(Per Shri Narendra Kawde, Hon’ble Member)
(1) This complaint pertains to alleged deficiency in service against the opponent, Bajaj Allianz Genernal Insurance Company (hereinafter to be referred to as ‘Insurance Company’) for rejecting insurance claim under the policy in respect of loss sustained due to burglary of gold ornaments in the insured premises of the complainant.
(2) Undisputed facts are that the complainant subscribed ‘Jwellers’ Box Policy’ bearing No.OG-08-1901-4099-8 for sum assured of `20,00,000/- for the period of 13/04/2007 to 12/04/2008. On 15/11/2007, the insured shop of the complainant was robbed and gold and silver ornaments were looted worth `30,00,000/-. Police complaint was promptly lodged followed by submission of the insurance claim for reimbursement of the loss by the opponent Insurance Company. The opponent insurance company appointed a surveyor to assess the loss and surveyor after visiting the insured premises assessed the loss of theft to the tune of `19,01,890/- as against the loss claimed by the complainant to the extent of `30,00,000/-. The claim of the complainant was repudiated by invoking the general policy condition No.2 i.e. on ground that the insured failed to take reasonable precaution for safety of the property and to place safeguards in position as referred to in the proposal form which is detrimental to the interest of the opponent insurance company. Aggrieved by the repudiation, the complainant preferred this consumer complaint thereby claiming an amount of `30,00,000/- on account of loss sustained due to loot together with cost of `10,000/- and `50,000/- compensation for mental harassment.
(3) The opponent insurance company by filing written version opposed the contentions of the complainant on all possible counts and averred that the repudiation of insurance claim is based on general conditions of the insurance policy as the complainant failed to fix CCTV cameras and protect the premises deploying watchmen as mentioned in the proposal form duly signed and submitted by the complainant at the time of subscribing the policy. The general condition No.2 provides for adequate safeguards as referred to in the proposal form. While making the proposal, the complainant undertook to install cameras and deployment of the watchmen to safeguard the property in reply to question No.3 (c) and 3 (d) of proposal form; which is part of condition. It is further averred by the opponent Insurance Company that the report of surveyor is supported by affidavit of the surveyor, who conducted the survey.
(4) The complainant’s contention is that the opponent insurance company incorporated to comply with social & welfare purpose stated in Article 39 (c) of The Constitution of India by rendering services keeping in mind, policy, rules & regulations, guidelines etc. Further, it is stated that various Hon’ble Courts and competent authorities delivered various judgments which are legal precedents and decisions are binding on the opponent insurance company.
(5) This is an old matter placed for hearing and disposal on board from the sine-die list. Notices were sent to the parties and published on the Notice Board and internet. However, at the time of hearing, the opponent insurance company preferred to remain absent. Finally, the case was placed for arguments on 19/04/2012. The learned counsel for the appellant was heard.
(6) Learned counsel for the complainant submitted that the gold and silver ornaments worth `30,00,000/- were robbed and looted by the robbers on 15/011/2007. Police complaint was promptly lodged and insurance claim was submitted to the insurance company and further pleaded that in written note of arguments that the repudiation of insurance company on ground that the insured failed to take reasonable precaution for safety of the property and to place safeguards in position as referred to in the proposal form is unacceptable and arbitrary. Further, the theft was not traced by the police. The surveyor has not filed affidavit in support of the report and therefore what is stated in the complaint is to be taken as not denied.
(7) Perused the record placed before us. Para 7.7 in report by the surveyor shows that the complainant during the course of survey conveyed that they do not have any type of security system like watchmen, CCTV camera, TV monitor etc. as the volume was too less and they could not afford the cost for these security charges. Though the camera was fixed, it was un-connected and rest of system not yet purchased/installed. Report of the surveyor is supported by affidavit of Shri Sandip Shah, who conducted the survey in detail. In view of this, complainant’s submission that the surveyor has not filed affidavit denying contention of the complainant is not acceptable. Survey report is an important piece of evidence and there is no specific denial or rebuttal adduced by the complainant for the observations made in the survey report.
(8) Contention of the complainant is that the terms & conditions of the policy have not been explained to the complainant by the opponent insurance company as required under IRDA Rules & Regulations. Terms & conditions together with policy documents have been submitted on record along with complaint compilation by the complainant himself. There is denial by the opponent insurance company of the averment of complainant. Provision to refer back to the insurer company about any unacceptable terms & conditions within a period of 15 days from receipt of such insurance policy apparently has neither been exercised by the complainant nor there is no such evidence on record. Therefore presumption is that the policy and terms & conditions were accepted by the complainant as is evident on record.
(9) Insurance is a contract between the parties. Parties thereto are governed by the terms & conditions of the contract. Therefore, the terms & conditions laid down under the policy are required to be strictly adhered and interpreted accordingly. In the instant case, general condition No.2 appended to the insurance policy is required to be read together with the contents of the proposal form submitted by the complainant to the insurance company and not in isolation. Installation of CCTV and deployment of watchman would have averted the incidence of robbery is although a debatable issue as argued by the learned counsel of complainant. However, compliance of terms & conditions as laid down in insurance policy is binding on both the contracting parties. Complainant has not come out with a case of compliance of the said terms & conditions as in proposal form. Therefore, the submission of learned counsel for the complainant of ‘no breach of condition’ by the complainant does not hold good and the ratio of judgement of Hon’ble Apex Court in case of Life Insurance Corporation of India Vs. Asha Goyal as relied by the complainant cannot be made applicable in the instant case as there is no breach of policy conditions by opponent Insurance Company in repudiating the claim arbitrarily. We, therefore, observe that the complaint is devoid of merit and repudiation of the claim by the opponent insurance company cannot be faulted with. Hence, no deficiency in service can be attributed to opponent Insurance Company. We hold accordingly and pass the following order.
ORDER
1) The consumer complaint stands dismissed.
2) In the given circumstances, parties shall bear their own costs.
Pronounced on 27th April, 2012.
