Haryana

Karnal

CC/218/2021

Rajesh Kumar - Complainant(s)

Versus

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

Abhimanyu Lather

13 Jun 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                       Complaint No. 218 of 2021

                                                        Date of instt.13.04.2021

                                                        Date of Decision:13.06.2023

 

Rajesh Kumar son of Shri Ranjit Singh, resident of VPO Aibla Jagir tehsil Nilokheri, District Karnal.

                                               …….Complainant.

                                              Versus

 

Universal Sampo General Insurance Company Limited SCF-55, third floor, main market sector-6, Karnal, Haryana Head office-Mumbai corporate office, unit number 401, 4^th floor, Sangam Complex 127 andheri kurla road Andheri (east) Mumbai Maharastra (27) pin 400059, GSTIN 27 aaacu8917f126.

 

                                                                      …..Opposite Party.

 

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.       

      Sh. Vineet Kaushik…….Member

      Dr. Rekha Chaudhary……Member

          

 Argued by: Shri Abhimanu Lathar, counsel for the complainant.

                    Shri Virender Sharma, 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 complainant is the owner of the vehicle Eicher Motors Truck Model Eicher 2016 bearing registration no.HR-45-B-1630. Complainant got insured the said vehicle from the OP, vide insurance policy no.2315/59153929/00/000, valid from 02.12.2018 to 01.12.2019 and the insured declared value of the vehicle was Rs.6,00,000/-. The said policy is the 0% debt policy or bumper to bumper policy. On 27.10.2019 at about 5.00 a.m. the driver of the vehicle namely Sunil Kumar was travelling from Ismalabad to his home after delivered the stock in Ismalabad and during that time near village Jhansa he met with an accident and died and in the said accident,  the abovesaid vehicle was also got total damaged. The vehicle got total loss so that there is no use of repair of the vehicle. Then complainant gave the intimation of the abovesaid vehicle to the Registering Authority for de-registering the vehicle because the vehicle is not of having any uses.  Thereafter, complainant approached the OP and lodged the claim for the claim of his total loss vehicle and submitted all the relevant documents and also completed all the formalities. Thereafter, complainant visited the office of the OP so many times and requested to settle the claim but OP did not pay any heed to the request of complainant and lastly refused to accede the genuine request of the complainant. In this way there is deficiency in service and unfair trade practice on the part of the OP. Hence this complaint.

2.             On notice, OP appeared and filed its written version, raising preliminary objections with regard to maintainability and cause of action. On merits, it is pleaded that OP sent several messages/ reminders to the complainant for submitting the relevant documents in respect of the alleged damaged vehicle but the complainant has not supplied the documents intentionally reasons best known to him. It is denied that unfortunately driver of complainant on 27.10.2019 at 5.00 a.m. was travelling from Ismalabad to his home after delivering the stock in Ismalabad and during that time near Jhansa he met with an accident as alleged. It is further denied that the vehicle in question was totally damaged. The complainant has got lodged a DDR in connivance with the police regarding the alleged accident. It is further pleaded that complainant cleverly gave the intimation to the registration authority for deregistering the abovesaid vehicle with malafide intention only with a view to get false claim from the OP. Thus, the OP has rightly closed the claim of complainant. 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.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of insurance policy Ex.C1, copy of police DDE report Ex.C2, copy of vehicle cancellation report of RC Ex.C3, copy of RC Ex.C4, copy of letter dated 25.02.2020 regarding closing of claim Ex.C5, copy of letter dated 12.02.2020 Ex.C6, copy of driving licence of driver (deceased) Ex.C7, copy of Aadhar card of complainant Ex.C8 and closed the evidence on 27.01.2022 by suffering separate statement.

5.             On the other hand, learned counsel for the OP has tendered into evidence affidavit of Ankita Bose, Assistant Manager Ex.OP1/A, copy of insurance policy Ex.OP1, copy of survey report Ex.OP2, copy of photographs of vehicle Ex.OP3, copy of surveyor details Ex.OP4, copy of vehicle photos Ex.OP5 and closed the evidence on 11.04.2023 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 during subsistence of insurance policy, the vehicle of the complainant met with an accident and became totally damaged.  Information was given to  the OP.  Complainant submitted all the required documents with the OP and requested to settle the claim but OP did not pay any heed to the request of complainant and lastly prayed for allowing the complaint. Learned counsel for the complainant relied upon the judgment of Hon’ble Supreme Court case titled as Gurmel Singh Versus Branch Manager, National Insurance Co. Ltd. in civil appeal no.4071 of 2022, date of decision 20.05.2022.

8.             Per contra, learned counsel for the OP, while reiterating the contents of the written version, has vehemently argued that OP sent several messages/reminders to the complainant for submitting the relevant documents in respect of the alleged damaged vehicle but the complainant has failed to supply the same and lastly prayed for dismissal of the complaint.

9                We have duly considered the rival contentions of the parties. 

10.           Admittedly, the vehicle in question was met with an accident during the subsistence of the insurance policy. It is also admitted that the insured declared value of the vehicle was Rs.6,00,000/-.

11.           The claim of the complainant has been closed by the OPs, vide letter Ex.C5 dated 25.02.2020 on the ground for non-submission of required documents. OP had sought the documents, vide letter Ex.C6 dated 12.02.2020, which are reproduced as under:-

1.     Print consent letter on Rs.100/- Stamp with Notary attested.

2.     Discharge voucher duly signed and Rs.1/- revenue stamp attached on it and stamped from financer, if any.

3.     NOC from financer, if any.

4.     KYC documents.

5.     Bank mandate for with bank account details of insured.

6.     Police Report, if any.

7.     CKYC Form fully filled by insured.

8.     R.C. cancellation receipt with RTO stamp sign.

 

12.           Learned counsel for the complainant has submitted that complainant has already submitted all the required documents. The onus to prove his case was relied upon the complainant. To prove his case, complainant has placed on file, the copy of police DDE report Ex.C2, copy of cancellation report of Registration Certificate of the vehicle Ex.C3 and copy of Registration Certificate of the vehicle Ex.C4. During the course of arguments, learned counsel for the complainant has placed on file No Objection Certificate issued by Axis Bank from where the vehicle was hypothecated. It has been proved from the said certificate that complainant has cleared the loan amount. Moreover, Registration Certificate has been cancelled only by the concerned authority on clearance of the loan amount. Remaining documents sought in repudiation letter Ex.C5 are no more relevant to decide the claim. Furthermore, when the complainant has placed on record the above mentioned documents then as to why he would not supply the same to the OP when his personal interest is involved.  It appears that OP has sought the alleged documents just to harass the complainant and to delay the claim of the complainant. Further, in Gurmel Singh’s case (supra) Hon’ble Supreme Court held that “while settling the claims, the insurance company should not be too technical and ask for the documents, which the insured is not in a position to produce due to circumstances beyond his control”.

Hence, keeping in view the ratio of the law laid down in the aforesaid judgment, the facts and circumstances of the present complaint, we found no substance in this contention of the OP and OP have taken the baseless plea only in order to reject/close the genuine claim of the complainant.

13.           On receipt of intimation with regard to accident, OP had appointed a surveyor namely Virender Kumar to assess the loss of the vehicle. The surveyor of the OP, vide his report Ex.OP4 has assessed the loss to the tune of Rs.7,64,050/-on repair basis and net loss of Rs.5,12,914/-. The insured declared value of the vehicle in question is of Rs.6,00,000/-. Hence the loss assessed by the surveyor of the OP is more than 75% of the IDV of the vehicle. The vehicle in question has been treated as total loss by the surveyor of the OP.    The registration certificate (RC) of the vehicle has already been cancelled by the complainant, vide cancellation report Ex.C3, and this fact has not been denied by the OP. Furthermore, the driver of the vehicle had expired in the said accident and the accident has also not denied by the OP. As per surveyor report Ex.OP4.

14.           Further,  Hon’ble Punjab and Haryana High Court in case titled as New India Assurance Company Ltd. Versus Smt. Usha Yadav & others 2008 (3) RCR (Civil) 111, has held as under:-

“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”.

15.           Keeping in view, 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 repudiating the claim of the complainant amounts to deficiency in service, which is proved otherwise genuine.

16.           As per the survey Ex.OP4 dated 31.10.2019, loss has been assessed by the surveyor of the OP to the tune of Rs.5,12,914/-but complainant has claimed Rs.6,00,000/- as IDV of the vehicle. The complainant has not placed on file any document to prove that the vehicle was damaged totally. Hence, the report of the surveyor will prevail. In this regard we are relying 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. In view of this authority as well as the facts and circumstances of the case, we are of the considered view that the OP is liable to pay the loss assessed by the surveyor alongwith interest, compensation for mental agony and harassment and litigation expenses.

17.           In view of the above discussion, we partly allow the present complaint and direct the OP to pay Rs.5,12,914/- (Rs.five lakhs twelve thousand nine hundred fourteen only) the loss assessed by the surveyor of the OP alongwith interest @ 9% per annum from the date of closing/repudiation of the claim till its realization to  the complainant. 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 expenses. Complainant is also directed to handover the salvage of the vehicle in question to the OP. 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:13.06.2023

                                                                  President,

                                                     District Consumer Disputes

                                                     Redressal Commission, Karnal.

 

(Vineet Kaushik)        (Dr. Rekha Chaudhary)

                          Member                      Member