State Consumer Disputes Redressal Commission
Pardeep Singh vs New India Assurance Co. on 14 March, 2018
Daily Order STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA First Appeal No : 809 of 2017 Date of Institution: 05.07.2017 Date of Decision : 14.03.2018 Pardeep Singh s/o late Sh. Ram Phal Saroha, Resident of House No.1425, Urban Estate, Jind, Tehsil and District Jind. Appellant-Complainant Versus The New India Assurance Company Limited through its Branch Manager, Jind. Respondent-Opposite Party CORAM: Hon'ble Mr. Justice Nawab Singh, President. Mr. Balbir Singh, Judicial Member.
Argued by: Shri Vikas Lochab, Advocate for appellant.
Shri Amit Kundra, Advocate proxy on behalf of Shri P.S. Saini, Advocate for respondent.
O R D E R BALBIR SINGH, JUDICIAL MEMBER This complainant's appeal is directed against the order dated May 30th, 2017 passed by District Consumer Disputes Redressal Forum, Jind (for short 'the District Forum') whereby complaint was dismissed.
2. Pardeep Singh - complainant (appellant herein) registered owner of car vehicle (Maruti Ritz) bearing registration No.HR-31H-9212 got insured the above mentioned car vehicle with The New India Assurance Company Limited-Opposite Party (for short 'the Insurance Company') vide insurance policy No.31260031140101817925 (Annexure R-6) regarding the period from July 31st, 2014 up to July 30th, 2015 on payment of Rs.13,328/- as premium mentioning total Insured Declared Value (IDV) as Rs.5,16,093/-. On January 05th, 2015 during the insurance period, Ramphal s/o Sh. Hazari Lal, Seema w/o Sh. Pardeep, Atma w/o Sh. Pardeep-complainant, Ms.Akshi d.o Deepak and Akshat s/o Sh. Deepak, Isha d/o Sh. Pardeep and Dhyan Singh s/o Sh. Sunehra were travelling in the above mentioned car vehicle on their way to Jind after attending a marriage party of Aman s/o Sh. Kanwar Sahab at Village Dilluwala, District Jind. Deepak was driving the above mentioned car vehicle with the car vehicle.
3. When the car vehicle reached in the area of Sector-9, Urban Estate, Jind near Redhu Service Centre, Deepak lost his control over the car vehicle when he tried to save a blue bull (Nilgai) which all of a sudden appeared on the road. The car vehicle struck with nearby standing trees. The car vehicle was badly damaged. Soon after Jai Kumar etc. who were travelling in another car also reached there. The injured were immediately shifted to General Hospital, Jind. The matter was reported to the Police Station immediately and entries were made in the Daily Diary Register at Sr.no.18 maintained in Police Station Sadar Jind. The complainant submitted insurance claim with the Insurance Company along with relevant documents and estimate of loss caused to the vehicle. On March 17th, 2015, assurance was given by the opposite party that the insurance claim to the tune of Rs.4,84,322/- had been passed and obtained an affidavit in the shape of consent letter from the complainant.
4. Later on the insurance claim of the complainant was repudiated by the opposite party vide letter dated 31st August, 2015 (Annexure R-1) on the ground that intimation was given to the Insurance Company regarding involvement of the vehicle in the accident after ten days and that eight persons were travelling in the vehicle at the time of accident in violation of the terms and conditions. It is pleaded that due to this accident, Akshat son of Deepak aged about three years was seriously injured and he remained admitted in a hospital at Rohtak from January 06th, 2015 up to January 12th, 2015 as indoor patient and thereafter he was provided treatment in other hospitals at Jind. Apart from it, father of the complainant Ramphal also succumbed to the injuries sustained by him at the time of accident. Age of three children travelling in the car vehicle Ashi, Akshat and Isha was 6 years, 2½ years and 10 years respectively. Dhyan Singh, who recorded his statement before the Police was not travelling in that vehicle.
5. The complainant filed complaint under Section 12 of the Consumer Protection Act, 1986 with a prayer to direct the opposite party to pay an amount of Rs.5,16,093/- on account of total damage caused to the car vehicle with interest at the rate of 18% per annum and to pay an amount of Rs.1,00,000/- as compensation on account of un-necessary harassment and mental agony.
6. The opposite party - Insurance Company in its written version has taken plea that the complainant has no cause of action and locus standi to file the present complaint; that the complaint of the complainant is not maintainable and that the District Forum has no jurisdiction to decide this complaint. It is pleaded that the Insurance Company received information regarding loss caused to the complainant due to involvement of the car vehicle in an accident. On January 15th, 2015 after ten days from the date of accident Shri Sanjay Kumar Jain was appointed as surveyor immediately who submitted report on January 19th, 2015. Thereafter, Shri I.B. Mehta, Government approved surveyor and loss accessor was also appointed for final survey who submitted his report dated 17th March, 2015 mentioning total loss caused to the complainant to the tune of Rs.3,14,322.50.
7. After receiving report of the surveyor, the insurance claim submitted by the complainant was repudiated vide letter dated August 31st, 2015 (Annexure R-1) firstly, because intimation regarding this accident was given to the Insurance Company after ten days and secondly eight members were travelling in the vehicle involved in the accident against the sitting capacity of the vehicle of five persons. The complainant violated the terms and conditions of the insurance policy, so the insurance claim was validly rejected. In the entries in daily diary register also it is mentioned that eight persons were travelling in the car vehicle at the time of accident. It is admitted fact that the complainant was provided insurance policy (Annexure R-6) regarding the period from July 31st, 2014 up to July 30th, 2015 mentioning total Insured Declared Value as Rs.5,16,093/-. The complainant is not entitled to receive any amount as claimed in the complaint. It is prayed that the complaint filed by the complainant be dismissed with cost.
8. Parties led evidence in support of their respective claims before the District Forum.
9. After hearing arguments, vide impugned order dated 30th May, 2017 the complaint filed by the complainant was dismissed by the learned District Forum.
10. Aggrieved with the impugned order dated 30th May, 2017 passed by the learned District Forum, the complainant-appellant has filed the present First Appeal No.809 of 2017 with a prayer to set aside the impugned order and to grant relief to the complainant as prayed in the complaint.
11. We have heard learned counsel for the parties and perused the case file.
12. During the course of arguments, there was no controversy of any type that car vehicle (Maruti Ritz) bearing registration No.HR-31H-9212 was insured with the Insurance Company-Opposite Party vide insurance policy Annexure R-6 regarding the period from July 31st, 2014 up to July 30th, 2015. The Insured Declared Value of the car vehicle was Rs.5,16,093/-. It is also not disputed that the car in question was damaged in an accident on January 05th, 2015 in Sector-9, Urban Estate, Jind when the persons travelling in the car vehicle were returning back to Jind after attending a marriage party at Village Dilluwala, District Jind. It is admitted fact that Ramphal-father of the complainant succumbed to the injuries sustained at the time of accident and another young child Akshat aged about 6 years sustained serious injuries at the time of accident who remained admitted in a hospital at Rohtak and thereafter got treatment in few other hospitals at Jind. The complainant has claimed insurance claim regarding damage caused to the car vehicle to the tune of Rs.5,16,013/- i.e. the IDV of the car vehicle, whereas after receiving complaint, the Insurance Company appointed Shri Sanjay Kumar Jain, as surveyor who submitted his report on 19th January, 2015 and thereafter Shri I.B. Mehta was appointed as surveyor and loss assessor who submitted his report dated 17th March, 2015 (Annexure R-2) whereby the total loss caused to the vehicle was assessed as Rs.3,14,322.50. The report of the surveyor appears to be well reasoned keeping in mind the year of manufacture of the car vehicle and all other circumstances.
13. The insurance claim of the complainant was repudiated by the Insurance Company after receiving report of the surveyor on two grounds. First ground of repudiation was that the Insurance Company received information regarding involvement of the vehicle in accident after ten days and second ground of repudiation was that eight persons were travelling in the car vehicle beyond the sitting capacity of the car vehicle. There is no un-necessary delay in giving information to the Police of Police Station, Sadar Jind regarding involvement of the vehicle in the accident and entries in this regard were made in the daily diary register maintained in the Police Station on January 06th, 2015. The delay of ten days in giving information to the Insurance Company regarding this accident also cannot be taken so seriously. Due to this accident, Ramphal-father of the complainant succumbed to the injuries sustained by him at the time of accident on the same date. Another young boy namely Akshat aged about two and half years sustained serious injuries on his body, more particularly head injuries. He remained admitted in a hospital at Rohtak for his treatment from January 06th, 2015 up to January 12th, 2015 and thereafter got treatment from other hospitals at Jind. In such a situation we cannot expect from an ordinary citizen to give preference to inform the Insurance Company regarding involvement of the vehicle in the accident ignoring treatment to be provided to the seriously injured passengers travelling in the vehicle and perform last rites who died due to the injuries sustained by him at the time of accident.
14. Apart from it, the Insurance Regulatory Development Authority (IRDA), which control and regulates the Insurance Companies, issued direction not to reject the genuine claims simply because of delay in registration of FIR and intimation to the Insurance Company. In the instructions of the IRDA it was mentioned that claims shall be intimated to the insurer with prescribed documents within a specified number of days is necessary for insurers for effecting various post claim activities like investigation, loss assessment provisioning, claim settlement etc. However, this condition should not prevent settlement of genuine claims, particularly when there is delay in intimation or in submission of documents due to unavoidable circumstances. The insurer's decision to reject a claim shall be based on sound logic and valid grounds. Support to this view can be taken from the case law cited as Bharti Axa General Insurance Company Limited vs. Ms. Monu Yadav and another, 2014(4) PLR 861, decided by Hon'ble Punjab and Haryana High Court, Chandigarh. Cited case law above fully supports the version of the complainant.
15. Coming now to the second ground regarding repudiation of complainant's claim that eight persons including driver were travelling in the vehicle involved in the accident. Dhyan Singh who recorded his statement before the Police has mentioned in his statement (Annexure R-5) that Ramphal s/o Sh. Hajari Lal, Deepak s/o Sh. Ramphal, Seema w/o Sh. Pardeep, Atma w/o Sh. Deepak, Ashi d/o Sh. Deepak, Akshat s/o Sh. Deepak and Isha d/o Sh. Pardeep were travelling in the car vehicle at the time of accident. Pardeep was driving the vehicle. Dhyan Singh was also travelling in the same car vehicle. The sitting capacity of the car vehicle, as mentioned in the Registration Certificate (Annexure R-4) and report of the surveyor (Annexure R-2), is 4+1. During the course of arguments, there was also no controversy that out of those eight persons, three were young aged children. The age of Ashi, Akshat and Isha was 6 years, 2½ years and ten years respectively. In the vehicles used for commercial purposes also, young aged children like in the case in hand are not provided separate seats however they are allowed to travel in the vehicle. In fact, these young aged children were travelling with their parents and other family members. Moreover, it is not the version of the Insurance Company that on the front passenger seat, more than one passenger were travelling and due to this reason it became the cause of accident. In our view due to the above mentioned reason also, the opposite parties should not have repudiated the insurance claim of the complainant. It is evident from the judgment dated 21st October, 2016 passed by the Motor Accidents Claims Tribunal, Jind (MACT) Annexure C-7 that the compensation amount has been awarded in favour of Akshat injured and Deepak Singh. Anyhow, the complainant has claimed compensation on account of his own damage but merely because these three young aged children were also travelling in the same vehicle, it will not be justified to repudiate the insurance claim of the complainant.
16. As a result as per discussions above in detail, findings are given that repudiation of the insurance claim vide repudiation letter dated letter dated 31st August, 2015 (Annexure R-1) is wrong, illegal and is not justified. The complainant is entitled to receive insurance claim on account of damage caused to his vehicle along with compensation and interest. It is held that the learned District Forum has committed an error while passing the impugned order dated 30th May, 2017 whereby the complaint filed by the complainant was dismissed.
17. For the purpose of assessment of the total loss caused to the vehicle, estimate Annexure C-4 prepared by Bansal Motors has been placed on the file wherein the total amount to be spent for repair of the vehicle has been assessed as Rs.6,05,489/-. Shri I.B. Mehta, Surveyor and Loss Assessor was appointed by the Insurance Company for assessment of the total loss caused who also in his report dated 17th March, 2015 (Annexure R-2) mentioned invoice value as Rs.6,06,653/- and assessed payment on total loss basis as Rs.4,84,322/- and net liability on total loss with RC Rs.3,14,322/- after deducting Wreck Value and depreciation value etc. The surveyor in his report has also mentioned it a case of total loss. In our view, when it was a case of total loss, no question arises to make payment on total loss basis and net liability of total loss as assessed by the surveyor as the accident took place after five months from the date of providing insurance policy. Keeping in mind all these circumstances, it is a case of total loss. The complainant is entitled to receive an amount of Rs.5,16,000/- being IDV of the vehicle with interest and compensation on account of un-necessary harassment, mental agony and costs of litigation.
18. As a sequel to the foregoing discussions, the appeal is allowed; the impugned order dated May 30th, 2017 passed by the learned District Forum is set aside. Accordingly, the complaint filed by the complainant stands allowed directing the opposite parties to pay an amount of Rs.5,16,000/- to the complainant with interest at the rate of 9% per annum from the date of filing of the complaint till realisation; to pay an amount of Rs.25,000/- as compensation on account of harassment and mental agony and Rs.10,000/- as litigation expenses.
Announced:
14.03.2018 (Balbir Singh) Judicial Member (Nawab Singh) President CL