complaint filed by the CC is liable to be dismissed on the ground that once the policy holder accepted the terms and condition of the policy with his free will, he cannot be permitted to back out later on from the same on the pretext that it does not suit him. Thus, alleging no deficiency in service on their part, OP No.1 and 2 have prayed for dismissal of the complaint against them.

3.            OP No.3 has chosen not to appear and was accordingly proceeded against ex-parte vide order dated 08.04.2019.

4.            In support of his complaint, the CC has submitted his affidavit and documents Ex.C-1 to Ex.C-5. On the other hand, OP No.1 & 2 have submitted affidavit of Ms. Hemlata Panwar, their authorized signatory alongwith document Ex.OP-1.

5.             We have heard the complainant and counsel for OP No.1 and 2 and have gone through the file.

          6.             OP No.1 and 2 mainly contested the claim of the CC on the ground that the CC has suppressed true and correct facts and that the CC did not disclose in the proposal form that he had already taken claim earlier from the OPs and was not entitled for no claim bonus, while subscribing the present policy of the OPs. We feel, that these are mandatory terms and conditions of the insurance policy for a person, who subscribe the policy to disclose each and every fact truly and do not conceal any fact. We feel, that concealment of fact is definitely a violation of terms and condition of the insurance policy which does not entitle the CC for any claim from the side of the OPs. The averments of the complaint appear to be concocted and false. It was incumbent upon the CC to peruse the terms and conditions of the policy before keeping the policy. We feel, that the CC very well knew that he had taken claim prior to subscription of the policy and it was his duty to disclose the same to the OPs which he never did. We are equipped with the judgment of the Hon'ble Supreme Court of India, in a case civil No.6739 of 2010, titled as Oriental Insurance Company Vs Parvesh Chander that the provisions are mandatory and not directory in nature. This view was again taken by the Hon'ble National Commission in case titled as M/s V.K. Kariyana Store Vs The Oriental Insurance Company Limited and Ors, 2014 (3) CPJ 12 by holding that it is well settled principal of law that the parties are bound by the terms and conditions of the insurance policy, and none of the parties can seek any relief beyond those terms and conditions of the same.

7.             In view of our above discussions, the complaint of the CC merits dismissal and the same is accordingly admitted. However, no order as to costs.  Free certified copies of this order be sent to the parties, as per rules. The file be consigned to record room.

Announced

November 10, 2021

(Sanjiv Dutt Sharma)

I agree.

(Gagandeep Gosal)