Present: Mr. Dheeru Nigam, counsel for the appellant appeared through VC. Mr. Kumar Manish and Mr. Diwakar Awasthi, counsel for the respondent.

PER: HON’BLE JUSTICE SANGITA DHINGRA SEHGAL, PRESIDENT

JUDGMENT

1. The facts of the case necessary as per the District Commission record are: “

Complainant has filed the present complaint seeking direction to the OP to pay Rs.7,61,209/- with interest @18% per annum and Rs.50,000/- as litigation cost.

1. It is stated by the complainant that it is a company duly incorporated and owns vehicles, one such vehicle is Ashok Leyland bearing No. HR 55 M9411 and was covered under the comprehensive insurance covered policy of the OP.

2. It is stated that on night of 15.03.2019, the driver of the complainant, namely, Suresh Yadav was driving the vehicle from Moradabad to Loni and it suddenly caught fire near Buxar. It is stated that the patrolling police spotted the fire and called the fire brigade to extinguish but by that time the vehicle was badly burnt. Complainant intimated the OP and submitted the claim form for on 19.03.2019.

3. It is further stated that the estimated repair and maintenance of the vehicle from M/s Sandeep Engineering Workshop, Tilpata Karanvaas ICD Dadri, Greater Noida for an amount of Rs.7,61,209/- was submitted to the OP.

4. It is further stated that the Entire documentation process was completed by the complainant and the appointed surveyor also completed inspection and submitted the report to the OP. Despite the complainant providing all required documents compliances yet the OP sought the mode of payment made by the complainant and the original receipt of M/s Sandeep engineering workshop vide email dated 22.07.2020.

5. ⁠it is stated that the complainant submitted the above information/documents and requested for the processing of the claim however, the OP did not respond till date.

6. It is further stated that the employee of the complainant has made several visits to the OP seeking status and during one of such visits official of the OP casually informed the complainant that the claim application has been closed as „no claim‟.

7. Complainant was shocked to hear and wrote to OP on 27.01.2021 seeking the status of his claim which letter was submitted personally at the Moradabad branch office of the OP. It was informed to the complainant that the claim application is still under process and that the complainant will receive an official intimation soon.

8. Further the complainant sent a legal notice dated 23.06.2022 vide speed post demanding immediate processing of the delayed insurance claim however, no reply was received from the OP.

9. OP, in its written statement has stated that there is no deficiency in service on the part of the OP and the present complaint has been filed on the basis of forged and fabricated documents. It is stated that an investigator was appointed but when the investigator visited the workshop, no such workshop was found. Copy of the said investigator dated 13.07.2020 is annexure A.

10. It was noticed by the investigator that the certificate issued by Sandeep Engineering Workshop did not mention the mode of payment in the receipt therefore OP requested the complainant to provide the same along with the original receipt of Sandeep Engineering Workshop as everything regarding the said workshop was doubtful. It is stated that the complainant failed to provide the same.

11. It is further stated that the bill provided by the complainant was fake and Sandeep engineering workshop does not exist at given address therefore the claim was closed by the OP as „No Claim‟.

12. ⁠It is further stated that the complainant had taken the policy for a goods carrying the vehicle which was for a commercial purpose and therefore as per the definition complainant is not a consumer as commercial activities are barred.

13. ⁠It is further stated that their allegations of forgery and fraud which cannot be decided in a summary trial and requires detailed evidence and cro