Punjab

Ludhiana

CC/20/65

Jagdish Lal Malhan - Complainant(s)

Versus

Oriental Insurance Co.Ltd - Opp.Party(s)

Arun Anand Adv.

09 Aug 2022

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                Complaint No: 65 dated 14.02.2020.                                                Date of decision: 09.08.2022.

Jagdish Lal Malhan son of Sh. Manohar Lal Malhan, R/o. H. No.497         , B-12, Kamran Road, Field Ganj, Ludhiana.                                                                                                                                                    ..…Complainant

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1. The Oriental Insurance Company Ltd., Sona Complex, Near Fire Brigade, G.T. Road, Ludhiana, through its Manager/Authorized Representative.
2. The Oriental Insurance Company Ltd., Having Its Head Office at A-25/27, Asaf Ali Road, New Delhi, through its Managing Director/Director/Authorized Representative.                                                                                                               …..Opposite parties 

Complaint under Section 12 of the Consumer Protection Act.

QUORUM:

SH. K.K. KAREER, PRESIDENT

SH. JASWINDER SINGH, MEMBER

 

COUNSEL FOR THE PARTIES:

For complainant             :         Sh. Arun Anand, Advocate.

For OPs                         :         Sh. Rajeev Abhi, Advocate.

ORDER 

PER K.K. KAREER, PRESIDENT

1.                In brief, the case of the complainant is that he is owner of one Nissan Redi Go car bearing registration No.PB-10-GT-2229. The complainant got the said car insured from the OPs vide insurance policy No.4426000/31/2019/NRF/8797 on 13.02.2018 and paid a premium of Rs.10,657/-. The policy as valid from 16.02.2019 to 15.02.2020.

2.                It is further alleged that on 07.07.2019, the nephew of the complainant namely Sagar son of Raj Kumar and complainant’s son Deepak Malhan were proceeding to Rajpura from Ludhiana. The car was being driven by complainant’s nephew Sagar. The car met with an accident near Khanna as one stray animal came in front of the car. The nephew of the complainant immediately applied brakes due to which the car scrolled many times on the road resulting in injuries to the nephew and the son of the complainant. The car was totally damaged in the accident. Intimation with regard to the accident was given to the OPs immediately. Injureds were hospitalized. After getting recovered, the nephew of the complainant got a DDR No.22 lodged with the police on 16.07.2019. Thereafter, the complainant lodged a claim for the  damaged car but the same was not paid by the OP. Later on, the OPs repudiated the claim on false and frivolous ground vide repudiation letters dated 06.12.2019 and 18.12.2019 on the ground that at the time of the accident Deepak was driving the car and he was pulled out of the car from driver side but he was not having any valid driving licence. According to the complainant, in fact, Sagar was driving the car at the time of accident. Therefore, the repudiation of the claim is illegal and arbitrary. In the end, it has been requested that the OPs be directed to pay the claim of Rs.3,17,000/-  to the complainant along with interest @12% per annum and further the OPs be made to pay the compensation of Rs.1,00,000/-.

3.                The complaint has been resisted by the OPs. In the written statement filed on behalf of the OPs, it has been, inter alia, pleaded that the complaint is not maintainable According to the OPs, on receipt of the claim, the same was registered and processed. M/s. A.K. Enterprises, Kitchu Nagar, Ludhiana was appointed as surveyor and loss assessor. The surveyor investigated the vehicle on 18.07.2019 and 26.07.2019, took photographs and other documents into possession and prepared his report dated 16.08.2019. In the report dated 16.08.2019, the surveyor gave an opinion that it was a case of total loss. The Ops also appointed M/s. Krish Associates as investigator to investigate the claim. The said investigator made thorough investigation and prepared report dated 21.11.2019 and gave an opinion that the car met with an accident on 07.07.2019 near Khanna and at the time of the accident, Deepak Kumar Malhan was driving the car but he did not have any driving licence. Investigator further reported that the complainant wrongly claimed that Sagar was driving the car at the time of the accident. After the receipt of the survey and investigator’s reports, the claim was repudiated vide letter dated 06.12.2019. After the receipt of the letter dated 06.12.2019, the complainant sent reply dated 16.12.2019. On receipt of the reply from the complainant, the OPs called upon the investigator to give reply to the letter dated 16.12.2019 of the complainant. The investigator gave satisfactory reply to the letter of the complainant stating that right side door glass was broken which pierced the right arm of Deepak which indicates that in fact, Deepak was sitting on the driver side seat door and he received injuries on the right arm. On receipt of the reply of investigator, the claim was repudiated. Thus, there has been no deficiency of service on the part of the OPs. The other allegations made in the complaint have been denied as wrong and a prayer for dismissal of the complaint has also been made.

4.                In evidence, the complainant submitted his affidavit as Ex. CA along with documents Ex- C1 to Ex- C10 and closed the evidence.  

5.                On the other hand, learned counsel for the OPs tendered affidavit Ex. RA of Sh. Sukhwinder Singh, Senior Divisional Manager of the OPs, affidavit Ex. RB of Sh. Yogesh Kochar, Surveyor and Loss Assessor, affidavit Ex. RC of Sh. A.K. Chawla of M/s. A.K. Enterprises and affidavit Ex. RD of h. Raksh Pal Kalotra, Prop. Of M/s. Krish Associates along with documents Ex. R1 to Ex. R53 and closed the evidence.

6.                We have heard the arguments advanced by the counsel for the parties and have carefully gone through the record.

7.                In this case, the claim has been repudiated by the OPs on the ground that the vehicle in question was being driven by Deepak Malhan who was not having a driving licence at the time of the accident. Now it has to be seen as to who was driving the car in question at the time of the accident. The accident took place on 07.07.2019. No police report was immediately lodged after the accident and DDR Ex. R20 was lodged on 16.07.2019 on the statement of Sagar son of Raj Kumar. In the DDR, Sagar stated that on 07.07.2019 in between 8-9 PM he along with Deepak was proceeded from Ludhiana to Rajpura in car bearing registration No.PB-10-GT-2229 When they reached near I.D. Banquet Hall, G.T. Road, Khanna, suddenly a stray animal came in front of the car and to save it, he applied brakes but the car went out of control and happened to climb the divider and overturned. The car was badly damaged. The accident took place all of sudden when a stray animal came in front of the car. There was no fault of anybody in the accident.

8.                After the receipt of the claim, the OPs appointed Krish Associates as investigator who gave its report Ex. R35. During the investigator, the investigator recorded the statements of Deepak Malhan and Sagar whereby it was claimed that Sagar was driving the car at the time of the accident. It was further stated that Deepak was pulled out of the car from the co-driver’s side while Sagar was pulled out from driver side. It was further stated before the investigator that Deepak received fracture in his right shoulder and belt was applied for two months and Sagar  received inner jerk and due to sudden impact his ribs were pressed and he was taking treatment from Kalyan Hospital on the very first day of the accident. It was further stated in the statement that Deepak was not having driving licence as he did not know how to drive and Sagar was driving the car at the relevant time. In the concluding part of the report Ex. R35, the investigator has stated that as per the medical record Deepak Kumar received injuries on his right arm and his right shoulder bone was fractured for which he applied belt for about two months. Deepak Kumar further received treatment from P.G.I., Chandigarh. It was further found that pieces of broken glass pierced in the right arm of Deepak Kumar, which indicated that he was taken out of the car from the right door and the broken glasses injured him. It was further revealed from the physical investigation of the damaged car that steering had come on the driver seat which must have caused severe injuries to the driver on chest, legs etc. and as per the record of Kalyan Hospital, right shoulder of Deepak was fractured and belt was applied for two months. On the contrary, Sagar received only minor injuries. It is further stated in the investigation report Ex. R35 that during the course of investigation, Deepak and Sagar stated that both front doors were jammed and they were pulled out from the broken glass whereas this statement was found to be false as both front door could easily be opened without any hindrance as can be seen in the photographs. The investigator has further concluded that in fact Deepak Mahan was driving the car at the relevant time and he received severe injuries and since he was not having a driving licence, the insured has not lodged the genuine claim.

9.                All the facts narrated in the investigation report have not been rebutted by the complainant. It is not disputed that Deepak Kumar suffered fracture and glass injuries on his right arm. From the photographs Ex. R48 to Ex. R50, it can be seen that only the glass of right door of the car had broken in the accident whereas the glass of left door was intact. It is further evident from the photographs that both the doors could be easily opened. Since Deepak Kumar was extracted out of the car from the right side and had also suffered glass piercing injuries on his right arm which was fractured, it clearly indicated that Deepak Kumar was at the driving seat at the time of the accident. It clearly shows that that the complainant has twisted facts to claim insurance by wrongly projecting that the car was driven by his nephew Sagar at the time of accident and not by his son Deepak Malhan who was actually driving the car at the relevant time. Therefore, the repudiation of the claim cannot be said to be illegal nor any case of deficiency of service is made out.  

10.              As a result of above discussion, the complaint fails and the same is hereby dismissed. However, there shall be no order as to costs. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room.

11.              Due to rush of work and spread of COVID-19, the case could not be decided within statutory period.

 

                             (Jaswinder Singh)                            (K.K. Kareer)

                    Member                                           President

 

Announced in Open Commission.

Dated:09.08.2022.

Gobind Ram.

Jagdish Lal Malhan Vs Oriental Insurance Company Ltd.         CC/20/65   

Present:       Sh. Arun Anand, Advocate for complainant.

                   Sh. Rajeev Abhi, Advocate for OPs.

 

                   Arguments heard. Vide separate detailed order of today, the complaint fails and the same is hereby dismissed. However, there shall be no order as to costs. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room.

 

                             (Jaswinder Singh)                            (K.K. Kareer)

                    Member                                           President

 

Announced in Open Commission.

Dated:09.08.2022.

Gobind Ram.