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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
Ajit Bharihoke, P.M and Rekha Gupta, Member
IFFCO-TOKIO GENERAL INSURANCE COMPANY LTD. - Appellant
Versus
BEENA RAGHAV - Respondent
Revision Petition No. 3217 of 2014. (Against the Order dated 03/04/2014 in Appeal No. 52/2014 of the State Commission Haryana).
Decided on : 27-02-2015
Harshvardhan, Advocate, for the Appellant; Ankur Bansal with Gaurav Raghav, Advocates, for the Respondent
The independence and qualifications of the surveyor governed by IRDA and the duty of the insurance company to indemnify the loss suffered by the consumer at the earliest.
Headnote:
Insurance - Car Insurance Claim - Insurance Act, 1938 - Section 64 UM(2) - National Commission Case Law - United India Insurance Company Limited v. Gupta Tyre House, 2011 (3) CPC 105 - The court discussed the assessment of loss by the surveyor, the estimate of repair prepared by the authorized workshop, and the indemnity of the insured declared value (IDV) of the car. The court emphasized the independence and qualifications of the surveyor governed by IRDA and the importance of valid reasons for dismissing the survey report as untrustworthy.
Fact of the Case:
The insured car met with an accident, and the insurance company failed to pay the benefits of insurance. The District Forum allowed the complaint, awarding the IDV of the car to the respondent and compensation for mental agony. The State Commission dismissed the appeal, upholding the District Forum's decision.
Finding of the Court:
The court found that the insurance company was deficient in providing services to the consumer and had harassed the complainant, thus entitling the complainant to compensation and litigation expenses.
Issues: The issues revolved around the assessment of loss, estimate of repair, and indemnity of the insured declared value (IDV) of the car.
Ratio Decidendi: The court emphasized the independence and qualifications of the surveyor governed by IRDA and the importance of valid reasons for dismissing the survey report as untrustworthy. It also highlighted the duty of the insurance company to indemnify the loss suffered by the consumer at the earliest.
Final Decision: The revision petition was allowed, the orders of the State Commission and the District Forum were set aside, and the complaint was dismissed.
Dispute Facts
The insured car met with an accident on 25.08.2012 while driven by the respondent's son, leading to a police Daily Diary Report (DDR) no. 22 at Sadar Gurgaon police station, and the insurance company was informed the same day.[12000374440001] The insurance company appointed surveyor Mukesh Mendiratta, who assessed the repairable loss at Rs. 97,619/- vide report dated 26.11.2012 (later noted as 26.11.2013 in some references), noting the vehicle was repairable with parts available and repair cost below 75% of IDV.[12000374440001][12000374440002][12000374440009] (!) The respondent obtained a higher estimate of Rs. 3,18,558/- from M/s Apra Auto India Pvt. Limited on 04.09.2012, with IDV at Rs. 2,12,828/-, and claimed total loss, refusing repairs despite surveyor requests and communications to authorize repairs and submit bills.[12000374440001][12000374440002][12000374440009] (!) (!) The insurance company offered settlement on repair basis, sent letters to insured and repairer, but respondent insisted on IDV payout without repairing, leading to denial of full claim.[12000374440002][12000374440009][12000374440010][12000374440011] District Forum awarded IDV, compensation for mental agony (Rs. 15,000/-), interest @9% p.a., and litigation costs (Rs. 5,000/-), preferring workshop estimate over surveyor report. (!) (!) State Commission dismissed insurance company's appeal, upholding District Forum. (!) (!)
Court's Holding
The National Commission allowed the revision petition, set aside orders of State Commission and District Forum, and dismissed the complaint.[12000374440012] (!) (!) It held the surveyor was independent and qualified under statutory provisions, with report of significant evidentiary value that cannot be dismissed as untrustworthy without valid reasons.[12000374440006][12000374440011] Repair estimate is prospective, not actual cost, and vehicle was repairable with assessed loss below 75% IDV, so no total loss settlement warranted.[12000374440007][12000374440009][12000374440011] Respondent failed to controvert surveyor findings with credible evidence, refused repairs despite opportunities, and sought IDV instead, showing no interest in repair indemnity.[12000374440007][12000374440010][12000374440011] No deficiency in insurance service; lower fora erred in preferring respondent's estimate without basis and ignoring policy terms excluding deductibles.[12000374440011][12000374440012] Insurance company must indemnify assessed loss promptly, but only per surveyor report and policy.[12000374440006][12000374440011]
ORDER
Rekha Gupta, Member - Revision petition no. 3217 of 2014 has been filed against the ORDER dated 03.04.2014 of the Haryana State Consumer Disputes Redressal Commission, Panchkula ('the State Commission') in First Appeal no. 52 of 2014.
2. The brief facts of the case as per the respondent/complainant are that the insured car of the respondent met with an accident while it was being driven by the respondent's son Gaurav Raghav on 25.08.2012. The Daily Diary Report (DDR) no. 22 was registered on the same day with police station Sadar, Gurgaon. The petitioner/insurance company was also informed on the same day and Shri Mukesh Mendiratta of New Delhi was appointed as the Surveyor and Loss Assessor, who assessed the loss to the tune of Rs. 97,619/- vide his report dated 26.11.2013. The respondent also got an estimate of Rs. 3,18,558/- from M/s Apra Auto India Pvt. Limited on 04.09.2012. The Insured Declared Value (IDV) of the said car was Rs. 2,12,828/-. The respondent lodged her claim with the insurance company but it did not pay the benefits of insurance.
3. In their written statement before the District Consumer Disputes Redressal Forum, Gurgaon ('the District Forum') the petitioner/opposite party/insurance company have denied that there was deficiency in service on the part of the insurance company as the petitioner had appointed Mukesh Mendiratta as surveyor and loss assessor. The surveyor and loss assessor was an independent and qualified person being governed by IRDA. As per the report of the surveyor, the net amount payable was Rs. 97,619.42 on repair basis as the car was repairable. During the discussion with the repairer, he was informed that since the repair cost was well below 75% of the IDV and the vehicle was repairable there was no other possibility. As per the investigator, on 05.10.2012 the repairer was advised to start the repair work but the repairer refused to do so as the insured had specifically instructed the repairer not to start the repair work. A letter was also sent to the insured informing her of their decision and requesting her to carry out the repairs in her car. The written settlement of repair was also sent to the repairer personally but the repairer showed his inability to settle the claim saying that the insured does not want to get the vehicle repaired at any cost and the respondent wants some other settlement. It was also observed by the surveyor and the loss assessor that the vehicle was easily repairable and all the parts were easily available with the repairer. The surveyor also sent a letter dated 05.11.2012 requesting the insured to authorise the repairer to start the repairs and submit the bills of repairs but there was no response from the insured. The surveyor had also sent the assessment report to the repairer and also written the final letter to the insured. The surveyors report was admissible and cannot be brushed aside. Moreover the respondent herself was lingering in the matter and though the car of the insured was repairable the respondent had refused to give approval to the repairer to start the repair work as the insured knew very well that the cost of the repair assessed by the surveyor was perfectly correct and on the contrary the estimate given by the repairer was on the higher side and exaggerated. The repairer after receiving the mail of the surveyor had not objected to the veracity of the report of assessment. The repairer, in fact, had not assessed the loss as total loss. It was the insured who had alleged that the vehicle was a total loss.
4. The District Forum vide order dated 17.10.2013, while allowing the complaint observed that:
"Thus, keeping in view the law laid down by the Hon'ble National Commission in the above recent Orders the estimate of repair prepared by the engineers of the authorised workshop of the manufacturer (C-3) has attached much more value than the paid Agent of the Insurance Company who is not even engineer in the concerned field. Thus, the Repo
