Delhi

East Delhi

CC/374/2016

TARANJEET KAUR - Complainant(s)

Versus

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

30 Sep 2019

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.       374/2016

                                                                                                   Date of Institution                10/08/2016

                                                                                                   Order reserved on                30/09/2019        

                                                                                                   Date of Order                        30/09/2019                                                                                    

 

In matter of

Mrs Taranjeet Kaur    

BG 582, Sanjay Gandhi Transport Nagar    

New Delhi 110042 ………………………….……………....…………….Complainant

                             

                                      Vs

The Manager

United India Insurance Co. Ltd. 

Core 4, First Floor,

Score Minar Complex,

Laxmi Nagar District Centre, Delhi 110092……..........…………Opponent

 

Complainant  Advocate                Mr Pranav Mishra        

Opponent  Advocate                     Mr G. Ghose     

 

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 filed this complaint u/s 12 of the Consumer Protection Act, 1986 for claiming entire IDV of commercial vehicle in accident under “No Claim” category.                                                                                                    

Complainant, owner of commercial vehicle open truck vide registration numbers HR-55K-1566 was insured by OP having GCV Public Carrier Policy DL-1VB-6220 got insured from present OP vide policy no. 2218003114P108738171 having tenure from 22/01/2015 to 21/01/2016 for IDV Rs 13 Lacs (Ex CW1/1). The vehicle met with an accident and got damaged which was driven by driver with valid driving licence. The intimation was given to the local OP branch office.

The policy issuing office of OP appointed surveyor for assessing loss of the vehicle. Mr R K Jain, surveyor, but complainant had obtained estimate from Highway Autotech Pvt Ltd. an authorised service station (Ex CW1/2) for a sum of Rs 22,47469/-with labour charges Rs 2,20,000/- (Ex CW1/2A). It was stated that complainant obtained final surveyor report through RTI filed with OP (Ex CW1/3) where loss was shown contrary to the total loss of the vehicle. Complainant had assessed mental loss to one lac and accused OP for unfair trade practice. When vehicle met with total loss/damage had alleged OP for not paying full IDV. Thus, filed this complaint and claimed full IDV of 13 Lacs with 18% per annum and compensation Rs one lac.  

 

OP denied all the allegations of deficiency and submitted that complainant took estimate of her own from a known workshop and did not disclose when and how accident took place and also did not lodge police complaint. She gave intimation to the local branch office of OP at Panchkula, Haryana who took spot surveyor interim report through Mr K.K. Taneja dated 22/06/2015(Ex OPW1/1). Before surveyor could be appointed by main policy issuing office, complainant had given estimate to the tune of over 22 lacs much beyond the IDV in a commercial vehicle, a truck from M/s Eminent SolvServe Insurance Surveyor & Loss Assessors without statutory basis (Ex OPW1/3). OP as soon as received intimation from their branch office at Panchkula, nominated official surveyor Mr R K Jain (Ex OPW1/2) who assessed loss to Rs 6.5 Lacs vide surveyor’s report as intimated complainant with condition to submit certain required documents (Ex OPW1/2A), but complainant had demanded full IDV of the vehicle which was not considered. OP submitted that full IDV was only applicable when loss/ damages were over 75% of IDV, but in this case it was less than 50% of IDV.

 

It was submitted that despite of sending repeated reminders for complying steps and submitting required documents to OP surveyor, complainant did not comply the demand of notice which were based on the surveyor protocol as per IRDA & GR 8 of the India Motor Tariff followed by all General Insurers. Hence, claim was put under the category of “No Claim” (Ex OPW1/4, 5 & 6). Hence there was no deficiency in services or unfair trade practice adopted by OP.

 

Complainant filed rejoinder to the written statement and denied all the replies submitted by OP. Complainant stated that despite of repeated follow up to OP office, genuine accidental claim was not paid despite OP’s surveyor report. Complainant stressed that all his facts and evidences under complaint were correct and on record. So, OP was deficient in their services and relief claimed in the complaint may be awarded. Complainant also filed her evidences by way of her own affidavit where she affirmed on oath that all the facts of her complaint were true and correct. She relied on policy documents and estimate submitted to OP stressed his evidence as ownership of vehicle and copy of Insurance issued by OP (Ex CW1/1) and workshop estimate. She also relied upon estimate charges for repair given by the authorised workshop of Tata Motors. Hence, all her evidences prove deficiency in the service of OP for not passing accident claim based on IDV, so her claim be processed as per policy IDV.

 

OP submitted evidences on affidavit through Mr T C Gupta, Regional Manager with OP and relied on the policy terms and conditions under policy (Ex OPW1/1). It was stated that claim was not rejected, but put under “No Claim” because complainant did not compel demands of OP appointed surveyor despite of reminding complainant for supplying claim documents which were not complied, so claim was put under No Claim.

 

Both the parties submitted written synopsis and taken on record. On the date of arguments, none of the parties put their appearance, hence after perusal of materials on record written arguments were considered.

 

After going through all the facts and evidences on record, it was observed that the claim was put on “No Claim” which means the claim was neither passed nor rejected by OP. By going through evidences on record, it is evident that complainant had not followed claim process though claim was based on commercial vehicle policy where vehicle was insured by OP and insurance was a comprehensive. Complainant took estimate arbitratorly based on no substantial basis. We have considered OP nominated surveyor who gave his final surveyor report of damage as said vehicle could be repaired, but said vehicle was not damaged to 75% where total loss could be considered and full IDV was payable.  

 

We have also considered citation where OP were always bound by the terms and conditions in reference to United India Insurance Co. vs M/s Harchand Rai Chandan Lal, JT 2004(8) SC 8 and  in LIC vs G M Channabasamma, 1991(1) SCC 357 where law was laid down by the Hon. Supreme Court that contract between Insurer and insured was based on good faith and if concealment of material fact was found it amounts to cancellation of policy based on misrepresentation of material facts under policy terms and conditions. In this complaint, claim was put under “No Claim” due to non compliance of submission of claim documents to surveyor nominated by OP. Though there is no merit as complainant has failed to prove OP deficiency or unfair trade practice ever adopted by OP, but based on GR 8 Guidelines, we direct complainant to fulfill claim formalities in 30 days and thereafter OP would complete claim formalities under policy terms and conditions in commercial policy in 60 days.

 

The first free copy of this order be sent to the parties as per the Section 18 (6) of the Consumer Protection Regulations (in short the CPR) and file be consigned to Record Room under Section 20 (1) of the CPR.

 

(Dr) P N Tiwari  Member                                                                 Mrs  Harpreet Kaur  Member                                             

                                                  Sukhdev Singh  President