Insurance claims cannot be repudiated solely on the ground of delayed intimation if the accident is genuine and the delay occurs due to unavoidable circumstances, such as personal injuries; additionally, the surveyor's report serves as the primary basis for assessing quantum of loss.

First Appeal under Section 41 of the Consumer Protection Act, 2019 against the order dated 06.10.2022 passed by the District Consumer Disputes Redressal Commission, Gurdaspur in C.C. No. 405 of 2018.

Quorum:-

Hon’ble Mrs. Justice Daya Chaudhary, President

Ms. Simarjot Kaur, Member

Mr. Vishav Kant Garg, Member

VISHAV KANT GARG, MEMBER :

1. Appellants/Opposite Parties i.e. Reliance General Insurance Company Limited, have filed the present Appeal through its Area Manager (Legal Claims) to challenge the impugned order dated 06.10.2022 passed by the District Consumer Disputes Redressal Commission, Gurdaspur (in short, “the District Commission”), whereby the Complaint filed by the Respondent/Complainant-Harjinder Singh had been Partly Allowed.

2. It would be apposite to mention here that hereinafter the parties will be referred, as were arrayed before the District Commission.

3. Briefly, the facts of the case as made out by the Respondent/Complainant in the Complaint filed before the District Commission are that he had purchased Mahindra Scorpio Vehicle, having Engine No. WGH4C16172, Chassis No. MA1TA2WGXH2C34892 on 26.06.2017. Said vehicle was insured with the OPs for the period w.e.f. 26.06.2017 to 25.06.2018 on paying the premium of Rs.59,884/-. Total IDV of the vehicle was Rs.11,37,982/-. Said vehicle met with an accident on 07.07.2017 and the Complainant had received multiple injuries in the accident. In the accident, the vehicle was badly damaged. DDR No. 7 dated 15.07.2017 was lodged with Incharge Police Chowki, Naushera Majja Singh Police, District Batala. The vehicle in question was allotted Registration No. PB-06-AN-7604. The Complainant had lodged claim with the OPs, which was repudiated by the OPs vide letter dated 03.04.2018.

4. Stating the act of the opposite parties to be a case of ‘deficiency in service’ and ‘unfair trade practice’, it was prayed in the Complaint that the OPs be directed to pay the claim amount and Rs.50,000/- be granted as compensation on account of wrongly repudiating his claim, suffering mental agony and harassment at the hands of OPs and Rs.50,000/- be also awarded as litigation expenses.

5. Upon issuance of notice in the Complaint, the Appellants/ Opposite Parties had filed their written statement by raising certain preliminary objections that the Complainant had violated the terms and conditions of the Insurance Policy as he had informed the OPs on 26.02.2018 regarding the accident of the vehicle in question. In this process, a delay of 235 days had occurred, which was long one. Due to such a long delay, the OPs had failed to identify the exact reason of the accident. Said accident was doubtful in nature and it required cross examination of the witnesses to find out the exact cause of accident, which could not be adjudicated in summary procedure and the matter needs to be relegated to the Civil Court. At the time of accident, the vehicle was not registered with the Registering Authority and without registration, plying of vehicle is an offence. As the Complainant himself had violated the Condition No.1 of the Policy, therefore, scrutinizing the claim under the terms and conditions of the policy, the same had been repudiated. Intimation with regard to repudiation of the claim had been sent to the Complainant vide letter dated 03.04.2018. As the Complainant had violated the terms and conditions of the policy, therefore, no liability was fastene