Insurance claims for damage from hydrostatic lock not covered unless specified; clear depiction of coverage obligations and consumer rights established.

ORDER

DR. INDER JIT SINGH, PRESIDING MEMBERIHGFEDCBA

1. This Second Appeal(SA) has been filed by the Petitioner against Respondent(s) as detailed above, under section 51(2) of Consumer Protection Act 2019, against the order dated 26.05.2025 of the State Consumer Disputes Redressal Commission, Uttarakhand (hereinafter referred to as the 'State Commission'), in First Appeal (FA) No. SC/5/A/205/2022 in which order dated 29.08.2022 of District Consumer Disputes Redressal Commission, Haridwar (hereinafter referred to as District Commission) in Consumer Complaint (CC) No. 349/2021 was challenged, inter alia praying to set aside the order passed by the State Commission.

2. While the Appellant(s) were Respondent(s) before the State Commission and Opposite Party before the District Commission and the Respondent were Appellant before the State Commission and Complainant before the District Commission. Notice was issued to the Respondent on 28.08.2025. Parties filed their Written Arguments/ Synopsis on 01.12.2025 (Appellant) and 17.10.2025 (Respondent).

3. Brief facts of the case, as presented by the Complainant and as emerged from the Second Appeal, Order of the State Commission, Order of the District Commission and other case records are that:-

3.1 The Complainant purchased a Mercedes-Benz vehicle for Rs. 65,00,000/-, financing Rs.31,00,000/- through a loan from Axis Bank and contributing Rs.34,00,000/- from her own funds. The vehicle was purchased from respondent no.2 herein (OP-3 before the district commission) registered with the A.R.T.O., Haridwar on 11.11.2011 (Registration No. UK-08-V-0700), and used by the complainant.

3.2 The complainant obtained a comprehensive insurance policy (Policy No. 2311200415793200000) from the Appellant insurance company for the period 23.01.2013 to 22.01.2014. The policy included a "Zero Depreciation" (Zero Dep) add-on. Complainant alleges that at the time of sale, representatives of the insurer (opposite party nos. 1 & 2) verbally represented that damage due to "drowning in water" would be fully covered.

3.3 On 15.06.2013, during heavy rain, the vehicle became immobilized and suffered water ingress at Bhagat Singh Chowk, Haridwar. The complainant notified the insurer, which deputed a surveyor. Relying on the surveyor's advice and assurance that repair costs would be borne by the insurer, the vehicle was towed to the authorised workshop, T & T Motors Limited, New Delhi.

3.4 The workshop provided a repair estimate of Rs. 74,45,257/-.It is alleged that the insurer refused to pay this amount. Subsequently, via a letter dated 07.10.2013, the insurer repudiated the claim in substance, stating its liability was restricted only to "cleaning, opening & refitting of parts" and "flushing" of the engine.

3.5 Following this repudiation, the complainant alleged that he made several unsuccessful requests for settlement of the claim. The claim has been repudiated by the Insurance Co. vide its letter dated 09.10.2023 Prior to this, two letters dated 15.07.2013 and 19.07.2013 were issued. Alleging deficiency in service and unfair trade practice, the complainant filed a consumer complaint bearing no.CC/2021/349 before the District Commission seeking appropriate relief.

4. The District Commission vide Order dated 29.08.2022, in the CC no.349/2021, while dismissing the complaint passed the following order:

21. On the basis of aforesaid comments we are of the opinion that the complaint is time barred and the damage caused to the vehicle is due to the driving of the vehicle in deep water by the complainant or her driver for which the opposite party cannot