Chandigarh

DF-I

CC/125/2024

NIKHIL RANA - Complainant(s)

Versus

UNITED INDIA INSURANCE COMPANY PVT. LTD. THROUGH ITS GENERAL MANAGER - Opp.Party(s)

SAURAV KANOJIA

04 Nov 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-I,

U.T. CHANDIGARH

                                     

Consumer Complaint No.	:	CC/125/2024
Date of Institution	:	4.3.2024
Date of Decision	:	4/11/2024

 

1. Nikhil Rana aged about 32 years son of Sh. Mohinder Singh, resident of House No.2207/1, Sector 45C, Chandigarh.

2. Nikita Rana aged about 25 years Daughter of Sh. Mohinder Singh, resident of 94. Near shiv mandir, Adarsh Nagar Naya Gaon Tehsil Kharar.

...Complainants

Versus

 

1. United India Insurance Company Pvt. Ltd. Divisional Office-30 (Gurugram) POLICY BAZAAR CLAIMS Hub, Vipul Trade Centre Door no: 34, 35, 6A, 6B, Ground Floor, Sector-48, Sohna Road, Gurugram, Haryana, 122001 through its General Manager.

2. United India Insurance Company Pvt. Ltd. Head office: 24, White Road, Chennai-600014, Corporate office: #19, Nungambakkam High Road, IV Lane, Chennai-600034 through Managing Director/Principal Officer.

Opposite Parties

 

CORAM :	SHRI PAWANJIT SINGH	PRESIDENT
	MRS. SURJEET KAUR	MEMBER
	SHRI SURESH KUMAR SARDANA	MEMBER

 

                                                                               

ARGUED BY	:	Sh. Saurav Kanojia, Advocate for complainant
	:	Sh. Sukaam Gupta, Advocate for OPs.

Per Pawanjit Singh, President

1. The present consumer complaint has been filed by the complainant against the opposite parties  (hereinafter referred to as the OPs). The brief facts of the case are as under :-
   1. It transpires from the averments as projected in the consumer complaint that the complainant No.1 is registered owner of  Mahindra Thar bearing No.CH-01-CL-8171 (hereinafter referred to be subject vehicle )  and the same was got insured from OP No.1 for a period of 3 years covering third party liability commencing from 5.7.2022 to 4.7.2025 and one year own damage policy commending from 5.7.2022 to 4.7.2023,  by paying premium amount of Rs.47,077/-. The copy of insurance policy is annexed as Annexure C-3  The complainant NO.2 with the assistance of complainant No.1 usually drive the subject car and is having valid driving license Annexure C-4.  On 19.11.2022 at midnight when the complainant No.2 was returning back to his residence after completion of her work from Panchkula to Nayagaon and reached near Light Point of sector 9-8 Panchkula, one vehicle was coming from side of the vehicle of complainant no.2 in a rash and negligent manner and the driver of the said offending car suddenly applied brakes resulting in the accident with vehicle being driven by complainant no.2 and the said driver of the car did not stop the car and on account of darkness the number of the car could not be noted down by the complainant no. 2 or any other person. The complainant no. 2 on account of the impact of the accident suffered a great shock and lost senses for a bit and suffered minor injuries due to the impact of the accident. The impact of the accident was such that the side portion of the vehicle was damaged badly. After coming to the senses from the impact of the accident, the complainant called the panchkula police  and also to the concerned officials. In the said accident the subject vehicle was damaged so badly and the same was towed down to Harbir Automobile PVT LTD.(hereinafter referred to be as repairer) and the receipt regarding the towing of the vehicle is attached as Annexure C-5.  The complainants were informed by the official of the OP that before claiming the insurance, the loss to the subject vehicle to be assessed by the Surveyor and thereafter theComplainants haveto make the whole payment to the repairer and only then the claimed amount will be  reimbursed to complaints as per the bill generated after the repairs. Thereafter the  OP got inspected  the damaged vehicle by M/s Classic Insurance Surveyors & Loss Assessors Private Limited, who had assessed the loss to the tune of Rs.3,42,097/- . The copy of Surveyor Loss Assessment report is annexed as Annexure C-6. The complainants have made a payment of
      Rs.50,000/- as advance to the repairer on 27.12.2022 and on the completion of repair work, the repairer has raised a complete bill dated 05.05.2023 with regard to the repair work of Rs3,88,591/- and the complainant has paid the said 05.05.2023. A copy of the receipt no 11465 dated 27.12.2022, bill dated 05.05.2023 and Receipt No 1377 dated 05.05.2023 are annexed as Annexure C-7 to C-9. In this manner the complainant have paid a total amount of Rs.3,88,591/- to the repairer, out of which the OPs have paid only an amount of Rs.3,34,477/- , which was received by the complainant vide receipt Annexure C-10. Hence, the complainants are entitled for an amount of Rs.54,114/-  the deficient amount not paid by the OPs to the complainants, which was paid by the complainants to the repairer. Thereafter the complainant issued legal notice Annexure C-11 to the OPs  but with no result.   In this manner, the aforesaid act amounts to deficiency in service and unfair trade practice on the part of OPs. OPs were requested several times to admit the claim, but, with no result.  Hence, the present consumer complaint.
   2. OPs resisted the consumer complaint and filed their written version, inter alia, taking preliminary objections of maintainability, cause of action. However, it is admitted that the subject vehicle is registered in the name of the complainant and the same was got insured by complainant No.1 from the answering OPs and accordingly policy document Annexure R1-3/A alongwith terms and conditions were issued. It is further admitted that the claim was lodged by the complainant and thereafter the surveyor was deputed by the OPs and the surveyor has assessed the loss to the tune of Rs.3,42,097/-  but as per terms and conditions of the policy the claim was only admissible to the tune of Rs.3,34,477/-  after applying certain deductions which were not covered under the policy. Not only this as the claim amount  was disbursed on 10.1.2024 and since then no protest has ever been raised by the complainants  with regard to mode of settlement/disbursed claim amount within a reasonable time period, the complaint of the complainant is not maintainable. On merits, the facts as stated in the preliminary objections have been re-iterated. The cause of action set up by the complainant is denied.  The consumer complaint is sought to be contested.
   3. In rejoinder, complainant reiterated  the claim put forth in the consumer complaint and prayer has been made that the consumer complaint be allowed as prayed for.
2. In order to prove their respective claims the parties have tendered/proved their evidence by way of respective affidavits and supporting documents.
3. We have heard the learned counsel for the parties and also gone through the file carefully, including the written arguments on record.
   1. At the very outset, it may be observed that when it is an admitted case of the parties that the complainant No.1 is registered owner of the subject vehicle which met with an accident on the night of 19.11.2022, having been driven by complainant No.2 who was possessing valid driving license and thereafter the complainants lodged the claim with the OPs, who deputed a surveyor to assess the loss to the damaged subject vehicle and the surveyor assessed the loss to the tune of Rs.3,42,097/- of the subject vehicle  and the OPs settled the claim to the tune of Rs.3,34,477/-, the case is reduced to a narrow compass as it is to be determined if the OPs are unjustified in not paying the full claimed amount and paid Rs.54,114/- less to the complainant out of the total claimed amount of Rs.3,88,591/-, which was paid by the complainant to the repairer and the complainant is entitled for the said amount, as is the case of the complainant  or if the  OPs are justified in settling the claim of the complainant to the tune of Rs.3,34,477/- as per terms and conditions of the policy and the complaint being not maintainable is liable to be dismissed as is the defence of the OPs. 
   2. As per case of the complainants they have paid a total amount of Rs.3,88,591/-  to the repairer for the repair of the subject vehicle, which is evident from Annexure C-7 and C-9 the receipts   issued by the OPs but the OPs  arbitrarily settled the claim to the tune of Rs.3,34,477/- which is clear cut deficiency on the part of the OPs.
   3. On the other hand defence of the OPs is that the surveyor has assessed the loss to the tune of Rs.3,42,097/-  as is evident from Annexure C-6 on  making 50% depreciation on plastic parts as per terms and conditions of the  policy and the claim of the complainants was settled for an amount of Rs.3,34,477/-, which was admittedly accepted by the complainant on 10.1.2024 without any protest and objection and thereafter filed the instant complaint, which is not maintainable.
   4. In the light of the  foregoing admitted and disputed facts on record, it is clear that the entire case of the parties is revolving around the tax invoice Annexure C-8 issued by the repairer for the repair of the subject vehicle and surveyor report Annexure C-6, which are required to be scanned carefully.
   5. Perusal of Annexure C-6 the Surveyor report clearly indicates that after making 50% depreciation on plastic parts less salvage and excess clause, the surveyor assessed the  liability of the insurance company to the tune of Rs.3,42,097/-  as per terms and conditions of the policy.  In our opinion the  amount assessed by the surveyor is based on various details and  verification of documents and the complainants are entitled for the amount assessed by the surveyor as per law settled and not the tax invoice amount as raised by the repairer vide Annexure C-8 and subsequently paid by the complainant.   
   6.  The Hon’ble National recently in case titled as Oriental Insurance Co. ltd vs. Arss Infrastructure Project Ltd. II (2023) CPJ 468 (NC) held as under:-

“(i) Insurance — Surveyors’ report — Survey and investigation are one of fundamentals in settling claim, and cannot and should not be disregarded or dismissed without cogent reasons, though it also goes concomitantly that survey or investigation should be convincing and pass test of credence in scrutiny — State Commission has not gone into contents of surveyors’ reports at all on ground that reports were filed belatedly before it — Reports were in any case available before State Commission and as such it ought to have examined their contents rather than dismissing them outright — Depending upon circumstances State Commission could have even imposed terms including cost for belatedly filing reports but to treat them as suspicious and to perfunctorily dismiss them outright merely because they were filed belatedly was not approach either justified or called for — No need to examine surveyors’ reports at this stage at any great length since both parties agree that settlement may be made on basis of respective surveyor’s assessment of actual loss in each case.”

 

7. The  Hon’ble National Commission further in case titled as Detco Textiles Pvt . Ltd. versus New India Assurance Company Ltd. & anr. II (2023) CPJ 535 (NC) held as under:-

“The Surveyor conducted a very detailed inspection of the premises and assessed the loss after due verification of documents. He assessed the total loss to the building, plant & machinery and furniture etc. at Rs.11,21,18,099/- after making necessary deductions of Rs.5,605,905/- towards excess clause and taking care of the process charges, debris removal, architects fee and goods held in trust arrived at the net adjusted loss of Rs.10,65,12,194/-. For every item, the Surveyor had explained the basis of arriving at the amount. The Complainant on the other hand had not placed any evidence to establish that the assessment made by the Surveyor was incorrect. The Complainant, therefore, cannot be allowed the amount beyond the assessment of the Surveyor. We see no reason not to agree with the assessment made by the Surveyor.”

 

8.           As held above the surveyor report is an important piece of evidence and has to be given due weightage and can only be ignored if there is any other cogent evidence otherwise, which the complainants have failed to lead by way of any concrete evidence. However, as it has come on record that the OPs have wrongly paid amount of Rs.3,34,477/- which is against the settled law and even no explanation was given by the OPs as to how they arbitrarily assessed the settled amount paid to the complainants despite of fact that the surveyor has assessed the loss and liability of the OPs to the tune of Rs.3,42,097/- it is safe to hold that there is also deficiency in service and unfair trade practice on the part of the OPs.
9. So far as the quantum of relief is concerned it is proved on record that the OPs have already paid an amount of Rs.3,34,477/-  to the complainant whereas as held above the complainants are entitled for the amount as assessed by the surveyor vide surveyor report Annexure C-6 to the tune of Rs.3,42,097/-, hence, the  complainant is entitled for Rs.7,620/- i.e. the difference of the already paid amount and the amount assessed by the surveyor.  

4. In the light of the aforesaid discussion, the present consumer complaint succeeds, the same is hereby partly allowed and OPs are directed as under :-

 

1. to pay ₹7,620/- to the complainants alongwith interest @ 9% per annum (simple) from  the date of filing the complaint till onwards.
2. to pay lump sum amount of ₹10,000/- to the complainants as compensation for causing mental agony and harassment and towards cost of litigation.

 

5. This order be complied with by the OPs jointly and severally within a period of 45 days from the date of receipt of certified copy thereof, failing which the amount(s) mentioned at Sr.No.(i) & (ii) above shall carry penal interest @ 12% per annum (simple) from the date of expiry of said period of 45 days, instead of 9% [mentioned at Sr.No.(i)], till realization.
6. Pending miscellaneous application(s), if any, also stands disposed off.
7. Certified copies of this order be sent to the parties free of charge. The file be consigned.

Announced 4/11/2024			[Pawanjit Singh] President
mp
			[Surjeet Kaur] Member
			[Suresh Kumar Sardana] Member