PANKAJ KUMAR vs Branch Manager, Cholamandalam General Insurance Co Ltd

REVISION petition no. 592 of 2013 has been filed against the judgment dated 08.11.2012 passed by the Haryana State Consumer Disputes Redressal Commission, Panchkula (''the State Commission'') in First Appeal no. 1668 of 2011.

THE facts of the case as per the petitioner/ complainant are that the petitioner was the registered owner of Tata Safari bearing registration no. HR 10K 7798. The petitioner got insured the said vehicle from the respondents/ opposite parties vide cover note no. 7841305 dated 22.02.2010. The said vehicle was insured by the agent of the respondent at Sonepat, after receiving the insurance premium amounting to Rs.16,275/ - for a sum assured of Rs.6,05,000/ -.

THE said vehicle met with an accident and the same was reported and the claim of the petitioner was registered vide claim no. 390630 dated 09.03.2010 at 12.15 p m. The damaged vehicle was taken to the authorized service centre of Tata Safari named Raj Motors, Rohtak. The respondents appointed Mr Alok as its surveyor who surveyed the damaged vehicle. The petitioner furnished the required documents and information to the surveyors of the respondents. Thereafter, the vehicle was repaired. The petitioner paid the total bills of repairing, amounting to Rs.1,46,553/ -. After paying the bills, the petitioner approached the surveyor of the respondents for submission of bills for reimbursement thereof. The surveyor of the respondents showed his inability to collect the bills personally being out of station and he instructed the petitioner to leave the bills at the service centre itself from where the vehicle was repaired. Later on when the petitioner enquired from the service centre, it transpired that the surveyor had collected the bills from the service centre.

THE respondents also appointed an investigator named Mr Sharma who was introduced by the surveyor Mr Alok. The said investigator sought some documents and got fulfilled the certain formalities from the petitioner, which the petitioner accordingly fulfilled. The petitioner also took Mr Sharma, the investigator at the spot of accident, at his own costs. The said investigator also collected broken pieces of glass from the spot and also took the photographs.

LATER on the surveyor of the respondent Mr Alok started demanding Rs.10,000/ - from the petitioner as illegal gratification in lieu of getting settled the claim of petitioner. The petitioner along with his friends Mr Gaurav Dahiya, Sandeep Kumar and Anand Khatri met the said surveyor Mr Alok and tried to persuade him that it was a genuine case and hence, the petitioner was not going to give any illegal gratification but the surveyor was adamant and again demanded illegal gratification from the petitioner in the presence of the above named persons.

THE petitioner time and again approached the respondents for settlement of his claim and also got lodged a complaint on telephone vide complaint reference no. 455729 dated 31.05.2012. Ultimately, on 14.06.2010, the respondents told that the petitioner''s claim was not settled due to non -submission of bills and documents. Whereas the petitioner had submitted the requisite documents including driving licence of Sandeep Kumar who was driving the vehicle at the time of accident, copy of the registration certificate, copy of cover note, ID proofs etc. and the bills were left at the service station as per the instructions of the surveyor who collected the bills from the service centre.

THE petitioner also got issued a legal notice dated 07.06.2010 requesting the respondents to settle his claim and to release the sum assured/ damages but of no avail. The petitioner also got issued a legal notice dated 07.06.2010 requesting the respondents to settle his claim and to release the sum assured/ damages but of no avail. The respondents on 14.06.2010 told that the documents were not submitted to the company.

THERE was great deficiency in service on the part of the respondents due to which the petitioner had suffered great harassment, humiliation, mental shock and agony.

PETITIONER therefore, prayed that in view of the above facts and circumstances, the respondents be directed to: - Reimburse the repairing bills, the amount incurred by the petitioner on repairing of insured vehicle, along with interest @ 18% per annum from the date of damage of vehicle till actual realization; Pay and compensation of Rs.20,000/ - on account of mental agony and harassment caused to the petitioner; Pay the litigation expenses of Rs.5,000/ - to the petitioner in the interest of justice.

THE respondents/ opposite parties in their written statement before the District Consumer Disputes Redressal Commission, Sonepat (''the District Forum'') stated that the petitioner malafidely arranged to obtain the cover note on 23.02.2010 by manipulation of facts because the previous insurance policy of the insured vehicle no. HR 10 K 7798 was fake and the alleged cover note was the result of collusion of the petitioner with the alleged agent of the respondent/ company.

NO FIR regarding the alleged accident was got registered with the concerned police station which was mandatory and in the absence of the same, the plea taken by the petitioner was not legally tenable. As per the report of the said surveyor, the petitioner did not cooperate and did not provide the required information and documents and avoided the same on one pretext or the other. From the investigator, it was also found that previous insurance policy was alleged to have been taken from the Reliance General Insurance Co. Ltd., by the petitioner in respect of the said vehicle and the same was found fake and the petitioner malafidely managed to get insurance of the said vehicle with the respondent company on the basis of the previous fake insurance policy on 23.02.2010 while the alleged accident took place on 08.03.2010.

THE claim of the petitioner had been repudiated on the ground that the cover note produced by the petitioner to avail the insurance with the respondent company was found to be a fake one. Hence, as the petitioner had committed serious policy violation and mis -represented facts, the petitioner was informed about the repudiation accordingly vide letter dated 22.07.2010.

THE District Forum vide its impugned order dated 13.09.2011 while allowing the complaint observed as under: "But this Forum finds no force in the contentions raised by the learned counsel for the respondents. The policy/cover note no.7841305 was issued by the respondents for the period 23.2.2010 to 22.2.2011 and during the validity of the above said cover note, the vehicle of the complainant met with an accident. Further the plea of the respondents that the complainant has not incurred the amount of Rs.1,46,553/ - on the repair of his vehicle, is also not tenable in the eyes of law as the complainant has placed on record the copy of bill issued by Raj Motors, Rohtak.

Further to prove that Mr. Alok surveyor of the respondent has demanded Rs.10000/ - from the complainant, Gaurav Dahiya, Tarjeet Chhikara, Sandeep Kumar and Anand has tendered their affidavits in support of the case of the complainant and this fact also proves that when the complainant refused to pay the bribe of Rs.10000/ - to Mr Alok, his claim was not settled by the respondents and in our view, the respondents only to harass and humiliate the complainant has repudiated his legal and genuine claim. Accordingly, it is directed to the respondents to make the payment of Rs.1,46,553/ - (Rs.one lac forty six thousands five hundred fifty three) alongwith interest at the rate of 09% per annum from the date of lodging of the claim with the respondents till realization and further to compensate the complainant to the tune of Rs.1000/ - (Rs.one thousand) for rendering deficient services, for causing mental agony& harassment and under the head of litigation expenses. However, it is also directed to the complainant to complete the formalities of the respondents and also to submit all the required document with the respondents for the settlement of his claim at the earliest possible.

With these observations, findings and directions, the present complaint stands allowed".

AGGRIEVED by the order of the District Forum, the respondents - insurance company filed an appeal before the State Commission. The State Commission while accepting the appeal has observed as under: "It is settled by law that terms of agreement have to be strictly followed. In view of the observation made by the Hon''ble Apex Court in later case cited as Suraj Mal Ram Niwas Oil Mills (P) Ltd., vs United India Insurance Co. Ltd., and Another, 2011 CTJ 11 (Supreme Court) (CP) case as under: -

Before embarking on an examination of the correctness of the grounds of repudiation of the policy, it would be apposite to examine the nature of a contract of insurance. It is trite that in a contract of insurance, the rights and obligations are governed by the terms of the said contract. Therefore, the terms of a contract of insurance have to be strictly construed and no exception can be made on the ground of equity. 24. Thus, it needs little emphasis that in construing the terms of a contract of insurance, the words used therein must be given paramount important, and it is not open for the court to add, delete or substitute any words. It is also well settled that since upon issuance of an insurance policy, the insurer undertakes to indemnify the loss suffered by the insured on account of risk covered by the policy, its terms have to be strictly construed to determine the extent of liability of the insurer. Therefore, the endeavor of the court should always be interpret the words in which the contract is expressed by the parties. The facts and circumstances of the instant case are fully attracted to Suraj Mal Ram Niwas Oil Mills (P) Ltd., case . Opposite parties have placed on the file the verification report from Reliance General Insurance Company that policy no. 2013382311100796 does not pertain to vehicle no. HR 10 K 7798 and the same was fake. Complainant had submitted declaration at the time of obtaining insurance policy verifying the information given to be correct. Since, the declaration was found false, as the cover note purported to have been issued by Reliance General Insurance Company with respect to the earlier period and on the basis of which the vehicle was got insured, was found fake, the opposite parties were justified in repudiating the claim. Clause 8 of the terms and conditions of the policy is reproduced below: - The due observance and fulfillment of the terms, conditions and endorsements of this policy in so far as they relate to anything to be done or complied with by the insured and the truth of the statements and answers in the said proposal shall be conditions precedent to any liability of the company to make any payment under this policy.

It is crystal clear that OPs were justified in repudiating the claim of the complainant. Thus there was no deficiency in service on the part of the OPs.

Thus, learned District Forum committed a serious error in allowing the complaint. For the reasons recorded above, this appeal is accepted and impugned order is set aside and consequently the complaint is dismissed".

HENCE , the present revision petition.

WE have heard the learned counsels for the parties and have carefully gone through the records of the case. Learned counsel for the petitioner has stated that the impugned order of the State Commission deserves to be set aside, because, the State Commission had failed to appreciate that no policy was given by the petitioner and the said documents had been fabricated by the respondent and the respondent had rejected the claim only, because, the petitioner refused to give illegal gratification demanded by the surveyor of the respondents and because, the State Commission failed to appreciate that no notice was issued to the petitioner by the State Commission before passing their order.

ON other hand, the learned counsel for the respondent has stated that since the policy was being taken in continuation of the earlier policy, there was no check of the vehicle concerned. Further, as per the investigator''s report on verification of the previous insurance, it was found that insurance was done with Reliance GIC Ltd. The investigator found no proof of the accident having taken place and no FIR had been lodged with regard to the alleged accident. He further stated in his report that "the undersigned repeatedly contacted the insured to give detailed statement regarding the accident of the said vehicle, but till date insured extended no co -operation to give written statement regarding the accident of the said vehicle. He had always excuses that he was busy in one thing or the other. Even when he was in Rohtak, he denied to give written statement regarding the above and added that he could only give the statement in the present of Tarjeet, to avoid differences in statements. He verbally confirmed that he had not attended the said ring ceremony, so exact details of mishap are only known to Tarjeet and reported driver Sandeep, whereas Sandeep and Tarjeet stated that the insured was in other vehicle at the time of mishap. So there seems possibility of manipulations regarding the date of mishap of said insured vehicle, because previous insurance policy of the insured vehicle is fake and current insurance was arranged on 23.02.2010 and accident reportedly happened on 08.03.2010".

WE note from the order of the State Commission that the State Commission has observed in its order as follows: "Case called several times but none has appeared on behalf of the parties. Keeping in view the heavy pendency of appeals/ complaints in this Commission, we do not think it appropriate to adjourn this appeal after going through the case file".

Hence, the argument of the learned counsel for the petitioner that no notice was given before passing the final order cannot be a ground for setting aside the order of the State Commission.

WE have carefully gone through the record. Though the learned counsel for the petitioner had stated that he had given no information regarding the previous insurance to the respondent, on our perusal of the cover note placed on file for insurance taken from the respondent for the period 23.02.2010 to 22.02.2011, we find that it has been recorded that the previous insurance was from RGICL.

WE also noted that the year of manufacturing of the vehicle in question was 2007. On our enquiry, the learned counsel for the petitioner could not give any details regarding the insurance of the said vehicle for the period from 2007 to 23.02.2010. On the other hand, the investigator in his report, has stated that he had visited the office of Reliance GIC Ltd., at Rohtak and met the concerned Branch Manager Mr Swapan Dutt, who verified from computer record and verbally confirmed that no such policy number existed as per the computer record of Reliance GIC Ltd., Hence, as per verifications from Reliance GIC office it was evident that the previous insurance policy of the insured vehicle was fake.

WE went through the letter sent by the respondent to Branch Manager of Reliance GIC Ltd., regarding verification of the policy no. 2013382311100796, Cover note no. 200702622518 in the name of Mr Pankaj Kumar for the period 23.02.2009 to 22.02.2010. The report of Reliance General Insurance Co. Ltd., thereon reads as under: "It is confirmed that as per data available policy no. 2013382311100796 is issued in the name of Shri Krishan Bhagwan only for the period of 07.03.2008 to 06.03.2009 whereas it is not applicable for the year 23.02.2009 to 22.02.2010 and same is applicable for cover note also".

THE actual policy of that number was issued in favour of Krishan Bhagwan Gaushala, also a resident of Rohtak, for a Mahindra Bolero SLX II and not for TATA Safari for the period 07.03.2008 to 03.03.2009 and not for the period 23.02.2009 to 22.02.2010. The petitioner could not deny or explain this fact. Hence, we agree with the State Commission that the Respondents were justified in repudiating the claim of petitioner and that there was no deficiency in service on the part of the respondent.

THE Hon''ble Supreme Court in Mrs Rubi (Chandra) Dutta vs M/s United India Insurance Co. Ltd., 2011 3 Scale 654 has observed: "Also, it is to be noted that the revisional powers of the National Commission are derived from Section 21 (b) of the Act, under which the said power can be exercised only if there is some prima facie jurisdictional error appearing in the impugned order, and only then, may the same be set aside. In our considered opinion there was no jurisdictional error or miscarriage of justice, which could have warranted the National Commission to have taken a different view than what was taken by the two Forums. The decision of the National Commission rests not on the basis of some legal principle that was ignored by the Courts below, but on a different (and in our opinion, an erroneous) interpretation of the same set of facts. This is not the manner in which revisional powers should be invoked. In this view of the matter, we are of the considered opinion that the jurisdiction conferred on the National Commission under Section 21 (b) of the Act has been transgressed. It was not a case where such a view could have been taken by setting aside the concurrent findings of two fora."

In view of the above, we find that there is, no jurisdictional or legal error or misrepresentation of facts have been shown to us to call for interference in the exercise of powers under Section 21 (b) of Act. The order of the State Commission does not call for any interference nor does it suffer from any infirmity or erroneous exercise of jurisdiction or material irregularity. Thus, the present revision petition is hereby, dismissed with no order as to cost.