DISTRICT CONSUMER DISPUTE REDRESSAL FORUM (EAST)

GOVT. OF NCT OF DELHI

CONVENIENT SHOPPING CENTRE, FIRST FLOOR,

SAINI ENCLAVE, DELHI – 110 092

C.C. NO. 41/13

Shri Sunny Chawla

R/o House No. 224,

Prakash Mohalla

East of Kialash, New Delhi – 110 065                                       ….Complainant

Vs.

United India Insurance Company Ltd.

Through the Branch Manager

Service-Hub, Regional Office – II

Core-IV, Ist Floor, Scope Office

Laxmi Nagar Distt. Centre

Delhi – 110 092                                                                                   ….Opponent

Date of Institution: 23.05.2013

Judgment Reserved for : 26.08.2016

Judgment Passed on : 31.08.2016

CORUM:

Sh. Sukhdev Singh (President)

Dr. P.N. Tiwari  (Member)

Ms. Harpreet Kaur Charya (Member)

Order By : Shri Sukhdev Singh (President)

JUDGEMENT

The complainant Shri Sunny Chawla has filed a complaint under Section 12(a) of the Consumer Protection Act 1986 (hereinafter to be referred as Act), against M/s. United India Insurance Company Ltd. (OP) to award compensation of Rs. 4,49,336/- due to loss suffered by the complainant and deficiency in service.

2.        The facts in brief are that the complainant got his car bearing registration no. DL-IV-B-6191, Make Toyoto Innova, insured with United India Insurance Company Ltd. (OP) under policy no. 2218003111C002430600, which was valid from 26.06.2011 to 25.06.2012.  On 22.01.2012, at around 3.30 a.m., the said car met with an accident near Delhi Gate and was so badly hit that it was not in a condition to be moved without a crane’s assistance.  With the help of crane, it was towed to the Galaxy Toyota Service Station at Okhla.  On 23.01.2012, a claim was lodged with OP.  A complaint was also lodged with police authorities.  The vehicle was got repaired at the cost of Rs. 2,49, 336/- from the authorized service station of M/s. Galaxy Toyota Service Station, Okhla, New Delhi.  A claim was lodged with insurance company, which was rejected by it through their letter of dated 11.12.2012.  The complainant has stated that the claim has been rejected at flimsy grounds, hence, he has claimed an amount of              Rs. 4,49,336/- on account of mental harassment alongwith cost. 

            In the WS, OP has taken various pleas such as the complainant did not inform to United India Insurance Company Ltd. (OP) with regard to his having not filed any claim with the previous insurance company i.e. IFFCO-TOKIO General Insurance Company Limited.  Believing the same, OP gave him 25% no claim bonus (NCB).  However, on enquiry, it was found that the statement given by him was wrong and he deposited the amount of No Claim Bonus with OP on 20.01.2012, one day prior to the date of accident.  Towing bill amounting to Rs. 1,100/- was found fake.  The accident took place on 22.01.2012, whereas the information was given to the police on 09.06.2012.  The complainant did not submit the complete documents to the surveyor and surveyor assessed a loss of Rs. 1,64,623/- less Rs. 7,432/- to the expected salvage value making a net total of Rs. 1,57,191/-.  It is further been stated that the surveyor’s report concluded that “based on the documents, statements obtained, enquiries made and subsequent verification done at various places and with the persons concerned, the undersigned is of the considered opinion that the alleged accident’s claim is not substantiated by the insured”.  Thus, he recommended no claim.  That being so, the insurance company closed the file.  Other pleas of the complainant have also been denied. 

The complainant has filed rejoinder to the WS of OP, wherein he has controverted the pleas taken in the WS and reasserted his pleas.

3.        In support of its claim, the complainant has examined himself, who has deposed on affidavit.  he has narrated the facts, which have been stated in the complaint.  He has also got exhibited documents such as policy (Ex. CW1/1), claim documents (Ex. CW1/2), police complaint (Ex. CW1/3), repair bill (Ex. CW1/4) and copy of rejection letter dated 11.12.2012 (Ex. CW1/5). 

In defence, United India Insurance Co. (OP) has examined           Shri Rajesh Bajaj, Manager, who has deposed on affidavit.  He has also narrated the facts, which have been stated in the WS.  He has got exhibited documents such as complaint/DD entry made at police station, Darya Ganj (Ex. OPW-1/1), report of RTO (Ex. OPW-1/2), surveyor report and investigation report (Ex. OPW-1/3) and repudiation letter                (Ex. OPW-1/4).

4.        We have heard the Ld. Counsel for the parties and have perused the material placed on record.  It has been argued on behalf of the complainant that the insurance company has rejected the claim solely on the report of investigating agency and have not followed the surveyor’s report.  It has further been argued that the surveyor have assessed the damage to the tune of Rs. 1,64,623 by its report of dated 13.03.2012 whereas the investigator have given its report on 19.10.2012 after a period of about 7 months.   

On the other hand, Ld. Counsel for the insurance company has argued that in the investigation report, the investigator have pointed out many discrepancies, which the complainant have failed to meet out. 

To appreciate the arguments of Ld. Counsel for the parties, a look has to be made to the surveyor’s report.  If the surveyor’s report is looked into, it is noticed that the surveyor has given its report on 19.03.2012 where he has given his remarks that R/C, F/C, Permit and D/L were verified from original and found in order.  He has further stated that he visited the site of accident but photographs could not be arranged due to heavy traffic.  He has further stated that the accident took place in the night hours and police authorities insisted to ensure to remove the vehicle immediately as there was the route of Republic Day Parade Rehearsal.  From this report, it is noticed that the surveyor has inspected the vehicle.  During the course of repair, he has assessed the damage for an amount of Rs. 1,64,623/-.  Instead of accepting the report, the insurance company has appointed the investigator, who submitted his report on 19.10.2012 and has recommended as No Claim.  The fact that investigation has been done after a period of 6-7 months after the accident and surveyor has already submitted the report, who has recommended an amount of Rs. 1,64,623/-, the surveyor report prior to the investigation report primacy has to be given to the surveyor’s report, as the fact remains that the accident has occurred which cannot be disputed.  That being so, the surveyor’s report being the primary document that has to be relied upon.  Thus, the amount assessed by the surveyor as Rs. 1,64,623/- less Rs. 7,432/-, being the assessed salvage value, which comes to an amount of Rs. 1,57,191/- should have been allowed by the insurance company to the complainant.  By not paying the assessment amount to the complainant, certainly, there was deficiency of services on the part of insurance company. 

In view of the above, we are of the opinion that the insurance company was liable to pay an amount of Rs. 1,64,623/- less Rs. 7,432/-, which comes to an amount of Rs. 1,57,191/-.  Since, the complainant was not paid the assessed amount, certainly, he has suffered mental pain and agony, for which an amount of Rs. 15,000/- including the cost of the litigation is allowed will be paid within a period of 30 days. 

If the order is not complied, the amount of Rs. 1,72,191/- awarded will carry 9% interest from the date of filing of the complaint till realisation. 

Copy of the order be supplied to the parties as per rules.

File be consigned to Record Room.

(DR. P.N. TIWARI)                                                  (HARPREET KAUR CHARYA)

Member                                                                                Member    

       (SUKHDEV SINGH)

             President