Punjab

Tarn Taran

CC/3/2020

Munish Arora - Complainant(s)

Versus

Universal Sampo Gen. - Opp.Party(s)

28 Jan 2021

ORDER

Before the District Consumer Disputes Redressal Commission, Room No. 208 2^nd Floor, District Administrative Complex, Tarn Taran

 

Consumer Complaint No  :    03 of 2020

Date of Institution                      :  13.01.2020

Date of Decision               :  28.01. 2021

Mr. Munish Arora son of Sh. Mohinder Pal Arora resident of 6/281, Gali Rajan Wali, ward No. 12, Tarn Taran.

                                                                             ......Complainant

                                                Versus

Universal Sompo General Insurance Company Limited through its Chairman/ Managing Director/ Principal Officer through its Divisional Office at District Shopping Complex, Ranjit Avenue Amritsar through its Divisional Manager.

                                                                             .....Opposite Parties.

Complaint Under Section 12 and 13 of the Consumer Protection Act, 1986.

Quorum:               Sh. Charanjit Singh, President

Smt. J.S. Pannu, Member

For Complainant                     Sh. Deepinder Singh Advocate

For Opposite Party                           Sh. Amit Dhawan Advocate.

 

ORDERS:

Charanjit Singh, President;

1        The complainant has filed the present complaint by invoking the provisions of Section 12 and 13 of the Consumer Protection Act against the opposite party on the allegations that the complainant got insurance for his vehicle Vitara Breeza bearing registration No. PB-02 CY 9200 from Opposite party covering the risk period 7.6.2019 to 6.6.2020 and he is consumer as provided under the Act and is competent to invoke the jurisdiction of this Commission. The complainant parked his said vehicle in old Dana Mandi on 11.9.2019 and the four tyres of the said vehicle were stolen and a complaint to the said effect was made to P.S. Tarn Taran City promptly and the opposite party was immediately intimated and the vehicle was taken to Authorised service centre of the Maruti Vehicles Jaycee Motors and the opposite party deputed the surveyor to assess the loss to the vehicle but the opposite party and the said repairer made the preliminary estimate of repair Rs. 50,000/- for the replacement of tyres and Rs. 12000/- for the repair work and the vehicle was repaired by the said service center. The opposite party instead of making the said payment to the repairer repudiated the genuine claim of the complaint vide their repudiation letter dated 3.10.2019 on frivolous grounds that the said vehicle was not fitted with the original tyres and were fitted with extra width tyres which is absolutely wrong, the vehicle was fitted with the tyres which were road worthy and according to the approved specifications for the Maruti Vitara Breeza vehicle. The aforesaid act of repudiation of the genuine claim of the complainant on frivolous grounds is against the principles of natural justice and against the spirit of the law and insurance which is based on principles of indemnification. No policy terms and conditions are conveyed to complainant. The aforesaid acts of the opposite party in not settling the genuine claim of the complainant and repudiating the same on frivolous grounds is an act of deficiency in services, malpractice, unfair trade practice and has caused lot of mental agony, harassment, inconvenience besides financial loss to the complainant for which opposite party is liable to pay the compensation of Rs. 50000/- to the complainant. The complainant has prayed that the opposite party may be directed to pay the amount of insurance of Rs. 62,000/- alongwith interest at the rate of 12% per annum from 11.9.2019 till realization. The complainant has also prayed Rs. 50000/- as compensation and litigation expenses etc. Alongwith the complaint, the complainant has placed on record his affidavit Ex. C-1, Self attested copy of insurance cover note Ex. C-2, Self attested coy of Police complaint Ex. C-3, Self attested copy of Bill of tyres Ex. C-4, Self attested copy of repudiation letter Ex. C-5.

2        After formal admission of the complaint, notice was issued to Opposite Party and opposite party appeared through counsel and filed written version contesting the complaint by taking preliminary objections that the instant complaint is false, malicious, incorrect and with malafide intent and is nothing but an abuse of the process of law and it is an attempt to waste the precious time of this Commission, as the same has been filed by the complainant just to avail undue advantage. The complaint is thus liable to be dismissed under Section 26 of the Consumer protection Act 1986. From perusal of instant complaint, it would be observed that averments made therein, are vague, baseless and with malafide intent. The complainant has made misconceived and baseless allegations of deficiency of services without any documentary evidence in support of his allegations made in the complaint. The complaint filed by the complainant does not fall within the definition of a consumer dispute under the Act, as there is neither any unfair trade practice adopted by this opposite party nor any deficiency in services being established against this opposite party, hence the averments and/ or allegations made therein are false, frivolous, baseless and misconceived and the complaint is liable for rejection and the same may kindly be rejected in totality. The complaint filed by the complainant is bad for joinder and mis-joinders. The complainant has concealed the material facts from this commission and has violated the terms of insurance policy, as such he is not entitled for any relief claimed. On merits, it was pleaded that the complainant has filed claimed on false grounds and with and intent to cheat the opposite parties and for wrongful gain to the complainant and has willfully breached the terms of insurance policy. The claim of the complainant is investigated through its authorized investigator/ Surveyor/ Loss Assessor Mr. Venus Kumar to inspect the vehicle inter- alia to assess the reported loss, who during his investigation visited the repair workshop M/s Jaycee Motors, where the complainant left his said vehicle for repair. Upon scrutiny of the pre inspection report and written statement of complainant the appointed surveyor has observed that all the four tyres of the said vehicles were replaced and fitted with tyres of an extra width and weight and it is not OEM fitment. No request of endorsement with respect to the alteration of tyre of extra width and weight were ever made to the opposite party in order to bring the same under the purview of said insurance policy. The same has been stolen from the vehicle of the complainant as such the stolen oversized tyres were not OEM Fitment hence not cored in Insurance Policy and also breach of policy terms and conditions, hence the claim of the complainant is rightly repudiated by opposite party vide its repudiation letter dated 3.10.2019 for breaching the terms of policy, all the terms and conditions were duly communicated to the complainant at the time of issuance of insurance policy, the complainant has willfully and intentionally, knowing well violated the terms of insurance policy. The opposite party has denied the other contents of the complaint and prayed for dismissal of the complaint. Alongwith the written version, the opposite party has placed on record affidavit of Piyush Shankar Ex. OP1 and OP2, Report of investigator Ex. OP3, Claim repudiation letter dated 3.10.2019 Ex. OP4, Terms and conditions Booklet Ex. OP5

3        We have heard the Ld. Counsel for the complainant and opposite parties and have gone through the evidence and documents placed on the file by the parties.

4        The combined and harmonious reading of pleadings as well as documents on record shows that the complainant has purchased the tyres in question amounting to Rs. 50,000/- for his car bearing registration No. PB02-CY-9200 and placed bill on record as Ex. C-4. As per version of the complainant, the complainant parked his vehicle in Old Dana Mandi on 11.9.2019 and the four tyres of said vehicle were stolen and to this effect a complaint was lodged with Police Station Tarn Taran City. A copy of said complaint is Ex. C-3 and opposite party was immediately intimated as the said vehicle was insured with the opposite party and said policy was effective from 7.6.2019 to 6.6.2020 and insurance policy cover note is Ex. C-2 on the record. After that vehicle was taken to the authorized service centre of Maruti Vehicles i.e. Jaycee Motors. Subsequently, the opposite party has deputed a surveyor to access the loss and a preliminary assessment of repair was prepared to the tune of Rs. 50,000/- for the replacement of tyres and Rs. 12,000/- for repair work which was carried out in the said service centre. But the opposite party has repudiated the claim vide repudiation letter dated 3.10.2019, copy of which is Ex. C-5 on the ground that “the all 4 tyres of subject vehicle were replaced and fitted with tyres of an extra width and weight and it is not OEM fitment. The same has been stolen from your vehicle, we bring your notice that stolen oversized tyres are not an OEM fitment.” . Now question arises that as to whether the opposite party can repudiate the claim on this sole ground ? As the opposite party has not placed on record any literature of Mazruti Vitara Breeza which shows that which size of tyres is recommended for above said vehicle and not even single document has been placed on record which clear that tyres which were placed by the complainant are not recommended for Vitara Breeza.  The complainant is not demanding claim for removing any technical defect from the vehicle which could be occurred by the extra size and weight fitted tyres. It is a simply theft case because insurance company is liable to indemnify the complaint as the opposite party has failed to prove that which tyres size is recommended for the vehicle in question. the complainant has specifically denied that he has not received the terms and conditions of said policy and opposite party has not proved on record any document which shows that opposite party has ever supplied the terms and conditions of the policy in question to the complainant. He placed reliance on citation 2001(1)CPR 93 (Supreme Court) 242 titled as M/s Modern Insulators Ltd Vs The Oriental Insurance Company Ltd, wherein Hon’ble Apex Court held that clauses which are not explained to complainant are not binding upon the insured and are required to be ignored. Furthermore, it is generally seen that Insurance Companies are only interested in earning the premiums and find ways and means to decline the claims. He  further placed reliance on citation 2008(3)RCR (Civil) Page 111 titled as New India Assurance Company Ltd Vs Smt Usha Yadav & Others, wherein our Hon’ble Punjab & Haryana High Court held that it seems that Insurance Companies are only interested in earning premiums and find ways and means to decline the claims. The conditions, which generally are hidden, need to be simplified so that these are easily understood by a person at the time of buying any Policy. The Insurance Companies in such cases rely upon the clauses of agreement which a person is generally made to sign on dotted lines at the time of obtaining the policy. He further put reliance upon citation 2012(1) RCR (Civil) 901 titled as IFFCO TOKYO General Insurance Company Ltd Vs Permanent Lok Adalat (Public Utility Services), Gurgaon and others, wherein our Hon’ble Punjab and Haryana High Court held that Contract act, 1872-Insurance Act, 1938-contract among unequal – Validity – Mediclaim Policy - Exclusion Clause – Pre Existing Disease - Exclusion Clause is standard form of contracts – when bargaining power of the party is unequal and consumer has no real freedom to contract-Courts can strike down such unfair and unreasonable clause in a contract where parties are not equal in bargaining power.  So deficiency stand proved and the opposite party has incorrectly refused the payment of the claim. Moreover, the opposite party has not mentioned any clause under which the claim of the complainant has been repudiated as per terms and conditions of the policy.

5        The opposite party has placed on record the copy of alleged surveyor report as Ex. OP-3. But from the perusal of document Ex. OP-3 no such type of finding has been given by Surveyor which shows that stolen tyres are not covered under the policy. Moreover no affidavit of concerned surveyor has been placed on record. In the absence of which no evidentiary value can be made on the report submitted by the surveyor. Reliance in this connection has been placed upon Manikant Vs. New India Assurance Co.Ltd. 1(2012) CPJ 88 (NC) of the Hon’ble National Commission wherein it has been held that the surveyor did not appear in court and subject himself to cross examination nor was any affidavit filed by him to prove his report . Producing a document in court does not by itself constitute proving the document. It has to be backed by credible evidence. In the instant case, no evidence was led to prove the surveyor’s report in the absence of which the surveyor’s report has little evidentiary value.

6        For the aforesaid reason it proves that the opposite party is liable to indemnify the insurance amount to the complainant. By not giving the genuine claim to the complainant in time, it amounts to deficiency in service and unfair trade practice on the part of the opposite party.

7        In view of the above discussion, the present complaint is allowed and the opposite party is directed to make insurance claim regarding the tyres to the complainant within one month from the date of receipt of copy of this order. The complainant has also been harassed by the opposite party, as such the complainant is also entitled to Rs. 5,000/- ( Rs. Five Thousand only) as compensation on account of harassment and mental agony and Rs 5,000/- (Five Thousand only) as litigation expenses. Opposite Party is directed to comply with the order within one month from the date of receipt of copy of the order, failing which the complainant is entitled to interest @ 12% per annum, on the awarded amount, from the date of repudiation of claim till its realisation.  Copy of order be supplied to the parties free of costs as per rules. File be consigned to record room.

Announced in open Commission

28.1.2021