The complainant Lachhmn Dass (here-in-after referred to as complainant) has filed complaint U/s 12 of Consumer Protection Act, 1986 against opposite party United India Insurance Co. Ltd. (here-in-after referred to as opposite party).
Briefly, the case of the complainant is that he is having truck bearing registration No.PB-13AR-8931. This vehicle was purchased by him with the assistance of Fullertone India Credit Company Limited for his livelihood. It was comprehensively insured with opposite party for Rs.5 lakhs (IDV) valid w.e.f. 30.11.2017 to 29.11.2018 vide insurance policy bearing No.2004063117P112286617.
It is alleged that opposite party issued only insurance policy, but it has not issued any terms and conditions till date. At the time of issuance of insurance policy, opposite party has given 20% NCB after confirming from the complainant that there was not loss or claim during period of previous policy of New India Assurance Company Limited.
It is further alleged that on 28.12.2017, the vehicle met with an accident at Lehra Mohabbat. The intimation was given to opposite party. After receiving the intimation, the officials of opposite party deputed the spot surveyor, who conducted the spot survey. Thereafter opposite party deputed Er.Dinesh Goyal for conducting final survey. He conducted survey at M/s Baba Bhai Roop Chand Truck Boddy Repair Works, Rampura. He also took the bills to the tune of Rs.73,540/-. Copy of survey report is in the possession of opposite party and same has not been supplied to the complainant, which is mandatory. The complainant lodged the claim against accident and submitted all the bills with opposite party vide claim No.2004063117C0501950001/1. The surveyor gave assurance to the complainant that the claim will be settled and paid to him within 1/2 months. He also obtained signatures of the complainant on various blank printed forms including full and final payment voucher, but till date opposite party did not settle the claim of the complainant. Opposite party has rather filed the claim as 'No Claim' vide letter dated 26.3.2018 on the ground that the complainant has wrongly claimed 'No Claim Bonus discount'. As per Indian Motor Tariff General Regulation 27, entitlement of NCB shall follow the fortune of the original insured and not the vehicle or policy. The insured becomes entitled to 'NCB' only at the renewal of the policy after expiry of full duration of 12 months. The previously policy period was from 14.7.2017 to 29.11.2017. Other ground is that the complainant has not submitted the load challan as per claim intimation. The vehicle was loaded with cement. The letter is totally, illegal, null, void and having no value in the eyes of law.
It is further case of the complainant that he purchased the vehicle from original registered owner in the month of July 2017. The vehicle was already transferred in his name. On the basis of transfer, the previous insurance company i.e. New India Assurance Company Limited has transferred the insurance in the name of the complainant and issued the fresh policy. The previous insurance policy was valid w.e.f. 30.11.2016 to 29.11.2017. As such, 12 months w.e.f. 30.11.2016 to 29.11.2017 has already been completed. The abovesaid insurance company has also issued 'NCB' in favour of the complainant to the effect that no claim has been reported by him against previous policy. Opposite party has also confirmed 'NCB' from previous insurance company in the month of March 2018 i.e. after delay of 4 month from the date of loss, which is also violation of terms of IMT, which should confirm within 21 days. As such, opposite party has wrongly, illegally and arbitrarily repudiated the legal and genuine claim of the complainant with malafide intention to cause him financial loss and harassment. It amounts to deficiency of service on the part of opposite party.
On this backdrop of facts, the complainant has filed the complaint with the prayer for directions to opposite party to settle the claim and pay damages amounting to Rs.50,000/- alongwith interest @ 18% per annum and cost of litigation amounting to Rs.10,000/-. Hence, this complaint.
Upon notice, opposite party appeared through its counsel and contested the complaint by filing written version. In the written version, opposite party has raised the legal objections that the intricate questions of law and facts are involved in the complaint. These require voluminous documents and evidence for determination. It is not possible in the summary procedure under 'Act'. The appropriate remedy, if any, lies only in the civil court. The complainant has concealed the material facts and documents from this Forum and opposite party. He has concealed the fact that he had wrongly availed 'No Claim Bonus' discount. As per Indian Motor Tariff General Regulations 27, entitlement of NCB shall follow the fortune of the original insured and not the vehicle or policy. The insured becomes entitled to 'NCB' only at renewal of a policy after expiry of the full duration of 12 months.
It is further pleaded that previously, the vehicle was insured from 30.11.2016 to midnight of 29.11.2017. During this period, one Vishakhi Singh S/o Sham Singh was owner of the vehicle. The complainant purchased the vehicle from Vishakhi Singh and got the same transferred in his name including insurance of the vehicle after making payment of Rs.60/- on 14.7.2017. As such, the insurance in name of Lachmann Dass is commenced from 14.7.2017 to 29.11.2017. The complainant has not submitted the load challan. As per claim intimation, vehicle was loaded from cement plant. As such, the claim was repudiated vide letter dated 26.3.2018.
Further legal objections are that the complainant is estopped from filing the complaint by his own act and conduct. He is not 'consumer' of opposite party. The complaint is false and frivolous to the knowledge of the complainant and lastly, the complainant has given wrong and false declaration in his proposal form that NCB @ 20% in respect of vehicle for year 2017-18 obtained by him is correct.
On merits, regarding ownership and insurance, version of opposite party is that same is matter of record, but it is further mentioned that insurance is strictly as per terms and conditions of the policy.
It is also asserted that opposite party supplied the insurance policy alongwith terms and conditions. It is reiterated that the complainant has wrongly availed 'NCB' discount. In further written version, opposite party has reiterated its stand as taken in the legal objections and detailed above. In the end, it has prayed for dismissal of complaint.
Parties were asked to produce the evidence.
In support of his claim, the complainant has tendered into evidence his affidavit dated 10.7.2018, (Ex.C1); photocopy of policy, (Ex.C2); photocopy of R.C, (Ex.C3); photocopy of fitness certificate, (Ex.C4); photocopy of tax receipt, (Ex.C5); photocopy of permit, (Ex.C6); photocopy of D.L, (Ex.C7); photocopies of estimates, (Ex.C8 to Ex.C13); photocopy of previous policy, (Ex.C14); photocopy of certificate, (Ex.C15); photocopy of repudiation letter, (Ex.C16) and submitted written arguments.
To rebut the claim of the complainant, opposite party has tendered into evidence affidavit of Baldev Singh dated 15.10.2018, (Ex.OP1/1); photocopies of policy schedule, (Ex.OP1/2 and Ex.OP1/5); photocopy of transfer policy documents, (Ex.OP1/3); photocopy of proposal form, (Ex.OP1/4); photocopies of letters, (Ex.OP1/6 and Ex.OP1/9); photocopy of no claim bonus certificate, (Ex.OP1/7); photocopy of survey report, (Ex.OP1/8); photocopy of GR-27, (Ex.OP1/10) and closed the evidence.
We have heard learned counsel for parties and gone through the file as well as written arguments submitted by learned counsel for complainant.
Learned counsel for parties have reiterated their stand as taken in their respective pleadings and detailed above.
We have given careful consideration to these rival submissions.
Admitted facts are that the complainant got his truck bearing registration No.PB-13AR-8931 insured from opposite party w.e.f. 30.11.2017 to 29.11.2018. The vehicle met with an accident on 28.12.2017 i.e. within cover period. The complainant lodged the claim with opposite party, it appointed the surveyor, but subsequently, opposite party has repudiated the claim vide letter dated 26.3.2018, (Ex.C16).
A perusal of this letter reveals that opposite party has repudiated the claim on the ground that the complainant has wrongly claim 'NCB' discount. As per IMT General Regulation 27, entitlement should be followed fortune of the original insured and not the vehicle or policy. The insured becomes entitled to 'NCB' only at the renewal of policy after the expiry of the full duration of 12 months. The previous policy period was 14.7.2017 to midnight of 29.11.2017. Copy of previous policy is on file as Ex.C14. It was valid from 30.11.2016 to 29.11.2017 and it is in the name of the complainant Lachhman Dass.
Opposite party has also placed on record copy of previous policy and policy documents, (Ex.OP1/2 and Ex.OP1/3) to show that previously, policy was issued in the name of Vishakhi Singh (previous owner) valid from 30.11.2016 to 29.11.2017. The complainant got it transferred vide policy, (Ex.OP1/3). After transfer period, insurance was from 14.7.2017 to 29.11.2017.
The main contention of opposite party is that as per Regulation GR-27, the complainant was entitled to 'NCB' only at the renewal of policy after expiry of the full duration of 12 months. The previous policy in the name of the complainant after transfer was not for full duration of 12 months. Therefore, the complainant has availed 'NCB' for which he is not entitled to.
Point for determination is whether there is any false misrepresentation or whether the complainant has received any claim during previous policy. There is neither any allegation to this effect nor there is evidence to support this fact. When previous insurer has given benefits of 'NCB' without any misrepresentation on the part of the complainant, opposite party cannot deny the benefits under policy. Therefore, repudiation of the claim on this ground is not sustainable.
Other ground to justify the repudiation is that the complainant has not submitted the load challan. There is nothing on record to prove that there was any purpose of load challan to settle the claim when opposite party has already got assessed the loss after appointing surveyor. Moreover as per surveyor report, (Ex.OP1/8) relied upon by opposite party itself, vehicle was empty at the time of accident as mentioned in the spot survey report.
Therefore, keeping in view the observations of surveyor, there remained no purpose for load challan. The net conclusion is that repudiation of claim is not sustainable.
Now, question is regarding the claim for which the complainant is entitled to. The complainant has submitted bills, (Ex.C8 to Ex.C13) to prove that he has spent a sum of Rs.73,540/-, but the surveyor has assessed the loss to the tune of Rs.32,750/-. There is nothing to show that the surveyor was bias or his report is not correct.
Hon'ble National Commission in case of Narinder Kumar Joshi Vs. Reliance General Insurance Company Limited (IV) 2017 CPJ 366 (NC) has observed that the insurance claim is to be settled on the basis of surveyor report unless legitimate reasons are pointed out for not accepting the surveyor report.
Similarly, in case of Sri Venkatshwar Sindikat Vs. Oriental Insurance Company and Anr., II (2010) CPJ 1 (SC), Hon'ble Supreme Court of India has observed that the surveyors were appointed under statutory provisions and they are linked between insurer and insured when question of settlement of loss or damage arises. The report of the surveyor could become base for settlement of claim by the insurer in respect of loss suffered by the insured.
Therefore, keeping in view the aforesaid law also, the surveyor report is to be accepted. The surveyor has assessed the loss to the tune of Rs.32,750/-. The complainant is held entitled to claim to this extent. Opposite party has repudiated the claim illegally. Therefore, he is also entitled to interest @ 9% per annum from the date of repudiation i.e. 26.3.2018 till date of payment.
. For the reasons recorded above, the complaint is partly accepted with Rs.5000/- as cost and compensation against opposite party. Opposite party is directed to pay Rs.32,750/- alongwith interest @ 9% per annum from the date of repudiation i.e. 26.3.2018 till date of payment, to the complainant.
The compliance of this order be made within 45 days from the date of receipt of copy of this order.
The complaint could not be decided within the statutory period due to heavy pendency of cases.
Copy of order be sent to the parties concerned free of cost and file be consigned to the record.
Announced:-
27-03-2019
(M.P Singh Pahwa)
President
(Manisha)
Member
