Haryana

Karnal

CC/634/2022

Ajit - Complainant(s)

Versus

United India Insurance Company Limited - Opp.Party(s)

Jang Sher Singh Rana

10 Jul 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No.634 of 2022

                                                        Date of instt.14.11.2022

                                                        Date of Decision:10.07.2024

 

Ajit, age 35 yeas son of Shri Ved Parkash, resident of village Sheikhpura Khalsa, District Karnal.

                                                 …….Complainant.

                                              Versus

 

United India Insurance Company Limited, Branch at old G.T. Road, near Old Bus Stand, Karnal through its Branch Manager.

 

                                                              …..Opposite Party.

 

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.      

      Sh. Vineet Kaushik…….Member

 

Argued by: Shri J.S. Rana, counsel for the complainant.

                   Shri Virender Adlakha, counsel for the OP.

 

                     (Jaswant Singh, President)

ORDER:   

                

                The complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that complainant is the registered owner of vehicle bearing registration no.HR-45D-0099. The said vehicle is insured with the OP, vide policy bearing no.1120013121E04124414, valid from 30.07.2021 to 29.07.2022 covering interalia the risk of loss or damage to the said motor vehicle and/or its accessories whilst thereon by accident, burglary, breaking or theft. Unfortunately, on 22.09.2021, the said vehicle met with an accident and totally damaged. The intimation in this regard was sent to the OP and requested for claim amount but OP did not pay any heed to the request of complainant. The officials of the OP asked the complainant to get repaired the vehicle from an authorized dealer of TATA Motors. The said damaged vehicle was brought to the Mangla Automotive Private Limited, 1Km Stone, Bahalgarh Chowk, NH-1, Delhi Road, Sonepat with the help of a crane, which costs Rs.6,000/-, where he got repaired his vehicle, which total costs Rs.7,26,552/-, vide invoice no.IMNESN2122007476 dated 28.03.2022. Complainant again approached the OP and submitted all the relevant documents alongwith the bill but despite their prior assurance, they did not accede to the genuine request of the complainant. In the last week of August, 2022, the OP flatly refused to disburse the claim of the complainant and rejected the claim application of the complainant without any rhyme, reason or justification. Due to this act and conduct of the OP, complainant has suffered mental pain, agony and harassment as well as financial loss. In this way there is deficiency in service and unfair trade practice on the part of the OP. Hence this complaint.

2.             On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability; cause of action; locus standi and concealment of true and material facts. On merits, it is pleaded that the claim of the complainant was rightly repudiated and was treated as ‘no claim’ as there is violation of the policy terms and conditions. The claim does not fall under the purview of H.O. circular bearing reference no.HO-Motor-OD:CIR:19:2020 dated 11.02.2021. The accident in question took place on 22.09.2021 whereas the fee for route permit was deposited on 24.09.2021 and the validity of the route permit commenced from 24.09.2021 and as such the claim is not at all payable, which is violation of section 66(3) of the Motor Vehicle Act. All the documents were got verified from Shri A.P. Chawla-Surveyor and Loss Assessor and as such the claim was treated as No Claim. There is no deficiency in service on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of aadhar card Ex.C1, copy of intimation to OP Ex.C2, copy of RC Ex.C3, copy of insurance policy Ex.C4, copy of estimate of damage vehicle Ex.C5, copy of invoice of damage vehicle after repair Ex.C6 and closed the evidence on 12.06.2023 by suffering separate statement.

5.             On the other hand, learned counsel for the complainant has tendered into evidence affidavit of Raj Kamal, Assistant Manager Ex.OPW1/A, affidavit of  A.P. Chawla, Techncial Consultant, Surveyor and Loss Assessor Ex.OPW1/B, copy of claim form Ex.OP1, copy of spot survey report Ex.OP2, copy of permit verification report Ex.OP3, copy of letters dated 01.12.2021 Ex.OP4 and Ex.OP5, copy of letter dated 01.12.2021 to complainant Ex.OP6, copy of letter dated 18.02.2022 Ex.OP7, copy of final report of A.P. Chawla Ex.OP8, copy of letter dated 21.03.2022 Ex.OP9 and closed the evidence on 15.04.2024 by suffering separate statement.

6.             We have heard the learned counsel of the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that complainant got his vehicle insured with the OP. On 22.09.2021, the said vehicle met with an accident and became total damaged. The intimation in this regard was given to the OP. The said damaged vehicle was brought to the Mangla Automotive Private Limited, Sonepat where complainant got repaired his vehicle and has spent Rs.7,26,552/-. Complainant lodged the claim and submitted all the relevant documents alongwith the bill for disbursement of the said amount but OP did not pay the same and lastly refused to disburse the claim of the complainant and rejected the claim of the complainant on the false and frivolous ground and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OP, while reiterating the contents of written version, has vehemently argued that complainant has violated the terms and conditions of the insurance policy. The vehicle was being plying without route permit. The accident took place on 22.09.2021 whereas the fee for route permit was deposited on 24.09.2021 and the validity of the route permit commenced from 24.09.2021. So, the claim of the complainant was rightly repudiated by the OP and lastly prayed for dismissal of the complaint.

9.             We have duly considered the rival contentions of the parties.

10.           Admittedly, the vehicle in question met with an accident during the subsistence of the insurance policy. It is also admitted that the insured declared value of the vehicle in question was Rs.42,00,000/-

11.           The claim of the complainant has been closed by the OP, vide letter Ex.OP9 dated 21.03.2022 on the ground, which is reproduced as under:-

“The letters dated 01.12.2021 and 06.01.2022 sent by the surveyor to the complainant for submitting the following document within five days of receipt of the letter for settlement of the claim.

1. Valid Route Permit as no date of accident.

Kindly treat this letter as final reminder and in case we do not receive any reply from him within the stipulated time period as above, it shall be assured that you are no more interested in pursuing your claim and they shall have no option other than to close your claim as No Claim.”

12.           The claim of the complainant has been closed by the OP on the abovesaid ground. OP has alleged that the accident took place on 22.09.2021 whereas the fee for route permit was deposited on 24.09.2021 and the validity of the route permit commenced from 24.09.2021, the vehicle was being plying without route permit. The onus to prove its version was relied upon the OP. To prove its version, OP relied upon the Permit Verification Report Ex.OP3. On perusal of said report, it reveals that fees of route permit was deposited on 24.09.2021 and route permit was also issued on 24.09.2021 and valid till 08.09.2026. Meaning, thereby, at the time of accident, the complainant was not having valid route permit of the vehicle in question. The vehicle in question was being plying without route permit on the date of accident. Thus, the complainant has violated the terms and conditions of the insurance policy. For the sake of gravity, if it is presumed that complainant has violated the terms and conditions of the insurance policy, in that eventuality, the claim of the complainant cannot be repudiated in toto.  In this regard, we relied upon the case laws cited in Revision Petition no.1870 of 2015(NC) decided on 14.08.2018 titled as New India Assurance Co. Ltd. Versus Thirath Singh Brar and authority of our own Hon’ble State Commission in First Appeal no.717 of 2016 decided on 6.4.2017 titled as United India Insurance Company Limited and others Versus Anshul Bansal.  In both judgments it was held that in case of any breach of warranty/condition of the policy the insurer is liable to pay 75% of admissible claim on non-standard basis.

13.           Further, Hon’ble Punjab and Haryana High Court titled as New India Assurance Company Ltd. Versus Smt. Usha Yadav & others 2008 (3) RCR (Civil) 111, has held as under:-

“It seems that the Insurance Companies are only interested in earning the premiums which are rather too stiff now a days, but are not keen and are found to be evasive to discharge their liability. In large number of cases, the Insurance companies make the effected people to fight for getting their genuine claims. The Insurance Companies in such cases rely upon clauses of the agreements, which a person is generally made to sign on dotted lines at the time of obtaining policy. This is, thus pressed into service to either repudiate the claim or to reject the same. The Insurance Companies normally build their case on such clauses of the policy, but would adopt methods which would not be governed by the strict conditions contained in the policy”.

14.           Keeping in view the ratio of the law laid down in the abovesaid judgments, facts and circumstances of the present complaint, the act of the OP amounts to deficiency in service and unfair trade practice while repudiating the claim of the complainant in toto. Hence, complainant is entitled to get 75% only of the admissible claim on non-standard basis.

15.           The complainant alleged that he has spent Rs.7,26,552/- on repair of his vehicle. To prove his version, complainant has relied upon the rough estimate Ex.C5 and tax invoice Ex.C6. On the other hand, surveyor of the OP, vide his report Ex.OP8, has assessed the loss to the tune of Rs.5,22,500/-.  The surveyor is an independent and qualified person and his report cannot be dismissed summarily. Hence, the surveyor report will prevail. In this regard we are relying upon the judgment 2(2008) CPJ paged 182 (NC), United India Insurance Co. Vs. Maya, wherein it has been held that a surveyor report should not be dismissed summarily as the surveyor is independent and qualified person under the relevant provision of Insurance Act, 1938. In view of this authority as well as the facts and circumstances of the case, the OP is liable to pay the loss assessed by the surveyor alongwith interest, compensation for mental agony and harassment and litigation expenses.

16.           In view of the above discussion, we partly allow the present complaint and direct the OP to pay Rs.3,91,875/- (Rs.three lakhs ninty one thousand eight hundred seventy five only) i.e. 75% of the loss assessed by the surveyor alongwith interest @ 9% per annum from the date closing of the claim (21.03.2022) till its realization to the complainant. We further direct the OP to pay Rs. 25,000/- to the complainants on account of mental agony and harassment suffered by them and Rs.11,000/- for the litigation expense. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:10.07.2024                                                                     

                                                                President,

                                                   District Consumer Disputes

                                                   Redressal Commission, Karnal.

 

                  (Vineet Kaushik)     

                        Member