Before the District Consumer Disputes Redressal Commission, Rohtak.
Complaint No. : 637
Instituted on : 10.11.2022
Decided on : 10.01.2024
Manish Kumar age 35 years, s/o Sh. Randhir Singh R/o Sher Vihar Colony, near Plywood Factory, Rohtak-124001.
………..Complainant.
Vs.
- The Branch Manager, HDFC ERGO, office at First Floor, SCF-13, HUDA Complex, Rohtak -124001.
- The Manager, Raj Motors, Delhi Road, near D-Park Rohtak.
……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
DR. TRIPTI PANNU, MEMBER.
DR.VIJENDER SINGH, MEMBER
Present: Sh.Sandeep Kumar Hooda Advocate for complainant.
Sh.Gulshan Chawla, Advocate for opposite party No.1.
Opposite party No.2 already exparte.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case as per complainant are that he is registered owner of a car bearing registration number HR-29AM-1099 make TATA Tiago and the same was insured with the opposite party No.1 vide policy no.2311204232970300000 for the period 26.07.2021 to 25.07.2022. The alleged car met with an accident on 01.05.2022 and the complainant had visited TATA MultitechMotors Faridabad for the repairing of his car. The estimate given by Tata Services was of Rs.119975/- and the liability regarding the payment of the damaged vehicle of the complainant was of the company. On 09.05.2022 the complainant received a letter from the opposite party No.1 regarding the assessment of the claim wherein it was stated that some of the damaged parts are not covered by the surveyor in the insurance. Whereas as per the policy, the respondent no.1 is fully liable to pay the accidental claim amount to the complainant. The above mentioned vehicle was got repaired by opposite party No.2 on 06.09.2022 vide job card dated 01.09.2022 and consolidated invoice amounting to Rs.98760/- was generated on 06.09.2022. The complainant had paid the alleged amount of the invoice whereas respondent no.1 was liable to pay the same. On 09.02.2022 the respondent no.1 has paid an amount of Rs.15390/- and is liable to pay the remaining amount of Rs.83370/-. The complainant had paid the premium for “Zero dept. policy” to respondent no.1 and it was the duty of the respodnent,no.1 to pay full claim amount without any delay to the complainant. But the opposite party had denied the genuine claim of the complainant. The act and conduct of the opposite parties is illegal and amounts to deficiency in service. Hence this complaint and it is prayed that opposite party may kindly be directed to pay the remaining claim amount of Rs.83370/- alongwith interest, to pay Rs.30000/- as compensation on account of deficiency in service and Rs.20000/- as litigation expenses to the complainant.
2. After registration of complaint, notices were issued to the opposite parties. Opposite party No.1 in its reply has submitted that the claim was lodged through call centre by the insured and after receiving the information regarding the accident of insured vehicle, the opposite party appointed surveyor to assess the loss and damages. The surveyor assessed the loss and damages of the insured vehicle and accordingly a sum of Rs.15390/- has been paid by the answering opposite party to the complainant on account of damages caused to the insured vehicle as per the terms and conditions of the insurance policy. During survey it was observed by the surveyor that the damages mentioned by the complainant in the claim form and on physical verification of the vehicle, the below mentioned were found to be correlating with the accident: Bonnet Replace and Grille However the claim of damages towards Rh.Fender, Left Fender, Front Bumper and both head light of the vehicle as claimed by the complainant did not correlate with the accident. The damages did not commensurate with the loss details. This fact was shared with the insured vide letter dated 09.05.2022. It is further submitted that zero depreciation coverage is a coverage where depreciation is not applied while assessing the liability, however coverage of Zero depreciation is not applicable where damaged are disallowed, which happened in the present case. The claim of the complainant already stands paid by the answering opposite party, as per the assessed amount. Hence there is no deficiency in service on the part of opposite party and dismissal of complaint has been sought. However, notice sent to opposite party No.2 received back duly served but none appeared on behalf of opposite party No.2 and opposite party no.2 was proceeded against exparte vide order dated 14.12.2022 of this Commission.
4. Ld. counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A, documents Ex.C1 to Ex.C7 and closed his evidence on 07.04.2023. On the other hand, Ld. counsel for opposite party no. 1 has tendered affidavit Ex. RW1/A & Ex.RW1/B, documents Ex.R1/1 to Ex.R1/4 and closed his evidence on 21.08.2023.
5. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
6. We have perused the documents placed on record by both the parties. The complainant has got repaired his vehicle from the authorised service centre and placed on record bill Ex.C5 amounting to Rs.98760/-. On the other hand survey report Ex.R1/3 has been placed on record by the respondent counsel and also submitted claim survey report ‘Annexure-JN-A’ and as per this document, the insurance liability comes to Rs.15390/- and this amount has already been paid by the respondent to the complainant and further submitted that the damages are not co-related with the accident.Moreover as per letter Ex.R1/4 of the opposite party, it is mentioned that : “During survey it has been observed that the damages mentioned by you in the Claim Form and on physical verification of the vehicle, the below mentioned damaged are correlating with the accident. Hence, the same are allowed as mentioned below. 1. Bonnet Replace and Grille. Please note that damages to Rh.Fender, Left Fender, Front Bumper and both head light of the vehicle as claimed by you in the accident, do not correlate with the accident. The damages do not commensurate with the loss details.The said damages have been accumulated to the present claim which has been disallowed”. No technical report or affidavit has been placed on record by the opposite party to prove that these damages could not be occurred due to fighting of animals/cows who suddenly came in front of the car of complainant while fighting each other and due to which the car of the complainant was totally damaged.At the time of arguments ld. Counsel for the insurance company placed on record claim summary report as Annexure JNA, as per which the insurance company has assessed an amount of Rs.15390/- against the loss suffered by the complainant in the alleged accident and the same has been paid to the complainant.Ld. Counsel for the complainant has also placed reliance upon the judgment of Hon’ble National Commission dated 17.10.2022 in First Appeal No.401 of 2013 titled as Bajaj Allianz General Insurance Co. Ltd. Vs. Dr. Kumar Bhandari and order dated 01.05.2023 in CC No.359 of 2013 titled asM/s Flowtex Products Vs. M/s United India Insurance co. Ltd. as per which the Hon’ble National Commission has held that: “The Surveyor’s report is not the final work and it is not binding upon the insured or insurer”. The policy is zero dep policy and the complainant has got repaired his vehicle from the authorised service centre i.eRaj Motors and spent an amount of Rs.98760/- on the repair of his vehicle. Hence the complainant is entitled for the balance amount of Rs.83370/-.
7. In view of the facts and circumstances of the case we hereby allow the complaint and direct the opposite party No.1 to pay the remaining claim amount of Rs.83370/-(Rupees eighty three thousand three hundred and seventy only)alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 10.11.2022 till its realisation and also to pay Rs.5000/-(Rupees five thousand only) as compensation on account of deficiency in service and Rs.5000/-(Rupees five thousand only) as litigation expenses to the complainant. Order shall be complied within one month from the date of decision.
8. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
10.01.2024.
.....................................................
Nagender Singh Kadian, President
..........................................
TriptiPannu, Member.
..........................................
Vijender Singh, Member.
