State Consumer Disputes Redressal Commission
Charanjit Sharma vs Bajaj Allianz General Insurance ... on 1 August, 2013
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB, DAKSHIN MARG, SECTOR 37-A, CHANDIGARH.
First Appeal No.76 of 2011
Date of institution : 17.01.2011
Date of decision : 01.08.2013
Charanjit Sharma, Advocate s/o Dr. D.C. Sharma, R/o Prem Street,
Bhawanigarh, District Sangrur.
.......Appellant-Complainant
Versus
1. Bajaj Allianz General Insurance Co. Ltd. through its Branch
Manager.
2. Bajaj Allianz General Insurance Co. Ltd., through its Claims
Manager, SCO 146-147, Feroze Gandhi Market, 6th Floor, Near
Ludhiana Stock Exchange, Ludhiana-141 001.
......Respondents-Opposite Parties
First Appeal against the order dated
1.11.2010 of the District Consumer Disputes
Redressal Forum, Sangrur.
Quorum:-
Hon'ble Mr. Justice Gurdev Singh, President.
Shri Baldev Singh Sekhon, Member.
Present:-
For the appellant : Shri Dinesh Kumar, Advocate. For the respondents : Shri Paras Money Goyal, Advocate. JUSTICE GURDEV SINGH, PRESIDENT :
The appellant/complainant, Charanjit Sharma, has preferred this appeal against the order dated 1.11.2010 passed by District Consumer Disputes Redressal Forum, Sangrur (in short "District Forum"), vide which the complaint filed by him under Section 12 of the Consumer Protection Act, 1986, for directing the opposite parties to pay Rs.16,429/- as damage to the vehicle, Rs.15,000/- on account of First Appeal No.76 of 2011. 2 mental agony, harassment, inconvenience and lack of service and Rs.5,500/- as litigation expenses, was dismissed.
2. He averred in his complaint that he purchased one insurance policy for his car make Ford Fiesta bearing registration No.PB-13R- 0129 (in short "the car") from the opposite parties on 19.6.2009 and paid Rs.8,227/- as premium. The insurance was valid from 20.6.2009 to 19.6.2010. On 20.10.2009 he was going to Bhawanigarh from Sangrur when a stray animal suddenly came on the road from the field side and he steered his car to the left side but lost the control. When he stopped the car, he found that there were scratch marks on the left side, which happened from the brushing of trees. He approached the opposite parties for getting the needful done and the surveyor was sent for the purpose of preparing the estimate of loss. However, the opposite parties did not agree to pay the damage caused to him by taking the excuse that scratching/grazing could not have happened with brushing of trees. His claim was rejected, vide letters dated 1.12.2009, 9.12.2009, 16.12.2009 and finally, vide letter 18.1.2010. Ultimately, he paid the amount of Rs.16,429/- to Bhagat Ford, Patiala from his own pocket.
3. Written reply was filed by opposite party No.2. It admitted that the car was insured with it by the complainant for the period 20.6.2009 to 19.6.2010 and that on receipt of the information from the complainant the surveyor was appointed to inspect the car and assess the loss. It also admitted the writing of letters to the complainant and First Appeal No.76 of 2011. 3 the repudiation of his claim. While denying the other contentions made in the complaint, it averred that Rajesh Garg, Surveyor, inspected the car on 23.10.2009 and wrote letter dated 24.10.2009 to the complainant for clarification with regard to the fact that the damage to the car does not match with the cause of accident as mentioned in the Motor Claim Form. That surveyor observed horizontal scratches/grazing on left side of the car, which could not have happened on account of brushing of trees as no vertical damage on the same surface was observed. He also observed the previous multiple damages appearing on the same surface, which indicated that the said part was hit previously at different times. On 14.11.2009, the surveyor again wrote a letter to the complainant asking him to clarify the cause of accident so as to enable him to assess the loss and to show him the place of accident but the complainant had shown his unwillingness to go to that place. Thereafter, the surveyor gave his report dated 23.11.2009 mentioning therein that he cannot assess the loss for the reason mentioned therein. Thereafter, the letter dated 1.12.2009 was written to the complainant asking him to clarify as to why he had not given opportunity to inspect the car on the spot of the accident and that the damage to the vehicle does not correlate with the cause of accident but no response was received from his side. Subsequent letters dated 9.12.2009 and 16.12.2009 met the same fate. It was also mentioned by them in the letter dated 16.12.2009 that in the absence of any response from the side of the complainant, they were First Appeal No.76 of 2011. 4 left with no other option except to treat the claim as "No Claim". It was only thereafter that letter dated 24.9.2009 was received from the side of the complainant and in reply to that letter he was informed that his claim had already been repudiated on the ground that he failed to explain as to how the vehicle got damaged. There is no deficiency in service or unfair trade practice on its part and, as such, the District Forum has no jurisdiction to entertain and try the complaint. The complainant deliberately suppressed the material facts and has not come to the District Forum with clean hands. It prayed for the dismissal of the complaint with costs of Rs.20,000/-; being false and baseless to the knowledge of the complainant.
4. Both the sides produced their evidence in support of their respective averments before the District Forum, which after going through the same and hearing learned counsel on their behalf dismissed the complaint, vide aforesaid order.
5. We have heard learned counsel for both the sides and have carefully gone through the records of the case.
6. It was submitted by the learned counsel for the complainant that the claim of the complainant was repudiated in view of the report of the surveyor, who concluded, on the basis of the existence of the horizontal scratches and absence of vertical scratches on the left side of the car, that the car had not brushed/grazed with the trees after the complainant lost the control on account of the sudden appearance of the animal on the road. The report of the surveyor is not the final First Appeal No.76 of 2011. 5 word and from the evidence produced by the complainant before the District Forum, it stands proved that the scratches were received after the car went out of the control of the complainant and it brushed into the trees on the side of the road. Therefore, the opposite party was not competent to repudiate his claim and the repudiation of a valid claim amounts to deficiency in service on its part for which complainant is entitled to receive the compensation.
7. On the other hand, it was submitted by the learned counsel for the opposite parties that the claim of the complainant was not repudiated on the basis of the report of the surveyor but the same was repudiated as the claim made by the complainant was not found in consonance with the cause of damage disclosed by him and he was repeatedly asked to explain the position but he opted not to explain the same as the letters written to him by the opposite parties in that regard remained unreplied. Ultimately, the letter received from his side falsified the averments made by him in the complaint. The complainant failed to prove that the damage to the car was caused in the manner alleged by him and, therefore, the opposite party was not bound to pay any such claim to him. Correct finding to that effect was recorded by the District Forum and there is no ground for upsetting that well reasoned finding.
8. The Motor Insurance Claim form submitted by the complainant to the opposite party for claiming the amount in respect of the damage to the car was proved on the record as Ex.R-5. He mentioned therein First Appeal No.76 of 2011. 6 the statement of how the accident occurred. That statement is reproduced below:-
"On the way to home, all of sudden a cow came from right side of the road, to save ourselves we turned the car to left side after the road curved. Left side rubbed with small trees and dry plants."
9. It is the admitted case of the parties that after the intimation of the loss was given by the complainant, the surveyor was appointed for assessing the loss to the car. That surveyor had been writing letters to the complainant asking him to explain as to how the damage was caused to the car. The complainant himself has proved on record two of those letters dated 24.10.2009 and 14.11.2009, Ex.C11 and Ex.C12. In the first letter, he mentioned that after physical verification of the damage and going through the cause of accident in the claim form it was clear that the damage does not match with the cause of accident and that there was previous multiple damage on the same surface appearing, which indicated that the said part had previously hit at different times. He asked for clarification but no such clarification was sent to him by the complainant. He reminded the complainant, vide his letter dated 14.11.2009 for submitting the reply to his previous letter but no such reply was sent. The opposite parties themselves had written letter dated 9.12.2009 to the complainant, which has been proved by him on the record as Ex.C-4. Vide that letter he was asked to clarify the points mentioned therein. He had not given any First Appeal No.76 of 2011. 7 opportunity to the opposite parties to inspect the vehicle on the spot of the accident and he was asked to clarify the point that the damage to the vehicle did not correlate with the cause of loss, as per the report of the surveyor. Even that letter was not replied by him. Ultimately, his claim was treated as "No Claim", vide letter dated 16.12.2009 Ex.C-5. The final repudiation was made by the opposite parties, vide letter dated 18.1.2010 Ex.C-6 on the ground that he was unable to explain how the vehicle got damaged and the cause of accident explained by him in the claim form was not in consonance with the damages. It was also mentioned in that letter that no response had been received from his side to the letters written to him regarding his claim.
10. The complainant relied upon the letter dated 15.12.2009 Ex.C-8 and according to him, this letter was written by him to the opposite party. In this letter he tried to explain as to how the damage was caused to the car. For better appreciation the matter of that letter is reproduced below:-
"...On dated 20.10.2009 when I was going to Bhawanigarh from Sangrur, suddenly a stray animal appeared from field side, I steered L/S to save but lost control and when I came out from the car & found that car was at side of road.
I did not know that with which the car got hit or grazed. At the time of survey the same was First Appeal No.76 of 2011. 8 explained to your officer Mr. Rajnesh Kumar. So please approve my claim as soon as possible."
11. From the contents of this letter, it becomes very much clear that the complainant could not offer any explanation regarding the damage caused to the car and rather changed the story, which was put forward by him in the Claim Form. In the Claim Form, he submitted that the scratches were caused on the left side as a result of the brushing/grazing of the trees etc. in the body of the car and in this letter he by stating that "I do not know that with which the car got hit or grazed" he has shown his ignorance as to in which particular article the car hit or grazed. In all these circumstances, the opposite parties were well within their rights to repudiate the claim of the complainant and a correct finding to that effect was recorded by the District Forum, which is hereby upheld.
12. The appeal is dismissed accordingly. However, no order is made as to costs.
13. The arguments in this case were heard on 25.7.2013 and the order was reserved. Now, the order be communicated to the parties.
14. The appeal could not be decided within the statutory period due to heavy pendency of court cases.
(JUSTICE GURDEV SINGH)
PRESIDENT
August 01, 2013 (BALDEV SINGH SEKHON)
Bansal MEMBER
First Appeal No.76 of 2011. 9