Punjab

Ludhiana

CC/20/87

Pardeep Kumar - Complainant(s)

Versus

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

Gaurav Gupta Adv.

21 Mar 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                Complaint No:87 dated 09.03.2020.                                                Date of decision: 21.03.2023.

 

Pardeep Kumar aged 60 years son of Sh. Jugal Kishore, R/o. House No.230, Sherpur Khurd, Adjoining Suvidha Woolen Mill, Ludhiana, Punjab.              

..…Complainant

                                                Versus

1. United India Insurance Co. Limited, having its Regional Office at Surya Tower, Mall Road, District Ludhiana, Punjab-141001 through its Regional Manager.
2. United India Insurance Co. Limited, through its Branch Office at Ahmedgarh, Bombay Cloth House, Floor No.1, Dhurkot Chowk, Ahmedgarh-148021, District Sangrur, Punjab through its Branch Manager.                                      

.….Opposite parties.

Complaint Under Section 12 of the Consumer Protection Act.

QUORUM:

SH. SANJEEV BATRA, PRESIDENT

SH. JASWINDER SINGH, MEMBER

MS. MONIKA BHAGAT, MEMBER

 

COUNSEL FOR THE PARTIES:

For complainant            :         Sh. Gaurav Gupta, Advocate. 

For OPs                         :         Sh. G.S. Kalyan, Advocate.

 

ORDER

PER SANJEEV BATRA, PRESIDENT

1.                In brief, the facts of the case are that the complainant purchased one vehicle make Toyota Innova 2.5G having registration No.PB-10DT-4247 from Radiant Toyota, G.T. Road, Juggiana vide invoice dated 30.06.2012. The complainant purchased insurance for the said vehicle bearing policy No.200602/31/16P/104410149 for the period from 04.07.2016 to 03.07.2017 from the opposite parties having coverage of loss suffered by the complainant on account of theft of the vehicle. The complainant further submitted that the said Innova car was taken by his nephew Aman Singla son of Sh. Jiwan Singla for business trip to New Delhi on 17.04.2017. The said car was parked outside his cousin’s house at B-3/74, Paschin Vihar, New Delhi and when he returned on 23.04.2017, he found that the aforesaid car was missing. Intimation of theft of the car was given by Aman Singla to P.S. Paschin Vihar, New Delhi on 23.04.2017 who registered an FIR No.012050 dated 23.04.2017.  The complainant imediately lodged claim with the opposite parties who appointed Sh. Balbir Singh Behl as investigator to investigate the claim of the complainant. The said investigator investigated the claim and assessed the loss payable as Rs.6,98,000/-. The complainant further submitted that though he has submitted all the documents but the investigator stated that documents have not been submitted. The complainant written letter with regard to submission of all the documents as per requirement of the opposite parties. However, the claim was not settled and in August 2018, the complainant received one letter dated 24.08.2018 from the opposite parties stating that the claim has been repudiated on the grounds mentioned in the letter. The opposite parties have wrongly repudiated the claim on flimsy grounds and it has been wrongly stated that the insured vehicle was left unattended for a period of 6 days on road side which is a breach of clause No.4 of the policy. The grounds of repudiation letter dated 24.08.2018 are reproduced as under:-

“1)     Insured vehicle was left unattended for a period of 6 days on road side which is breach of Clause of policy.

2)      Key of vehicle has not been submitted by the insured as he has misplaced the second key few years back. He did not take step to recover the same nor reported to police which is gross negligence and violation of condition no.4.

3)      Date of theft informed to RTO Ludhiana is 19.8.17 whereas date of intimation informed to insurance company is between 17.04.17 to 23.04.17.

4)      As per written statement of Mr. Aman Singla, he alongwith his business partner went to Ahmedabad via Jaipur and returned to Delhi on 23.04.17 around 10 A.M. As per FIR, Driver went to Ahmedabad and Nagpur then returned to New Delhi on 23.04.2017. Whereas Air ticket of Aman Singla (Driver) from New Delhi to Nagpur is on 21.04.17 and return is on 23.04.17. But in statement of Mr. Aman Singla and  FIR, date of leaving New Delhi is 17.04.2017 and nothing is mentioned about 21.04.17 1eads to misrepresentation.

5)      As per written statement of insured Mr. Pardeep, Driver Aman Singla is running a business of Iron trading of high altitude Medical plant, is also contradictory statements leads to misrepresentation.

6)      As per insured's explanation placed in the clam file, Mr. Aman along with friend left for Ahmedabad by road from Delhi on 17.04.17 and reached Ahmedabad on 18.04.17 then both returned from Ahmedabad by road via Jaipur on 19.04.17 and reached Delhi on 20.04.17 in late night. In morning of 21.04.17 at 9:00AM Aman along with friend took the flight to Nagpur and returned on 23.04.17 to Delhi."

The complainant further submitted that all the grounds taken by the opposite parties are false. Firstly, the detailed policy was not supplied and it was only the cover note which was supplied. The detailed policy was given by the office on 12.05.2018. Ever Regional Office on otherwise, there is no violation of any terms o 21 the policy. The respondents have misinterpreted the terms as per their own convenience in order to repudiate the claim of the complainant. The relevant clause No.4 is reproduced as under:-

“4.    The insured shall take all reasonable steps to safeguard the vehicle from loss or damage and to maintain it in efficient condition and the company shall have at all times free and full access to examine the vehicle or any part thereof or any driver or employee of the insured. In the event of any accident or breakdown, the vehicle shall not be left unattended without proper precautions being taken to prevent further damage or loss and if the vehicle be driven before the necessary repairs are effected any extension of the damage or any further damage to the vehicle shall be entirely at the insured’s own risk.”

The complainant further submitted that fact that the vehicle was parked outside the house is not a ground to deny the claim of the complainant or that the reasonable steps were not taken by the complainant. Parking of the vehicle outside the house cannot be said that the vehicle was left unattended for a period of 6 days on road side. Even the story of second key is also not tenable and is not a ground to deny the claim of the complainant. However, the FIR was got lodged and untraceable certificate was issued by the concerned police officials on 26.09.2017. The complainant further submitted that the date of theft intimated to RTO was a typographical mistake and it cannot be a ground to repudiate his claim. Moreover, the opposite parties have misinterpreted the FIR.  Mr. Aman along with his friend left for Ahmadabad by road from Delhi on 17.04.2017 and returned from there via Jaipur to Delhi on 20.04.2017 at late night and thereafter, immediately left for Nagpur on 21.04.2017 and returned to Delhi on 23.04.2017 where he saw the vehicle was missing and the matter was reported to P.S. Paschim Vihar and as such, there is no ambiguity in the statements and there is no misrepresentation. After repudiation of the claim, the complainant filed application before the office of Insurance Ombudsman who also wrongly rejected the claim of the complainant on the ground that there are lots of discrepancies in the date of loss and in the statement of insured Pardeep Kumar and Aman Singla and that the vehicle was kept unattended on roadside for six days which is breach of policy clause No.6. Due to repudiation of his claim, the complainant has suffered immense mental harassment and agony which amounts to deficiency in service and unfair trade practice on the part of the opposite party for which they are liable to pay Rs.2,00,000/- as compensation besides the claim of Rs.6,98,000/- along with interest @18% per annum.  In the end, the complainant has prayed for directing the opposite parties to pay the claim amount of Rs.6,98,000/- with interest @18% per annum along with compensation of Rs.2,00,000/- and litigation expenses of Rs.55,000/-.

2.                Upon notice, the opposite parties appeared and filed joint written statement in which they assailed the complaint on the ground of maintainability; concealment of material facts; lack of jurisdiction etc. The opposite parties alleged that on receipt of claim intimation, they immediately deputed Mr. B.S. Behl Investigator, D-37, Old Gupta Colony, Delhi-110009 to survey and assess the loss. The said investigator sent by hand letter i.e. reminder-1 dated 08.05.2017, a speed post letter i.e. Reminder-02 dated 27.06.2017 and a speed post letter i.e. Final Reminder dated 28.07.2017 and required some documents for further proceeding, the operative part of which is reproduced as under:

 Please refer to my earlier by hand letter dated 08.05.2017. In reference to the above the undersigned has been deputed by the Insurance Company on 01.05.2017 to investigate the subject vehicle, in which the undersigned required the certain necessary details/documents Information in support of your theft claim So, you are requested to produce the following documents in original within 7 days from the receipt of this letter in support of your claim. In case you are not submitting the pending documents to the undersigned within 7 days from the receipt of this letter, You are advised to submit the pending documents in the Motor Claim Hub Directly to pursue your claim.

1. Original RC for verification along with photocopy of the same.

2. Original DL, for Verification along with photocopy of the same.

3. Original purchase invoice for verification.

4. RC particulars (from the concern RTO)

5. Copy of letter to R.T.O. for Freezing of Documents.

6. Documents pertains to vehicle such as service details, Finance Details, Maintenance Details, Petrol Receipts/Parking Receipts/Toll Receipts/Challan.

 7. Documents pertains to your Residence/Profession such as Ration Card, Voter Card, Pan Card, Electricity/Water/Power/Telephone Bills/Salary Slips.

8. Original keys of vehicle for verification

9. Final Report from Court.

10. NCRB Report

11. Affidavit for RC Stolen

12. FIR: Address & Year to be corrected.

13. To check all the three keys

14. Toll tax receipt MCD Delhi.

Thereafter on non-receipt of above said documents, the said Investigator submitted his detailed survey report dated 07.09.2017 with the following remarks:- 

“Insured has not submitted certain necessary details/documents/information in support of his theft claim even after 1 by hand letter dated 08.05.2017 and 1 speed post letter dated 27.06.2017 and final notice was given on 28.07.2017, more than 4 months have passed but the insured has not submitted the required documents till date. Undersigned have no other option but to suggest the underwriters TO CLOSE THE FILE due to non compliance of the insured. 

The opposite parties further alleged that their officials applied their mind and closed the claim of the complainant as no claim vide letter dated 27.02.2018, the operative part of which is reproduced as under:-

We have received intimation regarding theft of the above said vehicle and deputed Mr. B. S. Behl Investigator on dated 28.04.2017 by Motor Tech. Dept. RO, Ludhiana, and same is repudiated as no claim due to non-completion of documents and we closed the claim as "No Claim", as per recommendation of Investigator. In this manner, there is no deficiency in service on the part of answering respondent, as such the complaint is liable to be dismissed on this score only.

The opposite parties further alleged that on persisting requests of the complainant and on submission of documents, they reopened the claim of the complainant and deputed Sh. Jaspreet Singh Malik, Surveyor, Loss Assessor & Valuer, 1315, Urban Estate, Ph-II, Dugri, Ludhiana to survey and assess the loss. The said surveyor submitted his report dated 24.04.2018. On receipt of above said survey reports, the company has deputed Sh. Govind Puri, Advocate for legal status of the facts of the claim file in view of the policy terms and conditions who submitted his opinion dated 26.07.2018 with following remarks:-

As per your instructions I have gone through the claim file. As per the investigation/surveyors report the insured vehicle was handed over to Mr. Aman Singla nephew of Mr. Pardeep Kumar insured on 14.04.2017 for his travelling purpose. The said Aman Singla after borrowing the vehicle from his went to Delhi on 17.04.2017 in the subject vehicle in question. After reaching Delhi Mr. Aman Singla parked the vehicle near to the house of his cousin on road side and left for Jaipur along with said cousin brother and returned to Delhi on 23.04.2017 at 10 a.m.

The act and conduct of Mr. Aman Singla shows that he left the vehicle parked on the road side unattended and did not entrusted to vehicle in anyone custody to take care of the safety of the vehicle in his absence. Thus, Mr. Aman Singla was totally negligent towards the safety of the vehicle in question. Thus the insured/owner of the vehicle Mr. Pardeep Kumar handed over the vehicle in question to Mr. Aman Singla without taking care of the safety of the subject vehicle and committed breach of clause 4 of policy terms and conditions.

As per the investigation report the insured/owner of the vehicle in question has also misplaced/lost the 2^nd ignition key of the subject vehicle and he is not aware of the fact on which specific date said 2^nd key has been lost, neither any FIR/DDR has been lodged by him with regard to the said 2^nd ignition and door lock key. Thus the insured/owner has again committed breach of clause 4 of the insurance policy terms and conditions which says that "The insured shall take all reasonable steps to safeguard the vehicle from loss or damage and to maintain it in efficient condition".

"Thus as per my opinion, the claim is not payable as the insured/owner of the vehicle in question did not ensured the safety of the subject vehicle as discussed above. There is breach of insurance policy conditions by the owner.”

On receipt of all claim documents, the officials of the company applied their mind and repudiated the claim vide letter dated 24.08.2018. The opposite parties denied any deficiency in service on their part in any manner at any stage.

                    The opposite parties further alleged that thereafter the complainant moved the application before Ombudsman and the office of Ombudsman rightly rejected the application of the complainant.

                   On merits, the opposite parties denied the averments made in the complaint as incorrect and in the end, a prayer for dismissal of the complaint has been made.

3.                In support of his claim, the complainant tendered his affidavit Ex. CA in which he reiterated the allegations and the claim of compensation as stated in the complaint. The complainant also tendered documents Ex. C1 is the copy of Aadhar card of the complainant, Ex. C2 is the copy of registration certificate No.PB-10-DT-4247, Ex. C3 is the copy of tax invoice dated 30.06.2012, Ex. C4 to Ex. C6 are the copies of customer receipts dated 04.07.2012, Ex. C8 is the copy of Form-Receipt of Tax of Punjab Motor Vehicle Department, Ex. C9 is the copy of Form-Receipt of Society Fees of Punjab Motor Vehicle Department, Ex. C9 is the private car package policy, ex. C10 is the letter dated 05.05.2017 written to investigator Balbir Singh Behal, Ex. C11 is the copy of FIR No.012050 dated 23.04.2017, Ex. C12 is the copy of untraced report order dated 26.09.2017, Ex. C13 is the copy of email, Ex. C14 and Ex. C17 are the copies of air tickets, Ex. C18 is the copy of declaration of the complainant, Ex. C19 is the copy of letter written by the complainant to opposite parties, Ex. C20 is the copy of instructions, Ex. C21 is the copy of cancelled cheque, Ex. C22 is the copy of affidavit of the complainant, Ex. C23 is the copy of driving license of the complainant, Ex. C24 is the copy of assessment of the surveyor, Ex. C25  is the copy of letter dated 24.08.2018 written by opposite parties to the complainant, Ex. C26 is the copy of letter written by the complainant to RTO, Ludhiana, Ex. C27 is the postal receipt, Ex. C28 is the copy of email, Ex. C29 is the copy of order of Insurance Ombudsman, Ex. C30 is the copy of driving license of Aman Singla and closed the evidence.

4.                On the other hand, the counsel for the opposite parties tendered affidavit Ex. RA of Sh. Prem Pahuja, Divisional Manager of the opposite parties along with documents Ex. R1 is the copy of letter dated 13.09.2019, Ex. R2 and Ex. C3 are the copies of self contained note submitted by the opposite parties before Insurance Ombudsman, Ex. R4 is the copy of photo of envelop, Ex. R5 is the private car package policy Ex. R6 is the copy of letter dated 24.08.2018, Ex. R7 is the copy of email, Ex. R8 is the copy of recommendation dated 21.08.2018, Ex. R9 is the copy of letter dated 20.08.2018 calling recommendations, Ex. R10 is the copy of letter written to Motor Technical Department Regional office, Ludhiana dated 06.08.2018, Ex, R11 is the copy of email, again Ex. R11 is the copy of  affidavit of the complainant, Ex. R12 is the copy of cancelled cheque, Ex. R13 is the copy of  bill No.459 dated 26.07.2018 of Sh. Govind Puri, Advocate, Ex. R14 is the legal opinion dated 26.07.2018 of Sh. Govind Puri, Advocate, Ex. R15 is the copy of declaration of the complainant, Ex. R16  is the copy of letter written by the complainant to RTO, Ludhiana, Ex. R17 is the copy of PAN card of the complainant, Ex. R18 is the copy of Aadhar card of the complainant, Ex. R19 is the copy of postal receipt, Ex. R20, Ex. R25 are the copies of interse communication between the insurance company, Ex. R21 and Ex. R22 are the copies of NEFT details, Ex. R23 is the copy of office note dated 24.08.2018 of the opposite parties, Ex. R24 is the copy of letter dated 22,.08.2018 written by the opposite parties to D.O. Khanna,  Ex. R26 is the copy of claim note, Ex. R27, Ex. R28 are the copies of verification reports dated 24.04.2018 of Jaspreet Singh Malik Loss Assessor, Ex. R29 is the copy of letter written by the complainant to the opposite parties, Ex. R30  to Ex. R32, Ex. R41 are the copies of air tickets, Ex. R33 is the copy of untraced order dated 26.09.2017, Ex. R34 is the copy of Aadhar card of the complainant, Ex. R35 is the copy of email, again Ex. R33 to Ex. R35 are the copies of office note, Ex. R36 is the copy of letter of complainant to opposite parties, Ex. R37 is the copy of certificate issued by the opposite parties, Ex. R38 is the copy of letter dated 30.10.2017 written by Aman Singla to opposite parties, Ex. R39 is the copy of RC No.PB10-DT-4247, Ex. R40 is the copy of tax invoice dated 30.06.2012, Ex. R42  is the copy of letter written by the complainant to RTO, Ludhiana, Ex. R43 is the copy of affidavit of the complainant, Ex. R44 is the copy of retail cash memo dated 02.01.2017, Ex. R45 is the copy of PAN card of the complainant, Ex. R46 is the copy of Aadhar card of the complainant, Ex. R47 is the copy of letter dated 05.05.2017 written by the complainant to Sh. Balbir Singh Behal, Investigation officer, Ex. R48 is the copy of email, Ex. R49 is the copy of Aadhar card of Aman Singla, Ex. R50 is the copy of PAN card of Aman Singla, Ex. R51 is the copy of letter dated 04.09.2017 issued by the opposite parties to the complainant, Ex. R52 to Ex. R54 are the copies of email, Ex. R55 is the copy of investigation report dated 02.09.2017 of Sh. Balbir Singh Behal, Investigator,  Ex. R56 is the copy of order of Insurance Ombudsman and closed the evidence.

5.                We have heard the arguments of the counsel for the parties and also gone through the complaint, affidavit and annexed documents and written reply, affidavit and documents produced on record by both the parties.

6.                Undisputably, a vehicle make Toyota Innova bearing registration No.PB-10-DT-4247 owned by the complainant was stolen in between period from 17.04.2017 to 23.04.2017 from the outside of the house situated in the area of Paschim Vihar, New Delhi. Prompt intimation to the police lead to the registration of FIR No.12050 dated 23.04.2017 (Ex. C11). The claim was also lodged and the opposite parties deputed Mr. Balbir Singh Behal to investigate and assess the loss. Initially, due to non-submission of certain documents, on the suggestion of investigator on 27.02.2018, vide letter/office note Ex. R36 the claim file was closed treating it to be “NO CLAIM”.

                   However, at the request and on submission of required documents, the claim file was reopened. Mr. Jaspreet Singh Malik, Surveyor, Loss Assessor and Valuer assessed the loss to be Rs.6,98,000/- vide his report Ex. R29. Legal opinion was also obtained. Thereafter, opposite parties invoked the clause 4 of the Insurance Policy which casts an obligation upon the complainant to take all reasonable steps to safeguard the vehicle from the loss or damage and to mention it in efficient condition and repudiated the claim vide letter/office note dated 24.08.2018 Ex. R6 and Ex. R23 respectively.

                   The main reason for repudiation is that the vehicle was left unattended for a period of six days on roadside and did not entrust the vehicle in anyone’s custody.

                   It can be borne from the record that on 17.04.2017, the complainant entrusted the vehicle to his nephew namely Aman Singla for his business trip to New Delhi who parked the vehicle at Paschim Vihar, New Delhi. The complainant gave plausible explanation to the opposite parties that on reaching New Delhi, he left for Ahmedabad and came back on 20.04.2017 in the late night. Further, in the morning of 21.04.2017 at 09.00 AM, Aman Singla flew to Nagpur and returned on 23.04.2017 at Delhi. Meaning thereby till 21.04.2017, the vehicle was still there. It is not the case of the opposite parties that either the cousin of Aman Singla or his family members were not there in the house. It is a matter of common knowledge that in metropolitan cities like New Delhi, parking of vehicles in the garages are available for few select strata of society and majority of vehicle owners park their vehicle on roadside locations. So, it cannot be concluded that the vehicle was left unattended on roadside. Non-reporting the loss of 2^nd key to policy authorities cannot be considered as gross negligence on the part of the complainant. Bare reading of repudiation letter Ex. R6 inevitably suggest that the opposite parties were too technical and harsh. In this regard, reference can be made to 2022(2) Apex Court Judgment 281 (SC) in case title Gurmel Singh Vs Branch Manager National Insurance Company Ltd. whereby it has been held by the Hon’ble Supreme Court of India that the insurance company has become too technical while settling the claim and has acted arbitrarily. The appellant has been asked to furnish the documents which were beyond the control of the appellant to procure and furnish. Once, there was a valid insurance on payment of huge sum by way of premium and the Truck was stolen, the insurance company ought not to have become too technical and ought not to have refused to settle the claim on non­submission of the duplicate certified copy of certificate of registration, which the appellant could not produce due to the circumstances beyond his control. In many cases, it is found that the insurance companies are refusing the claim on flimsy grounds and/or technical grounds. While settling the claims, the insurance company should not be too technical and ask for the documents, which the insured is not in a position to produce due to circumstances beyond his control.

Ex. R55 is the assessment summary in which the liability has been assessed as Rs.6,98,000/-. However, it was the duty of the opposite parties to assess the loss even when the documents were not submitted to them. Sh. Balbir Singh Behl, Investigator vide his report Ex. R55 has given his report and has assessed the insurance company’s liability as Rs.6,98,000/-. The complainant has not controverted the facts mentioned in the written statement, so far as the surveyor report Ex. R55 is concerned as the complainant has neither filed any objections to controvert the averments made in the written statement. In the given facts and circumstances, it would be just and appropriate if the opposite parties are directed to the claim of Rs.6,98,000/- to the complainant as per survey report Ex. R55 within 45 days from the date of receipt of copy of order failing which the complainant shall be held entitled for interest @8% per annum from the date of order till date of actual payment.

7.                As a result of above discussion, the complaint is partly allowed with an order that the opposite parties shall pay the claim of Rs.6,98,000/- to the complainant as per survey report Ex. R55 within 45 days from the date of receipt of copy of order failing which the complainant shall be held entitled for interest @8% per annum from the date of order till date of actual payment. However, there shall be no order as to costs. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room.

8.                Due to huge pendency of cases, the complaint could not be decided within statutory period.

 

(Monika Bhagat)          (Jaswinder Singh)                      (Sanjeev Batra)                          Member                            Member                                       President         

 

Announced in Open Commission.

Dated:21.03.2023.

Gobind Ram.

 

 

Pardeep Kumar Vs United India Insurance Co. Ltd.               CC/20/87

Present:       Sh. Gaurav Gupta, Advocate for complainant.

                   Sh. G.S. Kalyan, Advocate for OPs.

 

                   Arguments heard. Vide separate detailed order of today, the complaint is partly allowed with an order that the opposite parties shall pay the claim of Rs.6,98,000/- to the complainant as per survey report Ex. R55 within 45 days from the date of receipt of copy of order failing which the complainant shall be held entitled for interest @8% per annum from the date of order till date of actual payment. However, there shall be no order as to costs. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room.

 

(Monika Bhagat)          (Jaswinder Singh)                      (Sanjeev Batra)                       Member                     Member                                       President         

 

Announced in Open Commission.

Dated:21.03.2023.

Gobind Ram.