Haryana

Ambala

CC/192/2014

VINAY KUMAR - Complainant(s)

Versus

UII CO. - Opp.Party(s)

ARVIND GOEL

19 Jun 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMBALA.

 

Complaint Case No.      : 192 of 2014

Date of Institution         : 28-07-2014

Date of Decision            : 19-06-2017

 

 

Vinay Kumar Verma son of Sh. Kanwar Chand Verma, R/o House No. 23-P, Sector-7, Urban Estate, Ambala City.                                                              

……Complainant.

 

Versus

 

1. M/s United India Insurance Company Ltd. Micro Office : - Ambala Jagadhri Road 1^st Floor, Near Bus Stand, Saha Ambala through its officer Incharge.
2. M/s United India Insurance Company Ltd. Triloki Chambers, Opp Municipal Council Ambala Cantt. through its Sr. Divisional Manager.   

 

                                                ……Opposite Parties.

 

Complaint Under Section 12 of the Consumer Protection Act

 

BEFORE:   SH. D.N. ARORA,  PRESIDENT.

                   SH. PUSHPENDER KUMAR, MEMBER.

                   MS. ANAMIKA GUPTA, MEMBER.

                  

Present:       Sh. Arvind Kumar, counsel for complainant.

                   Sh. Deepak Sharma, counsel for opposite parties.

 

ORDER.

 

                    In nutshell, brief facts of the complaint are that the complainant is having Santro Xing Car bearing Registration No. HR-01-P-2349 and complainant took comprehensive insurance policy bearing policy No. 110183/31/13/01/00000406 of his Vehicle Santro Xing car bearing Registration No. HR-01-P-2349 from opposite party No. 1 for the period from 06-08-2013 to 05-08-2014. It is further submitted that the vehicle in question met with an accident on 07-01-2014 at Nada Sahib, Distt. Panchkula and then the complainant went to M/s K.L.G. Hyundai, Chandigarh and they got filed up the intimation letter which was addressed to OP No. 1. On which OP No. 1 had deputed Sh. Pardeep Goswami, Surveyor and he has assessed the loss of the vehicle and informed OP No. 1 and Sh. Pardeep Goswami took Rs. 1,500/- from complainant as his fees and he had further informed that the above said charges of Rs. 1,500/- will be paid by company at the time of settlement of claim. Thereafter, complainant got repaired his vehicle from K.L.G. Hyundai, Chandigarh and complainant has submitted the bill of Rs. 17,167 + 1500 fees of the surveyor to OP No. 1 but OP No. 1 on advise of competent authority, rejected the claim of the complainant vide information letter dated 31-03-2014 by mentioning reason that complainant had wrongly availed NCB against previous insurance policy from United India Insurance Company, Ambala City. It is the duty of insurance company to calculate the premium of vehicle after checking all the previous record available with the company, if the previous insurance company and the present insurance company are same.  It is further submitted that the previous insurance company and present insurance company are the same  i.e. United India Insurance Company.  In case the previous insurance company of any vehicle is different insurance company, then the present insurance company itself sent a letter to the previous company to take confirmation of previous claim or no claim bonus etc. as such repudiation of claim is against the facts and law. The complainant had served the legal notice dated 23-06-2014 to the opposite parties through his counsel through registered A.D., which was duly received by the opposite parties, but the opposite parties had failed to pay the claim of Rs. 17,167 +1500 till date. It is further submitted that there is deficiency in service on the part of the opposite parties. Hence, the complainant has prayed that the OPs be directed to pay the amount of Rs. 17,167 + 1500 along with interest @ 24 % per annum, Rs. 30,000/- on account of harassment, mental agony to the complainant.  

 2.               Upon notice, OPs appeared through counsel and filed written statement raising preliminary objections qua maintainability of complaint.  On merits, it is submitted that the surveyor & loss assessor assessed the loss to the sum of Rs. 8833.33/-.  The claim of the complainant was repudiated on the ground that the he had illegally availed no claim bonus against his previous insurance policy. The complainant was under the legal obligation to inform the OP about the past claim which he had obtained in respect of the previous policy. Rest of averments made by the complainant are denied. Thus the OPs have prayed that there is no deficiency in service on their part and sought for dismissal of complaint with costs.

3.                To prove his version, counsel for the complainant tendered affidavit as Annexure CX alongwith documents as Annexures C-1 to C-13 and closed the evidence on behalf of the complainant.  On the other hand, counsel for OPs tendered affidavit R1 and documents as annexure R2 and annexure R3 and closed the evidence on behalf of the OPs.    

4.                We have heard learned counsel for the parties and gone through the case file very carefully.  It is admitted that the vehicle of the complainant was insured with the opposite parties for the period from 06-08-2013 to 05-08-2014. Counsel for the complainant has argued that the vehicle in question met with an accident on 07-01-2014 and the OPs were duly informed.  On which OP No. 1 had deputed his Surveyor and he has assessed the loss of the vehicle. Thereafter, complainant got repaired his vehicle from K.L.G. Hyundai, Chandigarh and complainant has submitted the bill of repair of Rs. 17,167 + 1500 fees of the surveyor to OP No. 1 but OP No. 1 rejected the claim of the complainant vide letter dated 31-03-2014 on the ground that complainant had wrongly availed NCB against previous insurance policy from United India Insurance Company, Ambala City.  Counsel for the complainant has relied upon the case laws CPJ 2008 (II) 149, National Commission titled as New India Assurance Co. Ltd. vs. SPR Enterprises, CPJ 2008(II) 59, Rajasthan State titiled as National Insurance Co. v. Swaraj Jain, CPJ 2008 (IV) 89 National Commission titled as P. Shankaran Kutty vs. Telecom, BSNL & Ors, CPJ 2008 (IV) Himachal Pradesh titled as LIC v. Veena Puri, CPJ 2007 (III) 278 Andhra titled as LIC of India v. Sekhar Babu, wherein it is held that Consumer Protection Act, 1986- Section 2 (1) (g) – Life Insurance – Suppression of material facts – death of insured- claim repudiated on the ground of suppression of fact that insured had cancer – Forum allowed complaint –Appeal by OP – Certificate produced by OP regarding treatment  of insured neither supported by hospital records nor affidavit of doctor – For repudiation, suppressed material must be such which ought to have been disclosed and insured must have played fraud – Burden of proving suppression on Insurance Company – Claim repudiated wrongly – Orders of Forum upheld – interest reduced and CPJ 2007 (III) 246 Orissa titled as LIC v. Ghanashyam Naik, which are squarely covering the facts of the present case.

                   On the other hand counsel for the opposite parties has argued that the claim of the complainant was repudiated on the ground that the complainant has concealed the facts that he had already taken the claim on the basis of previous policy. Hence, the said reported claim of the complainant not admissible under the insurance policy in question. Counsel for the opposite parties has also relied upon the case law cited in II (2010) CPJ 272 (NC) titled as Tata IG General Insurance Company Ltd. Anr. v. Gulszari Singh and IV 2012 CPJ 80 (NC) titled as Brij Bhushan v. National Insurance company Ltd. & Anr, which are not applicable on the facts of the present case.

5.                     After hearing both the parties and gone through the case file, we observed that the opposite parties have failed to produce any document to the effect that the complainant has received the claim on the basis of previous policy. Moreover, counsel for the opposite parties has placed the surveyor report as Annexure R2, vide which surveyor has assessed the loss to the tune of Rs. 8833.63/-, whereas the complainant has prayed for the claim of Rs. 17,167/.

                   In this regard we have perused the case law laid-down in 2013(3)CLT 126 titled Kaur Singh Vs. National Insurance Co. Ltd. whereby Hon’ble National Commission has held that: “Survey report is an important document and cannot be brushed aside,”  and Hon’ble National Commission in 1(2010)CPJ 272 (NC) titled New India Assurance Company Ltd. Vs. Subash Kumar, has held that: “Surveyor’s report has considerable evidential value, cannot be ignored, unless discredited by producing contrary evidence- Settlement of claim on repair basis directed as per surveyor’s report”. On the other hand contention of the complainant is that he had spent a sum of Rs.21455/- on the repair of vehicle and has placed the copy of bill Ex.C5 but regarding the quantum of loss Hon’ble National Commission in III(2008) CPJ 93(NC) titled Champalal Verma Vs. Oriental Insurance Co. Ltd., has held that: “Insurance-Quantum dispute-Loss assessed by Surveyor awarded by State Commission-Amount spent on repairs claimed by complainant-Surveyor’s report to be given due weightage-Consumer Fora cannot go into quantum dispute-Complainant free to approach Civil Court/IRDA/Arbitration-Time spent before Consumer Fora to be set off”.

6.                 In view of the aforesaid discussion as well as aforesaid case laws and laws placed by the counsel for the complainant, we are of the considered view that the opposite parties have wrongly withheld the genuine claim of the complainant, for which they are legally liable to pay. Hence, it is unfair trade practice as well as deficiency in service on the part of the opposite parties withholding the claim of the complainant, As such, complainant is entitled for a sum of Rs. 8833.63/- as per survey report and Rs. 1,500/-, which was paid to the surveyor by the complainant as surveyor’s fee, alongwith interest and costs which is assessed to the tune of Rs. 3,000/-.   Hence, OPs are directed to comply with the following directions within thirty days of the receipt of copy of the order:-

1. To pay a sum of Rs.8833.63/- and Rs. 1,500/-, to the complainant alongwith interest @ 9% per annum from the date of filing the complaint till actual payment. If the opposite parties failed to pay the above said amount within the stipulated period, then OPs will be liable to pay further interest @ 12 % per annum on the awarded amount for the period of default. 
2. And to pay a sum of Rs.3,000/- as costs on account of litigation.

          Copies of the order be sent to the parties concerned, as per rules.  File after due compliance be consigned to record room.  

 

ANNOUNCED ON: 19.06.2017.                               (D.N. ARORA)

                            PRESIDENT       

         

 

(PUSHPENDER KUMAR)

                                                                                      MEMBER

                                                                                  (ANAMIKA GUPTA)

                                                                                      MEMBER