A car owner from Gujarat's Navsari has been awarded Rs 1.25 lakh in insurance compensation despite failing to conclusively establish how the accident occurred that damaged his vehicle. The ruling was delivered by the Navsari Consumer Disputes Redressal Commission (CDRC), which held that while doubts remained over the alleged accident, the damage to the car was undisputed, entitling the policyholder to compensation.
According to a Times of India report, complainant Chirag Desai 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 Rs 3.10 lakh and covered both own-damage and third-party liabilities. Desai paid an annual premium of Rs 6,853.
Desai claimed that his vehicle met with an accident on June 20, 2023, during the policy period and suffered extensive damage amounting to a total loss. He subsequently filed a claim with the insurer, which appointed a surveyor to assess the vehicle.
However, on July 27, 2023, ICICI Lombard rejected the claim, citing an unjustified cause of loss and alleged concealment of material facts. The insurer also questioned the absence of an FIR or police complaint, particularly given the claim of total loss.
After the claim was denied, Desai approached the consumer commission on October 4, 2024, seeking Rs 3.10 lakh towards the vehicle's loss along with Rs 1 lakh for harassment and litigation expenses.
During the proceedings, it emerged that the insurer had commissioned an independent investigation into the claim. The investigator flagged several inconsistencies in Desai's account of the accident, noting that the damage to the dashboard did not appear consistent with a collision involving a truck.
The report also highlighted discrepancies regarding the accident location, the driver's injuries and other circumstances surrounding the incident. It noted that despite the extent of damage claimed, the driver reportedly suffered only minor injuries and did not seek medical treatment.
Investigators were unable to identify any eyewitnesses to the accident. The report further stated that the damaged vehicle was sent for repairs four days after the alleged incident.
The commission observed that Desai had failed to provide key details, including the registration number of the truck allegedly involved and the identity of its driver. It also noted that the delay in repairs, lack of eyewitnesses and absence of medical treatment raised questions about the accident claim.
Despite these shortcomings, the commission found that the vehicle had undeniably suffered damage. It also took note of the insurer's own surveyor report, which assessed the loss at Rs 1.25 lakh. During the hearing, the insurer's counsel reportedly indicated a willingness to settle the claim for the amount assessed by the surveyor.
The commission ultimately ruled that the insurer's outright rejection of the claim amounted to deficiency in service, particularly when the vehicle damage had been acknowledged.
As a result, it directed the insurer to pay Rs 1.25 lakh towards the assessed loss, along with Rs 15,000 as compensation for the physical and mental harassment suffered by the complainant.
“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,” the commission said in its order.
