Delhi

East Delhi

CC/823/2015

AMIT KUMAR - Complainant(s)

Versus

U.I.C - Opp.Party(s)

01 May 2017

ORDER

            DISTRICT CONSUMER DISPUTE REDRESSAL FORUM, EAST, Govt of NCT of Delhi

              CONVENIENT SHOPPING CENTRE, 1^st FLOOR, SAINI ENCLAVE, DELHI 110092  

 

                                                                                                   Consumer complaint no.        823/2015

                                                                                                   Date of Institution               20/10/2015

                                                                                                   Order reserved on               01/05/2017        

                                                                                                   Date of Order                        02/05/2017                                                                                     

 

In matter of

Mr Amit Kumar, adult   

s/o Sh Mahinder Singh  

R/o- F 289, Lado Sarai

Mehrauli Delhi. ….…………………………….……………...…………….Complainant

                             

                                      Vs

 

M/s Manager,

United India Insurance Co. Ltd. 

8^th Floor, Kanchanchanga Building  

18, Barakhamba Rd, New Delhi 110001.……………..….…………..Opponent

 

Quorum   Sh Sukhdev  Singh       President

                  Dr P N Tiwari                 Member

                  Mrs Harpreet Kaur      Member                                                                                             

 

Order by Dr P N Tiwari  Member  

Brief Facts of the case                                                                                                

Complainant purchased Bajaj pulsar motor cycle having its registration no. DL03SBT 4334 vide engine no. DJGBBSH17248 and chassis no. MD2DHDJZZSCH 01913. The said motor cycle was insured by OP having policy no. 0413033113P108311509 from 15/03/2014 to 13/03/2015 as annexed here Ex CW1/1.

On 27/07/2014, complainant Mr Amit Kumar was returning home via NH 24, Ghaziabad towards Lado Sarai in Delhi with his mother. As soon as he reached at red light Mayur Vihar, Phase II underpass, he was hit by a speeding car and sustained injuries. He along with his mother were taken to hospital where treatment was done and medico legal report was prepared. FIR was registered vide Ex CW1/1 and CW1/2. He sustained injuries over body and got his color bone fractured due to the accident. OP was intimated about the accident and claim was registered vide claim no. 0413033114C050050001. Complainant took his motor cycle for repair at Dewan Auto where he got his vehicle repaired. He paid estimated repair cost Rs 33,490/-vide bill marked as CW1/3A, B and C. OP deputed investigator to verify the facts from the treating hospital and police station. After conducting inquiry, neither claim was passed nor rejected. Complainant inquired number of times from OP about his claim status, but did not got reply.

Complainant received a repudiation letter from OP stating that his claim was rejected as he was under the influence of Alcohol at the time of driving the vehicle which was in contravention of policy terms as marked here CW1/4. Aggrieved by the rejection letter, complainant sent legal notice dated 18/05/2015 for paying his repair charges as marked CW1/5. When no reply was received complainant filed this complaint claimed sum of Rs 33,490/ as repair cost and Rs 4 lakh compensation for harassment with 11,000/- as litigation cost.

 

Notice was served. OP submitted written statement where the allegations of deficiency were totally denied. OP submitted that the said two wheeler / Bajaj Pulsar motor cycle was registered by them and had valid policy cover also. It was also stated that the complainant had met with an accident and got FIR registered which was on record, but complainant did not disclose that he was driving his motor cycle under the influence of alcohol which was evident from the evidence collected by the surveyor which showed that at the time of accident complainant was under the influence of Alcohol which was also evident from MLC report obtained from the treating hospital and verification from the treating doctors who treated him as Ex. OPW1/1 and 1A.

It was submitted by the OP that driving under the influence of Alcohol was violation of policy terms and condition and so their rejection was justified. OP also submitted that a surveyor was nominated as soon as claim intimation was received from complainant/insured. The surveyor report stated IDV value of the said vehicle for a sum of Rs 32,700/- and the said vehicle was also financed from Bajaj Auto Fin. Ltd. The report submitted a total loss of Rs 14,500/-as per OPW1/2. OP also submitted their terms and condition of the said policy under which vehicle was registered and stated that there was no delay or deficiency in their services, so the complaint may be dismissed.  

Complainant filed his rejoinder and evidence on affidavit and affirmed on oath that all the facts and evidence submitted by him were correct and true. OP also filed their evidence on affidavit through Mr Angela Samed, Dy. Manager Legal who stated that their rejection was based on the terms and condition of the policy which clearly showed the violation of policy conditions though it was admitted that their policy was in force and complainant had met with an accident, but driving vehicle under the influence of Alcohol and causing hurt/damages violates their policy conditions.  

Arguments were heard from both the parties and order was reserved.

After going through all the facts and evidences on record, it was observed that the rejection of accidental claim by OP was justified as per terms and conditions of the policy which clearly states that under exclusion clause (d) ‘Section I : Loss of or Damage to the vehicle insured” which reads as “ Any accidental loss or damage suffered whilst the insured or any person driving the vehicle with the knowledge and consent of the insured is under the influence of intoxicating liquor or drugs.”

Hence, we come to the conclusion that complainant had failed in establishing the deficiency of the OP and this complaint has no merit and the same deserves to be dismissed, so dismissed without cost.

Copy of this order be sent to the parties as per the Act and file be consigned to Record Room.

 

(Dr) P N Tiwari  Member                                                                         Mrs  Harpreet Kaur  Member                                                                                                                         

                                      

                                                  Shri  Sukhdev Singh  President