District Consumer Disputes Redressal Commission ,Faridabad.

Consumer Complaint  No. 438/2022.

 Date of Institution:22.08.2022.

Date of Order:05.07.2023.

Sher Singh s/o Shri Mohar Pal r/o Village Jajru (52), Sagarpur, District Faridabad (Haryana).

                                                          …….Complainant……..

                                                Versus

1.                Universal Sompo General Insurance Co. Ltd., 103, First floor, Ackruti Star, MIDC Central Road, Andheri (East), Mumbai – 400 093 through its Manager/Authorised Signatory.

2.                M/s. Universal Sompo General Insurance Co. Ltd., Ist floor, Kanishka Tower, Sarai Khawaja, Bypass Road, Faridabad, through its Managing Director/Director/Authorised Signatory.

                                                                              …Opposite parties

BEFORE:            Amit Arora……………..President

Mukesh Sharma…………Member.

Indira Bhadana………….Member.

PRESENT:                   Sh.  N.P.Singh,  counsel for the complainant.

                             Sh.  Nitish Kumar Wadhwa, counsel for opposite parties Nos.1 & 2.

ORDER:

                             The facts in brief of the complaint are that the complainant had

purchased a Hero Electric E-Bike bearing chassis No.MEPHEFL4811C5035, motor No. HEFL2010489682, Controller No. HEFL20100690,Charger No. SSXH21GS111827, Booklet Owners Manual No.) 760942 on 24.12.2021 vide Tax invoice No.BM2021-22/265 from BM Hero Electric, 92, Gali No.3, Shiv Colony, Tigaon Road, Ballabgarh District Faridabad for a sum of Rs.59,640/- and the said vehicle was got insured with the opposite party for a total value of Rs.59,640/- comprehensively, vide insurance policy No. USGIHE/2021054941 valid from 24.12.2021 to 23.12.2022 on payment of premium of Rs.1408/-, thereby covering all type of risks like accident, damages etc.   During the enforcement of the said insurance policy i.e 17.4.2022 in the morning at about 8.830 am complainant went to his work and on the way when the complainant crossed the small nail the said scooty was slipped on nail and due to which its handle stem, front shocker LH and front shocker RM were damaged.  Thereafter the complainant had immediately informed the opposite parties and their surveyor had inspected the vehicle on 19.4.2022. After inspection of the spot by their surveyor, the complainant took the said accidental/damaged vehicle to B.M.Hero Electric for repairing and replacement of damaged vehicle.  The complainant also got lodged his claim No. CL22023019 through BM Hero Electric regarding the damage of vehicle under the provision of insurance policy in their office and the complainant completed all the formalities/documents regarding claim amount, which told by their officials to the complainant, but the opposite parties had illegally effused to pass the claim of the complainant regarding the damaged vehicle with false and frivolous reason.   The complainant had repaired his vehicle and replaced the damaged parts from BM Hero Electric and they also charged an amount of Rs.3850/- vide tax invoice No. BM SP 222320 dated 26.4.2022.  The complainant shocked and surprised that the

opposite parties had refused to perform their liability to consider the claim of the complainant on the basis of false and frivolous grounds vide letter dated 19.5.2022.   The complainant sent legal notice  dated 5.5.2022 to the opposite party  through registered post but all in vain. The aforesaid act of opposite party amounts to deficiency of service and hence the complaint.  The complainant has prayed for directions to the opposite parties to:

a)                release the claimed amount of Rs.3850/- with interest @ 24% p.a. from the date of incident.

 b)                pay Rs. 20,000/- as compensation for causing mental agony and harassment .

c)                 pay Rs. 11,000 /-as litigation expenses.

2.                Opposite party put in appearance through counsel and filed written statement wherein Opposite party refuted claim of the complainant and submitted that answering opposite parties deputed IRDAI/licensed surveyor M/s. Shivaayam Insurance to survey and assess the loss and the final survey report had been received bearing reference No. 31/2022 on date 23.04.2022.  The claim had been reviewed based on the supporting documents and survey report submitted and after consideration of all facts, following findings was arisen:-

i)                 As per physical verification, no external body/internal parts were found damaged.  Both the claimed shockers were found in leakage condition.

ii)                Losses being claimed were not corroborated with the incident.  In the absence of any outward physical damages to the vehicle, alleged damages were not accidental and were of wear and tear in nature. In view of the above, the answering

opposite parties found that claim was not admissible as per the policy terms and conditions Exclusion No.1, which states “Insurance does not cover the damages the wear and tear losses.

Opposite parties Nos.1 & 2 denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.

3.                The parties led evidence in support of their respective versions.

4.                We have heard learned counsel for the parties and have gone through the record on the file.

5.                In this case the complaint was filed by the complainant against opposite parties–Universal Sompo General Insurance Co. Ltd.. with the prayer to: a)  release the claimed amount of Rs.3850/- with interest @ 24% p.a. from the date of incident.  b) pay Rs. 20,000/- as compensation for causing mental agony and harassment . c)  pay Rs. 11,000 /-as litigation expenses.

                    To establish his case the complainant  has led in his evidence,  Ex.CW1/A – affidavit of Sher Singh, Ex.C-1 -Tax  invoice, E x.C-2 -  Insurance certificate for Hero Electric Bike, Ex.C-3 – Tax invoice, Ex.C-4 – repudiation letter, dated 19.05.2022, Ex.C-5 – legal notice, Ex.C-6 – postal receipt.

                    On the other hand counsel for the opposite parties strongly agitated and opposed.  As per the evidence of the opposite parties Ex.RW1/A – affidavit of  Ankita Bose, authorized person of M/s. Universal Sompo General Insurance Co. ltd., Ex.RW-1/1 -  repudiation letter dated 4.07.2022,   Ex.RW-1/2 – letter dated 19.05.2022, Ex.RW1/3 – report of Surveyors & Loss Assessors, Ex.RW1/4 -  All Risks insurance policy schedule cum tax invoice.

6.                In this case, the complainant purchased a Hero Electric E-Bike bearing chassis No.MEPHEFL4811C5035, motor No. HEFL2010489682, Controller No. HEFL20100690,Charger No. SSXH21GS111827, Booklet Owners Manual No.) 760942 on 24.12.2021 vide Tax invoice No.BM2021-22/265 from BM Hero Electric, 92, Gali No.3, Shiv Colony, Tigaon Road, Ballabgarh District Faridabad for a sum of Rs.59,640/- and the said vehicle was got insured with the opposite party for a total value of Rs.59,640/- comprehensively, vide insurance policy No. USGIHE/2021054941 valid from 24.12.2021 to 23.12.2022 on payment of premium of Rs.1408/- vide Ex.C1 & C2,  As per Ex.C-3 , the complainant had repaired his vehicle and replaced the damaged parts form BM Hero Electric and they also charged an amount of Rs.3850/- vide Tax invoice No. BM SP 222320 dated 26.4.2022 vide Ex.C-3.  Opposite parties had repudiated the claim of the complainant vide letter dated 19.5.2022 (Ex.C-4) on the ground that the following observations, are being noted in the subject matter:

a)                as per our physical verification done by the surveyor vehicle loss occurred due to wear and tear surveyor found that both the shocker are leakage and insured want to replace the shocker in insurance claim.  As per photographs no external body/internal body parts damaged..

b)      As per policy Exclusion No.1 which states “Insurance does not cover the damages the wear and tear losses.  Hence claim is not admissible and recommended for repudiation.

7.                After going through the evidence led by the parties, the Commission is of the opinion that the complaint is disposed off with the direction to opposite parties to pay Rs.3850/- alongwith interest @ 6% p.a. from the date of filing of complaint till its realization as per T &C of the policy.  There are no order as to

costs.  Compliance of this order  be made within 30 days from the date of receipt of copy of this order.   Copy of this order be sent to the parties concerned free of costs.  File be consigned to the record room.

Announced on:  05.07.2023                                 (Amit Arora)

                                                                                  President

                     District Consumer Disputes

           Redressal  Commission, Faridabad.

                                                           (Mukesh Sharma)

                Member

          District Consumer Disputes

                                                                                Redressal Commission, Faridabad.

                                                              (Indira Bhadana)

                Member

          District Consumer Disputes

                                                                                   Redressal Commission, Faridabad.