Orissa

Jharsuguda

CC/141/2017

Sanjib Kumar Patel S/O- Prasant Patel - Complainant(s)

Versus

Branch Manager The New india Assurence Co.Ltd. Jharsuguda Branch - Opp.Party(s)

P. Mail

09 Dec 2021

ORDER

DISTRICT   CONSUMER DISPUTES REDRESSAL COMMISSION, JHARSUGUDA.

                                                          

C.C.NO-141/2017

 

Sanjib Kumar Patel, aged about 34 yrs.

S/O-Prasanta Patel,

       R/o- Near Indian Bank, Beheramal,

       Po/Ps/Dist : Jharsuguda……………………………………………...……Complainants.

     

Versus

 

1.  Branch Manager,

The New India Assurance Co. Ltd., Jharsuguda Branch,

1^st Floor, Mishra Complex, Mangal Bazar Road,

Jharsuguda………………………………………………….……..…………Opp. Parties.

 

            Counsel for the Parties:-

For the Complainant                       :-         Sri P.Mali,Adv. & Associates.                  

For the Opp. Party                           :-         Sri A.K.Mishra,Adv. & Associates.

 

             Present:-     1. Shri  Dipak Kumar Mahapatra, President.

                                     2. Smt. Anamika Nanda, Member (W).

 

Date of Hearing:- 17.11.2021, Date of Order: 09.12.2021

 

SRI DIPAK KUMAR MAHAPATRA, PRESIDENT:- Brief facts of the case is that, that the Complainant is the registered owner of a Tata Indigo CS Car bearing Regd no- OR-16-0183 which was not insured with the O.P vide policy no- 31030031160100059949 for a period of Dtd.31.10.2016 to dtd. 29.10.2017 with payment of Insurance Premium. On dtd. 24.09.2017 the said Car got accident and the policy in force. After getting information the O.P sent Surveyor to ascertain the damage and investigation was conducted/ photographs taken by the O.P. The Complainant submitted an estimate for the Spare Parts and Labour amounting to Rs. 37,000/- and Rs. 26,326/- respectively on dtd. 26.09.2017. After getting assurance from the Complainant got the Car ready on dtd. 14.10.2017 after incurring expenses from his own. The total sum incurred is Rs. 68,726/-. When the Complainant reached to the office of the O.P to claim his expenses of Rs. 68,726/- the O.P demanded for PREVIOUS POLICY PAPER. i.e for the previous year 2015-16 which was not readily available with the Complainant.  After visiting several times to the office of the O.P the O.P suggested him to bring NCB for 5 years from Policy Bazar.com, where the previous Insurance was availed. The Complainant applied online for NCB vide policy No- 55270031156160096942 and the Policy Bazar. Com replied in the mail that “there is no claim found in 5 years”. The report was submitted with the O.P but the O.P did not accept it and the claim were not settled.  The cause of action arose on dtd.28.11.2017 when the claim of the Complainant was repudiated by the O.P.

 As per the O.P the Complainant has taken an Insurance Policy through Policy Bazar by feeding data online in the New India Assurance Co Ltd. Portal and obtained Private Car Package Policy of Insurance bearing policy no- 31030031160100059949 for his Tata Indigo CS Car bearing Registration NO- OR-16-E-0183  which was valid from dtd. 30.10.2016 to 29.10.2017. During the currency of the said policy the car was met with accident on dtd. 24.09.2017 a about 9.30 PM as informed by the Complainant.  The Complainant has made written representation to the Jharsuguda Branch  and a IRDA Surveyor an Loss Assessor  was engaged  by the O.P  on the same day  to conduct the Survey and assess the Loss as per the provision of 64 UM.  His vehicle was taken to the garage and an estimate was prepared to an amount of Rs. 28,900/- for spare parts and Rs.  37,000/- for labour charges was submitted by the repairer. After repairing is over the Surveyor on request of the Insured on dtd. 14.10.2017 re-inspected the vehicle and the insured has submitted a bill of Rs 26,326/- towards parts and Rs.42,400/- towards labour with no mention of GST on spare parts. On dtd. 25.10.2017 a final survey report was submitted amounting to Rs.32,000/-. As per the policy condition the Insurance company calculated the liability at Rs. 29,590/-. While processing the claim it was observed by the officials of the O.P that the insured has availed 50% NO CLAM BONUS in the policy at the time of taking policy through policy Bazar. vide previous policy no-55270031156160096942 issued by National Insurance Co. Ltd., Sundargarh. On contact with them by the O.P no information regarding previous claim under the previous policy was availed. As the Insurer anticipating some errors in the policy because of changing of Insurance company, the Complainant was asked submit a copy of previous insurance policy. But the Complainant did not supply the previous year policy to facilitate search of Own Damage Claim by the O.P Company.  A requesting letter was sent to the Complainant on dtd. 28.11.2017 to cooperate the O.P and o provide the copy of previous policy paper of the vehicle No- OR-16-0183 within seven days of receipt of this letter failing which the claim will be closed as NO CLAIM. On the basis misrepresentation/ false declaration.  As the Insured did not prefer to submit the previous policy particulars but preferred to file this case. The O.P denies the claim of Rs 1,70,000/- against the Insurance Company and the liability is restricted to Rs. 29,590/-. As the O.P has not committed any deficiency in service the Complainant petition deserves to be dismissed by the Commission.

POINTS OF DETERMINATION:-

1. Whether the Complainant is comes under the purview of Consumer Protection Act-2019?
2. Whether the O.Ps has committed any Deficiency in Service to the Complainant?

From the above discussion and materials available on records we inferred that the Complainant comes under the purview of Consumer as he had purchased an Insurance policy from the O.P on payment of premium as consideration amount.  The Complainant submitted a claim form and estimate before the O.P to settle the accident claim. The O.P demanded the previous policy particulars to confirm about the NCB whether availed by the Complainant from the previous owner or not and due to non-submission of the said particular the claim was repudiated by the O.P.

Even assuming that NCB was taken by the Complainant, OPs should have confirmed that the factum of NCB from previous owner concerning any claim on the vehicle. The position has been elucidated in “Meena Kumar v. National Insurance Company” IV (2015) CPJ 10 BCN. Insurance Company after issuing policy had not written to previous insurer and confirmed entitlement of "No claim bonus" while it was obligatory for issuance of company to write to previous insurer within 21 days of granting the cover and previous insurer was obliged to furnish information within 30 days of receipt of the letter- provision under GR 27 binds Insurance company Tested on the anvil of the aforesaid yardstick, OP cannot substantiate it stand of repudiation of bona fide claim on the grounds of no claim bonus. The cases in which it is established that the insured by making wrongful declaration has taken benefit of No Claim Bonus and the insurer had means to verify the correctness of the declaration of the insured seeking No Claim Bonus by exercising ordinary diligence of verifying the truthfulness of the claim from the insurer's own record, Exception to 19 of Indian Contract Act would come into play and the insurer would not be justified in repudiating the insurance claim on the ground of misrepresentation or concealment of fact. “The matter has been well settled in the case of “L & T General Insurance Co. Ltd. vs Shadi Lal Kapoor” on 6 October, 2020 by State Consumer Disputes Redressal Commission, Delhi. In fact, the onus was on the appellant to check from the previous insurer about the status of the no claim bonus of the insured- Complainant, which the appellant failed to do.  Again the Complainant has not ge the vehicle repaired from any authorized garage or service station where genuine spare parts are available at company prices. So the estimate submitted by the Complainant is cannot to be said as authenticate and genuine.  So the claim for Rs. 1,70,000/- is not accepted. Hence we order as under:-

ORDER

The Complaint petition is allowed. The O.P is directed to settle the claim at minimum 50% of the claim amount i.e at Rs 85,000/-/-(Rupees Eighty Five Thousand) and pay to the Complainant. The O.P is further directed to pay Rs.5,000/-/-(Rupees Five Thousand) as Compensation towards harassment, metal pain and agony along with Rs. 5,000/-(Rupees Five Thousand) towards the cost of litigation. All the above orders are to be carried out within 30 (Thirty) days of receiving of this order, failing which, the complainant is at liberty to proceed in due process of law.

            Order pronounced in the open court today i.e, on 9^th day of December-2021 under my hand and seal of this Commission.

Office is directed to supply copies of the Order to the parties free of costs receiving acknowledgement of the delivery thereof.

I agree,                                                                                             

 

 

MEMBER.(W)                                                                                   PRESIDENT.

                                                            Dictated and Corrected

                                                                            By me.       

 

                                                                     

  PRESIDENT.