Delhi

North East

CC/109/2022

Sh. Chander Shekhar - Complainant(s)

Versus

Bajaj Allianz General Insurance Co. Ltd. - Opp.Party(s)

24 Jun 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION: NORTH-EAST

GOVT. OF NCT OF DELHI

D.C. OFFICE COMPLEX, BUNKAR VIHAR, NAND NAGRI, DELHI-93

Complaint Case No. 109/22

 

 

 

In the matter of:

 

		Sh. Chander  Shekhar S/o Sh. Nand Lal R/o Block 28/160 Near Dhobi Ghat, Tilok Puri, Delhi-110091   Presently at:- F 57/2, Khasra No. 284, Harsh Vihar II, Shahibabad, Ghaziabad, UP 201005		Complainant
		Versus
		Bajaj Allianz General Insurance Co. Ltd. Through its Manager Block No. 4, 7th Floor DLF Tower 15, Shivaji Marg, Delhi-110015		Opposite Party
			DATE OF INSTITUTION:         JUDGMENT RESERVED ON:                           DATE OF ORDER:		06.05.22 07.06.24 24.06.24

 

CORAM:

Surinder Kumar Sharma, President

Adarsh Nain, Member

ORDER

Ms. Adarsh Nain, Member

The Complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against Opposite Party alleging deficiency in services.

Case of the Complainant                                                                 

1. The case of the Complainant as revealed from the record is that the Complainant was the owner of an E-Rickshaw bearing No. DL5ERA 0825 purchased from Sathi Moters Elestric Moters Pvt. Ltd. on 13.01.21 for a sum of Rs. 89,250/-. It is stated that the said vehicle was insured by Opposite Party vide policy no. OG 21 2406 1803 00004144 valid up to 12.01.22 and Complainant paid premium of Rs. 6,816/-. The Complainant further stated that the vehicle was stolen on 15.04.21 and at the time of incident,  his brother was the rider of  the said vehicle and someone gave some toxic substance in cold drink to him due to which the brother of the Complainant got unconscious and thereafter Complainant got a telephonically message regarding his brother’s  unconsciousness by some unknown person from the mobile no. of the Complainant’s brother and informed that he was lying on the road thereafter Complainant has taken his brother to hospital and MLC was prepared having no. 1205/2021 and hospital referred to higher centre for further treatment. Then, Complainant took him to Safdarjung Hospital where doctors advised to take him to home due to severe wave of covid.  Thereafter, Complainant lodged an e-FIR in Police Station Welcome bearing no. 011344/2021 on 19.04.21 but police officials endorsed date 16.04.21 instead of 15.04.21. The Complainant gave intimation to Opposite Party when Complainant came to know the story thereafter Complainant contacted Opposite Party many times and submitted all required documents for releasing the compensation. The Opposite Party sent a letter dated 09.06.21 stating that there is a contradiction between the statement of Complainant and FIR and after that no amount was released to Complainant. The Complainant stated that an untraced report has been filed by police official P.S. –Welcome before the court of Sh. Muneesh Garg, ACMM SHD KKD Court on 20.07.21 regarding the stolen vehicle. The Complainant has also sent legal notice to Opposite Party dated 05.02.22 but all in vain. Hence, this shows deficiency in service on behalf of Opposite Party. The Complainant has prayed for the insured amount of Rs 95,000/- with interest 18 % p.a. and Rs. 4,00,000/- for mental harassment. He also prayed for Rs. 33,000/- towards litigation expenses.

Case of the Opposite Party

2. The Opposite Party contested the case and filed written statement. While taking preliminary objections, it is stated by the Opposite Party the complainant has not annexed any evidence in support of allegations of deficiency in service. It is submitted that the Opposite Party has acted as per the terms and conditions of the policy. There is no cause of action favour of the Complainant as there is violation of terms and conditions of the policy and as a result the policy was repudiated, no deficiency in service or any unfair trade practice on the part of the Opposite Party. On merits it has been contended that the FIR was lodged after a gap of 3 days and the Opposite Party was intimated after a gap of 12 days which is a violation of condition no. 1 of the policy.  it is also contended by the Opposite Party that upon intimation of claim, the investigator was appointed by them and the statements given to the investigator by the complainant and his brother are contradictory to the FIR version and Opposite Party sought clarification and also demanded certain documents which were not supplied by the complainant. Hence, the Opposite Party was left with no option but to close the claim. Thus, the complaint is liable to be dismissed.

Rejoinder to the written statement of Opposite Party

3. The Complainant filed rejoinder to the written statement of Opposite Party wherein the Complainant has denied the pleas raised by the Opposite Party and has reiterated the assertion made in the complaint.

Evidence of the Complainant

4. The Complainant in support of his complaint filed his affidavit wherein he has supported the averments made in the complaint.

Evidence of the Opposite Party

5. In order to prove its case, Opposite Party filed affidavit of Sh. Shyama Charan Vats Manager (Legal) of Opposite Party wherein the averments made in the written statement of Opposite Party have been supported.

Arguments & Conclusion

6. We have heard the Ld. Counsels for the parties.We have also perused the file and the written arguments filed by the parties.
7. The case of the Complainant is that the Complainant had insured the subject vehicle with the Opposite Party Company and the vehicle was stolen during the subsistence of said policy. At the time of incident, his brother was the driving the vehicle and someone gave him some toxic substance due to which the brother of the Complainant got unconscious. It is contended by the Complainant that on being informed, he had taken his brother to hospital and the hospital referred to higher centre for treatment. It is submitted that the Complainant lodged an e-FIR in Police Station on 19.04.21 after three days. It is alleged by the complainant that despite having submitted all required documents for releasing the compensation, no amount was released to Complainant and the claim was repudiated.
8. On the other hand, the case of the Opposite Party is that the complainant has lodged the FIR of the alleged incident with 3 days delay and intimated the Opposite Party insurance company after gap of 12 days which is a violation of condition no. 1 of the policy. The Opposite Party has also contended that upon intimation of claim, the investigator was appointed by them and the statements given to the investigator by the complainant and his brother are contradictory to the FIR version and Opposite Party sought clarification and also demanded certain documents which were not supplied by the complainant. Hence, the Opposite Party was left with no option but to close the claim. Hence, it is contended that no deficiency on their part has been there.
9. On perusal of the record, it is revealed that it is undisputed that the Complainant had taken an insurance policy for the vehicle in question. It is also not disputed that the theft took place during subsistence of the policy which was valid on the date of the incident.  
10. The contention of the Opposite Party is that there was 3 days delay in lodging FIR and 12 days delay in intimation to the Opposite Party Insurance Company which is a violation of condition no. 1 of the policy. The Opposite Party has also contended that the statements given by complainant and his brother are contradictory to the FIR version and Opposite Party sought clarification in that regards and also demanded certain documents in writing which were not supplied by the complainant, therefore the claim was rightly repudiated. The Opposite Party has also relied upon two letters written to the complainant of required documents. However, Opposite Party has failed to show that those letters were delivered to the complainant. Hence, the contention cannot be accepted. The perusal of the Investigator’s report and concerned FIR shows that the investigator confirms the FIR version and there is no contradiction.  
11. In any case, the defence of Opposite Party cannot be accepted in view of the fact that Police has, after due investigation, filed the Final Report with respect to the said FIR duly accepted by Court of law and the perusal of said report shows that police has not found or noted anything indicating that the alleged incident was false or manipulated.
12. It is to be noted that Hon’ble Supreme Court in the matter titled Om Prakash Vs. Reliance General Insurance and Anr. dated Oct 4,2017 held :

“ It is also necessary to state here that it would not be fair and reasonable to reject a genuine claim which has already been verified and found to be correct by the investigator. The condition regarding delay shall not be a shelter to repudiate the insurance claims which have been otherwise proved to be genuine”

13. It is alleged by the complainant that Opposite Party has rejected his claim despite having furnished all the required documents and the Opposite Party has failed to prove otherwise. Since, Opposite Party has failed to settle the valid insurance claim of the Complainant, it amounts deficiency on their part and the complainant is entitled to the insurance amount with compensation.
14. Thus, we allow the present complaint and direct the Opposite Party i.e. Bajaj Allianz General Insurance Co. Ltd. to pay to the complainant the insurance claim amount i.e. Rs. 95,000/- with interest @ 9 % per annum from the date of institution of the complaint, upon completion of requisite documentation formalities. The Opposite Party is further directed to pay Rs. 15,000/- towards compensation and the litigation cost along with 9 % interest p.a. from the date of this order till its recovery.

 

 

15. Order announced on 24.06.24.

Copy of this order be given to the parties free of cost.

File be consigned to Record Room.

 

(Adarsh Nain)      Member

(Surinder Kumar Sharma) President