PER:
Charanjit Singh, President;
1 The present complaint has been received from the District Consumer Disputes Redressal Commission Amritsar by the order of the Hon’ble State Consumer Disputes Redressal Commission Punjab, Chandigarh for its disposal.
2 The complainant has filed the present complaint by invoking the provisions of Consumer Protection Act under Section 12 and 13 against the opposite parties on the allegations that the complainant got insurance for his vehicle Volkswagon POLO bearing registration No. PB 41 C 0008 from opposite party covering the risk period from 13.11.2014 to 12.11.2015 and he is consumer of the opposite party. The said vehicle unfortunately met with an accident on 31.10.2015 and the said vehicle was taken to the authorized service center of the Volkswagon Vehicles Bhagat Automobiles Amritsar and the opposite party was immediately intimated and they deputed their surveyor to access the loss to the vehicle but the opposite party and said repairer made the preliminary estimate of Rs. 855981/71 and the vehicle was considered to be total loss vehicle. The IDV of the vehicle was Rs. 5,25,000/-. Opposite party instead of making the said payment till the filing of the present complaint is dilly dallying the matter on one pretext or the other as the complainant is making the futile visits to the opposite party regularly. The said act of the opposite party in not settling the genuine claim of the complainant is an act of deficiency in services, malpractice, unfair trade practice. The complainant has prayed the following reliefs:-
(i) The opposite party be directed to pay the amount of Rs. 5,25,000/- alongwith interest @ 12% from date of accident till realization.
(ii) The opposite party be directed to pay the compensation of Rs. 50,000/- to the complainant.
(iii) The opposite party be directed to pay the adequate cost of the litigation.
3 After formal admission of the complaint, notice was issued to opposite party and opposite party appeared through counsel and filed written version and contested the complaint by inter-alia pleadings that the complainant has not approached this commission with clean hands and has concealed material facts. In the entire complaint only allegation that opposite party has not settled the claim till date which version is absolutely wrong and incorrect because in fact the claim has already been repudiated by the opposite party vide repudiation letter dated 22.3.2016 addressed to Sandeep Singh informing that on receipt of reporting of loss dated 13.11.2015, the vehicle was surveyed by Mr. Rohit Kapoor Surveyor and loss was assessed immediately for the verification of the facts and assessment of the said loss. On careful perusal of report of surveyor and documents on record, it was noticed that the damages seen by the surveyor, the same were old and do not co relate with cause of accident. In the said repudiation letter attention of the complainant was also drawn towards the undertaking given by him in claim form which reads as follows:-
I/we the above named do hereby, to the best of my/our knowledge and belief, warrant the truth of the foregoing statements in every respect and agree that if I/we have made any false of fraudulent statement or there be any suppression or concealment of facts, the claim shall be forfeited.
According to condition No. 8 “The due observance and fulfillment of the terms, conditions and endorsements of this policy in so far as the relate to anything to be done or complied with by insured and the truth of the statements and answers in the said proposal shall be conditions precedent to any liability of the company to make any payment under this policy. In the light of aforesaid information it was conveyed that We regret to inform you that the claim is not tenable and does not fall under the purview of the policy. Hence the complaint filed by the complainant is not basically maintainable. As per observations made by the surveyor, in nutshell it is submitted that the loss does not corroborate with the damage sustained to the vehicle. The vehicle was got badly damaged in earlier accident and claim settled as total loss by ICICI Lombard. Insurance/ his representative purchased the vehicle as wreck from ICICI Lombard and now obtained the claim from Universal Sompo General Insurance Co. Insurance again fitted all those old damaged parts which were damaged in the earlier accident during ICICI Lombard’s claim. In this regard it is submitted that Airbag, Dash Board, Radiator, Condenser and many other parts were same in both the claims. Previous claim pictures from ICICI Lombard are supplied with the report. In such a major accident, no injury to any person occurred. Instead insured did not get the spot surveyor neither from the Co. nor himself. He did not report the matter to the Police authorities. As per P.I. Record meter reading was 39911 Kms as on 12.11.2014 whereas after 11.5 months now at the time of survey it was the same one. As the surveyor report is substantial piece of evidence and has to be relied upon by this commission, therefore in the light of said finds given by the surveyor, the decision taken by the Insurance Co. as mentioned hereinabove duly authenticated and valid one. On account of repudiation made on merit and conveyed to the insured. There is no question of any delay or deficiency on the part of the opposite party. The parties are bound by the respective terms and conditions and exclusion clauses of the said policy. In the present case the complainant has violated fundamental document i.e. declaration given by him in the claim form as well as violation of other conditions and tried to get wrongful claim from the opposite party and the claim already stands repudiated on the said ground, therefore, he is not covered under the definition of consumer nor he is entitled to invoke the jurisdiction of this commission. The opposite party has denied the other contents of the complaint and prayed for dismissal of the same.
4 To prove the case of the complainant, Ld. counsel for the complainant tendered in evidence affidavit of complainant Ex. C-1 alongwith documents i.e. cover note Ex. C-2, copy of estimate Ex. C-3, copy of Challan Ex. C-4, copy of the delivery certificate Ex. C-5, copy of pollution certificate Ex. C-6 and closed the evidence. On the other hands, Ld. counsel for the opposite party tendered in evidence affidavit of Piyush Shankar Assistant Manasger Ex. OP/1, affidavit of Sh. Rohit Kumar Surveyor and loss Assessor Ex. OP/2, Certified copy of surveyor report of Sh. Rohit Kapoor Ex. OP/3, copy of claim form Ex. OP/4, copy of Photographs of vehicle in question bearing No. PB41 C 0008 Ex. OP/5 to Ex. OP/15, copy of on line report of vehicle in question Ex. OP- 16, copy of repudiation letter sent to Sandeep Singh dated 22.3.2016 from Insurance Copy is Ex. OP/17, Certified copy of insurance policy alongwith terms and conditions Ex. OP/18 and closed the evidence.
5 We have heard the Ld. counsel for the complainant and opposite party and carefully gone through the record on file.
6 Ld. counsel for the complainant contended that the complainant got insurance for his vehicle Volkswagon POLO bearing registration No. PB 41 C 0008 from opposite party covering the risk period from 13.11.2014 to 12.11.2015 and insurance cover note is Ex. C-2. The said vehicle unfortunately met with an accident on 31.10.2015 and the said vehicle was taken to the authorized service center of the Volkswagon Vehicles Bhagat Automobiles Amritsar and the opposite party was immediately intimated and they deputed their surveyor to access the loss to the vehicle. The opposite party and said repairer made the preliminary estimate of Rs. 855981/71 and estimate is Ex. C-3 and the vehicle was considered to be total loss vehicle. The IDV of the vehicle was Rs. 5,25,000/-. Opposite party instead of making the said payment till the filing of the present complaint is dilly dallying the matter on one pretext or the other as the complainant is making the fertile visits to the opposite party regularly. The said act of the opposite party in not settling the genuine claim of the complainant is an act of deficiency in services, malpractice, unfair trade practice and prayed that the present complaint may be allowed.
7 Ld. counsel for the opposite party contended that complainant on receipt of reporting of loss dated 13.11.2015, the vehicle was surveyed by Mr. Rohit Kapoor Surveyor and loss was assessed immediately for the verification of the facts and assessment of the said loss. On careful perusal of report of surveyor and documents on record, it was noticed that the damages seen by the surveyor, the same were old and do not co-relate with cause of accident. In the said repudiation letter attention of the complainant was also drawn towards the undertaking given by him in claim form which reads as follows:-
I/we the above named do hereby, to the best of my/our knowledge and belief, warrant the truth of the foregoing statements in every respect and agree that if I/we have made any false of fraudulent statement or there be any suppression or concealment of facts, the claim shall be forfeited.
He further contended that according to condition No. 8 “The due observance and fulfillment of the terms, conditions and endorsements of this policy in so far as the relate to anything to be done or complied with by insured and the truth of the statements and answers in the said proposal shall be conditions precedent to any liability of the company to make any payment under this policy. As per observations made by the surveyor the loss does not corroborate with the damage sustained to the vehicle. The vehicle was got badly damaged in earlier accident and claim settled as total loss by ICICI Lombard. Insurance/ his representative purchased the vehicle as wreck from ICICI Lombard and now obtained the claim from Universal Sompo General Insurance Co. Insurance again fitted all those old damaged parts which were damaged in the earlier accident during ICICI Lombard’s claim. Airbag, Dash Board, Radiator, Condenser and many other parts were same in both the claims. Previous claim pictures from ICICI Lombard are supplied with the report. In such a major accident, no injury to any person occurred. Instead insured did not get the spot surveyor neither from the Co. nor himself. He did not report the matter to the Police authorities. As per P.I. Record meter reading was 39911 Kms as on 12.11.2014 whereas after 11.5 months now at the time of survey it was the same one. He further contended that the surveyor report is substantial piece of evidence and has to be relied upon by this commission, therefore in the light of said finds given by the surveyor, the decision taken by the Insurance Co. as mentioned hereinabove duly authenticated and valid one. On account of repudiation made on merit and conveyed to the insured. There is no question of any delay or deficiency on the part of the opposite party. The parties are bound by the respective terms and conditions and exclusion clauses of the said policy. In the present case the complainant has violated fundamental document i.e. declaration given by him in the claim form as well as violation of other conditions and tried to get wrongful claim from the opposite party and the claim already stands repudiated on the said ground and prayed that the present complaint may be dismissed.
8 In the present case, the complainant claimed that the his vehicle was insured and during the period of insurance his vehicle met with an accident and his vehicle damaged and it was total loss and as per insurance policy, IDV value of the vehicle is Rs. 5,25,000/- and the complainant is entitled to the same. But on the other hands, the case of the opposite party is that on receipt of reporting of loss dated 13.11.2015, the vehicle was surveyed by Mr. Rohit Kapoor Surveyor and loss was assessed and that damages were old and do not co-relate with cause of accident. The surveyor has made observation that the loss does not corroborate with the damage sustained to the vehicle. The vehicle was got badly damaged in earlier accident and claim settled as total loss by ICICI Lombard. Insurance/ his representative purchased the vehicle as wreck from ICICI Lombard and now obtained the claim from Universal Sompo General Insurance Co. Insurance again fitted all those old damaged parts which were damaged in the earlier accident during ICICI Lombard’s claim. Airbag, Dash Board, Radiator, Condenser and many other parts were same in both the claims. Previous claim pictures from ICICI Lombard are supplied with the report. In such a major accident, no injury to any person occurred. Instead insured did not get the spot surveyor neither from the Co. nor himself. He did not report the matter to the Police authorities. As per P.I. Record meter reading was 39911 Kms as on 12.11.2014 whereas after 11.5 months now at the time of survey it was the same one. The opposite party has placed on record report of surveyor which is Ex. OP/3 and the report of the surveyor is supported with his affidavit Ex. OP/2. Hon’ble National Commission held in “Suryachem Industries Vs. Oriental Insurance Co. Ltd.” I (2007) CPJ-278 (NC) that the surveyor report, being an important document, has to be given due weightage, unless rebutted by some cogent evidence on the record. The complainant has not produced any cogent and convincing evidence to rebut the report of the surveyor and there is no reason to disbelieve the said report. Accordingly, the complainant is not entitled to any claim as prayed for in the complaint and the opposite party has validly repudiated the claim of the complainant.
9 In view of above discussion, there is no merits in the present complaint and the same is hereby dismissed with no order as to costs. Copy of order be supplied by the District Consumer Disputes Redressal Commission, Amritsar as per rules. File be sent back to the District Consumer Disputes Redressal Commission, Amritsar.
Announced in Open Commission
15.09.2022
