Haryana

Karnal

CC/443/2021

Ajay Khokhar - Complainant(s)

Versus

United India Insurance Company Limited - Opp.Party(s)

Charanjit Wadhwa

22 Apr 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No.443 of 2021

                                                        Date of instt.03.09.2021

                                                        Date of Decision:22.04.2024

 

Ajay Khokhar son of Shri Prem Singh, resident of village Kalampura, tehsil and district Karnal.

                                                                        …….Complainant.

                                              Versus

 

United India Insurance Company Ltd. Old G.T. Road, Karnal through its Branch Manager.

                                                                …..Opposite Party.

 

Complaint under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.      

      Sh. Vineet Kaushik…….Member

      Dr.  Suman Singh…..Member

 

 Argued by: Shri C.J.Wadhwa, counsel for the complainant.

                    Shri Naveen Kheterpal, counsel for the OP.

 

                     (Jaswant Singh, President)

ORDER:   

                

                The complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that complainant  is the registered owner of Verna Car bearing registration no.HR-05AE-0500 and the same was insured with the OP, vide policy no.1123003118P105416113 for a period w.e.f.24.07.2018 to 23.07.2019. On 09.04.2019, the car of the complainant met with an accident, near Golden Future Public School, Khera-Mastan within the area of Police Station Phugana, District Muzafarnagar, as a result of which, the car of the complainant was badly damaged but nobody was injured in the said accident and DDR no.39 dated 09.04.2019 was registered with the Police Station Phugana, District Muzafarnagar. The car of the complainant was badly damaged in the accident and the estimated loss of the vehicle was more than Rs.2,00,000/- and immediate after the accident, the complainant lodged a claim with the OP and claimed insurance claim regarding damages of his vehicle, surveyor was deputed by the OP, who inspected the car and when the OP did not pay the claim amount, the complainant got his vehicle repaired by spending more than Rs.2,00,000/- from his own pocket. Complainant completed all the required formalities for settlement of the claim and submitted all the documents, which was required for settlement of the claim i.e. DL, RC, DDR and bills and receipts and estimated loss of vehicle in question with the OP and complainant visited the office of OP number of times and requested for payment of claim but OP did not pay the claim and rejected the claim of complainant after a long period, vide letter dated 12.04.2021 which is arbitrarily, unlawfully and illegally and without any sufficient legal cause on flimsy grounds. In this way there is deficiency in service and unfair trade practice on the part of the OP. Hence complainant filed the present complaint.

2.             On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability; cause of action; locus standi; jurisdiction and concealment of true and material facts. On merits, it is pleaded that complainant has not reported the accident to the police whereas police report has been obtained from the respective police station. As per the written statement of the complainant, his car was lifted through crane for the site of accident but Mr. Latti who had brought the car has confirmed that he had towed it from inside of Phugana and as such complainant-insured has deliberately mislead about the accident and as well as about police report. On visit to Police Station Phugana, G.D. no.039 dated 09.04.2019 was found registered on the basis of written compromise arrived in between both the registered owner of the vehicles but this facts has not been disclosed by the complainant. It is further pleaded that complainant confirmed in writing that he has given an affidavit that there is no loss of life/property of any third party whereas as per G.D. no.039 dated 09.04.2019 registered in Police Station Phugana Ford Figo car bearing registration no.TL-8CX-3207 was also damaged and further stated that nobody has sustained any injuries in the accident whereas the complainant has stated in its written statement that he and his friend Vishal sustained injuries but complainant failed to produce any medical treatment record. It is further pleaded that complainant has mentioned wrong site of accident but on enquiry made at the alleged site of the accident, the alleged accident and site have not confirmed by anyone which shows that the complainant has not shown the exact place of the alleged accident. Thus, the claim of complainant has rightly been repudiated by the OP. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complainant.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of the complainant Ex.CW1/A, copy of RC Ex.C1, copy of insurance policy Ex.C2, copy of DDR Ex.C3, copy of repudiation letter dated 12.04.2021 Ex.C4, copies of invoices Ex.C5 to Ex.C9 and closed the evidence on 28.09.2022 by suffering separate statement.

5.             On the other hand, learned counsel for the OP has tendered into evidence affidavit of Raj Kamal Ex.RW1/A, affidavit of Ee. Arvind Koesis, Surveyor and Loss Assessor Ex.RW2/A, affidavit of S.S. Bajaj Ex.RW3/A, copy of repudiation letter Ex.R1, copy of survey report Ex.R2, copy of investigation report Ex.R3, copy of insurance policy Ex.R4 and closed the evidence on 24.08.2023 by suffering separate statement.

6.             We have heard the learned counsel for the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that complainant got insured his vehicle with the OP. On 09.04.2019, the said vehicle  met with an accident and was badly damaged. A DDR no.39 dated 09.04.2019 was registered with the Police Station Phugana, District Muzafarnagar. The complainant got his vehicle repaired and spent more than Rs.2,00,000/-. Complainant submitted the claim with the OP and completed all the required formalities for settlement of the claim but OP did not pay the claim amount and rejected the claim of complainant, vide letter dated 12.04.2021 on the false and frivolous ground and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OP, while reiterating the contents of written version, has vehemently argued that complainant has not reported the accident to the police whereas police report has been obtained from the respective police station. Complainant has given in writing that there is no loss of life/property of any third party whereas as per G.D. no.039 dated 09.04.2019 Ford Figo car bearing was also damaged and further stated that nobody has sustained any injuries in the accident whereas the complainant has stated in its written statement that he and his friend Vishal sustained injuries but complainant failed to produce any medical treatment record. Complainant has mentioned wrong site of accident. Thus, the claim of complainant has rightly been repudiated by the OP and lastly prayed for dismissal of the complaint.

9.             We have duly considered the rival contentions of the parties.

10.           The claim of the complainant has been repudiated by the OP, vide repudiation letter Ex.C4/Ex.R1 dated 12.04.2021 on the following grounds, which are reproduced as under:-

1.     “Inspite of letters/reminders sent to you, you have not complied with the required papers/documents.

2.     As you have withdrawn your claim by giving your consent through your letter, we are closing your claim file as No Claim.

3.     We are closing your claim file, on account of the following reason:-

        Closing of claim by insurer.

We absolve ourselves from any further liabilities, arising out of this claim.”

11.           The claim of the complainant has been repudiated by the OP on the aforesaid grounds. OP has not placed on file any letters/reminders as alleged from which they demanded the documents. Moreover, it is also unbelievable an insured whose personal interest is involved for such amount why he will not supply the documents to the insurance company for getting his claim amount and will indulge himself in unwanted litigations. OP has also alleged in repudiation letter that complainant himself has withdrawn his claim but OP has failed to place on file consent letter given by the complainant in this regard. Hence, we found no substance in the contentions of OP.

12.           Furthermore, now a days it has become a trend of insurance companies, they issue the policies by giving false assurances and while giving claim amount, they make such type of excuses. Thus, the repudiation of the claim of complainant is arbitrary and unjustified. In this regard, we place reliance on the judgment of Hon’ble Punjab and Haryana High Court titled as New India Assurance Company Ltd. Versus Smt. Usha Yadav & others 2008 (3) RCR (Civil) 111, has held as under:-

“It seems that the Insurance Companies are only interested in earning the premiums which are rather too stiff now a days, but are not keen and are found to be evasive to discharge their liability. In large number of cases, the Insurance companies make the effected people to fight for getting their genuine claims. The Insurance Companies in such cases rely upon clauses of the agreements, which a person is generally made to sign on dotted lines at the time of obtaining policy. This is, thus pressed into service to either repudiate the claim or to reject the same. The Insurance Companies normally build their case on such clauses of the policy, but would adopt methods which would not be governed by the strict conditions contained in the policy”.

13.           Keeping in view the ratio of the law laid down in aforesaid judgments, facts and circumstances of the present complaint, the act of the OP while repudiating the claim of the complainant amounts to deficiency in service and unfair trade practice.

14.           The complainant has claimed Rs.2,00,000/- and in this regard he has placed on file photocopies of invoices Ex.C5 to Ex.C9 but the said invoices are not readable, thus same cannot be considered. As per the survey report Ex.R2 dated 19.07.2019, the net loss assessed to the tune of Rs.68,500/-. Hence, the report of the surveyor will prevail in view of case law titled as United India Insurance Co. Vs. Maya 2(2008) CPJ page 182 (NC). Hence, the complainant is entitled for the loss as assessed by the surveyor alongwith interest, compensation and litigation expenses etc.

 

15.           In view of the above discussion, we partly allow the present complaint and direct the OP to pay Rs.68,500/- as loss assessed by the surveyor of the OP to the complainant with interest @ 9% per annum from the date of repudiation of the claim i.e. 12.04.2021 till its realization. We further direct the OP to pay Rs.20,000/- to the complainant on account of mental agony and harassment suffered by him and Rs.11,000/- for the litigation expense. This order shall be complied within 45 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:22.04.2024                                                                     

                                                                President,

                                                   District Consumer Disputes

                                                   Redressal Commission, Karnal.

       

                  (Vineet Kaushik)              (Dr. Suman Singh)

               Member                             Member