State Consumer Disputes Redressal Commission
Cholamandalam Ms Gen.Insurance Co. vs Shish Ram And Another on 21 August, 2023
APPEAL NO.1264 OF 2018 21.08.2023
CHOLAMANDALAM MS GENERAL INS. COMP. LTD. & ANR. VS. SHISH RAM & ANR.
STATE CONSUMER DISPUTES REDRESSAL COMMISSION
HARYANA, PANCHKULA
Date of Institution: 20.11.2018
Date of final hearing: 21.08.2023
Date of Pronouncement: 21.08.2023
APPEAL NO.1264 OF 2018
IN THE MATTER OF
1. Cholamandalam MS General Insurance Company Limited, Jindal
Chowk, Near Punjab National Bank, Hisar through its Branch
Manager.
2. Cholamandalam MS General Insurance Company Limited "Dare
House" 2nd Floor, NSC Bose Road, Chennai-600001 through its
Managing Director.
....Appellants/Opposite Parties No.1 & 2
Versus
1. Shish Ram, aged about 29 years son of Shri Om Parkash, resident
of Near Shivalik Hospital, Dhani Badwali, Hisar, Haryana.
....Respondent No.1/Complainant
2. ABN Enterprises, Near City Hospital, Dabra Chowk, Hisar, Haryana
through its authorized person.
....Respondent No.2/Opposite Party No.3
CORAM: HON'BLE MR. JUSTICE T.P.S. MANN, PRESIDENT
MS. MANJULA, MEMBER
Present: Shri Rajneesh Malhotra, counsel for the appellants.
Shri S.K. Bishnoi, counsel for respondent No.1.
Presence of respondent No.2 already dispensed with.
PER: T.P.S. MANN, J.
ORDER
1. For the reasons stated therein, the miscellaneous application is allowed and delay in filing of the appeal is condoned. Page 1 of 6
APPEAL NO.1264 OF 2018 21.08.2023 CHOLAMANDALAM MS GENERAL INS. COMP. LTD. & ANR. VS. SHISH RAM & ANR.
2. The present appeal has been preferred by Cholamandalam MS General Insurance Company Limited through its Branch Manager as well as Managing Director (insurance company) for challenging the order dated 06.06.2018 passed by the District Consumer Disputes Redressal Commission, Hisar, whereby complaint preferred by complainant Shish Ram was allowed and insurance company directed to pay Rs.2,80,000/- i.e. net liability of insurer as mentioned in motor final survey report, along with interest @ 9% per annum from the date of filing the complaint i.e. 10.11.2017 till payment as well as compensation of Rs.5,000/- on account of harassment and mental agony besides Rs.1,000/- as litigation expenses to the complainant.
3. While filing the complaint, the complainant averred that he was the registered owner of car make Maruti bearing registration No.HR- 20V-8361, which was got insured with opposite parties No.1 and 2 i.e. Cholamandalam MS General Insurance Company by opposite party No.3 vide policy No.3362/01182292/000/00 valid from 06.05.2016 to 05.05.2017. The insured declared value (IDV) of the vehicle was Rs.5,50,000/-. On 15.12.2016 at about 10.30 p.m., the vehicle met with an accident in the area of Bye pass Chandan Nagar, Hisar. The vehicle was totally damaged in the accident. The complainant immediately informed the insurance company about the accident. The insurance company appointed a Surveyor, who conducted the spot survey and submitted its report to the insurance Page 2 of 6 APPEAL NO.1264 OF 2018 21.08.2023 CHOLAMANDALAM MS GENERAL INS. COMP. LTD. & ANR. VS. SHISH RAM & ANR. company. The complainant lodged his claim along with all required documents. The insurance company vide its letter dated 11.05.2017 repudiated the claim on the ground of misrepresentation of facts and deficiency in service on the part of the insurance company. The complainant also served a legal notice upon the insurance company but it did not respond to the said notice. Hence, the complaint with a prayer to direct the opposite parties to make the payment of IDV of Rs.5,50,00/- along with interest @ 18% p.a. from the date of filing the claim till its realization with other reliefs etc.
4. Upon notice, opposite parties No.1 and 2 appeared and filed their written version alleging therein that there was a deliberate and willful misrepresentation on the part of the complainant regarding the cause of loss as the damage to the vehicle was not one arising out of an accident as represented by him. The insurance company had rightly and legally repudiated the claim of the complainant and the same was fully binding on the rights of the complainant. Thus, there was no deficiency in service on the part of the insurance company.
5. Opposite party No.3 was given up by counsel representing the complainant before the District Consumer Forum on 09.02.2018.
6. In evidence, the complainant filed his affidavit (Exhibit CW1/A) and tendered documents (Exhibit C1 to Exhibit C6). On the other hand, opposite parties No.1 and 2 tendered documents (Exhibit R1 to Exhibit R4).
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APPEAL NO.1264 OF 2018 21.08.2023 CHOLAMANDALAM MS GENERAL INS. COMP. LTD. & ANR. VS. SHISH RAM & ANR.
7. After hearing counsel for the parties and on going through the record, the District Consumer Forum passed the order as mentioned above.
8. Aggrieved of the impugned order, opposite parties No.1 and 2 filed the present appeal.
9. Facts regarding ownership of accidental vehicle, coverage of vehicle, accident and intimating the insurance company are not in dispute. The insurance company is mainly relying on the Motor OD investigation report (Exhibit R4) prepared by Investigator, appointed by insurance company, wherein, the Investigator had reported that the damage was rusted and on being seen, it seemed that it was an old damage/accident. However, the parts of damaged vehicle were not examined by the insurance company from any forensic laboratory. Further, the investigator, who surveyed the spot, was not examined by the insurance company before the District Consumer Forum. In the report (Exhibit R4), the Investigator had reported that the matter was enquired from the neighborhood of insured, who confirmed that the accident was true and genuine. It was also reported that the team of Investigator visited the spot and found some parts of vehicle on the spot. Therefore, the State Commission is of the view that the said report of investigator alleging certain misrepresentation is not useful because it was not supported by affidavit. Report of investigator in our view has no evidentiary value. Appointment of investigator is for self-service purpose of Page 4 of 6 APPEAL NO.1264 OF 2018 21.08.2023 CHOLAMANDALAM MS GENERAL INS. COMP. LTD. & ANR. VS. SHISH RAM & ANR. the Insurance Company. Therefore, the said report is not to be relied on. In our view there is no need to give go by to the report of surveyor. Surveyor himself explained queries made by insurance authorities. Even then Insurance Company repudiated the claim on flimsy ground. In the absence of any evidence to prove alleged misrepresentation of facts by the complainant, the State Commission is of the view that the insurance company committed deficiency in service by repudiating claim of complainant without any proper reason.
10. On the other hand, as per the Motor Final Survey Report (Exhibit R2) prepared by Private Surveyor, the cause of accident was as under:
"Due to fog a parked vehicle could not be seen & IV dashed into back of that, meanwhile a following vehicle ALO dashed into back of that."
11. In the said report (Exhibit C2), the net liability of insurer is mentioned as Rs.2,80,000/-.
12. Accordingly, the State Commission finds that the District Consumer Forum rightly considered all the facts and record while allowing the complaint. The State Commission does not find any reason to interfere with the findings of the District Consumer Forum.
13. Resultantly, the appeal is devoid of any merit and therefore dismissed.
14. Application(s) pending, if any, stand disposed of in terms of the aforesaid order.
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APPEAL NO.1264 OF 2018 21.08.2023 CHOLAMANDALAM MS GENERAL INS. COMP. LTD. & ANR. VS. SHISH RAM & ANR.
15. The statutory amount of Rs.25,000/- deposited by the appellants at the time of filing the appeal be released in favour of the complainant against proper receipt and identification but in accordance with law.
16. A copy of this order be provided to all the parties free of cost as mandated by the law. The order be uploaded forthwith on the website of the Commission for the perusal of the parties.
17. File be consigned to record room along with a copy of this order.
(T.P.S. MANN) PRESIDENT (MANJULA) MEMBER Pronounced On: 21.08.2023 DR Page 6 of 6