Punjab

Ludhiana

CC/19/267

Mohinder Singh - Complainant(s)

Versus

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

Varul Jain Adv.

18 Apr 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                          Complaint No: 267 dated 30.05.2019.                                                                 Date of decision: 18.04.2023. 

 

Mohinder Singh S/o. Sh. Naginder Singh, R/o.5804, Street No.4½, Gobind Nagar Dabba Road, Ludhiana.                                                                                                                                                   ..…Complainant

                                                Versus

1. United India Insurance Company Ltd., having its Head Office at 24, Whites Road, Chennai-600014, through its Managing Director.      
2. United India Insurance Company Ltd., having its Branch Office at 151, Industrial Area a Cheema Chowk, Ludhiana, through its Manager.                                                                              …..Opposite parties

Complaint Under Section 12 of the Consumer Protection Act, 1986.

QUORUM:

SH. SANJEEV BATRA, PRESIDENT

SH. JASWINDER SINGH, MEMBER

 

COUNSEL FOR THE PARTIES:

For complainant            :         Sh. Vaarul Jain, Advocate.

For OPs                         :         Sh. R.K. Chand, Advocate.

 

ORDER

PER SANJEEV BATRA, PRESIDENT

1.                Briefly stated, the facts of the case are that the complainant is the registered owner of vehicle make Tata Indigo bearing registration No.PB-10-ES-8789 which is the source of his livelihood. The complainant got insured the vehicle from the opposite parties vide cover note Policy No.2011023117P113475145 dated 21.12.2017 valid from 21.12.2017 to 20.12.2018 for a sum of Rs.3,70,000/- on premium of Rs.20,835/-. The complainant submitted that the vehicle was secured against theft, accident, fire etc. for the above said valid period from any loss or damage to the vehicle of the complainant from bumper to bumper. The complainant obtained the insurance policy from the opposite parties earlier also but never sought claim earlier as no untoward incident ever happened and at the time of getting the vehicle insured the opposite parties apprised the complainant that the said policy will be cashless for any auto incident happens. The complainant further submitted that on 25.07.2018 met with an accident near Rawalpindi, District Kapurthala in which the car got damaged and FIR No.42 dated 27.07.2018 was registered at PS Rawalpindi. Intimation was given to the opposite parties in time by the complainant who sent their spot surveyor to enquire into the matter for conducting the spot survey of the car. The spot survey was done and photographs of the car were taken and after the spot survey conducted by approved surveyor of the opposite parties the car was towed from the place of accident to Ludhiana at Dada Motors near Jallandhar Byepass Ludhiana through Perfect Crane Service at Ludhiana for which the complainant paid Rs.2800/- rather same were to be paid by the opposite parties to crane service provider by reserving his right to claim his bonafide right/claim from the opposite parties. The complainant further submitted that the car was repaired by Dada Motors Near Jalllandhar Byepass Ludhiana but at the time of billing, he was shocked to listen from the workshop officials that the opposite parties had refused to pay any claim at that very stage and in order to save his further loss and detention charges, the complainant paid all the invoice amount i.e. Rs.1,29,702/- to Dada Motors through his HDFC credit card. The complainant tried to contact the opposite parties but they refused to give any satisfactory answer/reply to him. The complainant supplied all the required documents to the opposite parties within time as per their directions and demand but the opposite parties kept on delaying the matter with one pretext or the other and after expiry of long time, the opposite parties paid a partial claim amount of Rs.73,659/- via NEFT transfer. The complainant again contacted opposite parties to pay the balance amount of Rs.56,043/- along with Rs.2800/- of towing charges as the complainant has got insured his vehicle to the tune of Rs.3,70,000/- and he also paid the premium of the insured amount to the opposite parties but they did not give any satisfactory reply to the complainant. The complainant time and again visited the opposite parties in order to redress his grievance but they flatly refused to settle the claim which caused great mental pain, shock and cruelty to the complainant. The complainant served a legal notice dated 06.04.2019 upon the opposite parties through his counsel Sh. Vaarul Jain, Advocate but no reply was given. Hence this complaint whereby a prayer has been made to direct the opposite parties to pay a sum of Rs.58,843/- as insurance claim within interest @18% per annum along with compensation of Rs.1,00,000/- and litigation costs of Rs.31,000/-.

2.                Upon notice, the opposite parties appeared and filed written statement by taking preliminary objections and assailed the complaint on the ground of lack of jurisdiction;  maintainability of the complain; the complaint barred under Section 26 of the Consumer Protection Act; the complainant being estopped by his own act and conduct from filing the present complaint. The opposite parties alleged that the complainant lodged claim regarding damage of his car bearing No.PB-10-ES-8789 and immediately on receipt of the claim, it was duly registered, entertained and processed. Mr. Vishal Saini, Surveyor and Loss Assessor was deputed for spot survey who inspected the vehicle, took photographs, collected documents and submitted his preliminary survey report dated 13.08.2018 along with documents. Mr. A.S. Kapoor, Surveyor and Loss Assessor was deputed for final survey and for assessment of loss who inspected the vehicle, took photographs, collected documents and submitted his final survey report dated 12.12.2018 along with documents and he assessed the loss of Rs.73,700/- subject to terms and conditions of the policy. After receiving the investigation report along with documents, the officials of officials of opposite parties scrutinized the file and after due application of mind by them in terms of the insurance policy, the competent authority of the opposite parties found that amount of Rs.73,659/-  is payable and the complainant was called upon to provide particulars of the bank for making the payment. The complainant accepted the amount assessed by the surveyor and gave his willingness for acceptance of that amount and provided his bank account details and after that the opposite parties paid the amount of Rs.73,659/- through NEFT to the complainant on 23.01.2019 which was duly accepted by the complainant as full and final settlement of the claim. The claim has been paid as per terms and conditions of the policy and as per assessment of the surveyor and now the complainant has no right to file the present complaint. The opposite parties further submitted that the insurance policy is a contract between the insured and the insurer and both the parties are bound by the terms and conditions of the insurance policy. The claim of the insured/complainant has been settled and paid as per terms and conditions of the policy.

                   On merits, the opposite parties reiterated the crux mentioned in the preliminary objections. The Opposite parties alleged that the vehicle of the complainant was of 2014 model and depreciation, salvage and excess clause etc. are applicable for assessing the loss.  The surveyor assessed the loss observing terms and conditions of the insurance policy and after following the guidelines for assessing the loss.  The opposite parties denied any deficiency in service and in the end, a prayer for dismissal of the complaint has been made.

3.                In evidence, the complainant tendered his affidavit as Ex. CA and reiterated her averments of the complaint. The complainant also placed on record documents i.e. Ex. C1 is the copy of insurance policy w.e.f. 21.12.2017 to 20.12.2018, Ex. C2 is the copy of proposal form, Ex. C3 is the copy of certificate of fitness, Ex. C4 is the copy of RC No.PB-10-ES-8789, Ex. C5 is the copy of driving license of Naveen, Ex. C6 is the copy of tax invoice of Dada Motors, Ex. C7 is the copy of  invoice of Perfect Crane Service, Ex. C8 is the copy of Journal (PCD) voucher of Dada Motors, Ex. C9 is the copy of text message, Ex. C10 is the copy of FIR No.42 dated 25.07.2018, Ex. C11 is the copy of legal notice dated 29.04.2019, Ex. C12 and Ex. C13 are the copies of postal receipts and closed the evidence.

4.                On the other hand, the counsel for the opposite party tendered affidavit Ex. RW1/A of Ms. Lipi Moitra, Assistant Manager of the opposite parties as well as affidavit Ex. RW2/A of Sh. A.S. Kapoor, Surveyor and Loss Assessor, affidavit Ex. RW3/A of Sh. Vishal Saini, Surveyor and Loss Assessor  along with documents i.e. Ex. R1 is the copy of survey report dated 12.12.2018 of A.S. Kapoor, Ex. R2 is the copy of final survey report dated 12.12.2018 of A.S. Kapoor, Ex. R3 to R9, Ex. R13 to Ex. R15 are the copies of photographs of the vehicle, Ex. R10 is the copy of statement of driver Naveen Kumar, Ex. R11 is the copy of motor accident claim form, Ex. R12 is the copy of survey report of Vishal Saini dated 13.08.2018, Ex. R16 is the copy of policy w.e.f. 22.12.2016 to 21.12.2017, Ex. R17 is the copy of cheque issued in name of the complainant, Ex. R18 is the copy of legal notice dated 29.04.2019, Ex. R19 is the copy of reply dated 13.05.2019 to the legal notice dated 29.04.2019, Ex. R20 is the copy of postal receipt, Ex. R21 is the copy of estimation report of Dada Motors, Ex. R22 is the copy of tax invoice of Dada Motors, Ex. R23 is the copy of FIR No.42 dated 25.07.2018, Ex. R24 is the copy of report of the police of P.S. Rawalpindi, District Kapurthala, Ex. R25 is the copy of sapurdari order, Ex. R26 is the copy of RC verification report dated 12.12.2018 of A.S. Kapoor, Ex. R27 is the copy of status of RC, Ex. R28 is the copy of RC No.PB10-ES-8789, Ex. R29 is the copy of DL verification report dated 12.12.2018 of A.S. Kapoor, Ex. R30 is the copy of status of driving license, Ex. R31 is the copy of driving license of Naveen, Ex. R32 is the copy of certificate of fitness, Ex. R33 is the copy of permit, Ex. R34 is the copy of insurance policy w.e.f. 21.12.2017 to 20.12.2018, Ex. R35 is the copy of claim intimation form and closed the evidence.

5.                We have heard the arguments of the counsel for the parties and also gone through the complaint, affidavit and annexed documents and written statement produced on record by both the parties.  

6.                Undisputedly, the complainant is the registered owner of the vehicle make Tata Indigo Model 2014 bearing registration No.PB-10-ES-8789 and he got the said vehicle insured from the opposite parties having validity w.e.f. 21.12.2017 to 20.12.2018. On 25.07.2018, an accident took place in the area of Rawalpindi, District Kapurthala and an FIR No.42 dated 27.07.2018 Ex. C10=Ex.R23 was registered in this regard. Intimation was sent to the opposite parties and in the meantime, the complainant got his vehicle repaired from Dada Motors and incurred expenses of Rs.1,29,702/- vide invoice Ex. C6 and made payment vide voucher Ex. C8. On the receipt of the claim, the opposite parties deputed Sh. Vishal Saini, Surveyor and Loss Assessor gave his preliminary survey report dated 13.08.2018 Ex. R12, operative part of the same is reproduced as under:-

          “ASSESSMENT

Under the instructions received from your office, I immediately proceded for the site of accident with a view to inspect and report upon the loss, said to have been caused to the above captioned vehicle….

The vehicle was carefully inspected and necessary photographs depicting the extent of damaged sustained, were arranged to cover maximum of the damages….

The surveyor noted the damages on the external parts of the vehicle and further opined that some more damages may come into light during dismantling the vehicle. It may be considered as per cause and nature of the accident.”

Further Mr. A.S. Kapoor, Surveyor and Loss Assessor was appointed as investigator who found the registration certificate of the vehicle to be genuine and gave his final survey report Ex. R1 and Ex. R2     vide which he assessed the loss of the vehicle to be Rs.73,659/-. On the basis of the report Ex. R1 and Ex. R2, the opposite parties settled the claim and made a payment of Rs.73,659/- through NEFT on 29.01.2019 Ex. C9.

7.                Now the complainant has raised a grievance that out of the total amount spent Rs.1,29,702/-, the balance amount of Rs.56,043/- has not been paid by the opposite parties. The complainant sent legal notice dated 29.04.2019 Ex. C11=Ex. R18 to which the opposite parties had responded on 13.05.2019 vide reply Ex. R19.

8.                Now point of determination arises whether the opposite parties were justified in partially settling the claim of the complainant. The counsel for the complainant contended that surveyors were biased and did not take into account the actual loss suffered by the complainant and these surveyors were appointed without the consent of the complainant.

9.                On the other hand, the counsel for the opposite parties contended that the surveyors were appointed in accordance with the law and their report cannot be brushed aside. In this regard, the counsel for the complainant has relied upon 2016(4) CLT 191 in New India Assurance Co. Ltd., Vs Manjit Singh; 2021(4) C.P.R. 465 in Navdeep Agro Board Vs National Insurance Co. Ltd.; 2021(1) C.P.R. 366 in Mohan Lal Meena Vs United India Insurance Company Ltd. and another; 2016(30 C.P.R. 652 in M/s. Ishrose Industries Vs Divisional Manager, New India Assurance company Ltd. and another and 2010(1) CLT 22 in New India Assurance Co. Ltd. and another Vs New Good Luck Retrading Works.  The arguments of the counsel for the complainant are not tenable as the surveyor is an independent person and its report is a valuable piece of evidence. Even neither in the compliant nor by way of separate objections, the complainant has raised any such objections with regard to appointment and conduct of the surveyors. So there is no occasion for this Commission to disbelieve the opinion of the surveyors.

10.              The counsel for the opposite parties has drawn attention of this Commission towards Private Car Package Policy, relevant portion of the same is reproduced as under:-

          Section-I. Loss of or damage to the vehicle insured

          1.       The Company will indemnify the insured against loss or damage to the vehicle insured hereunder and / or its accessories whilst thereon

          i. by fire explosion self ignition or lightning;

          ii. by burglary housebreaking or theft;

          iii. by riot and strike;

          iv. by earthquake (fire and shock damage);

          v. by flood typhoon hurricane storm tempest inundation cyclone       hailstorm frost;

          vi. by accidental external means;

          vii. by malicious act;

          viii. by terrorist activity;

          ix. whilst in transit by road rail inland – waterway lift elevator or air;

          x. by landslide rockslide;

Subject to a deduction for depreciation at the rates mentioned below in respect of parts replaced:

1. For all rubber/nylon/plastic parts, tyres and tubes, batteries and air bags 50%
2. For fibre glass components 30%
3. For all parts made of glass Ni
4. Rate of depreciation for all other parts including wooden parts will be as per the following schedule :

AGE OF VEHICLE	% OF DEPRECIATION
Not exceeding 6 months	Nil
Exceeding 6 months but not exceeding 1 year	5%
Exceeding 1 year but not exceeding 2 years	10%
Exceeding 2 years but not exceeding 3 years	15%
Exceeding 3 years but not exceeding 4 years	25%
Exceeding 4 years but not exceeding 5 years	35%
Exceeding 5 years but not exceeding 10 years	40%
Exceeding 10 years	50%

 

5. Rate of Depreciation for Painting: In the case of painting, the depreciation rate of 50% shall be applied only on the material cost of total painting charges. In case of consolidated bill for painting charges, the material component shall be considered as 25% of total painting charges for the purpose of applying the depreciation.

2. The company shall not be liable to make any payment in respect of :-

1. consequential loss, depreciation, wear and tear, mechanical or electrical breakdown failure or breakages.
2.  damage to tyres and tubes unless the vehicle insured is damaged at the same time in which case the liability of the company shall be limited to 50% of the cost of replacement.

and

(c) any accidental loss or damage suffered whilst the insured or any person driving the vehicle with the knowledge and consent of the insured is under the influence of intoxicating liquor or drugs.

The opposite parties have rightly settled the claim of the complainant as per the provisions of the private car package policy and as such, there is no deficiency in service on the part of the opposite parties.

11.              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 the order be supplied to the parties free of costs as per rules. File be indexed and consigned to record room.

12.              Due to huge pendency of cases, the complaint could not be decided within statutory period.

 

(Jaswinder Singh)                      (Sanjeev Batra)        

                    Member                                      President

 

Announced in Open Commission.

Dated:18.04.2023.

Gobind Ram.

 

 

Mohinder Singh Vs United India Insurance Co. Ltd.              CC/19/267

Present:       Sh. Vaarul Jain, Advocate for complainant.

                   Sh. R.K. Chand, 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 the order be supplied to the parties free of costs as per rules. File be indexed and consigned to record room.

 

                    (Jaswinder Singh)                      (Sanjeev Batra)        

                    Member                                      President

 

Announced in Open Commission.

Dated:18.04.2023.

Gobind Ram.