BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SIRSA.
Consumer Complaint no. 71 of 2022.
Date of Institution : 21.01.2022.
Date of Decision : 26.03.2024.
Parmod Kumar aged about 26 years son of Shri Ramjas, resident of village Jasania, Tehsil Nathusari Chopta, District Sirsa, Haryana.
……Complainant.
Versus.
1. United India Insurance Co. Ltd., Divyam Complex, Opp. Easy Day, Dabwali Road, Sirsa, Haryana- 125055.
2. United India Insurance Co. Ltd. #19, Nungambakkam High Road, IV Lane, Chennai, Tamil Nadu- 600034.
...…Opposite parties.
Complaint under Section 35 of the Consumer Protection Act, 2019.
Before: SH. PADAM SINGH THAKUR ………………PRESIDENT
MRS.SUKHDEEP KAUR……………………….MEMBER.
Present: Sh. Rakesh Kashnia, Advocate for complainant.
Sh. A.S. Kalra, Advocate for opposite parties.
ORDER
The complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to OPs).
2. In brief, the case of complainant is that complainant is having a car model Venue 1.4 CRDI-MT bearing registration No. HR-31W/7693 which was got insured from ops for the period 02.04.2021 to 01.04.2022 under zero depreciation insurance policy bearing No. 1119003121P100323196. That complainant had purchased the above said vehicle from Deepak Kumar son of Sh. Kamlesh Kumar, resident of village Kagdana, Tehsil Nathusari Chopta, District Sirsa, Haryana and got transferred the ownership of same in his name. It is further averred that on 05.07.2021 the insurance of said vehicle was also got transferred in the name of complainant. Prior to transfer of ownership of said vehicle in the insurance, the insurance company got inspected the vehicle by their Surveyor Mr. V.K. Grover on 05.07.2021 and after inspection and submission of report by the Surveyor of the ops, the insurance policy was transferred in his name which became effective from 05.07.2021 to 01.04.2022 in the name of complainant. It is further averred that on 07.08.2021 at about 8.30 p.m, the above said vehicle met with an accident on Bhadra to Nohar road near village Sikrodi, Rajasthan and vehicle was completely damaged. At that time vehicle was being driven by relative of complainant namely Ramesh Kumar who was having valid driving licence at the time of accident. Intimation of the accident was given to the ops by the complainant upon which on 11.08.2021 the Surveyor of the ops visited the place of accident and prepared his report and told that he will get the claim after submission of his report and also told him to send Motor Claim Intimation Letter to the ops. That thereafter on 13.08.2021, the complainant took the above said vehicle to M/s D.N. Automobiles workshop at Sirsa for assessment and repair of vehicle and on the same day he sent Motor Claim intimation letter to the ops. It is further averred that mechanic of said workshop assessed the damage and estimated the amount of Rs.2,96,367/- on the repair of the vehicle. That thereafter complainant visited the op no.1 and submitted above said estimate and requested op no.1 for settlement of his claim on which the officials of op no.1 assured him that within 5-7 days he will get the complete amount which will be incurred on the repairing of damaged vehicle but till date he has not received any amount. It is further averred that about a week ago, when he again visited the op no.1 to inquire about his insurance claim the officials of op no.1 flatly refused to admit the claim of complainant and as such ops have caused unnecessary harassment, financial loss and deficiency in service to the complainant. Hence, this complaint.
3. On notice, ops appeared and filed written statement taking preliminary6 objections that complaint is not maintainable before this Commission as ingredient for maintaining the complaint are not there in the complaint, hence complaint is liable to be dismissed; that complainant has breached principle of utmost good faith and had lodged the claim for alleged damage to the vehicle No. HR-31Q-7693 allegedly suffered on 07.08.2021 at 8.30 p.m. in a fraudulent manner and an attempt was made by way of manipulation for the claim on the basis of forged and fabricated pre-inspection report of the vehicle for getting the policy transferred in his name by avoiding actual and factual inspection of vehicle. On this basis the claim was repudiated and rejected, hence complaint is liable to be dismissed. The plea of complainant that insurance company got inspected the above said vehicle by their Surveyor Mr. V.K. Grover on 05.07.2021 and after the inspection and reports submitted by the surveyor of the ops, the insurance policy was transferred in the name of complainant on 05.07.2021 to own knowledge of complainant is/ was false and frivolous. It is further submitted that after receipt of the claim, insurance company and surveyor when checked and confirmed the record, then came to know about breach of principle of utmost good faith by complainant and playing fraud with company by submitting the false and fabricated report of vehicle inspection allegedly issued by Mr. V.K. Grover on 05.07.2021 on which basis company transferred the insurance policy in the name of complainant without physical inspection of the same, which after corroboration gave an inference that on 05.07.2021 i.e. the day of alleged inspection vehicle was already damaged and there were no sign of any accident at spot as per inspection report of Surveyor and immediate information about alleged accident on 07.08.2021 was also avoided by complainant to get benefit of no sign of accident at spot. That from all this Competent Authority/ op has rejected the claim lodged by complainant, hence complainant is not entitled for any kind of relief from this Commission. It is further submitted that ops have deiced the claim by passing a speaking order after going through the record and clarification thereof from Mr. V.K. Grover Surveyor without having any ill-will or malafide intention against complainant vide order dated 09.03.2022 but complainant has filed present complaint without waiting the result of the claim, hence complaint can be said to be without any cause of action. That according to the law of insurance or availing own damage claim from the insurer, insurance policy should be either on his name from the inception or should have been transferred in his name prior to the accident and in both the situation it is the prime requisite/ requirement that vehicle will be inspected by the insurer either through officer or surveyor and in this case initial insured was Deepak Kumar and insurance policy in his name was from 02.04.2021 to 01.04.2022 and this vehicle was purchased by complainant, hence for getting the policy transferred in his name, he was required to get his vehicle inspected physically. But instead of bringing the vehicle physically before the insurer or surveyor complainant got applied for transfer of this policy by submitting a report of physical inspection of this vehicle to be issued and signed by Mr. V.K. Grover Surveyor which infact has never been issued by him and has been reported to be fake, forged and fabricated as confirmed by Surveyor V.K. Grover to the company. Further there were no sign of accident at spot. It is further submitted that delayed intimation about alleged damages of the vehicle (accident alleged to be occurred on 07.08.2021 and intimation given to company on 13.08.2021) clearly indicate, reflect, prove and gives an inference that vehicle was already damaged and in order to claim the amount for the damages from ops, complainant opted forged and fabricated mode, which has not been considered by ops and this Commission has not to condone this fraudulent act of complainant. On merits, while reiterating the pleas taken in the preliminary objections it is also submitted that competent authority has cancelled the said policy due to fraud played by complainant with the ops. It is wrong that any insurance policy was effective or was transferred at any point of time. It is further submitted that first time claim intimation was given to insurance company on 13.08.2021 and after receipt of intimation Mr. Nitish Chawla Surveyor and Loss Assessor was deputed for inspection. The vehicle and alleged place of accident were inspected by said Surveyor and he has submitted his report mentioning mere estimate of the loss initially submitted by complainant as vehicle was in same condition as on the day of initial survey. Further complainant failed to respond the queries made to him vide letter dated 25.10.2021, 22.12.2021 and 17.01.2022 qua the vehicle number mentioned therein, for which intimation was given and surveyor was deputed. Even complainant did not turn up to resolve the queries despite many telephonic message and letters by Surveyor as on checking no photos of alleged inspection of Mr. V.K. Grover Surveyor of the vehicle were there and even he denied the inspection and report being false and procured one. Further place of accident was not showing any impact of accident and damages to the vehicle were not fresh in nature. All other contents of complaint are also denied to be wrong and prayer for dismissal of complaint made.
4. The complainant in evidence has tendered his affidavit Ex. CW1/A and documents Ex.C1 to Ex.C8.
5. On the other hand, ops have tendered affidavit of S, M.L. Birpali, Sr. Divisional Manager as Ex.R1, affidavit of Sh. Nitish Chawla, Surveyor & Loss Assessor as Ex.R2, affidavit of Sh. V.K. Grover, Surveyor & Loss Assessor Ex.R3 and documents Ex.R4 to Ex.R16.
6. We have heard learned counsel for the parties and have gone through the case file.
7. Learned counsel for the complainant has contended that ops have wrongly and illegally withheld the genuine claim amount of estimated costs of Rs.2,96,367/- as assessed by their Surveyor and have caused unnecessary harassment, deficiency in service and financial loss to the complainant and prayed for acceptance of the complaint.
8. On the other hand, learned counsel for ops has contended that first of all the inspection report of the vehicle allegedly given by Sh. V.K. Grover, Surveyor on the basis of which complainant claims that insurance policy was transferred in his name itself is manipulated and forged one because said Surveyor himself has given his affidavit Ex.R3 to the effect that said inspection report is false and forged one and does not bears his signatures and he never inspected the vehicle no. HR-31Q-6739 before transfer of policy in the name of complainant. He has further contended that even as per report of Surveyor Sh. Nitish Chawla there were no sign of any accident at the spot and damages to the vehicle were not fresh one and complainant failed to give any reply to the queries raised vide letters dated 25.10.2021, 22.12.2021 and 17.01.2022 and even the intimation was given to the ops after delay on 13.08.2021 and as per terms and conditions of the policy, the claim of complainant has been rightly repudiated and complainant is not entitled to any claim and prayer for dismissal of the complainant made.
9. We have considered the rival contentions of the parties. It is not in dispute that earlier the vehicle in question bearing Registration No. HR31Q-7693 was in the name of previous owner Deepak Kumar and said vehicle was insured under the ownership of said Deepak Kumar for the sum insured amount of Rs.6,60,000/- for the period 02.04.2021 to 01.04.2022 as is evident from copy of policy schedule Ex.C7. Thereafter on 05.07.2021 the said insurance policy has been transferred in the name of complainant i.e. subsequent purchaser by the ops as is evident from endorsement schedule Ex.C8 and said endorsement/ period of policy in the name of complainant became effective from 05.07.2021 till 01.04.2022 as is evident from Ex.C8. The ops have failed to prove on record through any cogent and convincing evidence that above said inspection report Ex.C4 is forged and fabricated because ops have not placed on file any inquiry report by which it was revealed that said inspection report is forged one and once the insurance policy was transferred in the name of complainant by the company of the ops, therefore, now ops are estopped from taking the said pleas as taken in the written version since no authentic investigation report through any investigating agency has been placed on record. The ops were at liberty to inquire the matter about any connivance of the officials of the ops with the complainant regarding change of name of complainant in insurance policy on the basis of alleged forged inspection report but ops have failed to do so and have not placed on file anything to prove that any action against the erring officials has been taken by ops. So we are of the considered opinion that ops in order to deny genuine claim of complainant are taking such false grounds. The ops have also not proved through any cogent and convincing evidence that vehicle already met with accident prior to change of name of complainant in the insurance policy or that there were no fresh damages to the vehicle and as such the grounds taken by ops are also baseless. Since the ops have not paid the amount assessed by Surveyor therefore, vehicle could not be repaired and remained as it is in damaged condition. Since on the date of accident, the complainant was also having name in the insurance policy during the period of policy and accident also took place during the period of policy, therefore, the complainant is entitled to insurance claim amount of Rs.2,96,367/- as assessed by the Surveyor of the ops and as per estimate given by workshop since the insured value of the vehicle was assessed by ops as Rs.6,60,000/- at the time of insurance and as such repudiation of the claim of complainant is hereby set aside and non payment of claim amount by ops to the complainant clearly amounts to deficiency in service.
10. In view of our above discussion, we allow the present complaint and direct the opposite parties to pay the claim amount of Rs.2,96,367/- to the complainant alongwith interest at the rate of @6% per annum from the date of filing of present complaint i.e. 21.01.2022 till actual realization within a period of 45 days from the date of receipt of copy of this order. We also direct the ops to further pay a sum of Rs.10,000/- as compensation for harassment and Rs.5000/- as litigation expenses to the complainant within above said stipulated period. A copy of this order be supplied to the parties as per rules. File be consigned to the record room.
Announced. Member President
Dt. 26.03.2024. District Consumer Disputes
Redressal Commission, Sirsa.
