Order dictated by:

Ms. Rachna Arora Member

1.       Tarsempreet Singh complainant has brought the instant complaint under section 12 & 13  of the Consumer Protection Act, 1986 on the allegations that complainant got insured his vehicle Mahindra XUV 500 bearing registration No. PB 10 DX 4081 from the opposite party  covering the risk period from 23.11.2016 to 22.11.2017. Unfortunately the vehicle met with an accident  and the said vehicle was taken to the authorized service centre of Mahindra Vehicles i.e. Universal Motors, Amritsar. Opposite party was immediately intimated, who deputed surveyor to assess the loss to the vehicle. But the opposite party repudiated the genuine claim of the complainant  vide letter dated 21.12.2016 on the ground that the complainant has wrongly claimed NCB whereas he was not entitled to. The  total repair bill raised by the service centre comes to Rs. 55520/-. The act of the opposite party in repudiating the genuine claim of the complainant amounts to deficiency in service. The complainant has sought for the following reliefs:-

(a)     Opposite party be directed to pay the amount of Rs. 55520/- alongwith interest @ 12% p.a. from 21.12.2016 till realization ;

(b)     Compensation to the tune of Rs. 25000/- alongwith adequate litigation expenses may also be awarded to the complainant.

Hence, this complaint.

2.       Upon notice, opposite party appeared and filed written version taking certain preliminary objections therein inter alia that  the present complaint is not maintainable as the complainant has concealed the true facts from this Forum ; that complainant is estopped by his own act and conduct from filing the present complaint ; that no cause of action has ever arisen in favour of the complainant and against the opposite party ; that after accident complainant filed his claim with the replying opposite party and the fact of availing benefit of No claim bonus has come into the notice of the replying opposite party . Whereas National Insurance company has confirmed in writing that one claim was paid in their policy period and the complainant is not entitled for No claim bonus for next year . In this regard complainant was intimated to deposit Rs. 3706/-  with the replying opposite party  which were taken as No claim bonus by misleading and concealment of material facts . It was also made clear to the complainant that if complainant deposits NCB amount of  Rs. 3706/- after the accident, the complainant is not entitled for present claim. In future, if any claim arise, then replying opposite party can pay that amount.  The complainant has deposited the said NCB amount of Rs. 3706/- on 26.12.2016. As such complainant is not entitled for any claim. On merits facts narrated in the complaint have specifically been denied and a prayer for dismissal of complaint was made.

3.       In his bid to prove the case Sh. Deepinder Singh,Adv. Counsel for the complainant tendered into evidence duly sworn affidavit of the complainant Ex.C-1, copy of Insurance cover note Ex.C-2, copy of repudiation letter Ex.C-3, copies of payment receipts Ex.C-4 & Ex.C-5 and closed the evidence on behalf of the complainant.

4.       To rebut the aforesaid evidence Sh. Raman Kumar,Adv.counsel for the opposite party tendered into evidence affidavit of Sh.Harvinder Prinja,Sr. Divisional Manager Ex.OP1, copy of Insurance policy  Ex.OP2, copy of cover note Ex.OP3, copy of claim intimation letter Ex.OP4, copy of motor claim note Ex.OP5, copy of cover note of National Insurance Co. Ex.OP6, copy of No claim bonus certificate Ex.OP7, copy of endorsement Ex.OP8 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 record on the file.

6.       Ld.counsel for the complainant has reiterated the facts as detailed in the complaint and contended that complainant got insured his vehicle Mahindra XUV 500 bearing registration No. PB 10 DX 4081 from the opposite party  covering the risk period from 23.11.2016 to 22.11.2017. It was the case of the complainant that unfortunately the vehicle met with an accident  and the said vehicle was taken to the authorized service centre of Mahindra Vehicles i.e. Universal Motors, Amritsar and the  total repair bill raised by the service centre comes to Rs. 55520/-. The Opposite party was immediately intimated, who deputed surveyor to assess the loss to the vehicle. But however, the opposite party repudiated the genuine claim of the complainant  vide letter dated 21.12.2016 on the ground that the complainant has wrongly claimed NCB whereas he was not entitled to. Ld.counsel for the complainant contended that all this amounts to deficiency in service.

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 after accident complainant filed his claim with the replying opposite party and the fact of availing benefit of No claim bonus has come into the notice of the replying opposite party . Whereas National Insurance company has confirmed in writing that one claim was paid in their policy period and the complainant is not entitled for No claim bonus for next year . In this regard complainant was intimated to deposit Rs. 3706/-  with the replying opposite party  which were taken as No claim bonus by misleading and concealment of material facts . It was also made clear to the complainant that if complainant deposits NCB amount of  Rs. 3706/- after the accident, the complainant is not entitled for present claim. In future, if any claim arise, then replying opposite party can pay that amount.  The complainant has deposited the said NCB amount of Rs. 3706/- on 26.12.2016 as per As such complainant is not entitled for any claim.

8.       From the appreciation of the facts and circumstances of the case, it becomes evident that the plea of the opposite party is that the complainant has taken the benefit of ‘No Claim Bonus’ by stating that he has not taken any claim form from National Insurance Company, whereas National Insurance Co. has confirmed in writing that one claim was paid in their policy period and he is not entitled for No Claim Bonus for next year . But the opposite party has failed to prove this fact by submitting any documents that the complainant has taken any claim from National Insurance Company. The only document produced by the opposite party is Ex.OP7 which is ‘No Claim Bonus Certificate’. But this document is not legible in its entirety. From the document Ex.OP7 it seems that National Insurance Company has given the certificate regarding No Claim Bonus to the complainant which means that complainant has not availed any claim from that Company.  The other plea of the opposite party that when the fact of having taken claim from National Insurance Company by the complainant, came to the knowledge of the opposite party  , opposite party  intimated the complainant to deposit Rs. 3706/- with the replying opposite party which were taken by the complainant as “No Claim Bonus” and the complainant was also intimated that if the complainant deposits NCB of Rs. 3706/- after the accident , the complainant is not entitled for the present claim.  It was also contended by the opposite party that the complainant has deposited the said NCB amount of Rs. 3706/- on 26.12.2016. But the opposite party has again failed to produce on record any such letter written to the complainant demanding NCB of Rs. 3706/- which the complainant has deposited as alleged by the opposite party. If such plea of the opposite party demanding NCB of Rs. 3706/- after issuance of cover note is taken to be true, even then it was the duty of the opposite party to verify all the facts before issuing the cover note/policy to the insured . It is seen that insurance companies show green pastures to the insured persons at the time of selling  the insurance policy 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.       Regarding quantum of claim amount to the tune of Rs. 55520/- which the complainant has claimed , the complainant has placed on record copy of receipt Ex.C-5 which shows that the complainant has paid a sum of Rs. 49,273/- to Universal Motors from where the complainant has got repaired his vehicle . However, the opposite party has not produced on record any survey report  to assess the claim as demanded by the complainant. So the complainant is entitled to the amount of Rs. 49,273/-.

10.     From the aforesaid discussion, it emerges that the complainant has been able  to prove his case and the complainant is entitled for reimbursement of repair charges to the tune of Rs. 49,273/- .  The amount is ordered to be paid with interest @ 9% p.a. from the date of filing of the complaint until full and final recovery. Cost of litigation are assessed at Rs. 2000/-. Compliance of this order be made within a period of 30 days from the date of receipt of copy of order ; failing which, complainant shall be at liberty to get the order executed through the indulgence of this Forum. Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Forum. Copies of the order be furnished to the parties free of costs. File is ordered to be consigned to the record room.

Announced in Open Forum

Dated : 27.7.2017