Punjab

Ludhiana

CC/19/354

Varun Deepak - Complainant(s)

Versus

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

H.S.Grewal Adv.

08 May 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                Complaint No:354 dated 19.07.2019.                                                         Date of decision: 08.05.2023.

 

Varun Deepak son of Shri Harbans Lal, permanent resident of 2108, Urban Estate, Sector 32-A, Chandigarh Road, Ludhiana     at present residing 30, Altitude Drive, Doreen, Victoria, Australia-3754 through his special power of attorney i.e. his father Harbans Lal.                                                                                                                           ..…Complainant

                                                Versus

1. United India Insurance Company Ltd., registered office 24, Whites Roads, Chennai-600014 through its Managing Director/Director.
2. United India Insurance Company Limited, Malak Chowk, G.T. Road, (Ludhiana side), Jagraon, District Ludhiana 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             :         None.

For OPs                          :         Sh. Govind Puri, Advocate.

 

 

 

ORDER

PER SANJEEV BATRA, PRESIDENT

1.                Briefly stated, the facts of the case are that the complainant who is a renowned doctor/medical practitioner and is presently residing in Australia, owns a motor car make Hyundai I-20 Asta (O) DSL bearing registration No.PB-10-ER-1122 which was initially insured with ICICI Lombard General Insurance Company Ltd. W.e.f. 08.02.2017 to 09.03.2017. The complainant stated that one agent of United India Insurance Company approached him for renewal of the policy upon which the complainant paid him Rs.10,824/-  and got extended the insurance policy by issuing receipt No.10120120116116884560 dated 03.03.2017 and opposite parties issued cover note of the policy for the period w.e.f.10.03.2017 to 09.03.2018 vide policy Nio.2012013116P116440086 with insured declared value of the car for Rs.5,33,000/-. The complainant further stated that on the intervening night of 06.12.2017 to 07.12.2017, the car met with an accident and suffered heavy damage. The vehicle was sent to workshop of Grover Auto Mobiles Pvt. Ltd., Grover Hyundai Opp. Dhandari Kalan, Railway Station, G.T. Road, Ludhiana for its repair. Intimation was given to opposite parties by the officials of the workshop and requested opposite party No.2 to depute the surveyor vide email dated 14.12.2017 upon which, Mr. Sarabhjit Singh, Insurance Surveyor and Loss Assessor was deputed who inspected the vehicle and after inspection, repair of the vehicle was initiated by Grover Hyundai. After competition of the work, the concerned workshop intimated opposite parties about the total amount incurred on the vehicle with proper invoice as the policy was cashless but the cashless mode of payment of expensed of the repair of vehicle of the complainant was denied by the opposite parties as opposite party No.2 did not confirm no claim bonus on the aforesaid policy from ICICI Lombard. The complainant further stated that the opposite parties took false and frivolous plea that the complainant has availed some discount of no claim bonus/O.D. claim on the policy renewed by the opposite party and the complainant was not liable to get the NCB discount and they further stated that the complainant has concealed the material facts and wrongly claimed the NCB. The act of the opposite parties is arbitrarily and total unnatural as the complainant at no point of time concealed any facts as alleged. The opposite parties could have verified or made inquiry of claiming no claim bonus or not by the complainant at the time of issuing the policy. The complainant paid the requisite charges as stated by agent of the opposite parties. As per terms and conditions of the policy, it is being mentioned that the policy stands cancelled or void in event of cheque dishonourd. The company may cancel the policy by sending seven days notice in case of any fraud or misrepresentation, non disclosure of material facts, non-cooperation of the insured. According to the complainant, no such notice was ever given to him and the maximum no claim bonus to the tune of 25% for a mere amount of Rs.2341.58 and the said amount could have been urged by opposite parties at the time of issuance of policy and at the time of verification after issuance of receipt dated 03.03.2017 till dispatch of the policy but the opposite parties never made any inquiry in this respect. The complainant further stated that he had to pay the repair charges to Grover Automobiles on account of denial of cashless mode of payment and took the delivery of the vehicle from the said workshop. The complainant repeatedly requested opposite parties to settle his claim and to make the payment of amount incurred by him on repair of his vehicle but they refused to settle the claim and make the payment of amount to the complainant. The aforesaid act and conduct of the opposite parties is false and frivolous and totally unjustified which has caused mental harassment, pain and agony to the complainant. The complainant sent a legal notice to the opposite parties calling upon to make payment of Rs.1,79,695/- along with compensation. The opposite parties submitted an evasive reply but did not pay the claim. Hence this complaint whereby the complainant prayed for issuing directions to the opposite parties to pay Rs.1,79,695/- along with compensation of Rs.5,00,000/- and litigation expenses of Rs.33,000/-.

2.                Upon notice, the opposite parties filed joint written statement and by taking preliminary objections, assailed the complaint on the ground of maintainability of the complaint, the complainant estopped by his own act and conduct from filing the present complaint; concealment and suppression of facts by the complainant. According to the opposite parties, the complainant himself has been negligent and committed breach of policy terms and conditions and concealed the true facts from them at the time of obtaining insurance policy for the car bearing No.PB-10-ER-1122 due which his claim has been repudiated vide letter dated 02.05.2018 for reason “In the policy, NCB (No Claim Bonus) @25% was allowed, as confirmed that no claim was preferred on the previous policy issued by ICICI Lombard, it was confirmed by them that there is an OD claim on the policy, as such not eligible for NCB which shows that you have not disclosed the material facts at the time of insurance. Accordingly your claim has been repudiated by the competent authority.” The opposite parties stated that the car in question was previously issued from ICICI Lombard General Insurance Company Limited and insurance policy was effective from 08.02.2016 to 09.03.2017 and during said period, the complainant obtained the OD (own damage) claim for the car in question from ICICI Lombard General Insurance Company Limited. The complainant got insured the vehicle from the opposite parties from 10.03.2017 to 09.03.2018 and at the time of obtaining the policy, the complainant intentionally concealed the true fact that he has obtained the claim in the previous policy and is not entitled for discount in the premium amount for ‘No Claim Bonus’ in the present policy. According to the opposite parties the contract of insurance is of utmost good faith but the complainant has breached the contract by his malafide intention and his claim has been rightly repudiated due to non-disclosure of material facts. The opposite parties further stated that on receiving the intimation from the complainant regarding the damage caused to his car they immediately deputed surveyor Er. Sunil Kumar to make the spot survey, who submitted his survey report dated 18.12.2017. On receiving the spot surveyor report, opposite parties deputed Er. Sarabjit Singh, Surveyor and Loss Assessor to access the loss suffered by the vehicle who submitted his report dated 27.02.2018. In the meanwhile the opposite parties sought confirmation from ICICI Lombard General Insurance Company Limited regarding any claim in the policy period of the insurance policy issued by them and on getting the NCB confirmation from the previous insurer, it was confirmed by them that there is an OD claim on the policy issued by them. According to the opposite parties, the complainant is not entitled for NCB discount @25% at the time of migrating the insurance policy of his vehicle with them.

                   On merits, the opposite parties reiterated the crux of averments made in the preliminary objections. The opposite parties submitted that the complainant was having knowledge that he has obtained the claim from ICICI Lombard General Insurance Company and he will not be given the benefit of NCB (No Claim Bonus) by renewing the policy from ICICI Lombard General Insurance Company Limited, intentionally migrated the insurance policy of his car with them and while getting his car insured with the opposite parties, the complainant did not disclose about the claim obtained by him during the policy period of ICICI Lombard General Insurance Company. The complainant by concealing the true facts has obtained the insurance policy from the opposite parties and wrongly obtained 25% discount in the premium amount on account of No Claim Bonus. The opposite parties have denied that there is any deficiency of service and have also prayed for dismissal of the complaint.

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 special power of attorney, Ex. C2 is the copy of registration certificate No.PB10-ER-1122, Ex. C3 is the  copy of private car package policy, Ex. C4 is the copy of DDR No.21 dated 07.12.2017, Ex. C5 is the copy of invoice dated 21.02.2018 of Grover Automobiles Pvt. Ltd., Ex. C6 is the copy of email dated 26.02.2018, Ex. C7 is the copy of legal notice dated 26.04.2018, Ex. C8 and ex. C9 are the postal receipts and closed the evidence.

4.                On the other hand, 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 repudiation letter dated 02.05.2018, Ex. R2 is the copy of private car package policy, Ex. R3 is the survey report of Er. Sunil Kumar, Ex. R4 is the copy of survey report of Er. Sarabjit Singh, Ex. R5 is the copy of reply of legal notice dated 16.05.2018 Ex. R6 and Ex. R7 are the copies of postal receipts and closed the evidence.

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

6.                The complainant, a medical practitioner is the owner of vehicle bearing registration No.PB-10-ER-1122 model 2014 opted for migration from the earlier policy of the vehicle with ICICI Lombard General Insurance Company Limited to Private Car Package Policy of the opposite parties w.e.f. 10.03.2017 to 09.03.2018 Ex. C3=R2. The IDV value of the car was Rs.5,33,000/-. However, in the intervening night of 06.12.2017 and 07.12.2017, the vehicle of the complainant met with an accident  in the area of Ludhiana and a DDR No.21 dated 07.12.2017 Ex. C4 was lodged. Upon receiving intimation from the complainant, the opposite parties deputed Er. Sunil Kumar to make spot survey who submitted his survey report dated 18.12.2017 Ex. R3. Thereafter, the opposite parties appointed Er. Sarabjit Singh, surveyor and loss assessor to assess the loss suffered by the vehicle who vide his report Ex. R4 dated 27.02.2018 assessed the net loss of the vehicle to Rs.1,61,000/-.

7.                During the process of settlement of the claim, the opposite parties received no claim verification from the previous insurance company ICICI Lombard General Insurance Company Limited whereby it was disclosed that there was an OD (Own Damage) claim on the policy issued by them and the complainant is not entitled to No Claim Bonus @25% at the time of migration of the policy of his vehicle. The opposite parties treated it to be non-disclosure of material facts at the time of insurance so the claim of the complainant was rightly repudiated vide letter Ex. R1.

8.                Perusal of the policy documents shows that the terms and conditions have been enlisted in the policy schedule which reads as under:-

“Disclaimer: The policy stands canceled or void in the event of cheque dishonor. The company may cancel the policy by sending 7 days notice in case of any fraud, misrepresentation, non-disclosure of material fact or non-co-operation of the insured.”

The opposite parties have rightly invoked the aforesaid cause in arriving at the conclusion that there is concealment of material facts. The plea of the complainant that ‘No Claim Bonus’ to the tune of 25% is a meager amount of Rs.2341.58 at the most they could have deducted the said ‘No Claim Bonus’ instead of repudiating the whole of the claim is devoid of any merits as the terms and conditions of the policy do not admit such indulgence by the opposite parties. The complainant sent a legal notice Ex. C7 to the opposite parties which was suitably replied by the opposite parties vide reply dated 16.05.2018 Ex. R5 whereby the opposite parties have specifically brought into notice of the complainant that you have breached contract by not disclosing material facts at the time of insurance. As such, there is no deficiency in service on the part of the opposite parties.

9.                As a result of above discussion, the complaint fails and the same is hereby dismissed. 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.

10.              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:08.05.2023.

Gobind Ram.

 

 

Varun Deepak Vs United India Insurance Co. Ltd.                             CC/19/354

Present:       None for the complainant.

                   Sh.  Govind Puri, Advocate for the OPs.             

 

                   None turned up for the complainant today also. None has been appearing in this case on behalf of the complainant since 05.04.2023.

                   Arguments on behalf of the counsel for the OPs heard. Vide separate detailed order of today, the complaint fails and the same is hereby dismissed. 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:08.05.2023.

Gobind Ram.