The titled complainant Dr.Ananna Babbar has filed the present complaint against the titled opposite parties aggrieved at the impugned Partial Settlement/Partial Repudiation of her Car Accident-claim on 31.01.2022 on an alleged arbitrarily assumed ground of the pre-existing damages to the insured Car not eligible for cover under the related policy. The complainant had owned the Car Make Ford Model Endeavor RC # PB-06-AH-4500 and had got it comprehensively insured on 27.07.2020 from the OP1 insurers vide Cover Note # 1118013120 P104269662 @ premium of Rs.55,150/- for IDV Rs.20 Lac valid till 26.07.2021. Somehow, on 20.06.2021 the Car got badly damaged in a road-side accident of which the OP1 were duly intimated who appointed their Surveyor who assessed the loss/damage to the Car and advised the complainant to get the damaged Car repaired from the OP2 W/shop who had to be paid Repairs Bill @ Rs.2,78,860/- on 30.12.2021 to take back delivery of the repaired Car. Thereafter, the accident Repair-claim was duly submitted with the OP1 insurers along with all the requisitioned papers etc but to the complainant’s surprise his claim was settled for a partial amount of Rs.69,160/- only credited to his bank a/c on 31.01.2022. The OP1 insurers were served upon with the Legal Notice on 17.02.2022 who however preferred to ignore it unceremoniously; and, hence prompted the present complaint praying for settlement of the balance claim amount of Rs.2,09,700/-, in full, with interest @ 18% PA from the date of accident till realization besides Rs.1,00,000/- as compensation and a sum of Rs.10,000/- as cost of litigation, in the interest of justice etc. The complainant has filed his duly sworn out Affidavit (Ex.CW1/A) to successfully prosecute his complaint along with the listed documents as: Ex.C1– Copy of the RC of the accident-ed Car; Ex.C2– Copy of the Insurance-Policy; Ex.C3–Copy Driving License Complainant; Ex.C4– Copy of Bank Statement; Ex.C5–Copy of the Bills M/s A B Motors Pvt. Ltd., ASR; Ex.C6–Copy of the Legal Notice; Ex.C7 to Ex.C9– Copies of the Postal Receipts; Ex.C10– Copy Affidavit of the complainant dated 29.12.2021; Ex.C11 – Copy of the Aadhar ID of the complainant; Rejoinder to Written Reply of OP No.1.
2. The OP1 insurers upon summoning appeared through their counsel and filed their written statement raising preliminary as well as other (on merits) objections, and also the fresh pleadings as:
3. That the complainant has neither cause of action nor locus-standee to file the present complaint as there's no deficiency in service on their part as they got the related intimation of the alleged car accident and appointed Surveyor & Loss Assessor who submitted his report on 07.01.2022 that however was crosschecked by the insurers and the eligible claim amount of Rs.69,160/- was duly paid after deductions etc. Lastly, the OP1 insurers have filed their Affidavit (Ex.OPW1/A) along with the Ex.OP1/1- Copy of the Surveyor’s Assessment of Loss sans affidavit of the Surveyor and written arguments etc.
4. Opposite party No.2 was ordered to be proceeded against exparte vide order dated 16.06.2022.
5. We have carefully examined all the documents/evidence produced on record and have also judiciously considered and perused the arguments duly put forth by the learned counsels along with the incidental scope of adverse inference for some documents that have been somehow ignored to be produced by the contesting litigants. We further observe that the prime dispute had prompted at the OP1 insurers’ partial settlement of the claim alleging most of the damages having resulted from wear and tear sans the requisite categorization and specifying of these damages. The OP insurers have failed to enlist the repairs made to the car parts that were damaged on account of usual wear and tear. The Surveyor has not mentioned any wear and tear damages in his assessment of loss report. The wear n tear loss term has been added in the written reply (and in the affidavit) with ink (by hand) and as an after-thought and does not convey any sense in the running context. Moreover, the Report (Surveyor) has not been duly accompanied by the mandatory affidavit, as requisite.
6. We further observe that all the OP1's counter pleadings even taken together do not justify/nullify the irrational, intentional and uncalled-for retribution displayed throughout the proceedings continuing there-in-after, in succession. On the other hand, these reflect deficiency in service on the part of the OP1 insurers. We also observe that the opposite parties have pleaded or even have attempted to produce some cogent evidence/senior court rulings barring trial of issues branching-out, simultaneously or in succession, from the same stem-root of 'delinquency, deficiency in service and an open/proved employ of unfair trade practices etc. And, we also find the opposite party insurers to have caused stark violation as a consequence to their planned acts and omissions and that have placed them on the adverse side of law making them liable to suffer an adverse award.
7. Thus, we partly allow the present complaint and thus ORDER the OP insurers to pay the impugned balance claim-amount of Rs.2,09,700/-, in full, favoring the complainant with interest @ 6% PA from the date of the complaint till realization, in full, besides Rs.15,000/- in lump sum be paid to the complainant as cost and compensation within 45 days of receipt of certified copy of these orders otherwise the awarded amount shall attract additional interest @ 3% PA w.e.f. the date of orders till actually paid.
8. The complaint could not be decided within the stipulated period due to heavy pendency of Court Cases, vacancies in the office and due to pandemic of Covid-19.
9. Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to record.
(Naveen Puri)
President.
ANNOUNCED: (B.S.Matharu)
NOV. 23, 2022. Member.
YP.
