State Consumer Disputes Redressal Commission
Sh. Lekh Ram. vs United India Insurance Co. Ltd. on 13 July, 2022
H. P. STATE CONSUMER DISPUTES REDRESSAL
COMMISSION SHIMLA
First Appeal No. : 307/2019
Date of Presentation : 13.09.2019
Order Reserved on : 05.07.2022
Date of Order : 13.07.2022
......
Sh. Lek Ram, son of Shri Brebtu Ram, C/O Amar Highways,
NH-21, Rangari, Tehsil Manali,District Kullu, HP
...... Appellant/Complainant
Versus
United India Insurance Company Limited through its Branch
Manager, Himalayan Shopping Arcade, The Mall, Manali,
District Kullu, HP
......Respondent/Opposite party.
Coram
Hon'ble Justice Inder Singh Mehta, President
Hon'ble Ms. Sunita Sharma, Member
Whether approved for reporting?1 Yes
For the Appellant : Mr. Dibender Ghosh, Advocate.
For the Respondent : Mr. P.S. Chandel, Advocate.
Justice Inder Singh Mehta, President
ORDER
Instant appeal is arising from order dated 30.07.2019 passed by learned District Forum, Kullu, in Consumer Complaint No.16/2018 titled Shri Lekh Ram versus United India Insurance Company Limited. 1 Whether reporters of the local papers may be allowed to see the order?
Lekh Ram versus United India Insurance Company Ltd.
(F.A No.307/2019) Brief facts of Case:
2. Briefly, the case of the complainant is that, he is registered owner of vehicle No. HP-58-7358 (Hyundai Grand I.10 car). It was insured with the opposite party for the period with effect from 12.12.2015 to 11.12.2016. Earlier this vehicle was insured with New India Assurance Company. During the subsistence of the insurance policy, on 15.05.2016, the vehicle met with an accident. There was total loss to the vehicle in the accident. Necessary documents were supplied to the opposite party, but it illegally repudiated the claim vide letter dated 27.01.2017 on the ground that the complainant had availed benefit of no claim bonus by making a false declaration in the proposal form. Per the complainant, the agent of the opposite party simply asked for the copy of registration certificate of the vehicle and no inquiry was made from him by the opposite party regarding the claim, if any, under the previous policy. The claim has wrongly been repudiated by the opposite party. The opposite party was deficient in rendering services to the complainant.
3. The complaint was contested by the opposite party by filing reply. It is admitted that during the subsistence of the insurance policy, the vehicle of the complainant met with an accident. It is contended that after receiving information regarding the incident, a surveyor was appointed, 2 Lekh Ram versus United India Insurance Company Ltd.
(F.A No.307/2019) who assessed the loss on total loss basis at Rs. 4,59,000/- and on net of salvage basis at Rs.3,39,000/-. However, during the course of investigation, it was found that the complainant had made a false declaration while purchasing the instant policy and received No Claim Bonus benefit of Rs.2407.29 paisa whereas he had received an accident claim of his vehicle in the earlier insurance policy issued by New India Assurance Company. This material fact was concealed by the complainant in the proposal form and thereby breached the terms and conditions of the insurance policy. Therefore, the claim has been rightly rejected.
4. A rejoinder denying the contents of the reply and reiterating those of the complaint was filed by the complainant.
5. After hearing learned counsel for both the parties, the learned District Forum, below dismissed the complaint of the complainant.
6. Feeling aggrieved by the order of the Ld. District Forum, the complainant has filed the present appeal before this Commission.
7. Learned counsel for the appellant has submitted that the complainant is registered owner of the vehicle 3 Lekh Ram versus United India Insurance Company Ltd.
(F.A No.307/2019) bearing No. HP 58-7358. The said vehicle met with an accident on 15.05.2016 at Palampur and the incident was intimated to the opposite party. The respondent/opposite party appointed surveyor, who has assessed the loss to the tune of Rs.4,59,000/- on total loss basis. He further submitted that District Forum below went wrong and the complainant is entitled to the claimed amount. Learned counsel of the appellant further submitted that if at all claim is to be rejected by the District Forum below, it was a sum of Rs.11,000/- which was to be deducted and rest of the amount was to be released in favour of the appellant/complainant and relied upon order passed by State Commission, Delhi in F.A.No.226/2016 titled L&T General Insurance Co. Ltd. Vs. Shadi Lal Kapoor, decided on 06.10.2020.
8. On the other hand, learned counsel of the respondent has submitted that the appellant/complainant has concealed material facts resulting into no claim in favour of the complainant. He further submitted that if anything was to be paid, same would have been paid on the basis of non-standard basis and relied upon order of the Hon'ble National Commission in revision petition No.4045 of 2014, titled Ashok Kumar Vs. NIC 4 Lekh Ram versus United India Insurance Company Ltd.
(F.A No.307/2019) FINDINGS
9. Annexure R-4 is the proposal form proved on record. As per Annexure R-4, which has duly been signed by the complainant, he has concealed the material fact that he has not availed any NCB claim in the previous policy.
10. The insurance policy Annexure R-1 indicates that 20% rebate in the premium has been availed by the appellant/complainant and there is concealment to this effect. However, the concealment of this fact at the time of filling proposal form ipso fact does not bar the claim of the appellant /complainant.
11. As per GR 27 of the Indian Motor Tariff there lies an explicit obligation on the part of the new insurer to write to the previous insurer and confirm the entitlement of the insured with regard to the no claim bonus. The same has to be done within a span of 21 days from the date of granting cover by the new insurer to the insured. The relevant portion of GR 27 of Indian Motor Tariff is mentioned below:-
"Notwithstanding the above declaration, the insurer allowing the NCB will be obliged to write to the policy issuing office of the previous insurer by recorded delivery calling for confirmation of the entitlement and rate of NCB for the particular insured and the previous insurer shall be obliged to 5 Lekh Ram versus United India Insurance Company Ltd.
(F.A No.307/2019) provide the information sought within 30 days of receipt of the letter of enquiry failing which the matter will be treated as a breach of Tariff on the part of the previous insurer. Failure of the insurer granting the NCB to write to the previous insurer within 21 days after granting the cover will also constitute a breach of the Tariff"
12. From the facts and circumstances of the present case, it is clear that the respondent/insurance company did not comply with the requirements under GR 27 of the Indian Motor Tariff, else the issue related to misrepresentation of No claim bonus would have been raised. In fact, the onus was on the respondent/opposite party to check from the previous insurer about the status of the no claim bonus of the insured-appellant, which the respondent/insurance company failed to do. Therefore, the respondent/insurance company is not justified in repudiating the claim of the appellant/complainant in toto.
13. It is proved by the report of surveyor (Annexure R-3) that there was total loss to the vehicle in the accident as repair charges exceeded 75% of the insured declared value i.e. Rs.4,59,000/-. Therefore, the respondent/opposite party shall make payment to the appellant/complainant by treating the vehicle as total loss in terms of the insured declare value of the vehicle as per the terms of the policy.
6
Lekh Ram versus United India Insurance Company Ltd.
(F.A No.307/2019)
14. Since the appellant/complainant had availed no claim bonus of 20% while purchasing the policy in question, therefore, 20% is required to be deducted from the insured declared value i.e. Rs.4,59,000/-. As such, the appellant/complainant is held entitled to Rs. 3,67,200/-. He is also entitled to Rs.25,000/- on account of mental harassment etc., besides Rs.25,000/- towards litigation charges.
15. Therefore, the appeal of the appellant/complainant succeeds and impugned order dated 30.07.2019 of Learned District Forum Kullu, is set aside.
16. Accordingly, the complaint is partly allowed and the respondent/Insurance company is directed to pay Rs. 3,67,200/- to the complainant along with interest @ 9% per annum from the date of institution of the complaint i.e. 19.06.2018, till its realization. The respondent/insurance company is also directed to pay Rs.25,000/- as compensation to the complainant for his mental harassment etc., besides litigation charges to the tune of Rs.25,000/-.
17. The appellant/complainant is also directed to hand over the salvage of the vehicle and transfer the registration certificate of the vehicle in the name of the respondent/insurance company against receipt within 60 days from the date of receipt of the copy of this order, failing which the respondent/insurance 7 Lekh Ram versus United India Insurance Company Ltd.
(F.A No.307/2019) company shall be at liberty to deduct the salvage value as assessed by the surveyor from the awarded amount.
18. Certified copy of this order be sent to District Forum below and file of State Commission be consigned to record room after due completion. Certified copy of order be sent to parties and their counsel(s) strictly as per Rules. Pending application(s) if any also disposed of.
Justice Inder Singh Mehta President Sunita Sharma Member 13.07.2022 Pkw 8