DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION

PATIALA.

                                      Consumer Complaint No. 487 of 31.12.2018

                                      Decided on:   3.12.2020

Kapil Katoch aged about 38 years son of Sh.Ravinder Chand, R/o village Jandera, PO: Rajpur, Tehsil Palampur, District Kangra, Himachal Pardesh

Now resident of

C/o Chain Ram,Ward No.13, Near Judicial Court complex, Patran Road, Samana, Tehsil Samana, District Patiala.

                                                                   …………...Complainant

                                      Versus

National Insurance Co. Ltd., Branch office Ghagga Road, Samana, Tehsil Samana, District Patiala through its Branch Manager.

                                                                   …………Opposite Party

                                      Complaint under Section 12 of the

                                      Consumer Protection Act, 1986.

QUORUM

                                      Sh. Jasjit Singh Bhinder, President

                                      Sh.Vinod Kumar Gulati, Member    

ARGUED BY              

                                      Sh.B.K.Sharma, counsel for complainant.

                                      Sh.Alok Mathur, counsel for OP                      

 ORDER

                                      JASJIT SINGH BHINDER,PRESIDENT

1. This is the complaint filed by Kapil Katoch   (hereinafter referred to as the complainant) against National Insurance Co. Ltd.(hereinafter referred to as the OP/s).
2. The brief facts of the case are that the complainant is the owner of car Renault Kwid bearing registration No.HP-37E-1683. The complainant earlier purchased the insurance policy from New India Assurance Company for the period from 21.3.2016 to 20.3.2017.After expiry of the said period, he purchased the insurance policy for the period from 21.3.2017 to 20.3.2018 from the OP and paid the premium of Rs.6676/-
3. It is averred that on 11.1.2018, at about 11.45 p.m. the vehicle in question damaged in a road accident on New Una Highway between Una and Amb(H.P.).Intimation of the same was given to the OP. The company executive of the Op visited the spot next day and after inspecting the spot, asked the complainant to get repair the vehicle and company will pay all the expenses of repair. Accordingly the complainant approached Benchmark Motors Pvt. Ltd. for the repair/maintenance of the car and the surveyor made estimate and note down all the damages of the vehicle. He also got signatures of the complainant on some papers to pass the claim of the vehicle but now the OP has denied to grant the claim on the ground that the complainant has earlier claimed No claim Bonus and made the complainant to pay the repair charges  of Rs.74,877 from  his own pocket .The denial to make the payment showed deficiency in service on the part of the OP which caused mental and physical inconvenience to the complainant.
4. On this background of the facts, the complainant has filed this complaint with the prayer to accept the same by giving directions to the OP to release the claim amount alongwith interest and also to pay compensation to the tune of Rs.2,00,000/- on account of mental agony and harassment and also to pay Rs.15000/-as litigation expenses.
5. Upon notice OP appeared through counsel and contested the complaint by filing written reply raising preliminary objections that the present complaint is not maintainable; no cause of action has accrued to the complainant; the complkainant has not come to the court with clean hands and there is no deficiency in service of the OP and the complaint deserves to be dismissed.
6. On merits, it is admitted to the extent that the vehicle No.HP-37-E-1683 was issued by the OP vide policy No.4014083116610000782 for the period from 21.3.2017 to 20.3.2018 in the name of the complainant.
7. It is further submitted that on receipt of intimation Sh.Mohan Inder Singh, Surveyor was deputed by the competent authority of the OP for the survey of the vehicle who submitted the report with the OP. Mohan Inder Singh has also re-inspected the vehicle and submitted his re-inspection report with the OP. It is further submitted that previously the vehicle was insured with the New India Assurance Company and as per the information passed on the cover note, the complainant claimed to have been eligible for No Claim Bonus @20% which means that “No Claim” ought to have been reported in the previous policy of the complainant. However, on confirmation the OP noticed that a claim had been reported in the previous policy and as such the complainant was not entitled to No Claim Bonus as claimed by him at the time of getting insurance cover from the OP and ultimately the competent authority of the OP sent a registered letter to the complainant explaining each and everything to him. So the claim of the complainant is not payable and was rightly repudiated by the OP. There is no deficiency in service on the part of the OP. After denying all other averments made in the complaint, the OP prayed for the dismissal of the complaint.
8. In evidence, the ld. counsel for the complainant has tendered Ex.CA affidavit of the complainant alongwith documents Exs.C1 to C12 and closed the evidence.
9. On the other hand, the ld. counsel for OP tendered affidavit Ex.OPA of Mohaninder Singh, Surveyor, Ex.OPB affidavit of Balwinder Singh, Asstt. Branch Manager, Samana alongwith documents Ex.OP1 to  OP14 and closed the evidence.
10. Both the parties have filed written arguments. We have gone through the same, heard the ld. counsel for the parties and have also gone through the record of the case, carefully.
11. The Ld. counsel for the complainant has argued that the complainant is having Renault Car bearing registration No.HP-37E-1683 and got insured the same with New India Assurance Co. for the period from 21.3.2016 to 20.3.2017.The ld. counsel for the complainant further argued that thereafter he got insured the car from National Insurance Co. Ltd. for the period from 21.3.2017 to 20.3.2018 and paid Rs.6676/- as premium to the OP. The ld. counsel further argued that on 11.2.2018 at about 11.45p.m. the above vehicle was damaged in a road accident  between Una and Amb(H.P.) and the complainant intimated the OP. The ld. counsel further argued that surveyor made an estimate and noted down all the damages of the vehicle and also got signatures of the complainant on some papers. It is further argued that now the OP denied all the claims by making false excuses. The complainant has also claimed No Claim Bonus, which he has lodged with the OP but that was declined. The ld. counsel further argued that the complainant has submitted no claim bonus certificate but the OP had not paid Rs.74,877/- to the complainant. The ld. counsel for the complainant has relied upon the judgment passed by the Hon’ble Consumer Disputes Redressal Commission, Rajasthan, Jaipur  in the case titled as United India Insurance Co. Ltd. Vs. M/s Toshniwal Sensing Devices Pvt. Ltd.  First Appeal No.136/2018 .
12. On the other hand, the ld. counsel for the OP has argued that the OP has rendered best available services to the complainant and there is no deficiency in service. The ld. counsel further argued that complainant had not bonafidely approached this Commission and concealed the material facts. The ld. counsel further argued that the vehicle in question was insured with the OP for the period from 21.3.2017 to 20.3.2018.It is further argued that this vehicle was previously insured with New India Assurance Co. and as per the information passed on the cover note, the complainant claimed to  have been eligible for No Claim Bonus @ 20%, which means that “No Claim” ought to have been report in the previous policy. The ld. counsel further argued that however, on confirmation, the National Insurance Company has  noticed that the complainant a claim had been reported in the previous policy and the complainant was not entitled to any No Claim Bonus. The ld. counsel further argued that complainant has availed 20% No Claim Bonus by giving wrong declaration, whereas he has made a claim under previous policy, so the claim was repudiated. The ld. counsel for the OP relied upon the judgment of the Hon’ble Supreme Court of India passed in the case titled as Export Credit Guarantee Corpn. of India Ltd. Vs. M/s Garg Sons International 2013(2).
13. The complainant has tendered his affidavit, Ex.CA and has deposed as per the averments made in the complaint,Ex.C1 is the cover note of National Insurance Co. Ltd. for the period from 21.3.2017 to 20.3.2018, in which total premium of Rs.6676/- was paid  and he has claimed 20% as  No Claim Bonus
14. It is mentioned that previous policy of New India Assurance Co. was expired on 20.3.2017.Ex.C2 is the report of the accident.Ex.C3 is a bill of repair of Rs.74877/-.Ex.C4 is a letter written to National Insurance Company by the complainant to process his claim.Ex.C5 is another letter written by the complainant to OP.Exs.C6 and C7 are the registered postal receipts,Ex.C8 is the legal notice served upon the OP.Ex.C11 is No Claim Bonus of New India Assurance Co.,Ex.C12 is a letter written by the OP to the complainant. It is mentioned in the letter that as per information passed on the cover note Sh.Kapil Katoch has claimed to eligible for No Claim Bonus of 20%. However, it was noticed by the OP that a claim had been reported in the previous policy as such he is not entitled to any No Claim Bonus. It is further stated that as per Regulation 27(F) of Indian Motor Tariff, it is provided that if any insured claims No Claim Bonus for which he/she/they are not entitled to, all the benefits under the policy not be forfeited.
15. On behalf of the OP Mohinder Inder Singh, Surveyor Loss Assessor and Value tendered his affidavit, Ex.OPA, Ex.OPB is the affidavit of Balwinder Singh, Assistant Branch Manager of OP, who has deposed as per the written version. It is mentioned in the affidavit that complainant  has claimed 20% No Claim Bonus on wrong declaration basis, whereas he has availed claim under previous policy, so the claim  of the complainant was rightly repudiated and the OP sent a registered letter on 7.6.2018 explaining everything to him.Ex.OP1 is a survey report accompanied by photographs,Ex.OP4 is the letter written by the OP to the complainant, in which it is written that complainant   was not entitled to No Claim Bonus,Ex.OP5 is the reply to legal notice,Ex.OP7 is the proposal form of National Insurance Co. wherein there is a column that Whether the complainant was entitled to No Claim Bonus and he has stated ‘Yes’.There are regulations,Ex.OP10 of Insurance and there is instructions at No.27 No Claim Bonus: i.e. to claim No Claim Bonus there should be “No Claim made or pending during the preceding full year of insurance”.
16. Ex.OP13 is a most important document for disposal of the complaint.It is a letter of New India Assurance co. Ltd. where the car was previously insured for the period from 21.3.2016 to 20.3.2016. In this letter, it is mentioned that “The claim of the insured has been rejected for non completion of claim for – on 20.11.2017. So it is clear that in the previous policy, the complainant has applied for claim which was rejected.
17. As per Ex.OP10, it is clear that to claim 20% No Claim should be made or pending during the preceding full year of insurance. In the present case, the claim was made with the New India Assurance Company but that was rejected and thus violates the regulations/instructions of the insurance.
18. It has been clearly held by the Hon’ble Supreme Court of India in the case of Export Credit Guarantee Corpn. of India Ltd. Versus Garg Sons International (supra) that “it is not permissible for the Court to substitute the terms of the contract itself, under the garb of construing terms incorporated in the agreement of insurance. No exceptions can be made on the ground of equity”.
19. So  it is clear that complainant was not entitled to No Claim Bonus as he has lodged the claim with the New India Assurance Co. preceding year and that was rejected but this was concealed by the complainant  in his complaint. So due to our above discussion, the complainant has not come to the Commission, with clean hands and has concealed the material facts.
20. Keeping in view the aforesaid discussion the complaint stands dismissed as the complainant has violated the regulations/instructions of the insurance and is not entitled to any No Claim Bonus. Parties are left to bear their own costs.

It is submitted that the complaint could not be decided within the prescribed period due to heavy pendency of cases.

ANNOUNCED

DATED:3.12.2020

                             Vinod Kumar Gulati             Jasjit Singh Bhinder

                                    Member                                       President