Order dictated by:

Sh.Anoop Sharma, Presiding Member

1.       The complainant has brought the instant complaint under section 12 of the Consumer Protection Act, 1986 on the allegations that the complainant firm got insurance for his vehicle Maruti Ertiga bearing RC No.PB-02BX- 9054 from Opposite Party  covering the risk period from 10.9.2014 to 9.9.2015. Said vehicle was to be used by the complainant for for its  exclusive use of its directors. Said vehicle unfortunately met with an accident while coming from Amritsar Cantt and the Opposite Party  was immediately intimated and the vehicle was towed to the nearest Maruti service station Rishab Four Wheels and the Opposite Party  appointed its surveyor who surveyed the said vehicle and made preliminary estimate of the repair of the vehicle for more than Rs.6.3  lacs. It is pertinent to mention over here that the IDV of the said  vehicle is Rs.6.3 lacs and the surveyor assessed the loss as total loss of the vehicle. The complainant made several futile visits to the Opposite Party  to settle the genuine claim, but the Opposite Party  instead of settling the genuine claim of the complainant putting off the complainant on one pretext  or the other and finally issued the repudiation letter dated 30.6.2015 wherein the claim of the complainant was rejected on the frivolous ground that the driver was not holding the valid driving licence at the time of accident, which is against the true facts and the claim was rejected on flimsy ground without ascertaining the true facts, whereas the driver of the said vehicle was having the valid driving licence issued by the licencing authority.  The aforesaid acts of the Opposite Party  in not settling the genuine claim of the complainant is an act of deficiency in service, unfair trade practice, mal practices and is not sustainable in the eyes of law and has caused the agony and harassment to the complainant.          Vide instant complaint, the complainant has sought the following reliefs.

a)       Opposite Party  be directed to pay the claim of Rs.6.3 lacs alongwith interest @ 12% per annum from the date of repudiation  till realization.

b)      Opposite Party  be directed to pay the compensation of Rs.50,000/- to the complainant.

c)       Opposite Party  be directed to pay the adequate cost of the present litigation.  

Hence, this complaint.

2.       Upon notice, Opposite Party  appeared and contested the complaint by filing  written statement taking preliminary objections therein inter alia that the complainant having violated the basic terms and conditions of the insurance policy in question is not entitled to get the relief claimed for. The driver of the vehicle in question was not holding a valid and effective driving license at the time of alleged accident; that the complainant has not approached this Forum with clean hands and has  tried to conceal the material facts; that the complainant is estopped by its own act and conduct from filing the complaint. The driver of the vehicle in question was not holding a valid and effective driving license at the time of alleged accident, therefore, the Opposite Party  repudiated the claim merits vide repudiation letter dated 30.6.2015 which was addressed to the complainant clearly stating that the claim was not payable. It is further submitted that as the claim already stands repudiated, therefore, no consumer dispute survives. On merits, the Opposite Party  took almost same and similar pleas as taken by them in the preliminary objections.      Remaining facts mentioned in the complaint are also denied and a prayer for dismissal of the complaint with cost was made.

3.       In his bid  to prove the case, complainant tendered into evidence  affidavit Ex.C-1 in support of the allegations made in the complaint and also produced copies of documents Ex.C2   to Ex.C6  and closed his evidence.

4.       On the other hand, to rebut the evidence of the complainant, the Opposite Party tendered into evidence the affidavit of Sh.P.S.Mann, Deputy Manager Ex.OP1 alongwith copies of documents Ex.OP2 to Ex.OP5 and closed the evidence on behalf of the Opposite Party.

5.       We have heard the ld.counsel for the parties and have carefully gone through the evidence on record.

6.       The complainant has submitted his affidavit Ex.C1 in which he has reiterated the facts as detailed in the complaint and it is submitted that the complainant firm got insurance for his vehicle Maruti Ertiga bearing RC No.PB-02BX- 9054 from Opposite Party  covering the risk period from 10.9.2014 to 9.9.2015. Said vehicle was to be used by the complainant for for its  exclusive use of its directors. Said vehicle unfortunately met with an accident while coming from Amritsar Cantt and the Opposite Party  was immediately intimated and the vehicle was towed to the nearest Maruti service station Rishab Four Wheels and the Opposite Party  appointed its surveyor who surveyed the said vehicle and made preliminary estimate of the repair of the vehicle for more than Rs.6.3  lacs. It is pertinent to mention over here that the IDV of the said  vehicle is Rs.6.3 lacs and the surveyor assessed the loss as total loss of the vehicle. The complainant made several futile visits to the Opposite Party  to settle the genuine claim, but the Opposite Party  instead of settling the genuine claim of the complainant putting off the complainant on one pretext  or the other and finally issued the repudiation letter dated 30.6.2015 wherein the claim of the complainant was rejected on the frivolous ground that the driver was not holding the valid driving licence at the time of accident, which is against the true facts and the claim was rejected on flimsy ground without ascertaining the true facts, whereas the driver of the said vehicle was having the valid driving licence issued by the licencing authority.  The aforesaid acts of the Opposite Party  in not settling the genuine claim of the complainant is an act of deficiency in service, unfair trade practice, mal practices and is not sustainable in the eyes of law.

7.       On the other hand, ld.counsel for the Opposite Party  has repelled the aforesaid contention of the ld.counsel for the complainant on the ground that the complainant having violated the basic terms and conditions of the insurance policy in question is not entitled to get the relief claimed for. The driver of the vehicle in question was not holding a valid and effective driving license at the time of alleged accident; that the complainant has not approached this Forum with clean hands and has  tried to conceal the material facts; that the complainant is estopped by its own act and conduct from filing the complaint. The driver of the vehicle in question was not holding a valid and effective driving license at the time of alleged accident, therefore, the Opposite Party  repudiated the claim merits vide repudiation letter dated 30.6.2015.

8.       It is the case of the complainant that he got insurance for his vehicle Maruti Ertiga bearing RC No.PB-02BX- 9054 from Opposite Party  covering the risk period from 10.9.2014 to 9.9.2015, copy of the insurance cover note Ex.C3 and copy of registration certificate accounts for Ex.C5 on the file. The only contention for the repudiation of the claim of the complainant is that the driver of the vehicle was not having valid and effective driving licence. It is not disputed that the  type of the vehicle is LMV/ Car which is duly depicted on the Certificate of Registration Ex.OP4 produced by the Opposite Party  itself. The driving licence of the driver of the vehicle namely Harwinder Pal Singh, copy of which is Ex.C6 (Ex.OP3) clearly shows that the said driving licence was for M/Cycle with Gear, M/Car  and on the other hand, Opposite Party  has failed to explain why the said driver was not having valid driving licence because on the driving licence Ex.C6, it is clearly mentioned that the driver was competent to drive the vehicle Car i.e. the disputed and insured  vehicle. Hence, we are of the view that the repudiation of the claim of the complainant is not justified by the Opposite Party. In such a situation the repudiation made by Opposite Party regarding genuine claim of the complainant appears to have been made without application of mind. It is usual with the insurance company to show all types of green pesters to the customer at the time of selling insurance policies, and when it comes to payment of the insurance claim, they invent all sort of excuses to deny the claim. In the facts of this case, ratio of the decision of Hon’ble Apex Court in case of Dharmendra Goel Vs. Oriental Insurance Co. Ltd., III (2008) CPJ 63 (SC) is fully attracted, wherein it was held that, Insurance Company being in a dominant position, often acts in an unreasonable manner and after having accepted the value of a particular insured goods, disowns that very figure on one pretext or the other, when they are called upon to pay compensation.  This ‘take it or leave it’, attitude is clearly unwarranted not only as being bad in law, but ethically indefensible.  It is generally seen that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. In similar set of facts the Hon’ble Punjab & Haryana High Court in case titled as New India Assurance Company Limited Vs. Smt.Usha Yadav & Others 2008(3) RCR (Civil) Page 111 went on to hold as under:-

“It seams that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. All conditions which generally are hidden, need to be simplified so that these are easily understood by a person at the time of buying any policy.        The Insurance Companies in such cases rely upon clauses of the agreement, which a person is generally made to sign on dotted lines at the time of obtaining policy. Insurance Company also directed to pay costs of Rs.5000/- for luxury litigation, being rich.

9.       From the aforesaid discussion, it transpires that Opposite Party has wrongly repudiated the genuine claim of the complainant. Opposite Party is directed to make the payment of IDV value of the vehicle in dispute i.e. Rs.6,30,000/-.  Costs of the litigation are assessed at Rs.2,000/-. Compliance of this order be made within 30 days from the receipt of copy of the order; failing which, awarded amount shall carry interest @ 9% p.a from the date of filing of the complaint until full and final recovery. Copies of the order be furnished to the parties free of costs. File is ordered to be consigned to the record room. Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Forum.

Announced in Open Forum

Dated:19.04.2017.