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TATA AIG GEN.INSURANCE CO. v. LEELA YADAV ALIAS LEELAWATI
Factual and Procedural Background
The appellant, M/s Tata AIG General Insurance Co. Ltd., insured a vehicle bearing registration no. HR-26-AK-6789 for the period from 06.03.2011 to 05.03.2012. On 15.07.2011, during heavy rains and flooding in Panchkula, the complainant's husband was driving the vehicle when it stopped functioning due to flood water entering the engine up to a height of 2-3 feet. The vehicle was taken to a workshop where repair charges of Rs. 1,71,400/- were incurred. The insurance surveyor inspected the vehicle and reported the damage to be due to a mechanical defect, specifically citing hydrostatic lock, and the insurer repudiated the claim on 22.09.2011. The complainant filed a complaint before the District Consumer Disputes Redressal Forum, Gurgaon, seeking reimbursement of Rs. 1,71,400/-, compensation of Rs. 1,00,000/- for harassment and mental agony, and Rs. 20,000/- as litigation costs. The District Forum allowed the complaint and directed the appellants to reimburse the claim after deducting 25% depreciation, along with interest and compensation. The appellants filed the present appeal against this order.
Legal Issues Presented
- Whether the damage to the insured vehicle caused by flood water is covered under the terms and conditions of the insurance policy?
- Whether the repudiation of the insurance claim by the appellants on the ground of hydrostatic lock and mechanical defect was justified?
- Whether the complainant is entitled to compensation for harassment and litigation expenses?
Arguments of the Parties
Appellants' Arguments
- The damage to the vehicle was caused by hydrostatic lock due to water entering the engine as a result of the vehicle being driven into water.
- This type of damage is excluded from coverage under the insurance policy.
- There was no deficiency in service on the part of the appellants in repudiating the claim.
Respondent's Arguments
- The vehicle was insured and the damage occurred due to flood water, which is covered under the insurance policy.
- The repudiation of the claim was unjustified and caused harassment and mental agony.
- The complainant sought reimbursement of repair costs along with compensation and litigation expenses.
Table of Precedents Cited
No precedents were cited in the provided opinion.
Court's Reasoning and Analysis
The court examined the facts and found that the damage occurred during heavy flooding when the vehicle was driven through water gushing up to 2-3 feet. It noted that the surveyor undervalued the damage by attributing it solely to a mechanical defect and did not consider the impact of flood water. The court referred to the terms and conditions of the insurance policy, which explicitly cover damage caused by flood, typhoon, hurricane, storm, tempest, inundation, cyclone, hailstorm, frost, etc. Hence, the repudiation of the claim on the ground of hydrostatic lock was deemed illegal. The court upheld the District Forum’s order, rejecting the appellants’ plea and confirming the entitlement of the complainant to reimbursement and compensation.
Holding and Implications
The court dismissed the appeal filed by the appellants and upheld the order of the District Consumer Disputes Redressal Forum directing the appellants to reimburse the claim amount after depreciation, along with interest, compensation for harassment, and litigation expenses. The statutory amount deposited by the appellants at the time of filing the appeal was ordered to be refunded after the expiry of the appeal period. No new precedent was set; the decision directly enforces the insurance policy coverage terms and affirms consumer protection against wrongful repudiation of claims.
STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA
First Appeal No.282 of 2016 Date of Institution:22.03.2016 Date of Decision: 20.02.2017
1. M/s Tata AIG General Insurance Co. Ltd., having its registered office at Peninsula Corporate Park, Nicholas Piramal Tower, 9thFloor, Ganpatrao Kadam Marg, Lower Parel, Mumbai-400013.
2. M/s Tata AIG General Insurance Co. Ltd., 2ndFloor, SCO 6 Complex, Sector-14, Gurgaon- 122001, Haryana.
Both the appellants through its authorized officer Sh. Sanjay Bhagat, Chief Claims Manager, TATA AIG General Insurance Co. Ltd., 2md Floor SCO 232-234, Sector-34-A, Chandigarh. …Appellants
Versus
Leela Yadav @ Leelawti wife of Sh. B.S. Yadav, R/o H.No.39-P, Sector-31, Urban Estate Gurgaon. …Respondent
CORAM: Mr. R.K. Bishnoi, Judicial Member Mrs. Urvashi Agnihotri, Member Present: Mr.R.K. Sharma, Advocate for the appellants. Mr. B.S. Yadav, Advocate for the respondent.
O R D E R
MRS. URVASHI AGNIHOTRI, MEMBER
1. M/s Tata AIG General Insurance Company Ltd. and Anr. -OPs are in appeal against the Order dated 10.11.2015, passed by the learned District Consumer Disputes Redressal Forum, Gurgaon (for
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short 'District Forum'), whereby the complaint of Smt. Leela Yadav @ Leelawati has been allowed, by directing the OPs as under:-
"to reimburse the claim of the complainant for Rs.1,71,400/-, after deducting 25 % depreciation in view of term and condition No.1 of the insurance policy, with interest @ 9% p.a. from the date of filing of the present complaint i.e. 26.03.2012 till realization. The complainant is also entitled to Rs. 15,000/- as compensation for harassment and mental and Rs.3100/- as litigation expenses".
Briefly stated, according to the complainant, she got her vehicle bearing Regd. No.HR-26-AK-6789 insured with the OP-Insurance Company which was valid w.e.f. 06.03.2011 to 05.03.2012. During the subsistence of the insurance policy, on 15.07.2011 the husband of the complainant was driving the said car and went to Panchkula. On that day it was raining heavily and the said car stopped functioning all of sudden due to water flooding the road. Soon thereafter, the flood water entered the vehicle to the height of 2-3 feet and the engine stopped running. The vehicle was immediately taken to M/s Lally Automobiles Pvt. Ltd, Chandigarh and a sum of Rs.1,71,400/- were paid as the workshop charges. On 16.07.2011 the surveyor inspected the vehicle. On 18.07.2011, the car was again inspected by the workshop. But, the surveyor reported that the damage to the car was on account of mechanical defect. The claim of the complainant was, therefore, rejected on 22.09.2011 by the OP on the excuse that there was hydrostatic lock which was not liable to be reimbursed, as it did not amount to deficiency in service on the part of the opposite parties. Aggrieved by this, the complainant approached the District Forum claiming Rs.1,71,400/- alongwith Rs.1 Lac as compensation for harassment and mental agony with Rs.20,000/- as cost of litigation.
2.
Pursuant to notice, the opposite parties appeared and filed their joint written reply pleading that the husband of the complainant had driven the vehicle in the water and due to entering of water in the engine there was hydrostatic lock and the same was beyond the coverage of the insurance policy. Therefore, the claim of the complainant was rightly repudiated by the opposite parties as there was no deficiency in service on the part of the opposite parties. However, the learned District Forum rejected the pleas raised by the OPs and accepted the complaint vide order dated 10.11.2015 by granting the aforesaid relief to the complainant.
3.
Against the impugned Order, the OP/appellants have filed appeal before us reiterating the same pleas, as raised before the District Forum. We have heard the learned counsel for the parties and have also gone through the record. From the perusal of the record, it is evident that the damage to the car took place in the month of July when the rain water was heavily flooding the roads in Panchkula. The husband of the complainant was driving the car when the rain water suddenly flooded the road and gushed up to the height of 2-3 feet from the road level. The surveyor took pains in underestimating the damage to the vehicle by styling it only as a consequential loss, whereas in fact it was due to the sudden flooding of the water. The surveyor has not examined this aspect in its report i.e. 'flood'. If he had applied his mind to the damage to the vehicle due to gushing flood water entering the engine, his survey report would have been certainly been different. This is clear from the terms and conditions of the Insurance Policy (Annexure A-4) as under:-
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"Section I loss of or damage to the vehicle insured.
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(v) by flood, typhoon, hurricane, storm, tempest, inundation, cyclone, hailstorm, frost;"
Therefore, the OPs have illegally repudiated the genuine claim of the complainant and the learned District Forum had rightly allowed the complaint by rejecting the plea of the OPs. Hence, we uphold the decision of the learned District Forum and dismiss the appeal of the OPs.
5.
6. Statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the appellants against proper receipt and identification in accordance with rules, after the expiry of period of appeal and revision, if any filed in this case.
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February 20th, Urvashi Agnihotri R.K. Bishnoi 2017 Member Judicial Member
Addl. Bench Addl. Bench
R.K
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