Haryana

StateCommission

A/1013/2014

M/s Tata AIG General Insurance Company Ltd. - Complainant(s)

Versus

Ajit Singh - Opp.Party(s)

06 Feb 2017

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION, HARYANA, PANCHKULA.

 

                                                F.A.No.1013 of 2014

                                             Date of Institution: 21.10.2014 and 04.11.2014

          Date of Decision:06.02.2017

 

M/s Tata AIG General Insurance Company Ltd., Branch office at 301-308, 3^rd Floor, Aggarwal prestigae Mall, Plot no.2 Road No.44, near M2K Cinema Rani Bagh, Pitampura, New Delhi-110034 through its Manager.  (through its Authorized signatory, Tata AIG General Insurance Company Ltd., Lotus Towers, Ist Floor, community Centre, New Friends Colony, New Delhi-110065).

…..Appellant

Versus

 

1.      Ajit Singh S/o Sh.Ram Chander R/o Village Badli, Tehsil Bahadurgarh, Distt. Jhajjar.

2.      Master Insurance Office at Near Hero Honda Agency, Rohtak road, Jhajjar, through its Proprietor Mr.Satender.

          …..Respondents

 

CORAM:             Mr. R.K.Bishnoi, Judicial Member.

                   Mrs.Urvashi Agnihotri, Member.                                    

For the parties:  Mr.Rajneesh Malhotra, Advocate counsel for the appellant.

                             Mr. Vikrant Rana, Advocate counsel for the respondent.

O R D E R

 

R.K.BISHNOI, JUDICIAL MEMBER :-

Complainant requested for compensation due to theft of his truck bearing number HR-63B-1252 on 24.12.2012. It was alleged that truck was insured for Rs.18/- lacs for the period 14.09.2012 to 13.09.2013.  On 24.10.2012 when the truck was parked near tubewell of Mahender the same was stolen by unknown person at about 2.00/2:30 AM. FIR No.160 was registered to this effect on 27.10.2012. Information was given to O.Ps. immediately after lodging FIR.  Claim was rejected without ay reason.

2.      O.Ps. filed separate replies controverting his averments. O.P.No.1 alleged that FIR was lodged after three days. There was inordinate delay of three days in giving information to it.  M/s Vikas Kumar and Associates was appointed as investigator  It was reported that vehicle was stolen because complainant did not take proper pre-caution. Vehicle was being started with start button.  Key of the truck was also not supplied. When he violated terms and conditions of insurance policy his claim was rightly rejected.

3.      O.P.No.2 alleged that  it was agent  and carrying business of O.P.No.1.  Complainant did not suffer any loss due to it’s act, so he was not entitled to any compensation from it.

4.      After hearing both the parties, learned District Consumer Disputes Redressal Forum, Jhajjar (In short “District Forum”) allowed the complaint vide impugned order dated  26.08.2014 and directed the O.P.No.1 to pay the amount of Rs.18/- lacs alongwith interest @ 9% from the date of alleged theft and Rs.5500/- on account of  litigation expenses.

5.      Feeling aggrieved therefrom, O.P No.1.-appellant has preferred this appeal.

6.      Arguments heard. File perused.

7.      Learned counsel for the appellant vehemently argued that from the perusal of report of Vikas Kumar and Associates Ex.R-1 it is clear that complainant did not take proper care of the vehicle and that is why the same was stolen.  It is admitted by claimant that door lock was damaged and he used to start truck with start button. There is also inordinate delay of three days in lodging FIR and giving intimation to it, so, his claim was rightly rejected. Learned District Forum failed to take into consideration all these aspects and allowed the complaint, so the impugned order be set aside and complaint be dismissed.

8.      This argument is devoid of any force. As per facts mentioned above, it is clear that truck was parked at a tubewell and not at any public place.  If cabin lock was not working it does not mean that this fact helped the theft of the vehicle. Had it been parked at a public place then it could have been a different matter.

9.      More so investigator has no-where reported in Ex.R-1 that the theft was not genuine. When theft is genuine the claim cannot be rejected.  As per facts mentioned above, theft took place during the night of 24^th October, 2012.  FIR was lodged i.e. actually after two days, so it cannot be opined that there is inordinate delay in giving information.    

10.    The Insurance Regulatory and Development Authority has issued instructions not to reject the claim on the ground of delay only.  For ready reference the relevant portion of the instructions is reproduced as under:-

“The Authority has been receiving several complaints that claims are being rejected on the ground of delayed submission of intimation and documents. 

The current contractual obligation imposing the condition that the claims shall be intimated to the insurer with prescribed documents within a specified number of days is necessary for insurers for effecting various post claim activities like investigation, loss assessment, provisioning, claim settlement etc. However, this condition should not prevent settlement of genuine claims, particularly when there is delay in intimation or in submission of documents due to unavoidable circumstances.

The insurers’ decision to reject a claim shall be based on sound logic and valid grounds.  It may be noted that such limitation clause does not work  isolation and is not absolute.  One needs to see the merits and good spirit of the clause, without compromising on bad claims. Rejection of claims on purely technical grounds in a mechanical fashion will result in policyholders losing confidence in the insurance industry, giving rise to excessive litigation.

Therefore, it is advised that all insurers need to develop a sound mechanism of their own to handle such claims with utmost care and caution. It is also advised that the insurers must not repudiate such claims unless and until the reasons of delay are specifically ascertained , recorded and the insurers should satisfy themselves that the delayed claims would have otherwise been rejected even if reported in time.”

          From the perusal of these instructions, it is clear that complainant is entitled for claim in the present case. 

11.    Since the information was given to the police station in time, it does not mean that the claim should be repudiated in toto.  As per opinion of Hon’ble National Commission  expressed in Baljeet Vs. United India Insurance Company Ltd. decided on 02.12.2013 in Revision petition No.454 of 2013, the complainant is entitled for compensation on  non standard basis. It is discussed in this case as under:-

“The question whether the insurance company is justified in repudiating the claim of the insured for violation of the terms and conditions of the insurance policy in the case of theft of vehicle came up before the Hon’ble Supreme Court in the matter of National Insurance company Limited Vs. Nitin Khandelwal (2008) 11 SCC 259, wherein the Hon’ble Supreme Court observed thus:

“In the case in hand, the vehicle has been snatched or stolen.  In the case of theft of vehicle breach of condition is not germane. The appellant insurance company is liable to indemnify the owner of the vehicle when the insurer has obtained comprehensive policy for the loss caused to the insurer.  The respondent submitted that even assuming that there was a breach of condition of the insurance policy, the appellant insurance company ought to have settled the claim on non-standard basis.  The insurance company cannot repudiate the claim in toto in case of loss of vehicle due to theft.”

12.    Reference can also be made to the decision of Hon’ble National Consumer Disputes Redressal Commission, New Delhi (In short “National Commission”) rendered in the case of United India Insurance Company Limited v. Gian Singh reported in 2006 CTJ 221 (CP) (NCDRC). In that case Hon’ble National Commission held that in a case of violation of condition of the policy, the claim ought to be settled on non-standard basis.

13.    Hon’ble Supreme Court has given reference about this point in Amalendu Sahoo Versus Oriental Insurance Company Limited, 2010 CTJ 485 (Supreme Court) and relevant portion is as under:-

“ The said decision of the National Commission has been referred to by this Court in the case of National Insurance Company Limited v. Nitin Khandelwal reported in 2008 CTJ 680 (SC)(CP)=2008(7)SCALE 351. In paragraph 13 of the judgment, in the case of Nitin Khandelwal (supra) this Court held:

The appellant Insurance Company is liable to indemnify the owner of the vehicle when the insurer has obtained comprehensive policy for the loss caused to the insurer. The respondent submitted that even assuming that there was a breach of condition of the insurance policy, the appellant Insurance Company ought to have settled the claim on non-standard basis.

In the case of Nitin Khandelwal (supra) the State Commission allowed 75% of the claim of the claimant on non-standard basis. The said order was upheld by the Hon’ble National Commission and this Court refused to interfere with the decision of the National Commission.

In this connection reference may be made to a decision of Hon’ble on’ble Hon’bNational Commission in the case of New India Assurance Company Limited v. Narayan Prasad Appaprasad Pathak reported in (2006) CPJ 144 (NC). In that case also the question was, whether the insurance company can repudiate the claim on the ground of violation of terms and condition of insurance policy. While granting claim on non-standard basis the Hon’ble National Commission set out in its judgment the guidelines issued by the insurance company about settling all such non-standard claims. The said guidelines are as under:

Sr.No.	Description	Percentage of settlement
(i)	Under declaration of licensed carrying capacity	Deduct 3 years’; difference in premium from the amount of claim or deduct 25% of claim amount, whichever is higher.
(ii)	Overloading of vehicles beyond licensed carrying capacity	Pay claims not exceeding 75% of admissible claim
(iii)	Any other breach of warranty/condition of policy including limitation as to use	Pay upto 75% of admissible claim.

From perusal of the aforesaid guidelines it is clear that one of the cases where 75% claim of the admissible claim was settled was where condition of policy including limitation as to use was breached.”

14.    More so Hon’ble Punjab and Haryana High court has opined in LPA No.1242 of 2012 titled as ICICI Lombard General Insurance Co. Ltd. Vs. Permanent Lok Adalat and others decided on 23.11.2012 that if theft has taken place and act of insured did not help the theft then the claim cannot be rejected. Non-supply of key is no ground to dismiss claim.  No other point was urged before us.        Resultantly, appeal fails and the same is hereby dismissed.

15.    The statutory amount of Rs.25000/- deposited at the time of filing of the appeal be refunded to the appellant against proper receipt and identification.

 

February 06th, 2017

Mrs.Urvashi Agnihotri Member, Addl.Bench

R.K.Bishnoi, Judicial Member Addl.Bench

 

S.K.