BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no. 258 of 2012
Date of Institution : 20.12.2012
Date of Decision : 20.10.2015
Radhe Shyam son of Indraj, aged about 48 years, r/o House No.38, Street no.1, near Chautala House, Branala Road, Sirsa, tehsil and District Sirsa.
….Complainant.
Versus
Bajaj Allianz Life l Insurance Company Ltd., Sirsa through its Branch Manager at Sirsa.
...…Opposite party.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SMT.GURPREET KAUR GILL ………PRESIDING MEMBER.
SHRI RAJIV MEHTA ……MEMBER.
Present: Sh.Rajnish Sharma, Advocate for the complainant.
Sh.Manav Goyal Advocate for the opposite party.
ORDER
In brief, the complainant on 2.6.2011 vide policy no. 0217928115,
Radhe Shyam had got health insurance from respondent-company. At that time, it was assured by the officers/officials of respondent-company that if he suffered with any health problem during the period of this policy, then the company will pay all the medical expenses incurred thereupon by the complainant. But, thereafter, the complainant suffered health problem and on 21.4.2012 he got operated himself from Sidhu Nursing Home, Sirsa. The complainant provided all the medical records, bills of hospital and medicines, test etc. to the office of respondent as per their requirement and directions and requested the opposite party to make payment of Rs.15833/- , but they are postponing the matter on one pretext or the other, without any reasonable cause and ground. Ultimately, on 3.8.2012, the complainant sent legal notice to the respondent-company, but neither any reply has been given nor any action has been taken. Hence, this complaint for direction to the opposite party to pay Rs.15833 alongwith interest thereon, besides compensation for harassment, mental tension
and litigation expenses.
4. Opposite party, in its reply, has admitted the above said health insurance policy obtained by the complainant, but pleaded that the complainant has not informed about his ailment and also about his treatment from Sidhu Nursing Home, Sirsa. It is further pleaded that the complainant has not submitted any required documents to the opposite party, despite issuance of letters regarding submission of documents and particulars. Thus, on 5.6.2012 the claim of the complainant was rightly repudiated. letteris that the complainant violated the terms and conditions of the insurance policy and violated clause no.3 of insurance policy and thus, no compensation is payable to him. As per own admission of complainant, the keys and documents of said truck trolla were left by him in the said truck trolla. The theft is stated to have taken place on 14.2.2009, but the complainant reported the fact to the police on 18.2.2009 i.e. after a gap of four days and also did not inform the respondent well in time. The company got investigated the matter through the Royal Associates, Investigation and Detective Agency, Kurukshetra, who recorded the statement of complainant and other persons. Complainant and his driver Jagpal Singh in their statement admitted that keys and all the original papers of truck were lying inside truck and stolen with truck. Thus, the complainant failed to submit the required and necessary documents to respondent, despite issuance of several letters dt. 23.4.2010, 11.5.2010, 25.5.2010 and 1.6.2010. The claim of complainant cannot be settled till he supplied the required documents. The complainant is not entitled to any compensation as he allowed the theft of his vehicle by his negligence and kept the keys and original documents inside the truck. 5. Both the parties have led their evidence in the form of affidavits and documents. The complainant has tendered in evidence Ex.C1-his own affidavit; Ex.C2-legal notice; Ex.C3-postal receipt; Ex.C4-insurance policy; Ex.C5-acknowledgment of letter dt. 27.10.2009 by NIC; Ex.C6- letter dated 18.3.2009; Ex.C7-letter for fitness certificate; Ex.C8-Report u/s 173 Cr.P.C. and Ex.C9-application for recording FIR whereas respondents have tendered Ex.R1- affidavit of Sh.N.L.Grover, Asst.Divisional Manager; Ex.R2-affidavit of Kashmir Singh, surveyor and Ex.R3-investigaiton report.
6. We have heard learned counsel for the parties and have gone through the record carefully.
7. On the close and care consideration of the pleadings, evidence and the arguments advanced by the ld. counsel for the parties, it becomes very clear that there is no dispute between the parties that the trolla of the complainant was insured with the respondent-Insurance company and the insurance was valid for the period 3.10.2008 to 2.10.2009 . The copy of the insurance cover note Ex.C4 is also available on the file to prove this fact. As per case of the complainant he was coming from Atali Mandi to Sirsa. Driver and cleaner parked the trolla on roadside and went for tea at nearby Dhaba at about 6.00 p.m. After 20-25 minutes when they came back trolla was found stolen. Keys and papers were stolen with trolla. It has further been alleged by the complainant that we went at some distance for taking the tea when they returned the trolla was missing and they searched for trolla and lodged a report at Police Station Bhiwani on 18.8.2009. A copy of FIR was lodged by the complainant Police Station Sadar Bhiwani is Ex.C8. The case of the respondent-company is that the trolla of the complainant was stolen on account of the negligence of the complainant because he had left the key in the trolla itself. Respondent-company had also got the matter investigated and the investigator Royal Associates sworn in his affidavit Ex.R2 that he had investigated the theft claim of the complainant regarding his trolla and his report is Ex.R3. From the perusal of the report of the investigator Ex. Ex.R3, it is further revealed that he had recorded the statement of the complainant and their Associates and the complainant had stated in his statement that he had left the keys in the trolla itself, but he did not suspect anybody. Thus the investigator reported that the trolla of the complainant was stolen by some unknown person taking an advantage of the carelessness of the complainant. Ld counsel for the respondent –company thus argued that the respondent-company rightly and legally not settled the insured claim of the complainant.
8. The statement recorded by the investigator i.e. Royal Associates in the village Odhan scribed by one resident of this village namely Roshan Lal s/o Babu Ram V.P.O.Odhan (Sirsa). The investigator also recorded the statement of Jagpal Singh son of Nazar Singh driver of the trolla, he has stated in his statement that the original papers and keys were in the trolla at the time of occurrence of theft. They went to the Taj Hotel in the middle of Bhiwani and Charkhi Dadri nearVillage Katlana , for taking the tea and parked the vehicle on the roadside.
9. In the report of surveyor i.e. Royal Associates very clear that the trolla was stolen from the spot on 14.2.2009 at 7.00 p.m. but the FIR was lodged on 18.2.2009 at Police Station Sadar Bhiwani. Surveyor explained in his report that Taj Hotel situated between Charkahi Dadri and Bhiwani. Trolla was stolen from the front side of Taj Hotel. There is sufficient space for parking of trolla at that place. The owner Nazar Singh and the driver Jagpal Singh stated in their statement recorded by subscriber of their village that keys of the trolla left by them. In this manner they are careless to maintain the safeguard of the trolla. Even, intimation by the complainant has been given to the police after four days of occurrence.
10. Our Hon’ble State Commission in the First Appeal No. 3097 of 2007 decided on 4.2.2011 titled United India Insurance Co. Ltd. Verus Hardeep Singh accept the appeal of insurance company against the insured. The facts and the circumstances of this case in hand are same. To solve this case we are reproducing the relevant conditions of policy on the basis of above cited case law. In the present case, complainant has not produced policy on the record.
“This policy and the schedule shall be read together and any word or expression to which a specific meaning has been attached in any part of this policy or of the Schedule shall bear the same meaning whether it may appear.
- Notice shall be given in writing to the company , immediately upon the occurrence of any accident or loss or damage and in the event of any claim and thereafter the insured shall give all such information and assistance as the company shall require. Every letter claimed summons and/or proves shall be forwarded to the company immediately on receipt by the insured. Notice shall also be given in writing to company immediately the insured shall have knowledge of any impending prosecution inquest of fatal inquiry in respect of any occurrence which may given rise to a claim under this policy in case of theft or other criminal act which may be the subject of a claim under this policy, the insured shall give immediate notice to the policy and co-operate with the company in securing the conviction of the offender.
- xxx
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- The insured shall take all responsible steps to safeguard the vehicle from loss or damage and to maintain it in efficient condition and the company shall take at all time free and full access to examine the vehicle or any part there of any driver or employee of the insured. In the event of even of any accident or breakdown the vehicle shall not be left unattended without proper precaution being taken to prevent further damage or loss and if the vehicle he driven before the necessary repair are effected any extension of the damage or any further damage to the vehicle shall be entirely at the Insured’s risk”.
11. It is well settled principle of law that both the parties to the insurance policy are bound to comply with the terms and conditions of the policy and no relief can be given to any of the parties against the terms of the policy. Reference may be made to case law cited as Suraj Mal Ram Niwas Oil Mills (P) Ltd. Versus United India Insurance Co. Ltd. and another, 2011 CTJ 11 (Supreme Court) (CP) wherein the Division Bench of the Hon’ble Apex Court consisting of Hon’ble Mr. Justice D.K.Jain and Hon’ble Mr. Justice T,S.Thakur held that:-
“22. Before embarking on an examination of the correctness of the grounds of repudiation of the policy, it would be apposite to examine the nature of a contract of insurance. It is trite that in a contract of insurance, the rights and obligations are governed by the terms of the said contract. Therefore, the terms of a contract of insurance have to be strictly construed and no exception can be made on the ground of equity”.
“ 24. Thus, it needs little emphasis that in construing the terms of a contract of insurance, the words used therein must be given paramount important, and it is not open for the Court to add delete or substitute any words. It is also settled that since upon issuance the loss suffered policy, the insurer undertakes to indemnify the loss suffered by the insured on account of risk covered by the policy, its terms have to be strictly construed to determine the extent of liability of the insurer. Therefore, the endeavour of the court should always be to interpret the words in which the contract is expressed by the parties”.
12. In the above cited authority, so many judgments of National Commission as well as Apex Court, have been announced, which are supported to the case of Ops/insurance company.
13. In addition ld. counsel of the insurance company submitted the following authorities Oriental Insurance Co. Ltd. Versus Shyam Sunder II (2014) CPJ 567 (NC), Jagdish Parshad Versus ICICI Lombard General Insurance Co. Ltd. II (2013) CPJ 578 (NC), Delhi Dhulia Road Carrier Versus United India Insurance Co. Ltd. & Ant. III (2013) CPJ 36, Kulwant Singh Versus United India Insurance Co. Ltd. IV (2014) CPJ 350 (NC) and United India Insurance Company Ltd. Versus Jogendra Singh IV (2014) CPJ 637 (NC) .
14. In the above mentioned authorities the issue of unattended stolen vehicle and delayed intimation to insurance company have been discussed in full detail and held that delayed intimation to the insurance company and vehicle left unattended deprives the insurance company to investigate the matter under the terms of the policy. It was duty of complainant insured to take all reasonable steps for safeguard of the vehicle.
15. In view of the circumstances of present case and case law discussed as above, it is held that complainant himself was negligent for the safety of the trolla and for the loss suffered by him due to theft he cannot blame any other. Further, he himself breach the terms and conditions of the policy qua the safety measures of the property i.e. trolla, intimation of theft to the police in time and intimation to the insurer in time. As such, Ops cannot be held guilty of any kind of deficiency in service on their part. Resultantly, present complaint stands dismissed with no order as to costs. A copy of this order be supplied to the parties free of costs. File be consigned to record room after due compliance.
Announced in open Forum. Presiding Member,
Dated:14.9.2015. Member. District Consumer Disputes
Redressal Forum, Sirsa.
Nazar Singh Vs. NIC
Present: Sh.A.K.Gupta, Advocate for the complainant.
Sh.Ravinder Goyal Advocate for the opposite party.
Arguments heard. For order to come up on 14.9.2015.
Presiding Member,
Dt.9.9.2015. D.C.D.R.F,Sirsa.
Member.
Present: Sh.A.K.Gupta, Advocate for the complainant.
Sh.Ravinder Goyal Advocate for the opposite party.
Order announced. Vide separate order of even date, complaint has been dismissed with no order as to costs. File be consigned to record room after due compliance.
Announced in open Forum. Presiding Member,
Dated:14.9.2015. Member. District Consumer Disputes
Redressal Forum, Sirsa.
