Punjab

Faridkot

CC/14/111

Surinder Kumar - Complainant(s)

Versus

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

Uma Shankar

19 Feb 2015

ORDER

 DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FARIDKOT

 

Complaint No. :      111

Date of Institution:  27.08.2014

Date of Decision :   19.02.2015

 

 

Surinder Singh s/o Mange Lal r/o Sahibzada Fateh Singh Nagar, Dhana Basti, c/o MS Traders, Kotkapura, District Faridkot.                                                                                           ...Complainant

Versus

1. United India Insurance Company Ltd (Govt of India Undertaking), Branch Officer Near Old Bus Stand, Jaitu Road, Kotkapura, Tehsil Kotkapura through Branch Manager.

2. United India Insurance Company Ltd (Govt of India Undertaking)

   .......Opposite Parties(Ops)

 

Complaint under Section 12 of the

Consumer Protection Act, 1986.

 

Quorum: Sh. Ashwani Kumar Mehta, President,

               Smt Parampal Kaur, Member,

               Sh P L Singla, Member.

 

Present: Sh Uma Shankar, Ld Counsel for complainant,

              Sh Ashok Monga, Ld Counsel for OPs.

(A K Mehta, President)

                                   Complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 against United India Insurance Co etc/OPs seeking directions to OPs to make payment of Rs 1,59,240/- pertaining to Insurance Policy No. 2012023112P182178977 with interest and for further directing OPs to pay Rs1,00,000/- as compensation for financial loss, harassment, inconvenience, mental agony and litigation expenses.

2                               Briefly stated, the case of the complainant is that complainant being owner of Maruti Car bearing registration no. PB-04-H-8850 got insured his car from OP-1 and OP-1 charged Rs 2198/- for insurance and Ops issued only covernote to the complainant and as per cover note, insurance was valid from 28.04.2012 to 27.04.2013 and no other insurance policy was issued to the complainant; that on 12.12.2012, said car met with an accident and  car was damaged badly in the accident and complainant immediately informed OP-1 and FIR was got registered and thereafter OP-1 told complainant to get repaired the car and on assurance of OP-1, complainant got repaired the same; that after inspection of the car, the loss caused to the said car was assessed Rs 1,59,240/- and complainant lodged claim with OP-1, who assured complainant that his insurance claim would be passed within 30 days and OP-1 forwarded the claim to OP-2; that  after submission of claim, complainant visited the OP-1 many times, but OP-1 kept putting off the complainant on one pretext or the other and now Ops are denying to pay the genuine insurance claim on the ground that complainant got fitted gas kit; that there is deficiency in service and trade mal practice on the part of Ops and it has caused harassment and mental agony to complainant for which he has prayed for directions to Ops to pay Rs 1,00,000/-as compensation and for cost of litigation. Hence,  the present complaint.

3                                    The counsel for complainant was heard with regard to admission of the complaint and vide order dated 28.08.2014, complaint was admitted and notice was ordered to be issued to the opposite party.

4                                  On receipt of the notice, the opposite party filed written statement taking preliminary objections that complaint is without cause of action as the alleged vehicle involved in accident was not being driven by an authorized person having valid and effective driving licence at the time of alleged loss and insured has violated the terms and conditions of insurance policy and therefore, complaint is liable to be dismissed and there is no deficiency in service on the part of answering OP and complaint is not maintainable; that alleged loss took place on 12.12.2012, but intimation regarding this was given to answering OP on 12.04.2013 after a lapse of 4 months, which prevented the OP to gather first hand information of loss and to ascertain the actual position at the spot; that after receipt of intimation, an independent Surveyor U.P.S.Sachdeva of Ludhiana was appointed to assess the loss, who inspected the vehicle at the residence of complainant at Dhanna Basti, Kotkapura and found that parts of the car like battery, air cleaner, alternator ass, distributor ass., self starter, carburettor etc were missing and on further inquiry, it was disclosed by the complainant that the vehicle was left at the site of accident unattended for some days and the parts were stolen during the said period and in the light of these circumstances, the said Independent Surveyor assessed the loss at Rs 38,087.48p on the cash loss basis; that it was further found by the Surveyor that a gas kit was installed in the engine compartment indicating that car was being run on gas, but no sanction was obtained from the Company significantly by an endorsement upon the Policy by or on behalf of United India Insurance Co. Ltd and complainant also did not obtain necessary sanction from the registering authority, Faridkot to install the gas kit, thus, complainant has concealed the material fact from the Company and has violated the terms and conditions of the Policy; that complainant has also violated the provisions of the Motor Vehicle Act; that no liability attaches to the insurer as complainant submitted the vehicular documents i.e RC and DL after much belated stage after letter dt 20.06.2013 issued by OP; that RC was got verified from Registering Authority, Faridkotand DL was got verified from Licensing Authority (DTO) Zunheboto (Nagaland) vide report dt 16.11.2013 received on 19.11.2013 and then claim was processed and submitted to the competent authority, who after due application of mind and that also on merits and as per terms and conditions of policy and also as per provisions of law repudiated the claim and decision of competent authority was duly conveyed to complainant vide letter dt 19.08.2014 and as such, there is no deficiency in service on the part of answering Ops and complaint is not maintainable and is liable to be dismissed. However, on merits, OP has denied all the allegations levelled by complainant being wrong and incorrect and reiterated that there is no deficiency in service or unfair trade practice on the part of opposite party. The allegations with regard to relief sought too were refuted with a prayer that complaint deserves to be dismissed with costs.

5                            Parties were given proper opportunities to prove their respective case. The complainant tendered in evidence his affidavit Ex.C-1, and documents Ex C-2 to C-4 and then, closed his evidence.

6                                   In order to rebut the evidence of the complainant, the opposite party tendered in evidence, affidavit of A K Kanojia, Sr Divisional Manager Ex OP-1 and documents Ex OP-2 to OP-20 and then, closed the evidence.

7                        We have heard the learned counsel for the parties and have very carefully gone through the affidavits and documents on the file.

8                                   The Ld Counsel for complainant contended that complainant is owner of the Maruti Car in question bearing Registration No. PB04-H-8850, which he got insured with the OP Insurance Company for the period 28.04.2012 to 27.04.2013 and paid the premium and as such, complainant is consumer of the OP/ Insurance Company. He contended that unfortunately, car met with an accident on 12.12.2012 and was badly damaged and FIR was got registered and intimation was also given to Insurance company. He further contended that complainant got assessed the damage to the car in question and the same was assessed as Rs 1,59,240/- and complainant filed the claim accordingly with the OP/Insurance Company, but inspite of repeated visits and requests, OP Insurance Company did not pay the insurance claim and later on, refused to pay the insurance claim on the flimsy ground that a gas kit was fitted in the car in question, which is a violation of the terms and conditions of the policy. He contended that the act and conduct of the Insurance Company caused harassment, mental tension and mental agony to the complainant and as such, complaint is required to be allowed and complainant is entitled to insurance claim of Rs 1,59,240/- alongwith interest and complainant is also entitled to Rs 1 lac as compensation for harassment,  mental agony besides litigation expenses.

9                      The ld counsel for OP/Insurance Company admitted that the car in question was insured with the OP/Insurance Company vide insurance certificate Ex OP-20. He also admitted that the car was involved in accident on 12.12.2012, but complainant/insured did not comply with terms and conditions of the insurance policy as intimation was not immediately given to the Insurance Company as                      required in condition no 1 of the Insurance Policy and rather complainant informed the Insurance Company only on 12.04.2013 i.e after about 3½ months andas such, Insurance Company was prevented from making any spot inspection of the place of occurrence. He contended that even thereafter, OP/Insurance Company appointed Surveyor to inspect the car in question and to assess the loss and the Surveyor inspected the car in question in the residence of the complainant as complainant shifted the car in question to his residence after accident and found many parts missing in the car in question and gave his Survey Report Ex OP-5 and assessed the car loss of about Rs 38,087.48p. He contended that a gas kit was also found fitted in the engine compartment of the car in question, whereas RC of car shows that it was a petrol car and the endorsement of the gas kit was also not made in the registration certificate of the car, which is a violation of the terms and conditions of the Insurance Policy as well as Motor Vehicle Act. He contended that complainant is not at all entitled to any claim under the Policy in question and if at all claimant is entitled to any insurance claim, then, he is not entitled to more than Rs 38,087.48p, which is assessed by the Surveyor as Surveyor Report cannot be ignored without any cogent reason and no cogent reason has been given by the complainant to ignore the Surveyor Report and as such, complaint is false and is liable to be dismissed.

10                               Admittedly, complainant is owner of the car in question. It is also admitted fact that car in question was insured with the OP/Insurance Company for the period from 28.04.2012 to 27.04.2013. The car in question was involved in an accident on 12.12.2012 and immediately intimation was given to the Police and FIR Ex C-4 dt 12.12.2012 was registered. It shows that intimation to the Police was immediately given regarding accident and FIR was registered even on the date of accident. It is correct that complainant did not give intimation to the Insurance Company immediately, rather gave the intimation regarding accident to the Insurance Company on 12.04.2013, but the ld counsel for complainant explained that a member of the family of the complainant died in the accident and naturally, complainant and his family were under shock and as such, immediate intimation to the Insurance Company was not given though immediate intimation was given to the Police. FIR is proved as Ex C-4 and it shows that Pardeep Kumar and Varinder Kumar brothers of complainant were going on car in question on the fateful day and in the accident, Pardeep Kumar died. As such, there is force in the contentions of the ld counsel for complainant that due to demise of near relative, complainant and his family were under shock and as such, immediate intimation to the Insurance Company was not given. Otherwise also, the First Hand Information can be assessed from the copy of FIR, which was registered on the date of accident itself and no loss has been caused to the Insurance Company, if Insurance Company was informed with delay. The complainant has filed the estimate for Rs 1,59,240/-, which complainant claimed in the case, but complainant can be paid only that amount, which the complainant has spent on the repair of the car because estimate cannot be treated as actual loss and actual loss differs from the estimate when the car in question is repaired. Moreover, OP/Insurance Company appointed a qualified Surveyor to assess the loss, whereas estimate filed by the complainant is by a motor mechanic. The ld counsel for complainant has not given any reason to ignore the report of the Surveyor. In case titled as Manmandir Synthetics Pvt Ltd Vs New India Assurance Co. Ltd 2006 (1) Consumer Law Today page 203, it was observed by the Hon’ble National Consumer Disputes Redressal Commission, New Delhi that Surveyor Report in an Insurance claim is an important document and there must be sufficient ground to disagree with the Surveyor Report. The other contentions of the OP/Insurance Company in rejecting the insurance claim is that a gas kit was fitted in the engine compartment of the car in question, which is a violation of the rules. Moreover, there is no evidence on the file to show that the car was actually being driven on gas kit on the date of accident. Generally, petrol and gas are alternate sources of fuel for use in the car. In case titled New India Assurance Company Ltd Vs Jaspal Singh 2013(1) Consumer Law Today page 223, the insurance claim was filed but the same was repudiated by the Insurance Company due to violation of the terms of the Policy as insured vehicle was found fitted with LPG kit and Surveyor found LPG cylinder in the body of the car on the date of accident and use of LPG as an alternative fuel in the car was not permitted as per registration certificate of the car and it was violation of the Section 52 of the Motor Vehicle Act 1988 but it was observed by the Hon’ble National Commission that Insurance Company did not conclusively establish whether at the time of accident, the car was actually being run on petrol or LPG and violation of the said provision of the Motor Vehicle Act is not so ruinous as to render the insurance claim totally invalid and Insurance Company was directed to pay the insurance claim to the insured on non standardisation basis. The same proposition of law was held in case titled as National Insurance Co. Ltd Vs Ashok Chhibber, First Appeal No. 739 of 2013 by Hon’ble State Consumer Disputes Redressal Commission Haryana, Panchkula. Otherwise, the accident is admitted and loss to the car in question is also admitted in this case and even as per OP/Insurance Company, the  complainant is entitled to Rs 38,087.48p on cash loss basis, otherwise, the documents proved by the OP/Insurance Company on the file show that registration certificate of the car and driving license of the driver of the car were genuine and the OP/Insurance Company rejected the claim only on the ground that gas kit was installed in the engine compartment of the car, which is not such a defect to reject the genuine insurance claim of the complainant.

11                            In the light of above discussion, the complainant is entitled to insurance claim as assessed by the Surveyor. Therefore, complaint is allowed with costs against Insurance Company and complainant is held entitled to Rs 38,087.48p as claim under the complaint. The conduct of OP/Insurance Company in wrongly repudiating the insurance claim, must have caused harassment and mental agony to the complainant and as such, complainant is entitled to recover Rs 7,000/- as compensation and Rs 3,000/- as litigation expenses as due to wrong repudiation of the insurance claim, complainant had to file complaint. The OP/Insurance Company is directed to comply with the order within one month from the date of receipt of the copy of the order, failing which, the OP/Insurance Company is liable to pay interest at the rate of 9% per anum on the claim amount from the date of filing the complaint till realization. Copy of order be given to parties free of cost under rules. File be consigned to record room.

Announced in Open Forum

Dated : 19.02.2015

                               Member            Member                  President

 (P Singla)          (Parampal Kaur)     (A K Mehta)