Complainant Paramjit Saini vide the present complaint filed U/S 12 of the Consumer Protection Act, 1986 (hereinafter for short The Act) for issuance of the necessary directions to the titled opposite party United India Insurance Company Ltd, Pathankot to pay the total insured amount of Rs.3,74,950/- as per the policy alongwith interest @ 18% P.A. from the date of due till its realization and costs and damages of Rs.20,000/- be also awarded to him. Opposite party be also directed to pay Rs.1,00,000/- to him as his medical expenses incurred by him on his treatment as per the policy, medical terms and conditions.
2. The case of the complainant in brief is that he is owner of Mahindra Logan 1.6 GLX car model 2008 bearing R.C. No.PB-35K 2324 and the said vehicle was duly insured with the opposite party vide policy No.1111063112P000342068 valid from 03.06.2012 to 02.06.2013. The said policy is a comprehensive insurance policy and the sum insured as per the policy was Rs.3,74,950/-. He paid the entire premium amount of Rs.7067/- on 3.6.2012 to the opposite party. Unfortunately, the abovesaid car met with an accident on 16.5.2013 and was totally damaged. He suffered injuries in the accident and spent a lot of money on his treatment. The opposite party is also liable to pay medical expenses incurred by him on his treatment as per the policy, medical terms and conditions. He has further pleaded that the report of the accident was given to the opposite party. The opposite party got conducted the survey of his damaged car. The estimated cost of the repair of the vehicle was Rs.3,76,849.49/-. The car is still lying in the workshop in which he has to pay Rs.150/- per day. All the formalities have been completed by him and the entire file is with the opposite party. The accident has occurred on 16.5.2013 but the opposite party has not released the insurance claim of the car to him so far without any reason or cause. The opposite party is intentionally and willfully playing delaying tactics with him. The opposite party alleged that they got survey report of their own Gupta Associates after about 6 months from the accident and on the survey report of the opposite party the net value of the loss assessed shown Rs.1,26,610.95. The said survey report if any is false, frivolous and got procured by the opposite party in order to frustrate his claim. The said survey report is not believable and not binding upon him. The vehicle has totally lost. He requested so many times to the opposite party to finalise his claim and to release the insurance amount of Rs.3,74,950/- in his favour and Rs.1,00,000/- as medical expenses incurred on his treatment but the opposite party did not pay any heed to his request. Thus, the opposite party has indulged in unfair trade practice. The act and conduct of the opposite party is malafide and amounts to deficiency in service and opposite party is legally bound to pay the entire insurance claimed amount to him. Earlier complaint filed by him was withdrawn on some technical defect and the Ld.Forum allowed withdrawing the complaint with permission to file fresh complaint on same cause of action. Hence this complaint
3. Upon notice, the opposite party insurer appeared through its counsel and filed its written version taking the preliminary objections that the present complaint is legally not maintainable. As the complainant has already moved the same petition on the same cause of action without any defects being removed of the earlier petition filed on 5.6.2015 in Consumer Complaint No.228 of 2015 dismissed as withdrawn on 30.6.2015 by the Ld.Court. On merits, it was admitted that the report of the accident was received by the opposite party who appointed the surveyor Sanjeev Gupta and Associated to conduct the loss assessment of the damaged vehicle who submitted their detailed report on 16.10.2013. As per the report of the surveyor the summary of assessment on repair basis was allowed to the complainant for Rs.2,00,010/- for the net value of the loss assessed and the salvage value of the old parts was assessed at Rs.5000/- approx and the further assessment of loss on cash loss basis was assessed at Rs.1,26,611/-. He has next stated that if the assessed amount exceeds 75% of the value of the vehicle than it is to be termed as total loss and if on the repair basis the claim is to be settled than in that case the vehicle is to be repaired and the bills are to be submitted and the claim can be paid to the insured. If the insured is not interested in repair then the claim can be settled on cash loss on repair basis. The net of the salvage is total loss and the salvage belongs to the insurance Company. If the person wants to retain the vehicle then the claim is settled on the net of salvage basis and total loss is applicable only if the assessed amount increases the 75% of the total insured amount. As per the report of the surveyor the assessed amount of the damaged vehicle is less than 75% as such it cannot be termed as total loss in the present case. It has been next stated that the vehicle was assessed by Sanjeev Gupta and Associated who are authorized surveyors for the United India Insurance Co.Ltd. they have submitted the report based on the true facts. Other allegations of the complainant have been denied and specifically controverted. Lastly the complaint has been prayed to be dismissed with costs.
4. Complainant tendered into evidence his own affidavit Ex.CI, along with the other documents exhibited as Ex. C2 to Ex C7 and closed the evidence.
5. On the other hand, the opposite party tendered into evidence affidavit of Pardeep Singh, Sr.Branch Manager U.I.I. Ex.OP1, alongwith the other documents Ex.OP2 and Ex.OP3 and closed the evidence.
6. We have duly heard the learned counsels for both the sides on the points of law and have also thoroughly examined the records with requisite care & caution on the points of fact, as placed before us. We find that the complainant insisted upon the OP insurers to allow his Car Accident Insurance Claim to its full IDV of Rs.374,950/- considered as ‘total loss’ whereas the OP insurers intended to follow the Surveyor’s Net Value Loss assessed at Rs.2,00,010/- (and that being less than 75% of the IDV) were inclined to allow a sum of Rs.1,26,611/- only, on cash loss basis. Somehow, the complainant has failed to produce any cogent evidence to support his claim-award on ‘total-loss’ basis for the full IDV benefit. The complainant has neither contested/rebutted the surveyor’s assessment report nor has produced any other loss-assessment to counter the surveyor’s assessment and in its absence his ‘total-loss’ claim fades as a bald attempt in futility, only. Moreover, by the time, it has been a settled ‘law’ that the courts shall not ignore the Surveyor’s Assessment unless contested/opposed/rebutted with some cogent evidence duly supported by an expert opinion comprising of one logical and acceptable assessment. Incidentally, the complainant has produced the same Surveyor’s Report as Ex.C4 & C5 to prove his accidental loss/damage perhaps in the absence of one ‘fairer’ assessment. Under the circumstances, we find the OP insurers’ offer to settle the claim on ‘cash loss repair basis’ to be quite fair, justifiable and acceptable even in terms of the related policy, also.
7. In the light of the all above, we are of the considered opinion that the present complaint shall be best disposed of by directing the OP insurers to settle and pay the impugned accident claim as per ‘repair’ basis or on ‘cash loss’ basis (assessment per the Surveyor’s Report Ex.OP3) at the option of the complainant as conveyed (by him) to them in writing (with requisite documents etc) within 30 days of its receipt otherwise the claim amount shall attract interest @ 9% PA from the date of the present orders till actually paid.
8. Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to record.
(Naveen Puri)
President
Announced: (Jagdeep Kaur)
April 01, 2016 Member
*MK*
