| Final Order / Judgement | DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION PATIALA. Consumer Complaint No. 70 of 1.3.2017 Decided on: 1.9.2021 Balbir Kaur aged 62 years wife of Sh.Balwant Singh Premi, resident of # MIG-579, Urban Estate, Phase-1, Patiala. …………...Complainant Versus - United India Insurance Company Ltd.,22 No.Phatak, Leela Bhawan, Bhupindra Road, Leela Bhawan Market, Patiala through its Branch Manager.
- United India Insurance Co. Ltd. Registered & Head Office 24 Whites Road, Chennai-600014, through its Managing Director.
…………Opposite Parties Complaint under the Consumer Protection Act. QUORUM Sh. Jasjit Singh Bhinder, President Dr.Harman Shergill Sullar, Member ARGUED BY Sh.Maninderpal Singh Sahi, counsel for complainant. Sh.D.P.S.Anand, counsel for OPs. ORDER JASJIT SINGH BHINDER,PRESIDENT - This is the complaint filed by Balbir Kaur (hereinafter referred to as the complainant) against United India Insurance Co. Ltd.(hereinafter referred to as the OP/s) under the Consumer Protection Act (hereinafter referred to as the Act)
- Briefly the case of the complainant is that the complainant availed Private Car Package Policy No.1110063116P102301837 for his Toyata Innova 2.5 Gx 7 seated BS IV car having registration No.PB-11-AR-2122, for the period from 21.5.2016 to 20.5.2017 midnight and paid Rs.19,950/- as premium of the vehicle.
- It is averred that on 3.10.2016 the said vehicle was being driven by her son Harmanpreet Singh and met with an accident, due to the negligence of vehicle Maruti Dezire car bearing registration No.PB-11-BJ-6957 as a result of which the vehicle in question badly damaged. It is further averred that intimation with regard to the loss was immediately given to OP No.1 who told to park the vehicle in the Toyota agency namely EM Pee Motors Ltd., Focal Point, Patiala. It is further averred that after repair of the vehicle, the complainant approached OP No.1 for the payment and delivery of the vehicle who told to clear the bill amount and assured that the same will be reimbursed after getting sanctioned the claim of the total bill amount. Accordingly after clearing all dues, the complainant submitted bill of Rs.3,23,861/- alongwith requisite documents to OP No.1 but it did not reimburse the same despite several requests made by her and ultimately on 7.2.2017, OP No.1 arbitrarily and illegally repudiated the claim of the complainant. There is thus deficiency in service on the part of the OPs which caused mental agony, tension and harassment to the complainant. Hence this complaint with the prayer to accept the same by giving directions to the OPs to clear the amount of Rs.3,23,861/- alongwith interest @ 18% per annum ; to pay Rs.50,000/- as compensation and Rs.11000/-as costs of the complaint.
- Notice of the complaint was duly given to the OPs who appeared through counsel and contested the complaint by filing written reply having raised preliminary objections that the complaint is not maintainable, as the claim of the complainant has already been repudiated vide letter dated 17.4.2017 on the ground that the insured has not disclosed the fact of third party injuries caused to Sh.Jagjit Singh driver of car No.PB-11BJ-6957 and its occupant Lakhwinder Singh and has executed an agreement with them without consent and intimation to OP before lodging the claim, which amounts to violation of terms and conditions of the policy. It is pleaded that the accident had taken place on 3.10.2016 and intimation of loss was given on 12.10.2016. Intimation to the police has also not been given, so the complaint is liable to be dismissed.
- On merits, it is admitted that the OPs have issued Private Car Package Policy of car No.PB-11-AR-2122 for a sum of Rs.6 lacs in favour of the complainant for the period from 21.5.2016 to 20.5.2017. It is further submitted that on receipt of intimation on 12.10.2016 i.e. after 10 days of the accident, the OP No.1 deputed IRDA approved Eminent Surveyor and Loss Assessor, Patiala to assess the loss, who in his report dated 24.11.2016 assessed the loss to the tune of Rs.1,52,567/-.The OP also deputed Sh.Ashok Kumar, Investigator Patiala to investigate the case, who in his report dated 30.1.2017 found that the complainant has violated the terms and conditions of the policy, as such the OPs have rejected the claim vide letter dated 17.4.2017. It is further submitted that the complainant has got a adverse claim history as she had already taken two claims of Rs.82,202/- on 16.3.2016 and Rs.72,105/- on 11.7.2016.There is no deficiency of service on the part of the OPs. After denying all other averments, the OPs have prayed for the dismissal of the complaint.
- In support of the complaint, the ld. counsel for the complainant has tendered in evidence Ex.CA affidavit of the complainant alongwith documents Exs.C1 to C5 and has closed the evidence.
- On the other hand, the ld. counsel for the OPs has tendered in evidence Ex.OPA affidavit of Smt.Seema Goel, Dy.Manager ,Ex.OPB affidavit of Er.Anand Pal Singh Gurney, Surveyor, Ex.OPC copy of affidavit of Sh.Ashok Kumar Investigator alongwith documents Exs.OP1 to OP8 and closed the evidence.By way of additional evidence the ld. counsel for the OPs has also tendered documents Exs.OP9 to OP12.Vide separate statement he has stated that he has inadvertently documents Exs.OP9 to OP12 though as per order of the Forum he has allowed to tender e-mail dated 18.12.2017 and has further stated that the same may be read as Ex.OP13 and the documents Exs.OP9 to OP12 may not be read in evidence.
- We have heard the ld. counsel for the parties and have also gone through the record of the case, carefully.
- The ld. counsel for the complainant has argued that the complainant availed Pvt. Car package policy for his Toyota Innova car from the OPs for the period from 21.5.2016 to 20.5.2017 midnight and total premium was paid. The ld. counsel further argued that when her son Harmanpreet Singh Premi was driving the said car, the same met with an accident on 3.10.2016.The ld. counsel further argued that intimation of the accident was given to the OPs who told to the complainant to park the car in question in the Toyota Agency i.e. EM Pee Motors Ltd., Pioneer Toyota, Focal Point, Patiala. The ld. counsel further argued that Rs.3,23,861/-was spent but OPs have not given any amount. So complaint be allowed. The ld. counsel has relied upon the citation Oriental Insurance Co.Ltd. Vs. Dilip Kumar Kar 2014(1)CLT 613.
- On the other hand, the ld. counsel for the OPs has argued that the complainant is defaulter as she has also taken three claims from the insurance company. The ld. counsel further argued that during the tenure of insurance from 21.5.2016 to 20.5.2017 the complainant has received Rs.82,202/- and Rs.72105/-. The ld. counsel further argued that the claim was repudiated on 17.4.2017 on the ground that the complainant has not disclosed about the 3rd party injury caused to Sh.Jagjit Singh driver of Car No.PB-11-BJ-6957 in question. The ld. counsel further argued that son of the complainant was driving the car on the wrong side and he met with accident due to his own wrong. The ld. counsel has relied upon the judgment passed by the Hon’ble Punjab and Haryana High Court in the case titled as National Insurance Company Ltd. Vs. Rajwinder Kaur and others Vol.CLXII-(2011-2), The Punjab Law Reporter.
- To prove this case Smt.Balbir Kaur has tendered her affidavit, Ex.CA and she has deposed as per the complaint,Ex.C1 is the registration certificate, Ex.C2 is the Private Car Package Policy valid for the period from 21.5.2016 to 20.5.2017 midnight and total amount of premium was paid,Ex.C3 is the driving licnece of Harmanpreet Singh, Ex.C4 is bill of Pioneer Toyota of Rs.3,23,861/-.Ex.C5 is repudiation of claim dated 7.2.2017 in which it is mentioned that there was 3rd party injuries involved which was compromised and as per the report of investigator the vehicle was being driven negligently and also as per their record there is adverse claim history.
- On behalf of OPs Seema Goel, Sr.Branch Manager has tendered her affidavit, Ex.OPA and she has deposed as per the written statement,Ex.OPB is affidavit of Er.Anand Pal Singh Guruney, surveyor, Ex.OP3 is affidavit of Ashok Kumar, Investigator,Ex.OP1 is repudiation of claim dated 17.4.2017,Ex.OP2 is also repudiation of claim dated 7.2.2017,Ex.OP3 is statement of Balbir Kaur with the police, in which it is mentioned that she has insured her car No.PB-11-AR-2122 with the United India Insurance Company, Patiala and on 3.10.2016 her son Harmanpreet Singh Premi was driving the said car and at about 5.50PM near gate No.1 of DCW, the same met with an accident with the Swift Car No.PB-11-BS-6957 due to which both the cars were damaged. The matter went to the police and the matter was compromised on 5.10.2016.
So from this statement which was exhibited by Balbir Kaur before the policy, it is clear that the accident took place and the matter was compromised. Ex.OP4 is statement of Harmanpreet Singh dated 3.12.2016 regarding the accident, Ex.OP5 is investigation report of Ashok Kumar. It is mentioned that no spot survey was arranged and no police report was lodged. It is also stated that the occupant of the swift car was also received injuries and compromise was effected. He has also visited the house of the complainant on 28.11.2016 and has confirmed that accident has taken place and both the vehicles were damaged and driver of Swift car received injuries. It is also mentioned that the claim was lodged by Balbir Kaur. So from the report of investigator, it is clear that accident has taken place and the matter went to the police and the matter was compromised. The compromise is dated 5.10.2016, Ex.OP6. Ex.OP7 is survey report in which total damage is shown as Rs.1,52,567.89. So from the report of surveyor, it is clear that the loss to the tune of Rs.1,52,567/- was caused. Ex.OP8 is the insurance policy, Ex.OP9 is previous claim taken on this vehicle from United India Insurance Co. Ltd. of Rs.1,36,925/-, Ex.OP10 is also claim taken on 29.5.2015 of Rs.42,300/-, Ex.OP11 is also claim taken dated 11.7.2016 of Rs.72,105/-Ex.OP12 is claimtaken dated 17.3.2016 of Rs.88202/-.So from all the documents it is clear that complainant is taking claim from the insurance company but it is admitted fact that the vehicle in question was fully insured from 21.5.2016 to 20.5.2017 with the OPs. - Now coming to the amount of claim which is to be paid. As per the receipt of Pioneer Toyota the total amount was Rs.3,23,861/-,whereas from the surveyor report which is also detailed one in which the claim is mentioned which was admitted and the total claim amount is Rs.1,52,567.89 .In the present case there was no spot inspection report. So no spot inspection was got done by the complainant and also there are no photographs of the damaged car on the file. From the photographs it could have been easily gathered that to the what extent the car has caused damage and this vital evidence is missing which has to be given by the complainant on the file. But the accident is proved by the report of surveyor and the report of the investigator is on the file having assessed the loss to the tune of Rs.1,52,567/-.
- As the complainant has not got spot inspection done from the insurance company and she has not got the photographs clicked to show the actual loss caused to the vehicle in question, so the complainant is not entitled to the loss to the extent of Rs.3,23,861/- and is only entitled to Rs.1,52,567/- assessed by the surveyor.
- So due to our above discussion, the complaint is partly allowed and the OPs are directed to pay Rs.1,52,567/- to the complainant alongwith interest @6% per annum from the date of repudiation of claim till realization. No order as to costs and compensation.
Compliance of the order be made by the OPs within a period of 45 days from the date of the receipt of the certified copy of this order. ANNOUNCED DATED:1.9.2021 Dr.Harman Shergill Sullar Jasjit Singh Bhinder Member President | |
