State Consumer Disputes Redressal Commission
Oriental Insurance Co. Ltd. vs Smt. Anjana Thakur. on 22 July, 2025
H. P. STATE CONSUMER DISPUTES REDRESSAL
COMMISSION SHIMLA.
First Appeal No.: 127/2022
Date of Presentation: 27.09.2022
Reserved on: 07.07.2025
Date of Decision: 22.07.2025
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Oriental Insurance Company Ltd. Hardaspur, Tehsil and
District Chamba, Through its Authorized Officer.
.......... Appellant/Opposite party.
Versus
Smt.Anjana Thakur wife of Sh.Ravinder Singh, R/o
Mohalla Surara, Chamba Town, District Chamba, H.P.
.......... Respondent/Complainant.
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Coram
Hon'ble Justice Inder Singh Mehta, President.
Hon'ble Mr.Partap Singh Thakur, Member.
Hon'ble Ms.Yogita Dutta, Member.
Whether approved for reporting?1 Yes.
For the Appellant: Mr.Bunesh Pal, Advocate.
For the Respondent: Already Ex-parte.
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1
Whether Reporters of the local papers may be allowed to see the order?
Oriental Insurance Company Ltd. Vs. Smt. Anjana Thakur.
F.A.No.127/2022
Justice Inder Singh Mehta, President
O R D E R:
Present appeal is preferred against the order dated 22.07.2022 of learned District Commission, Chamba, in Consumer Complaint No.33/2019 titled Smt. Anjana Thakur Versus Oriental Insurance Company Ltd., whereby, the complaint filed by complainant was partly allowed and the opposite party was directed to pay an amount of Rs.1,76,939/- to the complainant alongwith interest @ 9% per annum from the date of complaint i.e. 21.08.2019 till its realization. The opposite party was further directed to pay compensation to the complainant to the tune of Rs.25,000/- , besides litigation costs quantified as Rs.5,000/-. Brief facts of the Case:
2. Brief facts of the case are that the complainant is registered owner of vehicle bearing registration No.HP-73-7285 which was insured with the opposite party/insurance company vide policy 2 Oriental Insurance Company Ltd. Vs. Smt. Anjana Thakur. F.A.No.127/2022
No.233802/31/2019/1749 dated 22.06.2018 w.e.f. 23.06.2018 to 22.06.2019. On 09.07.2018, the vehicle in question met with an accident at place near Saach Pass, Tehsil Pangi. Intimation of accident was given to the police as well as insurance company. The insurance company appointed a surveyor, who inspected the vehicle and submitted his report. The opposite party/insurance company asked the complainant to repair the accidental vehicle and submit repair bills for settlement of claim. The complainant submitted her claim alongwith all required documents and repair bills to the insurance company, but the insurance company did not settle the claim of the complainant. As such, there is deficiency in service on the part of the opposite party. Hence, the present complaint.
3. The opposite party/insurance company filed reply to the complaint and stated that the on receiving the intimation of accident, the insurance company 3 Oriental Insurance Company Ltd. Vs. Smt. Anjana Thakur. F.A.No.127/2022 appointed a surveyor who conducted final survey and assessed the loss to the tune of Rs.1,18,365/- on repair basis. On investigation, it was found that at the time of accident two unauthorized/ gratuitous passengers were traveling in the vehicle in question against the seating capacity of two which is fundamental violation of the terms and conditions of policy. Driving license of driver Raj Kumar was valid for LMV Non Transport only, whereas, the vehicle in question is a goods carrying vehicle. The complainant submitted two Goods Receipts No.6 & 7 of Peas issued in the name of driver Raj Kumar. The complainant was asked to clarify her position about the above points vide letter dated 21.08.2019, but the complainant failed to do so, and, as such, the claim of the complainant was repudiated by the insurance company. There is no deficiency in service or unfair trade practice on the part of the opposite party. A prayer for dismissal of complaint was made. 4
Oriental Insurance Company Ltd. Vs. Smt. Anjana Thakur. F.A.No.127/2022
4. The complainant filed rejoinder in which she has denied the allegations of the opposite party and reaffirmed the averments made by her in the complaint.
5. Thereafter, the parties led evidence in support of their respective pleadings.
6. After hearing the parties, learned District Commission partly allowed the complaint of the complainant.
7. Feeling aggrieved by the order of learned District Commission, appellant/opposite party has preferred the instant appeal before this Commission.
8. Arguments heard on behalf of the appellant- company and perused the case file carefully. No arguments were advanced on behalf of the respondent/ complainant as respondent-complainant was proceeded ex-parte vide order dated 07.07.2025.
9. Learned counsel of the appellant/insurance company has submitted that the complainant is owner of 5 Oriental Insurance Company Ltd. Vs. Smt. Anjana Thakur. F.A.No.127/2022 vehicle which was insured with the appellant-company. On 09.07.2018, the vehicle in question met with an accident. On receiving intimation, surveyor was appointed by the appellant-company who assessed the loss to the tune of Rs.1,18,365/- on repair basis. He further submitted that at the time of accident, two unauthorized passengers were traveling in the vehicle in question beyond the seating capacity of two, which is violation of terms and conditions of the policy as well as Motor Vehicles Act. He further submitted that learned District Commission has not considered the surveyor report, rather awarded Rs.1,76,939/- on the basis of bills produced by the complainant, which is bad in law. He has relied upon the order of this Commission in case titled Asgar Ali Vs. ICICI Lombard, General Insurance Company Ltd., 2022 (3) Shim.LC 1636. He prays that appeal of the appellant-company be allowed. 6
Oriental Insurance Company Ltd. Vs. Smt. Anjana Thakur. F.A.No.127/2022 FINDINGS
10. The admitted fact emerging on record is that the complainant is registered owner of vehicle i.e. Pickup bearing registration No.HP-73-7285 which was insured with the opposite party/insurance company vide policy No.233802/31/2019/1749 (Annexure-4) for a sum of Rs.4,25,000/- w.e.f. 23.06.2018 to 22.06.2019.
11. It is further an admitted fact emerging on record that on 09.07.2018, the vehicle in question met with an accident at place Sach Pass, Tehsil Pangi. Intimation regarding accident was given to the police as well as insurance company.
12. The insurance company appointed a surveyor who assessed loss caused to the vehicle amounting to Rs.1,18,365/- on repair basis. The insurance company repudiated the claim of complainant on three grounds, firstly, at the time of accident, 2 gratuitous passengers were sitting in the vehicle, 7 Oriental Insurance Company Ltd. Vs. Smt. Anjana Thakur. F.A.No.127/2022 secondly, the driver of vehicle in question was having LMV driving license, whereas, the vehicle is a goods carrying commercial vehicle and lastly, the complainant submitted two goods receipts in support of her claim and, as such, is hiding/concealing the material facts.
13. As per FIR Annexure OP-5, at the time of accident, two persons namely Harish Kumar and Ram Nivas were traveling in the vehicle in question alongwith driver, whereas, as per R/C Annexure OP-2 seating capacity of vehicle is two including driver.
14. Perusal of policy Annexure-4 indicates that the complainant was paying extra premium of Rs.75/- as NFPP i.e. Non Fare Paying Passenger on account of ADD: LL To- paid driver, conductor and cleaner excluding employees (owner of goods) IMT 37A. As per IMT 37-A, if the vehicle is goods carriage vehicle, then Rs.75/- has to be paid for non fare paying passengers, who are not the employee of the insured (commercial 8 Oriental Insurance Company Ltd. Vs. Smt. Anjana Thakur. F.A.No.127/2022 vehicle only). In the present case, vide policy Annexure- 4, the appellant-company has received extra premium of Rs.75/- from the complainant for non fare paying passengers, therefore, the aforesaid plea of the insurance company looses its significance and is not helpful to the insurance company.
15. So far another ground of repudiating the claim that driver was not having valid licence to drive the vehicle in question, is concerned, the same also looses its significance in presence of R/C Annexure C-5, perusal of which indicates that vehicle of the complainant is a light goods vehicle and driver was having LMV License (Annexure C-6), as such, driver Raj Kumar was competent to drive such vehicle.
16. The appellant-company has further alleged that the complainant submitted two goods receipts Annexure OP-12 and OP-13 in support of her claim and thereby concealed the material facts. The said plea of 9 Oriental Insurance Company Ltd. Vs. Smt. Anjana Thakur. F.A.No.127/2022 the appellant/insurance company does not seem to be correct and also looses its significance, as the complainant vide her letter Annexure C-14 issued to insurance company has clarified that she had submitted only one Goods Receipt dated 08.07.2018 amounting to Rs.63,000/- to the Surveyor. Said submission of complainant is duly supported by surveyor report Annexure OP-18 in which surveyor has specifically stated that vehicle was loaded with peas 900 Kg vide bill No. 6 dated 08.07.2018 of Raj Kumar. Therefore, there is no violation of terms and conditions of the policy in question on behalf of the complainant and the appellant- company has wrongly repudiated the claim of the complainant.
17. In the present case, learned District Commission has awarded a sum of Rs.1,76,939/- to the complainant on the basis of bills produced by the complainant Annexure C-9 to C-13 as well as affidavits of 10 Oriental Insurance Company Ltd. Vs. Smt. Anjana Thakur. F.A.No.127/2022 proprietor/repairer of workshop and the persons who had issued the aforesaid bills to the complainant.
18. Though, the complainant has filed the affidavits of repairer and the witnesses from whom she had taken the aforesaid bills of the spare parts of the vehicle in question, but all these witnesses have not stated in their respective affidavits that the spare parts purchased by the complainant were used/fixed in vehicle in question. There is also not mentioned in the affidavit of repairer Praveen Kumar Ext.CW-2 that what amount he had charged from the complainant to repair the vehicle in question.
19. Per contra, surveyor report Annexure OP-17 is duly proved by the insurance company by way of filing affidavit of Surveyor Ext.OPW-2 vide which the loss was assessed at Rs.1,18,365/- on repair basis and the said report was prepared by the surveyor on the basis of bills supplied by the complainant to him. Moreover, there is no evidence on record to show that deduction made by the 11 Oriental Insurance Company Ltd. Vs. Smt. Anjana Thakur. F.A.No.127/2022 surveyor is not on the basis of terms and conditions of the policy in question and the complainant has also not denied the surveyor report by filing any interrogatories.
20. Therefore, report of surveyor cannot be discarded without any reasonable cause, and as such, the complainant is only entitled for the amount as assessed by the surveyor and the impugned order is required to be modified to that extent.
21. As far as the judgment relied upon by the appellant-company, is concerned, the same is not applicable in the facts and circumstances of the present case.
22. In view of the above discussion, appeal of the appellant/insurance company is partly allowed and impugned order is modified to the extent that the opposite party is directed to pay a sum of Rs.1,18,365/- (One lakh eighteen thousand three hundred sixty five), the amount as assessed by surveyor, to the complainant alongwith 12 Oriental Insurance Company Ltd. Vs. Smt. Anjana Thakur. F.A.No.127/2022 interest @ 9% per annum from the date of complaint i.e. 21.08.2019 till its realization.
23. Remaining order of learned District Commission qua compensation and litigation costs remains upheld.
24. Parties are left to bear their own costs.
25. Certified copy of order be sent to the parties and their counsel(s) strictly as per rules. File of District Commission along with certified copy of order be sent back and file of State Commission be consigned to record room after due completion. Appeal is disposed of. Pending applications, if any, also disposed of.
Justice Inder Singh Mehta President Partap Singh Thakur Member Yogita Dutta Member Veena 13