Haryana

Karnal

CC/519/2020

Kulwinder Singh - Complainant(s)

Versus

Universal Sompo General Insurance Company Limited - Opp.Party(s)

S.S. Moonak

29 Apr 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                        Complaint No. 519 of 2020

                                                        Date of instt.19.11.2020

                                                        Date of Decision: 29.04.2024

 

Kulwinder Singh aged 40 years son of Shri Jaspal Singh, resident of village Pucca Khera, Tehsil Assandh, District Karnal, (Aadhar No.7374 2485 2925).

                                               …….Complainant.

                                              Versus

 

Universal Sompo General Insurance Company Limited, through its Branch Manager, Branch Office, SCF-55, Sector-6, Main Market, Karnal.

 

                                                                      …..Opposite party

 

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.

              Sh.Vineet Kaushik…….Member

      Dr. Suman Singh………Member

          

 Argued by: Shri S.S.Moonak, counsel for complainant.

                    Shri A.K.Vohra, counsel for the OP

 

                    (Jaswant Singh President)

 

ORDER:

 

                The complainant has filed the present complaint Under Section 35 of Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that the complainant is the registered owner of Truck bearing R.C. No. HR45B-9404, and the same was insured with the OP vide its Cover Note No. 2374/58796/784/ 01/000 valid from 12.08.2019 to 11.08.2020. The IDV of the vehicle was Rs. 14,40,833/-. The aforesaid vehicle was used by the complainant for earning his livelihood. On 12.01.2020 the truck was being driven by its driver Pargat Singh was going from Navpara, Distt. Bahraich (U.P.), on the way the truck met with an accident within the area of P.S. Dorhara, Distt. Khiri (U.P.), a case vide FIR No. 0019 dated 12.01.2020, under section 279/304-A/427 I.P.C. was registered. The truck was damaged extensively in this accident. The complainant was sitting in the cabin of the said truck at the time of accident, the complainant also received serious multiple, and grievous injuries on his person including fracture etc. The matter was reported to the O.P. who told the complainant to bring the truck at Karnal. Pargat Singh was having valid and genuine Licence to drive the heavy vehicles. The surveyor was appointed, who conducted the survey of the truck in the premises of M/s. Luxmi Auto, Karnal, photographs were taken by him. The complainant submitted the claim form alongwith relevant documents as demanded by the surveyor of the OP. Surveyor of OP assured the complainant that the claim will be settled very soon. Complainant visited the office of the OP. so many times but the officials of the OP did not give any satisfactory reply regarding the settlement of the OD claim of the vehicle. The official/s of the OP neither settled the claim nor gave any proper response to the complainant for the reasons best known to them. It is pertinent to mention here that the verification report regarding the Driving Licence of the driver Pargart Singh was also submitted to the office of OP. Despite submitting all the relevant documents, the claim of the damaged vehicle of the complainant was neither settled nor repudiated till date. However a letter dated 14.09.2020 was issued by the OP wherein the claim was declined without giving any plausible reason. The aforesaid letter is totally illegal, null and void, vide abinitio, not binding upon the rights of the complainant. Complainant had spent a sum of Rs.Six lakhs on the repair, change of parts, denting-painting etc. from his own pocket, beside this the complainant had spent a sum of Rs. One lakh on the incidental expenses. Thus, there is deficiency on the part of OP. Hence, the present complaint.

2.             On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability, suppression of true and material facts; estoppels; jurisdiction, cause of action, etc. On merits, it is pleaded that the claim of the complainant was duly processed, considered on merits and it was not found payable because driver of vehicle was not holding valid and effective driving license at the time of accident. The OP came to know through R.T.I. that DL of Pargat Singh has been suspended by the office of Secretary Regional Transport Authority Faridkot. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Complainant has tendered into evidence his affidavit Ex.CW1/A, copy of registration certificate Ex.C1, copy of insurance Ex.C2, copy of endorsement Ex.C3, copy of FIR Ex.C4, copy of DL of Pargat Singh Ex.C5, copy of report of DL Ex.C6, copy of bill Ex.C7, copy of letter dated 12.01.2020 Ex.C8, copy of treatment record Ex.C9, copy of discharge summary Ex.C10 and closed the evidence on 14.09.2022.

5.             On the other hand, learned counsel for the OP has tendered into evidence affidavit of Ankita Bose Ex.OP1/A, copy of policy Ex.O1, copy of FIR Ex.O2, copy of RTI application Ex.O3 and Ex.O4, copy of report of Faridkot Authority Ex.O5, copy of investigation report Ex.O6, copy of final survey report Ex.O7, copy of surveyor and loss assessor report Ex.O8, copy of letter dated 14.09.2020 Ex.O9 and closed the evidence on 10.08.2023 by suffering separate statement.

6.             We have heard the learned counsel for the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that complainant got insured his vehicle with the OP. On the 12.01.2020, the vehicle in question was met with an accident and damaged. Complainant intimated to the police and in this regard an FIR no.19 dated 12.01.2020 under section 279, 304A, 427 IPC was registered in Police Station Dorhara, District Khiri (UP). Intimation was also sent to the OP and complainant also lodged the claim alongwith all the required documents to settle the claim but despite repeated requests, the OP did not settle the claim of the complainant and lastly closed the same on the false and frivolous grounds and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OP, while reiterating the contents of written version, has vehemently argued that at the time of accident of vehicle in question, the driver was not having valid driving licence as the same has been suspended by the concerned authority. Hence, the claim was not found payable and the same has been rightly repudiated by the OP lastly prayed for dismissal of the complaint.

9.             Admittedly, the vehicle in question was met with an accident during the subsistence of the insurance policy. The claim of the complainant has been closed by the OP, vide letter Ex.C8/O9 dated 12.01.2020, on the following ground:-

“We have perused the pertinent claim documents submitted by you along with survey report of the independent surveyor and investigator appointed for assessing the loss and following discrepancy were noted:-

As per the driving licence submitted by you found suspended as per verification from the RTO. Hence, the driver has invalid driving licence.

In view of the foregoing, we sincerely regret that we are unable to consider this claim. If however, should you believe that we have overlooked any material facts or circumstances, or should you wish to present an alternative interpretation supported with documents, please draw the same to our attention for review afresh.”  

 

10.           The claim of the complainant has been closed by the OP on the abovementioned ground.

11.           The OP has alleged that as per verification from the RTO, the driving licence submitted by the complainant was suspended. To prove its version, the OP relied upon the report Ex.O5 dated 17.10.2020, issued by Regional Transport Authority, Faridkot. As per said report, the driving licence of Pargat Singh has been suspended but in the said report, nowhere, it has been mentioned that on what date the said driving licence has been suspended. The complainant has also placed on file certificate issued by Regional Transport Authority Faridkot (Punjab) India, Ex.C6, which is reproduced as under:-

“It is certified that Driving Licence No.PB0420130010021 for PSVBUS/Trans/LMVCAB/LMV only has been issued by our office in the name of Mr.Pargat Singh son of Bhagwant Singh, resident of Faridkot, Punjab, India. This licence is issued on 01.03.2013 and valid upto 20.05.2021 for Transport and 31.12.2029 for Non Transport. His date of birth is 20.05.1988 as per record of this office.

Further, it is certified that the above particulars of his Driving Licence are true as per this office record and the said licence is genuine and issued by this office.” 

 

12.           The vehicle in question met with an accident on 12.01.2020. As per report Ex.C6, dated 03.02.2020, the driving licence of Pargat Singh was valid and as per report Ex.O5 dated 17.05.2020, the driving licence of Pargat Singh has been suspended. Meaning thereby, that at the time of accident, the driving licence of Pargat Singh was valid. If the driving licence of a driver looks genuine on the face of it, the insurance company is not expected to further investigate into the authenticity of the license unless there is cause to believe otherwise. In this regard, we relied upon the judgment of Hon’ble Supreme Court titled as Nirmala Kothari Vs. United India Insurance Co. Ltd. in 2020 (1) Law Herald (SC) 801, decided on 04.03.2020, wherein it has been held that complainant had employed as driver after checking his driving license. After accident, on verification licensing authority reported that as record, license was not available with them. Not a case by insurance company that the owner is guilty of willful negligence while employing the driver. Driver had been driving competently and there was no reason for the owner/employer to doubt the veracity of the driver’s licence. Insurance Company is held liable to indemnify the owner. Hon’ble Supreme Court further held that fake license-liability of owner/insured-while hiring a driving the employer is expected to verify if the driver has a driving licence. If the driver produces a license which on the face of it looks genuine, the employer is not expected to further investigate into the authenticity of the license unless there is cause to believe otherwise.  

13.  

“It seems that the Insurance Companies are only interested in earning the premiums which are rather too stiff now a days, but are not keen and are found to be evasive to discharge their liability. In large number of cases, the Insurance companies make the effected people to fight for getting their genuine claims. The Insurance Companies in such cases rely upon clauses of the agreements, which a person is generally made to sign on dotted lines at the time of obtaining policy. This is, thus pressed into service to either repudiate the claim or to reject the same. The Insurance Companies normally build their case on such clauses of the policy, but would adopt methods which would not be governed by the strict conditions contained in the policy”.   

14.           The complainant has alleged that he has spent Rs.Six lacs on the repair of vehicle in question and to prove this fact, he has placed on file copy of estimate Ex.C7 dated 05.06.2020. The said document is only an estimate and the repair cost mentioned in it cannot be assumed to be exact. Whereas, as per surveyor report Ex.O7, net claim amount is Rs.1,21,272/-. Thus, the report of the surveyor will prevail. In this regard we relied upon the authority 2(2008) CPJ paged 182 (NC), United India Insurance Co. Vs. Maya, wherein it has been held that a surveyor report should not be dismissed summarily as the surveyor is independent and qualified person under the relevant provision of Insurance Act, 1938.

15.           Keeping in view that the ratio of the law laid down in aforesaid judgments, facts and circumstances of the present complaint, we are of the considered view that act of the OP while closing the claim of the complainant amounts to deficiency in service, which is otherwise proved genuine one. 

16.           In view of the above discussion, we partly allow the present complaint and direct the OP to pay Rs.1,21,272/- (Rs. One lac twenty one thousand two hundred and seventy two only) alongwith interest @ 9% per annum from the date of closing of the claim i.e. 12.01.2020 till its realization. We further direct the OP to pay Rs.25,000/- to the complainant on account of mental agony and harassment suffered by him and Rs.11,000/- for the litigation expense. This order shall be complied within 45 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:29.04.2024

                                                                  President,

                                                     District Consumer Disputes

                                                     Redressal Commission, Karnal.

 

(Vineet Kaushik)                (Dr. Suman Singh)

                           Member                                  Member