In a significant consumer rights ruling, the Navsari Consumer Disputes Redressal Commission (CDRC) directed an insurance company to compensate a car owner for vehicle damage, even though he failed to conclusively prove the circumstances surrounding the accident that allegedly caused the loss.
The commission observed that while the accident itself remained doubtful and unproven, the damage to the vehicle was undeniable. Based on this reasoning, it ordered the insurer to pay the assessed loss amount of ₹1.25 lakh along with additional compensation for harassment.
Insurance Policy and Claim
The case involved Chirag Desai, a 43-year-old resident of Navsari, who had purchased a comprehensive motor insurance policy from ICICI Lombard General Insurance Co. Ltd. on October 18, 2022. The policy carried an Insured Declared Value (IDV) of ₹3.10 lakh, covered both own-damage and third-party risks, and was valid for one year. Desai paid a premium of ₹6,853 for the policy. According to him, his car met with an accident on June 20, 2023, during the policy period. Claiming that the vehicle had suffered a total loss as a result of the accident, he filed an insurance claim and sought compensation under the terms of the policy.
Consumer Complaint Filed
After his claim was rejected, Desai approached the Navsari Consumer Disputes Redressal Commission on October 4, 2024. In his complaint, he sought ₹3.10 lakh towards the alleged total loss of the vehicle and an additional ₹1 lakh as compensation for harassment and litigation expenses.
Independent Investigation Raised Doubts
During the proceedings, it emerged that the insurance company had appointed an independent investigator to verify the claim. The investigator’s report highlighted several inconsistencies regarding the alleged accident. It noted that the damage found on the vehicle’s dashboard did not appear consistent with a collision involving a truck, as claimed by Desai. The report also found contradictions regarding the accident location and stated that descriptions of the driver’s injuries did not match the available evidence. Several surrounding circumstances of the accident appeared doubtful.
The investigation further noted that despite claims of extensive vehicle damage, the driver suffered only minor injuries and did not seek any medical treatment after the incident. No eyewitnesses to the accident could be traced, and the vehicle was sent for repairs four days after the alleged accident, raising additional questions about the claim.
Commission Finds Accident Not Proved
After reviewing the evidence, the commission concluded that the complainant had failed to establish crucial details about the alleged collision. It observed that Desai could not provide the registration number of the truck allegedly involved in the accident, identify the truck driver, or furnish sufficient evidence to conclusively prove how the accident occurred.
The commission further observed that the delay in taking the vehicle for repairs, the absence of eyewitnesses, and the lack of medical treatment despite claims of a serious accident all contributed to doubts regarding the accident narrative.
In its observations, the commission stated: “Based on the circumstances and suspicious aspects of the case, the complainant has failed to prove the accident. However, the fact remains that the car was damaged, making him eligible for compensation for the loss.”
Damage Was Undisputed
Despite questioning the accident claim, the commission emphasized that the vehicle had undeniably suffered damage. It noted that the insurer’s own surveyor had assessed the loss at ₹1.25 lakh and that the insurance company’s counsel had expressed willingness to pay the amount assessed by the surveyor.
The commission held that once the damage was acknowledged and quantified by the insurer’s own surveyor, completely rejecting the claim amounted to a deficiency in service.
Final Order
The Navsari Consumer Disputes Redressal Commission ruled partly in favour of the complainant and directed the insurance company to pay ₹1.25 lakh towards the assessed vehicle damage. It also ordered the insurer to pay an additional ₹15,000 as compensation for physical and mental harassment.
While the commission did not accept Desai’s claim that the vehicle had suffered a total loss worth ₹3.10 lakh, it held that the insurer could not deny compensation altogether when the damage to the vehicle had been independently verified. The ruling underscores that while insurers may question the circumstances surrounding an accident, they cannot ignore proven and assessed damage when determining compensation under a valid insurance policy.
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