Haryana

Karnal

CC/121/2017

Vijay Laxmi - Complainant(s)

Versus

Bajaj Allianz General Insurance Company Limited - Opp.Party(s)

Siddharta Parkash

12 Nov 2018

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

 

                                                      Complaint No.121 of 2017

                                                      Date of instt. 30.03.2017

                                                      Date of decision 12.11.2018

 

Vijay Laxmi daughter of Shri Ramesh Chandra, resident of house no.169-B, Mukarampur, Basant Vihar, Karnal.

                                                                                                                                                                …….Complainant       

                                                Versus

 

1. Bajaj Allianz General Insurance Company Limited, G.E.Plaza, Airport Road, Yerawada, Pune-411006, through its MD/CEO/Chairman Authorized signatory.

2. Bajaj Allianz General Insurance Company Limited, Policy Servicing Office at Block no.603, 6^th floor, Shree Ram Shyam Tower, Kingsway Sadar, near NIT Building, Magpur.

3. Bajaj Allianz General Insurance Company Limited, SCO no.226-227, 2^nd floor, Sector-12, Karnal, through its Branch Manager/Authorized Signatory.

                                                                    …..Opposite Parties.

 

           Complaint u/s 12 of the Consumer Protection Act.            

 

Before   Sh. Jaswant Singh……President.

     Sh. Vineet Kaushik………Member

             Dr. Rekha Chaudhary……Member

 

 Present   Shri Sidharth Parkash Advocate for complainant.

                Shri Rohit Gupta Advocate for OPs.        

 

ORDER:   

 

                (JASWANT SINGH, PRESIDENT)                

 

                        This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986 on the averments that complainant had purchased a Samsung Mobile Phone Model A-500 bearing IMEI no.359932/06/299446/3 and IMEI no.359933/06/299446/1 from M/s Raunak Sales, Kunjpura Road, Karnal vide bill no.987 dated 2.11.2015 for a sum of Rs.18,500/-. Complainant got insured the said mobile phone from the OPs vide “All Risk Policy” bearing no.OG-16-2101-9931-00000218 by paying final premium amount of Rs.1298/-. The policy was valid from 2.11.2015 to 1.11.2016. On 3.8.2016 the complainant alongwith her brother Ajay had gone Karan Stadium, Karnal for practice of Football, in Football ground where said mobile of complainant was stolen by unknown culprit from the bag of the complainant. The brother of the complainant lodged an FIR no.685 dated 23.8.2016 under section 379 of IPC in Police Station Civil Lines Karnal in this regard. The complainant informed the OPs in this regard immediately on toll free cell centre no.1800-22-5858.  Complainant lodged the claim in the office of OP no.3 and OP no.3 has also taken signature of the complainant on some printed and blank papers and also obtained cross/cancelled cheque of the complainant and given an assurance the entire claim amount of Rs.18500/- would be credited in the bank account of the complainant after approval from the office of OPs no.1 and 2. It is alleged that approximately 3-4 months had been lapsed, but the claim amount of Rs.18,500/- has not been credited in the bank account of the complainant as per assurance of OP no.3. In the last week of February 2017 the OP no.3 had flatly refused to pay the claim amount. Then complainant sent a legal notice dated 4.3.2017 in this regard to the OPs but it also did not yield any result. In this way there was deficiency in service on the part of the OPs. Hence complainant filed the present complaint.

2.             Notice of the complaint was given to the OPs, who appeared and filed their written version raising preliminary objections with regard to cause of action; concealment of true and material facts and intricate questions of facts and law are involved, which cannot be decided in summary manner. On merits, it is pleaded that the mobile set of the complainant was got insured from Nagpur office of Bajaj Allianz General Insurance Company Limited in the name of the complainant, vide policy no.OG-16-2101-9931-00000216 for the period from 2.11.2015 to 1.11.2016. It is further pleaded that the complainant had intimated a claim with the OPs on account of loss of Samsung Mobile Phone on 3.8.2016 and the same was registered as claim no.OC-17-2101-9931-00000084. The alleged claim was duly processed by the OPs by way of minutely going through the details of claim form filled by the complainant and examining the details of the claim form, intimation details, police records documents and related documents. The OPs after scrutinizing the documents by the insured/complainant alongwith police records and observed as following:

. Loss narration mentioned by complainant while intimating the claim through online portion is:

“Ghar se nikale duty pe train se je rhe the, tabhi train mai rush tha mobile jo ki pant ka right pocket mai thaw o choori, hua, train ka dabba check kiya but mobile nahi mila.”

. Loss narration mentioned on police letter:

 “date 3.8.2016 ko karan stadium karnal me abhyas karte samay football ground bag mese mere mobile chori ho gaya he me mobile ko aaj tak talash karta raha jo mujhe nahi mila he.”

It is further pleaded that the complainant had caused unreasonable  delay to intimate the loss to the police authorized and register the FIR. The complainant has further delayed by atleast one month to intimate loss details to the OPs. It is further pleaded that on the basis of noticing the discrepancies in narration of loss in claim documents, police complaint at the time of intimation as well as delay in police complaint the OPs rightly rejected/repudiated the claim of the complainant.  Hence there is no deficiency in service on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Complainant tendered into evidence her affidavit Ex.CW1/A and documents Ex.C1 to Ex.C14 and closed her evidence on 16.2.2018.

4.             On the other hand, OPs tendered into evidence affidavit of Sarpreet Kaur Ahluwalia Ex.RW1/A and closed his evidence on 15.10.2018.

5.             We have heard the learned counsel for both the parties and perused the case file carefully and have also gone through the evidence led by the parties.

6.             From the pleadings of the parties, it is clear that there is no dispute that the complainant insured his mobile phone with the OPs, vide policy no.OG-16-2101-9931. It is also not disputed that the said vehicle was insured with OP, which was valid from 02.11.2015 to 01.11.2016. It is also not disputed that the said mobile phone was stolen on 3.8.2016. It is also not disputed that the information was given to the OPs in this regard on 8.4.2016 and the same was registered as claim no.OC-17-2101-9931-00000084. The OPs repudiated the claim of the complainant on the ground that discrepancies in narration of loss in claim documents, police complaint at the time of intimation as well as delay in police complaint.

7.             The OPs in his written version stated that the claim of the complainant was rejected on the ground of discrepancies in narration of loss in claim documents, police complaint at the time of intimation. To prove this version OPs has not placed on file any documents and has also not produced the repudiation letter. Hence this plea of OPs is not tenable.

8.             The second objection of the OPs is that the claim of the complainant was rejected due to late intimation to the OPs regarding the theft of her mobile phone, which was violation of the terms and conditions of the insurance policy, therefore, the OPs are not liable to pay any compensation to the complainant.

9.             No doubt there was delay on the part of the complainant in giving intimation regarding theft of her mobile phone to the OPs and FIR lodged after 20 days from the date of occurrence but her claim cannot be rejected in toto on such ground alone. Insurance Regulatory and Development Authority issued circular dated 20.9.2011 and it is clear from the said circular that insurance company cannot repudiate the theft claim on technical ground like delay in intimation and submission of some required documents. The decision of insurer to reject a claim of the claimant should be based upon sound logic and valid reasons. The limitation clause does not work in intimation 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 policy holders losing confidence in the insurance industry, giving rise to excessive litigation.

10.           Hon’ble State Consumer Disputes Redressal Commission, Haryana, considered the question regarding delay in intimation of theft of vehicle in United India Insurance Company Limited and others Versus Anshul Bansal First Appeal no.717 of 2016 decided on 6.4.2017.  In that case there was delay of two months and five days in intimation of theft to the insurance company. Under those circumstances it was held that in case of any breach of warranty/condition of the policy including limitation as to use the insurer is liable to pay 75% of admissible claim on non-standard basis. Accordingly the insurance company was directed to pay Rs.3,00,000/- i.e. 75% of the IDV of the vehicle alongwith interest @ 9% per annum from the date of filing the complaint till its realization and Rs.5500/- as litigation expenses to the complainant.

11.           The proposition of law laid down by Hon’ble State Commission Haryana is fully applicable to the facts of the present case. Consequently, the complainant is held entitled to get 75% of the IDV of the mobile as compensation.

12.           As a sequel to the foregoing discussion, we accept the present complaint and direct the OPs to pay 75% of the insured amount i.e. Rs.13875/- to the complainant alongwith interest thereon @ 9% per annum from the date of filing of complaint till its realization. We further direct the OPs to pay Rs.5500/- to the complainant on account of mental agony and harassment suffered by him and for the litigation expenses. This order shall be complied within 30 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated: 12.11.2018

                                                                        President,

                                                           District Consumer Disputes

                                                           Redressal Forum, Karnal.

 

 

                     (Vineet Kaushik)       (Dr. Rekha Chaudhary)

                        Member                     Member