Punjab

Moga

CC/17/57

M/s H.S.Builders - Complainant(s)

Versus

United India Insurance Co. Ltd. - Opp.Party(s)

Sh. Vinay Kashyap

25 Oct 2017

ORDER

THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MOGA.

 

 

                                                                                      CC No. 57 of 2017

                                                                                      Instituted on: 06.06.2017

                                                                                      Decided on: 25.10.2017

 

M/s H.S. Builders, near Kokari Fula Singh Link Road, G.T. Road, Ajitwal, District Moga, through its Partner Harbans Singh r/o village Matwani Tehsil and District Moga.

                                                                                ……… Complainant

 

Versus

United India Insurance Co. Ltd. through its Divisional Manager, Divisional Office, Shaheed Bhagat Singh Market, G.T. Road, Moga District Moga.

 

                                                                           ……….. Opposite Party

 

 

Complaint U/s 12 of the Consumer Protection Act, 1986.

 

 

Quorum:    Sh. Ajit Aggarwal,  President

                   Smt. Bhupinder Kaur, Member

 

Present:       Sh. Vinay Kashyap, Advocate Cl. for complainant.

                   Sh. Vaneet Jaidka, Advocate Cl. for opposite party.

 

 

ORDER :

(Per Ajit Aggarwal,  President)

 

1.                Complainant has filed the instant complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as the "Act") against United India Insurance Co. Ltd. through its Divisional Manager, Divisional Office, Shaheed Bhagat Singh Market, G.T. Road, Moga District Moga (hereinafter referred to as the opposite party) directing them to make the payment of due amount of Rs.1,17,316/- regarding the repair of the vehicle with interest @ 12 % per annum from its due date till its realization. Further they may be directed to pay Rs.50,000/- as damages, Rs.50,000/- as loss of business and Rs.50,000/- on account of hiring the vehicle from the market and Rs.10,000/- other expenses to the complainant or any other relief which this Forum may deem fit may also be granted.

2.                Briefly stated the facts of the case are that the complainant is one of the partner of the firm M/s H.S. Builders and is conversant with the facts of the present dispute. So, the complaint is filed through Sh. Harbans Singh. It is alleged that a private car bearing no.PB-29P-0055 was insured with opposite party as per policy no.2012003116P100994711 from 24.04.2016 to 23.04.2017 and the same was further renewed by the opposite party. Unfortunately, the vehicle of the complainant met with an accident on 01.03.2017 and on receiving intimation opposite party appointed a surveyor, who submitted his report and allowed Rs.1,10,999/- as claim amount inspite of excess amount. As per terms and condition of the policy which was agreed by the then Divisional Manager, the opposite party is bound to make the payment directly to the agency. But they have not made payment to the agency inspite of the fact that the policy is cashless. The complainant informed the opposite party on 08.03.2017 that the vehicle is standing with M/s Lali Motors, Ludhiana for the repair and estimated value of the repair is Rs.1,17,000/- which has also been approved by the surveyor of the company. The vehicle was repaired, but the payment was not made by opposite party to the company. The said Lali Motor, Ludhiana informed the complainant that they have not received the payment and raised the demand of the rent of the vehicle as the same is standing in their premises after the completion of repair. This fact was duly informed to opposite party and legal notice on 07.04.2017 was also served upon the opposite party which was duly acknowledged by them and they sent a vague reply. The complainant again sent a legal notice to opposite party on 21.04.2017. But despite that payment was released by the opposite party. Ultimately the complainant was compelled to make the payment to Lali Motors on 21.04.2017 of Rs.1,17,316/- vide receipt no.452. Inspite of submission of all the documents and receipt, the opposite party failed make the payment, rather they sent another frivolous letter on 03.05.2017 with intention to delay the genuine payment of the complainant. The said letter was also replied through registered post on 16.05.2017, but payment was not released. Due to the acts of opposite party, the complainant has suffered mental tension, torture and harassment. Hence this complaint.

3.                Upon notice, opposite party appeared through counsel and filed written reply taking certain preliminary objections that the present complaint is not maintainable and is liable to be dismissed as the complainant has got no cause of action to file the same; that the present complaint is liable to be dismissed due to non-joinder of necessary parties. Allegations have been made against Baldev Singh the previous Divisional Manager of the opposite party regarding conferring of unsustainable status upon the complainant regarding the policy in question, which cannot be decided without his presence; that the present complaint is not maintainable as the same has been filed intentionally on false and frivolous facts. The true facts are that on lodging of the claim, the same was investigated and an amount of Rs.1,10,999/- was approved as claim amount. As the vehicle is the ownership of a partnership firm  and the claim was lodged by one of the partner, the opposite party in consonance with the Anti Money Laundering Guidelines issued by Govt. of India asked the complainant to submit the following requirements:-

a)         PAN Card of the individual Sh. Harbans Singh and of the firm M/s H.S. Builders.

b)        Partnership deed of the firm M/s H.S. Builders.

c)         Cancelled cheque with signatures and stamp of the person authorized to operate the bank account, duly attested by the concerned bank.

d)        Request letter on the firm's letter head.

e)         Cash memo qua the repairing charges.    

          The complainant instead of complying with the above mentioned requirements got issued a legal notice dated 07.04.2017 on false and frivolous facts including that the policy in question is a cashless policy. The opposite party duly replied the said legal notice vide reply dated 17.04.2017 bringing to the notice of the complainant that the term cashless policy is unknown to the terms and conditions of the policy and there is no liability of the insurance company to make any payment directly to the service centre undertaking the repairs of its vehicle and further it is required to submit the above mentioned documents. In response to the reply of opposite party, the complainant submitted partial requirements vide its further notice dated 21.04.2017. The cancelled cheque submitted by complainant was bearing signatures of one Sukhwinder Singh as authorized signatory but was not attested by the concerned banker. Further the name of said Sukhwinder Singh was also not printed on the submitted cheque. The PAN card of Sh. Harbans Singh was attested by proprietor of S.H. Saw Mills and not by the partner of complainant firm. No request letter and cash memo were submitted as per further notice dated 21.04.2017. As the opposite party was all out ready to make the payment of due amount but inconsonance with the A.M.L guidelines and also to dispel any complication, asked the complainant to submit the discharge receipt as full and final settlement of the claim amount on a stamp paper vide letter dated 03.05.2017, which the complainant failed to submit and has filed the present complaint on false and frivolous facts; that the present complaint is not maintainable as there is no deficiency in rendering the services to the complainant on behalf of opposite party. The claim of the complainant was approved by the opposite party for an amount of Rs.1,10,999/- from the very beginning without any dispute and the opposite party was all out ready to pay the same. But due to issuance of A.M.L guidelines by the Govt. of India and directions to comply the same with strict adherence, the opposite party was compelled to seek certain requirements as disclosed above, which the complainant either did not fulfil or were lacking. The claim of the complainant has been processed with due application of mind without any malafide or ill will on the part of the opposite party. As the complainant was stressing for performance of the acts which are not covered under the terms and conditions of the policy, the payment of claim amount could not be made. The opposite party is still ready, as always was, to release the payment of the claim amount of Rs.1,10,999/- to the complainant. On merits, it is admitted correct to the extent that as per the claim lodged an amount of Rs.1,10,999/- was approved by the opposite party. However, there is no clause in the terms and conditions of the insurance policy that opposite party will make the payment of the approved amount directly to the agency undertaking the repairs of the vehicle and thus the opposite party under no obligation to make the payment directly to the service centre. There is no work like cashless policy in the terms and conditions of the policy in dispute. The complainant was under a legal and moral obligation to make the payment to the service centre of the charged amount and get release his vehicle and thereafter to receive the approved amount from the opposite party after fulfilling the requirements. The legal notice dated 7.4.2017 was duly replied by opposite party through reply dated 17.04.2017, which has been received and acknowledged by complainant. The requirements as sought were never fulfilled. No fault can be found with opposite party in not getting released the vehicle by complainant from the repairing agency. No alleged loss has been sustained by the complainant due to any alleged act and conduct of the opposite party. Had the complainant been not satisfied by the services rendered by the opposite party in the previous years he might not had continued its endeavour with opposite party. The association of complainant with opposite party after the previous alleged mis-adventure itself shows the good services offered by opposite party to complainant and its complete satisfaction. The complainant is not entitled to claim any damages, compensation or interest from the opposite party for any of their alleged act. All other allegations made in the complaint have been denied and a prayer for dismissal of the complaint with special costs has been made.

4.                In order to prove the case, Sh.Harbans Singh s/o Gurdev Singh, Partner of complainant firm tendered in evidence his duly sworn affidavit as Ex. C1 and copies of documents Ex.C-2 to Ex.C-15 and closed the evidence. 

5.                On the other hand, opposite party tendered in evidence affidavit of Sh.R.N. Bansal, Divisional Manager, United India Insurance Co. Ltd. as Ex.OP-1 and copies of documents Ex.OP-2 to Ex.OP-4 and closed the evidence.

6.                We have heard ld. counsel for the parties and have very carefully gone through record placed on file.

7.                The case of the complainant is that they are the owner of car which was insured with opposite party from 24.04.2016 to 23.04.2017. During the insurance period, the vehicle of the complainant met with an accident on 01.03.2017 and they informed the opposite party regarding the said accident, who appointed a surveyor to assess the loss. The surveyor submitted his report and assessed the loss to the tune of Rs.1,10,999/-. The said policy was cashless policy and as per terms and conditions of the policy, the opposite party were bound to make payment directly to the repairer, despite that opposite party has not made any payment to repairer. The complainant contacted the opposite party that his vehicle is standing with M/s Lali Motors, Ludhiana for repair and estimated value of the repair is Rs.1,17,000/-, which is approved by surveyor of the company. Thereafter vehicle was repaired, but payment was not made to the service station. The said service station i.e. Lali Motors, Ludhiana informed the complainant that they have not received the payment from opposite party and raised demand of rent of vehicle as the same is standing in their premises after the completion of repair. The complainant informed the opposite party about it and also issued notice dated 07.04.2017, which was duly received by them. However, they sent vague reply to the said notice. The complainant again sent notice to opposite party on 21.04.2017, but despite that they did not release any payment. So, in compelling circumstances, the complainant has to make payment of Rs.1,17,316/- on 21.04.2017. In spite of submission of all the requisite documents and receipts, opposite party failed to make the payment to the service station, rather they sent another letter dated 03.05.2017, which was duly replied on 16.05.2017. Non releasing of payment by the opposite party despite getting all the required documents and receipts, amounts to deficiency in service on their part.

8.                On the other hand, counsel for opposite party argued that the present complaint is not maintainable and has been filed intentionally on false and frivolous grounds. The complainant has no cause of action to file the present complaint. True facts are that on lodging of the claim, the same was investigated and an amount of Rs.1,10,999/- was approved as claim amount. As the vehicle is the ownership of a partnership firm  and the claim was lodged by one of the partner, so as per guidelines of Government of India, the complainant was asked to submit certain documents i.e. PAN Card of the individual Sh.Harbans Singh and of the firm M/s H.S. Builders, Partnership deed of the firm M/s H.S. Builders, Cancelled cheque with signatures and stamp of the person authorized to operate the bank account, duly attested by the concerned bank, Request letter on the firm's letter head, Cash memo qua the repairing charges. The complainant instead of complying the above mentioned requirements got issued a legal notice dated 07.04.2017 on false and frivolous facts stating that the policy in question is a cashless policy. The opposite party duly replied the said legal notice vide their reply dated 17.04.2017 bringing to the notice of the complainant that policy in question is not a cashless policy as per terms and conditions of the policy and there is no liability of the company to make any payment directly to the service centre and further it is required to submit the above mentioned documents. In response to the reply of opposite party, the complainant submitted partial requirements vide its further notice dated 21.04.2017. The cancelled cheque submitted by complainant was bearing signatures of one Sukhwinder Singh as authorized signatory but was not attested by the concerned banker. Further the name of said Sukhwinder Singh was also not printed on the submitted cheque. The PAN card of Sh. Harbans Singh was attested by proprietor of S.H. Saw Mills and not by the partner of complainant firm. No request letter and cash memo were submitted alongwith notice dated 21.04.2017. As the opposite party were always ready to make the payment of due amount and asked the complainant to submit the discharge receipt as full and final settlement of the claim amount on a stamp paper vide letter dated 03.05.2017, which the complainant failed to submit and has filed the present complaint on false and frivolous grounds. There is no deficiency in services on the part of opposite party. The claim of the complainant was approved by opposite party for an amount of Rs.1,10,999/- without any dispute and they are ready to pay the same. Due to non completion and due to non submission of the documents, the claim was not paid. The claim of the complainant was processed with due application of mind without any malafide or ill will. As the complainant was stressing for performance of the acts which was not covered under the terms and conditions of the policy, the payment of claim amount could not be made. The opposite party is still ready and always ready to release the payment of the claim amount of Rs.1,10,999/- to the complainant. The present complaint deserves dismissal.

9.                Now, it is admitted case of the parties that the vehicle of the complainant was insured with opposite party, which met with an accident during the insurance period. On intimation, opposite party appointed a surveyor, who assessed the loss to the vehicle to the tune of Rs.1,10,999/-. The main grievance of the complainant is that the policy in question is cashless policy. As per terms and conditions of the policy, the opposite party have to pay the claim amount directly to the repairer, but opposite party denied that the policy in question is cashless. They argued that the policy in question was not a cashless as per terms and conditions of the policy. The complainant had to pay repair charges to the service station directly and after the payment, the approved amount would be paid to complainant. There is no agreement regarding the payment of claim amount directly to service station. The complainant failed to prove that the policy in question is cashless policy as alleged by them. Moreover, as the complainant has already paid the repair charges to the service station and now only reimbursement of repair charges as approved by surveyor is pending, as such the question of cashless policy is immaterial. The second grievance of the complainant is that the surveyor of the opposite party duly approved the claim amount of the complainant, even the complainant paid the repair charges to the service station directly and submitted all the required documents and receipts with opposite party, but they are still not paying the claim amount to them. On it, ld. Counsel for opposite party argued that for the payment of claim amount some documents were required by the opposite party, which were not submitted by the complainant and the notice dated 07.04.2017 issued by the complainant was duly replied on 17.04.2017. They further demanded these documents from the complainant i.e. PAN Card of the individual Sh. Harbans Singh and of the firm M/s H.S. Builders, Partnership deed of the firm M/s H.S. Builders, Cancelled cheque with signatures and stamp of the person authorized to operate the bank account, duly attested by the concerned bank, Request letter on the firm's letter head, Cash memo qua the repairing charges. In response to this notice, the complainant submitted partial requirements vide its further notice dated 21.04.2017. The cancelled cheque submitted by complainant was bearing signatures of one Sukhwinder Singh as authorized signatory but was not attested by the concerned banker. Further the name of said Sukhwinder Singh was also not printed on the submitted cheque. The PAN card of Sh. Harbans Singh was attested by proprietor of S.H. Saw Mills and not by the partner of complainant firm. Due to non submission of these documents, they had not made payment of the claim amount to complainant.  

10.              We have thoroughly gone through the file, evidence and arguments, lead by ld. Counsel for the parties. Now, the case remains only that as per the version of opposite party, complainant did not submit all the required documents as desired by them for the payment of claim amount. As per their version the cancelled cheque submitted by the complainant was bearing signatures of one Sukhwinder Singh as authorized signatory, but was not attested by the concerned banker and name of said Sukhwinder Singh was also not printed on the submitted cheque. They produced copy of this cheque as Ex.OP-3 this cheque bears the name i.e. For H.S. Builders and Authorized Signatory printed. The name of Sukhwinder Singh printed or not does not effect, as the cheque is duly issued from the cheque book of complainant’s firm. Further the allegation that the PAN card of Sh.Harbans Singh was not attested by partner of complainant firm, rather it was signed by one S.H. Saw Mills is also not a justify reason for not making payment of the claim amount, as the claim amount is to be paid to the complainant’s firm in their account and not to any individual partner. We are of the considered opinion that the opposite party are denying the payment of claim amount without any pulsible reason.

11.              In view of the above discussion, the present complaint is allowed and the opposite party is directed to make the payment of claim amount of Rs.1,10,999/- as approved by the surveyor alongwith interest @ 9% per annum from 06.06.2017 i.e. from filing of present complaint till realization. Compliance of the order be made within 30 days from the receipt of copy of this order, failing which, the complainant shall be entitled to initiate proceedings under section 25 & 27 of the Consumer Protection Act. Copy of the order be supplied to the parties, free of costs. File be consigned to record room.

Announced in Open Forum

Dated: 25.10.2017

                                                   (Bhupinder Kaur)                      (Ajit Aggarwal)                 

                                                        Member                                    President