The present complaint has been filed by the aggrieved complainant against the titled insurer upon receipt of repudiation (Ex.C3/ Ex.OP6) dated 25.09.2019 to his ‘vehicle-claim’ pertaining to his total-loss accidented but fully insured ‘Tempo-Traveler’ 12+1 Seater Passenger Transport Vehicle. The related letter further enunciated that the complainant’s Vehicle was carrying (14+1)=15 persons at the time of accident against its authorized sanctioned capacity of (12+1)=13 persons in terms of its R.C. (Registration Certificate) and has thus lost its eligibility to any insurance claim under the policy as having violated one of its applicable terms. The complainant had insisted that he was carrying only 13 persons in the vehicle at the time of the accident but the police had entered the names of 15 persons (including the two who died in the accident) in the FIR having noted these down from the list of injured persons undergoing treatment at the nearby civil hospital. However, the OP insurer refused to review its repudiation hence prompted the present complaint seeking the OP surveyed loss of Rs.5.50 Lac (net of salvage) as the Vehicle's Total-Loss Claim besides Rs.50,000/- as compensation for harassment, Rs.50,000/- for deficiency in service on the insurer's end and another Rs.50,000/- as cost of litigation, all in the interest of justice.

2.         The complainant in support of prosecution of his complaint has produced the certified copies of the following documents in evidence:

          i)  Ex.C1 Policy Endorsement Schedule of the policy in force;

          ii) Ex.C2 FIR # 0037 dated. 20.06.2019 incorporating names of 14+1=15 persons as being there in the vehicle at the time of the accident.

          iii) Ex.C3 Repudiation dated. 25.09.2019;

          iv)  Ex C4 Challan dated. 10.12.2019 U/s 173 CRPC put up  before the JMIC HSPR by the P.S. Hajipur (Punjab) having          incorporated names of 12+1=13 persons as being present in    the vehicle at the time of the accident.

3.         Upon summoning/notice the OP insurer appeared through counsel and filed its written reply putting forth therein its preliminary formal objections as i) complaint false and frivolous, ii) non-traversal be read as denial, iii) legally not maintainable, iv) no cause of action, v) no locus-standi, vi) terms and conditions of policy are binding, vii) misrepresentation as to the nos. of persons in the vehicle at the time of accident and viii) not come with clean hands so not entitled to any relief.  Further, on merits the OP have denied almost all the contents/allegations as set out in the complaint. However, the OP insurer has admitted having deputed his Surveyor & Loss Assessor Ch. Er.Sukhwinder Singh who has assessed the accident-loss (net of salvage) @ Rs.549,500/- vide his interim report dated. 27.07.2019. Further, M/s S A Investigating & Consulting Agency vide its investigation Report dated. 02.09.2019  did point out a clear cut violation of the Motor Vehicle Act as the accidented vehicle at the time of accident was carrying 14+1 persons against its sanctioned capacity of 12+1=13 persons as mentioned out in the related FIR # 0037 (20.09.2019). Lastly, the OP addressing its repudiation as in order has prayed for dismissal of the present complaint with special costs. In support of its prosecution of its defense, the OP insurer has placed on records the documents in evidence as:

          i) Ex.OP1 Interim Report dated 17.07.2019 of the Ch. Er.

          Sukhvinder Singh Surveyor and Loss Assessor assessing the gross accident-loss @ Rs.750,000/-

          ii) Ex.OP2 Final Report dated 27.07.2019 of the Ch. Er. Sukhvinder Singh Surveyor and Loss Assessor assessing the accident-loss net of salvage @ Rs.549,500/-

          iii) Ex.OP3 Investigation Report dated 02.09.2019 recommending rejection of claim on account of violation of provisions of the Motor Vehicle Act.

          iv)     Ex.OP4 Form 24 (Motor Vehicle Register) PB01A9565 dated. 07.03.2019 as duly in the N/o Vishal Kumar Complainant.

          v)      Ex.OP5 FIR 0037 dated 20.06.2019.

          vi)     Ex.OP6 Repudiation dated 25.09.2019.

          vii)    Ex.OP7 Duplicate Policy of the Vehicle.

4.         We have duly heard the learned counsels for both the sides, on points of law, and have also thoroughly examined the records with requisite care and caution on the points of fact, as placed before us. We are also inclined to examine the inference it’s ‘scope n spread’ on account of some documents ignored to be produced/not-produced during the course of proceedings. We observe that the OP insurer disallowed the impugned Insurance-Claim vide its repudiation letter (Ex.C3/ Ex.OP6) dated 25.09.2019 for of the one and only reason (as addressed therein) that there has been violation of the statutory provisions of the Motor Vehicle Act as two extra person i.e., 15 nos. of persons were found traveling in the vehicle (at the time of the accident) against the sanctioned capacity of 13 persons as recorded qua the related columns of the FIR. We observe that the OP insurer has not attempted to confirm the veracity of the nos. of the persons abroad the vehicle at the time of accident. It need be known that the contents of the FIR are recorded by the police in fidelity merely on the basis of information received from the informer/complainant U/s 154 of the CRPC sans verification as to its exactitude; and, then an investigating officer is deputed to thoroughly investigate the subject matter of the FIR in minute detail and then a Challan Report of the reported crime/ incident U/s 173 CRPC is prepared for putting up before the Ilaqa Magistrate for furtherance. The Challan depicts a true, investigated and authenticate information. Here, the related Challan Ex.C4 reports the nos. of persons on board the vehicle at the time of accident at 11+1+1 = 13 nos. i.e, within the sanctioned capacity of the accidented vehicle.            

5.        We are of the considered opinion at the face of the evidenced-facts as available on the records that there’s have been no misrepresentation and/or misstatements of facts and as such the impugned ‘repudiation’ of the insurance-claim, in question, by the OP Insurer had been unwarranted, arbitrary and unfair; neither in accordance with the provisions of the statutory law nor in conformity with the sanctity of natural justice, equity and good conscience. Further, it has violated with impunity the preferred consumer rights of the insured complainant causing him much physical harassment, mental agony and financial loss. Lastly, we hold the insurer guilty of statutory misconduct amounting to ‘unfair trade practices/ deficiency in service’ and thus liable to an adverse award under the provisions of the statute.

6.           We further observe that the OP had deputed its Surveyor & Loss Assessor who has assessed the accident loss (net of salvage) @ Rs.549,500/- and the same has implicitly been acceptable to the complainant having not contested the same.

7.         In the light of the all above, we partly allow this complainant and thus order the opposite party insurers to pay the total loss accident claim (net of salvage basis) @ Rs.549,500/- to the complainant with interest @ 7% PA from the date of filing of this complaint (till paid in full) besides Rs.20,000/- in lump sum as cost cum compensation within 45 days of receipt of the  certified copy of these orders.

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:                                   (R.S.Sukhija)

MAY 18, 2022.                                           Member.

YP.