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An insurance claim investigator cannot declare unilaterally a driving licence to be fake without any corroborating report from the transport authority, a Delhi district consumer forum has said.

Maintaining that an insurance firm cannot reject a claim based on the “uncorroborated whimsical report” of its claim investigator, the New Delhi District Consumer Disputes Redressal Forum directed Oriental Insurance Company Ltd to pay Rs 1.95 lakh to its policy holder for the damage to his car in an accident.

“It is seen that investigator is not basing his report on any direct report from Regional Transport Authority, but he himself is author of all reports sent to the opposite party (Oriental Insurance).

“In the absence of a report of fake driving license from the office Regional Transport Office (RTO), the insurance firm cannot repudiate (a claim) on (the) uncorroborated whimsical report of the investigator,” the forum said.

The forum’s order came on a plea by Delhi resident Bhupender Bakshi, who had said his vehicle was insured with the firm on the date of accident, September 29, 2008 and he had duly informed it of the same.

He said the loss was assessed by the investigator at Rs 1.45 lakh, but later the insurance firm rejected his claim on the ground that his driving license was fake.

The firm in its defence said its investigator had found Bakshi’s driving license to be fake.

Rejecting the contention, the bench presided by C K Chaturvedi pointed out to the firm that a letter from the RTO, Agra showed that driving license owned by Bakshi was valid till June 21, 2010 and there was no objection for its renewal.

“In these facts and circumstances the repudiation is arbitrary. We find the insurance firm to pay Rs 1,45,000 and award damages of Rs 50,000 to complainant,” the bench said.

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April 2024