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2026 Supreme(Online)(SCDRC) 2289
STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Sangita Dhingra Sehgal, President, Bimla Kumari, Member
Shefali Varma – Appellant
Versus
Reliance General Insurance Co. Ltd. – Respondent
FIRST APPEAL NO. 188/2024
For the Appellants/Petitioners: Pardeep Dahiya, Mahima Benipuri
For the Respondents: Saloni Dwary
The burden of proving deficiency in service lies entirely with the complainant. When a narrative is fraught with material inconsistencies regarding the chain of events and relevant documentation, the insurer is justified in rejecting claims, and the court will not interfere with such findings.
Headnote:(A) Consumer Protection Act, 2019 - Sections 2(11) and 2(42) - Motor Insurance Policy - Claim rejected due to exclusion of contractual liability - Burden of proof - Complainant failed to prove employment/authorization of driver, lacked cogent evidence regarding vehicle movement, and failed to explain inconsistencies in documents - Burden of proving deficiency of service rests on the person who alleges it - Deficiency cannot be alleged without proving fault or imperfection in performance.
Facts of the case:
The complainant purchased a private car package insurance policy. While the vehicle was at a service station, an employee/representative reportedly crashed the vehicle. The insurance company rejected the claim citing general exception no. 2 of the policy (contractual liability). The District Commission dismissed the complaint due to material inconsistencies in the complainant's version, lack of evidence regarding the driver's employment, and lack of explanation for the vehicle's movement between various service providers.
Findings of Court:
The Appellate Commission found that the appellant failed to clear material inconsistencies, specifically regarding payments to the crane operator and the sequence of vehicle movement between workshops. The court held that without sufficient evidence of the driver’s authorized capacity and verified documentation for the timeline of events, the allegation of deficiency in service is not established.
Issues: Whether the insurance company was deficient in service by rejecting the claim and whether the District Commission erred in dismissing the complaint due to evidentiary gaps.
Ratio Decidendi: The court affirmed that contracts of insurance are based on utmost good faith. If an insured fails to discharge the initial burden of proving both the occurrence/loss and the lack of deficiency in service by providing consistent, evidence-backed narratives, the claim cannot be upheld. The specific precedent cited regarding theft was distinguished because the present case involved material evidentiary gaps.
Result: Appeal dismissed.
| Table of Content |
|---|
| 1. overview of claimant allegations regarding insurance, service center interactions, and claim processing. (Para 1) |
| 2. district commission findings on non-disclosure, evidentiary gaps, and burden of proof in insurance contracts. (Para 2) |
| 3. arguments presented by appellant regarding procedural errors and respondent's denial of liability. (Para 3 , 4 , 5 , 6 , 7) |
| 4. appellate analysis of deficiency in service, definition of service, and evaluation of evidence. (Para 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17) |
| 5. final confirmation of dismissal and upholding the evidentiary requirement for insurance claims. (Para 18 , 19 , 20 , 21 , 22 , 23) |
PER: HON’BLE JUSTICE SANGITA DHINGRA SEHGAL, PRESIDENT
JUDGMENT
1. The facts of the case as per District Commission record are as under:
“The complainant has filed the present complaint seeking Rs. 48,51,000/- along with interest @ 18% per annum from the date of claim till realisation, Rs.7,19,800/- towards crane, parking charges, Rs,5,00,000/- as compensation for harassment and mental agony and Rs. 1,00,000/- as costs of the complaint. OP is Reliance General Insurance Company Ltd.
1. It is the case of the complainant that complainant had taken the private car package policy from OP in the year 2018 and had paid a premium of Rs.64,140/-. The same is annexed as Annexure C-1 and C-2.
2. It is the case of the complainant that she had sent her car to M/s British Auto Motors Marketing Pvt. Ltd. for air conditioning and servicing work on 02.06.2019 which was completed on 08.06.2019. Complainant sent her representative Mr. Kevin to collect the said car from the service station of British Auto Motors Marketing Pvt. Ltd., however, the car met with an accident near Sector-23 Dwarka, New Delhi. A local recovery van was called and vehicle was taken to another workshop Exclusive Motors Pvt. Ltd. located at Sector-14 Gurgaon. Copy of Jai Mata Di Recovery Crane is annexed as Annexure C-4
2. It is next stated by the complainant that on 17.09.2019 insurance claim for the damaged car along with the supporting documents was submitted to OP through Exclusive Motors. On 22.07.2019 the car was shifted to Patel Car Limited since Exclusive Motors Pvt. Ltd. raised parking charges Rs. 83,780/- as parking charges. Copy of the invoice dated 22.07.2019 by Exclusive Motors is annexed as Annexure C-5.
3. OP vide their letter dated 26.07.2019 rejected the insurance claim of the complainant on the ground that the loss occurred to the said vehicle happened was while it was under the service contract of M/s British Auto Motors Marketing Pvt. Ltd. and the Motors Insurance Policy excludes the losses under contractual liability which is the general exception No. 2 of Motors Insurance Policy. Copy of the letter dated 26.07.2019 is annexed as Annexure C-6.
4. It is stated that on 30.07.2019 Patel Cars Ltd. prepared an estimate of Rs. 13,26,707/- for repair of the damaged car annexed as Annexure C-7 and thereafter raised another invoice of Rs.74,800/- which is annexed as Annexure C-8.
5. The complainant alleged that the Ombudsman disposed of the complaint vide order dated 22.09.2020 stating that it was outside the scope of insurance Ombudsman rules. It is annexed as Annexure C-9.
6. It is further stated that Patel Cars Pvt. Ltd. raised another invoice towards parking charges from 07.08.2019 to 27.01.2021 Rs.6,36,020/-, the same is annexed as Annexure C-10.
7. It is the case of the complainant that refusal of the OP to pay the insurance claim not only amounts to deficiency in service but also amounts to unfair trade practice.
8. Right of OP to file reply was closed on 28.07.2022. Counsel for OP participated in final arguments and was given time to file his supporting documents, however, nothing has been filed. Counsel for OP has argued that onus to prove that Kevin i.e. Driver at the time of vehicle met with the accident was in the employment of the complainant is on the complainant and that the complainant has not pl
