PER:

Charanjit Singh, President

1        The complainant has filed the present complaint by invoking the provisions of Consumer Protection Act under Section  34, 35  and 36 against the opposite parties on the allegations that the complainant has purchased a tractor HP bearing registration No. PB46-AE-8192 for Rs. 6,40,000/-. The complainant got the above said tractor insured from the Bajaj Allianz General Insurance i.e. the opposite party No. 1 vide policy bearing invoice No. 204048779/1 which was issued in favour of the complainant for his above said vehicle. The insured’s declared value of vehicle is Rs. 6,08,000/- and the policy is valid insurance policy for the period of from 19.8.2020 to 18.8.2021. The above said vehicle is financed from the HBD Financial Services Ltd. i.e. the opposite party No. 2.  The vehicle of the complainant is covered under the above said policy which covers all the risks to the vehicle and the opposite party No. 1 is under obligation to settle the claim of the insured / complainant, in case of any loss occurs during the insurance period.  On 15.2.2021, the complainant was going to village Khan Chapri for giving the vehicle i.e. the tractor to his aunt’s son. In the way between villageBharowal to Fatehabad, the vehicle stopped running and the complainant has parked the vehicle on roadside and he went to village Fatehabad. Thereafter the complainant has arranged escort and went for taking back the vehicle and the complainant found that his vehicle was stolen from the spot by some unknown person. The complainant tried his best to find out the vehicle but failed. Thereafter, the complainant has intimated about the matter to the opposite party No. 1 and its officials have guided the complainant to lodge a Rapat with the police in this regard and provided the copy of Rapat to the officials of the company i.e. O.P No.1. As such, the complainant immediately reported the matter to police and the police started the investigation for finding the vehicle after lodging the rapat and combining the case with F.I.R No.21/16-02-2021 u/s. 457/380/411 IPC registered at P.S Goindwal.  Due to the above said incident, the complainant/insured has suffered total loss as the vehicle got stolen and the above kind of loss is covered under the insurance policy. The complainant has given the intimation to the company on time and has requested the company to give the claim of the insured vehicle. The officials of the O.Ps have assured the complainant that they will give the total claim to the complainant. Afterwards, the officials of the O.Ps have told the complainant to submit copy of Rapat along with copies of the registration certificate of the vehicle, driving license of the complainant i.e. driver and the complainant has provided all the demanded necessary documents to the officials of the company. Thereafter neither the police nor the complainant could find the vehicle inspite of best effort made. As such the police has given report that the vehicle could not be found even after investigation in the case bearing F.I.R No.21/16-02-2021 u/s. 457/380/411 IPC P.S Goindwal.  The complainant had requested the opposite parties many times to release his claim but the opposite parties are lingering on the matter on one and other pretext. The complainant has visited the office of the company and further given so many phone calls. After passing long time as opposed to law, the officials of the opposite party had orally told the complainant that the company will not release his claim. The complainant has demanded written document in this regard. Then the officials have sent a correspondence dated 2.8.2022 whereby it was mentioned that “Hence in view of above you have misrepresented the actual facts regarding usage please explain within 7 days from the date of this letter as to why the claim should not be repudiated.” After receiving of the above letter, the complainant had given required answer to the every query put forward by the company as the complainant had told the officials that he has immediately intimated the officials of the company regarding the theft of the vehicle and upon their instructions, he has lodged the Rapat with the police. Further the complainant had intimated them that he has got made another key when one original key got lost, which could never be found after best efforts made by him as such he has submitted both the keys with the company. The complainant had brought this fact into the notice of the officials of the company but they have not listened any requests of the complainant. The OP No.2 is threatening to recover the remaining amount of installments of the vehicle illegally from the complainant. The complainant had intimated them that the vehicle has been stolen as such they should not convince him to pay the remaining installments till the insurance release the insured amount of the vehicle. But the officials of the O.P. No.2 are not listening to the complainant. The complainant prayed thatopposite party No. 1 maybe directed to pay Rs. 6,08,000/- i.e. insured amount of the vehicle to the complainant on account of loss suffered due to theft of the vehicle. The opposite party No. 2 may be restrained from initiating any proceedings against the complainant for illegally recovering the financed amount from the complainant till the settlement of claim by the opposite party No. 1 and prayed Rs. 20,000/- as compensation and Rs. 10,000/- as litigation expenses. Alongwith the complaint, the complainant has placed on record his affidavit Ex. C-1, Self attested copy of bill dated 19.8.2020 Ex. C-2, Self attested copy of insurance policy Ex. C-3, Self attested copy of application to Police Ex. C-4, Self attested copy of Police report Ex. C-4, Self attested copy of repudiation letter Ex. C-6, Self attested copy of LokAdalat Case Ex. C-7,. Self attested copy of Adhar Card Ex. C-8.

2        Notice of this complaint was sent to the opposite parties and opposite party No. 1 appeared through counsel and filed written version by taking preliminary objections thatthe complainant has concealed the material facts from the knowledge of this Commission, therefore, he is not entitled for any claim. The complainant intimated the replying opposite party about the alleged loss on 9.3.2021 after a delay of 22 days. After receiving the intimation, the replying opposite party investigated the claim for verification of alleged theft claim of the complainant. As per complaint the theft was occurred on 15.02.2021 and the complainant intimated the opposite party on 9.3.2021 thus there is delay of 22 days which deprived the replying opposite party for timely investigation, which also effects the recovery chances of vehicle of the complainant, thereby the complainant has violated the conditions No.1 of the policy which states as under:-

“Notice shall be given in writing to the insurance company immediately upon occurrence of any accidental loss or damages in the event of any claim and thereafter, the insured shall given all such information and assistance and the company shall require.”

Thereafter, the replying opposite party sent both the keys submitted by the complainant for forensic examination and as per forensic examination report dated 28.07.2021, it was found that one key is original manufacturer made. Moreover, both keys are unused and show manual filing and scratch marks. As per dimensional analysis of key-1 and key-2, side gear profiles of both the keys are different and both keys cannot be used in the same lock-set. Therefore, insured is misrepresenting the fact regarding usage of the submitted keys.

The above said facts clearly show the willful and intentional misrepresentation, concealment of the material facts, which amounts to breach of trust since contract of insurance is based upon the principle of “Utmost Good Faith”, as such the complainant had clearly breached the declaration.

As such, the complainant is not entitled for any claim or compensation as he has intentionally misrepresented the facts and tried to mislead the replying opposite party and also intimated the alleged loss by un-explanatory delay of 22 days, moreover, with reference to the reported claim, letters were sent to the complainant on 02.08.2021, 09.08.2021 and 25.08.2021, therefore, his claim given unsatisfactory reply dated 26.08.2021, therefore his claim was rightly rejected and intimation in this regard was given to the complainant vide letter dated 20.09.2021. The complainant was bound to disclose the true and real facts with regard to loss, but he failed to do so, therefore, present complaint is liable to be dismissed.  The complainant himself admits that he left the vehicle unattended by any person with the vehicle on the road, therefore, he himself negligent and he did not take precaution to care/ safeguard the vehicle and he was duty bound to do sounder the terms and conditions of the policy, therefore, he is not entitled for any claim.  The complainant has violated the terms and conditions of the policy, therefore, he is not entitled for any claim.  The opposite party No. 1 has denied the other contents of the complaint and prayed for dismissal of the same. Alongwith the written version, the opposite party No. 1 has placed on record affidavit of SauravKhullar Ex. OP1/1, self attested copy of authority letter/ power of attorney Ex. OP1/2, Self attested copy of police Ex. OP1/3, Self attestee copy of terms and conditions Ex. OP1/4, Self attested copy of claim form Ex. OP1/5, Self attested copy of repudiation letter Ex. OP1/6, self attested copy of forensic report dated 28.7.2021 Ex. OP1/7, Self attested copy of affidavit of Mr. NivtreeMagar Senior Forensic Expert Ex. OP1/8, Self attested copy of investigation report of Associates KaithalEx. OP1/9, Self attested affidavit of Investigator Ex. OP1/10, Self attested copies of letters dated 2.8.2021, 9.8.2021 and 25.8.2021 Ex. OP1/11 to Ex. OP1/13, Self attested copy of unsatisfactory reply dated 26.8.2021 Ex. OP1/14.

3        The opposite party No. 2 appeared through counsel and filed written version by interalia pleadings that the complainant is not the consumer of the replying opposite party. The relationship between the complainant and replying OP is that of Borrower and debtor. This Commission has got no jurisdiction to try and entertain the present complaint. As per the loan agreement arrived at by the complainant and the replying OP No.2 in case any dispute difference/claim arises between the parties to the agreement, the same has  to be referred to the Arbitrator. In case there is an arbitration agreement between the parties, the provisions of the Arbitration and conciliation Act, 1996 are applicable to the facts of the case. The complainant has availed the financial assistance from the O.P.No.2 for commercial purpose as he use to get the vehicle plied for cultivation purposes. He has hired the services of labourer for earning profit from the financial assistance given by O.P. No.2. Hence, the present complaint is liable to be dismissed on this score alone. The present complaint is no maintainable against the replying O.P.as there is no deficiency on the part of replying O.P. as alleged or at all. Hence, the present complaint is liable to be dismissed on this very ground with exemplary cost.  The present complainant has no prima facie case against the replying opposite party. the replying opposite party posses goodwill and have an established market and have assumed a good reputation in respect of its business. The allegations mentioned in the complaint against the replying opposite party are vague and general in nature and that no specific averment, giving rise to filed the present complaint is made against the replying opposite party. Hence, the present complaint is liable to be dismissed qua replying OP on this ground with exemplary cost.  The complainant being defaulter of the replying OP No.2, is not entitled to any relief from this Commission. After getting financial assistance from the OP No.2 has committed substantial default in the repayment of the loan amount and interest thereon as per the repayment schedule. The complainant has got financial assistance for a sum of Rs.4,78,078/- from the OP No.2 vide loan agreement No.11936879 dated 17.08.2020 for the purchase of vehicle bearing No.PB46-AE-8192. Said amount along with interest thereon was repayable in 16 installments in 48 months payable after each quarter of the year. First 12 installments were agreed to be for Rs.45,000/- each whereas last 4 installments were agreed to  be of Rs.26,000/- each payable from 15.11.2020 to 15.08.2024. At the time of agreement, it was also agreed that present complainant shall be liable to pay Rs. 750/- plus Taxes for each cheque Bounce, cheque Swapping Charges, ACH, ECS, SI. Besides these, it was agreed that the complainant shall be liable to pay late payment interest @3% per month of unpaid EMI plus Taxes. Further it was also agreed that in case the present complainant wishes to pre close the loan account after six months of the loan agreement but between 7 to 36 months thereof, he will have to pay prepayment Charges @4% of Principal outstanding plus applicable Taxes and in case the complainant wishes to pre close the loan account after 36 months of the loan agreement, he will have to pay prepayment Charges @ 2% of Principal Outstanding Plus Applicable Taxes. All the Charges were duly agreed to be paid by the present complainant as per the schedule attached with the Loan Agreement. At the time of the loan agreement, he singed the loan agreement and schedule in token of their admission and correctness. However, the complainant remained irregular in making payment as per repayment. As on 21.05.2022, a sum of Rs.2,72,025/- is due against the complainant as Overdue Charges with 5 overdue installments alongwith Rs.3,29,000/- in lieu of future installments in respect of the aforesaid loan account. The complainant has filed the present false and frivolous complaint against the replying OP with the sole motive to pressurize the OP not to take any legal action against him for the recovery of the due amount. The complainant is defaulter of the OP No.1. The present complaint is not maintainable against the opposite parties as there is no deficiency on their part as alleged or at all. The complainant is using this  Commission as an attempt to avoid the legally enforceable debt and liability towards the replying OPNo.2which is not permitted under the law. Hence, the present complaint is liable to be dismissed on this very ground exemplary cost. The present complainant has no prima facie case against the replying OP. The replying opposite party possess goodwill and have an established market and have assumed a good reputation in respect of their business. The complainant has filed to show any damage on account of replying opposite party alleged actions and has also failed to establish any case for having suffered any loss due to the act of the replying opposite party. This is opposite party No. 2 who is actually suffering financial loss due to the willful default on the part of the present complainant.  The complainant has no locus standi to initiate the present proceedings against the OPs. The complainant has not approached this commission with clean hands and is guilty of suppression, concealment and misrepresentations of the true and material facts from this commission. Instead of complying with the terms and conditions of the loan agreement, he has arraigned the opposite party No. 2 in the present false and frivolous litigation. The payment of installments cannot be stopped on the ground of repudiation of claim of customer by insurance company. The opposite party No. 2 is totally different entity than the other opposite party. The liability of the other opposite party towards the present complainant cannot be fastened against the opposite party No.2. The liability of the complainant towards the opposite party No. 2 cannot be dependent upon the liability of the other OPs towards the present complainant.  The opposite party No. 2 has denied the other contents of the complaint and prayed for dismissal of the same. Alongwith the written version, the opposite party No. 2 has placed on record affidavit of Authorised officer/ attorney Ex. OP2/1, self attested copy of authority letter Ex. OP2/2, Self attested copy of loan agreement Ex. OP2/3, Self attested copy of statement of account Ex. OP2/4.

4        We have heard the Ld. counsels for the parties and have carefully gone through the record.

5        The combined and harmonious reading of documents and pleadings on record is going to prove that the complainant has purchased a tractor HP bearing registration No. PB46-AE-8192 for Rs. 6,40,000/-. The complainant got the above said tractor insured from the Bajaj Allianz General Insurance i.e. the opposite party No. 1 vide policy bearing invoice No. 204048779/1. The insured’s declared value of vehicle is Rs. 6,08,000/- and the policy is valid for the period from 19.8.2020 to 18.8.2021. The above said vehicle is financed from the HBD Financial Services Ltd. i.e. the opposite party No. 2. 

6        The counsel for the complainant contended that on 15.2.2021, the complainant was going to village Khan Chapri for giving the vehicle i.e. the tractor to his aunt’s son. In the way between village Bharowal to Fatehabad, the vehicle stopped running and the complainant has parked the vehicle on roadside and he went to village Fatehabad. Thereafter the complainant has arranged escort and went for taking back the vehicle and the complainant found that his vehicle was stolen from the spot by some unknown person. The complainant tried his best to find out the vehicle but failed. Thereafter, the complainant has intimated about the matter to the opposite party No. 1 and its officials have guided the complainant to lodge a Rapat with the police in this regard and provided the copy of Rapat to the officials of the company i.e. O.P No.1. As such, the complainant immediately reported the matter to police and the police started the investigation for finding the vehicle after lodging the rapat and combining the case with F.I.R No.21/16-02-2021 u/s. 457/380/411 IPC registered at P.S Goindwal.  Further the counsel for complainant contended that afterward the official of the opposite party have told the complainant to submit copy of Rapat along with copies of the registration certificate of the vehicle, driving license of the complainant i.e. driver and the complainant has provided all the demanded necessary documents to the officials of the company. To the best efforts made by the complainant as well as police, the vehicle could not be traced out. After this, the officials of have sent a letter dated 2.8.2022 where it was mentioned that “Hence in view of above you have misrepresented the actual facts regarding usage please explain within 7 days from the date of this letter as to why the claim should not be repudiated” . Further the complainant has intimated them that he has made another key when one original key was lost which could never been found after best efforts, as such, he has submitted both the keys with the company.  Hence, the counsel for the complainant prayed for allowing the complaint.

7        On the other hands, Ld. Counsel for the opposite party No. 1 contended that the complainant has intimated the replying opposite party about the alleged loss on 9.3.2021 i.e. after a delay of 22 days. After receiving the intimation, the replying opposite party investigated the claim for verification of alleged theft claim of the complainant. As per complaint the theft was occurred on 15.02.2021 and the complainant intimated the opposite party on 9.3.2021 thus there is delay of 22 days which deprived the replying opposite party for timely investigation, which also effects the recovery chances of vehicle of the complainant, thereby the complainant has violated the conditions No.1 of the policy which states as under:-

“Notice shall be given in writing to the insurance company immediately upon occurrence of any accidental loss or damages in the event of any claim and thereafter, the insured shall given all such information and assistance and the company shall require.”

After receiving both the keys the opposite party sent the same for forensic examination and as per the forensic examination report dated 28.07.2021, it was found that one key is original manufacturer made. Moreover, both keys are unused and show manual filing and scratch marks. As per dimensional analysis of key-1 and key-2, side gear profiles of both the keys are different and both keys cannot be used in the same lock-set. Therefore, insured is misrepresenting the fact regarding usage of the submitted keys.  As such, the complainant is not entitled for any relief.

8        The counsel for the opposite party No. 2 contended that the relationship between the complainant and replying OP is that of Borrower and debtor. This Commission has got no jurisdiction to try and entertain the present complaint. As per the loan agreement arrived at by the complainant and the replying OP No.2 in case any dispute difference/claim arises between the parties to the agreement, the same has  to be referred to the Arbitrator. In case there is an arbitration agreement between the parties, the provisions of the Arbitration and conciliation Act, 1996 are applicable to the facts of the case. The complainant has availed the financial assistance from the O.P.No.2 for commercial purpose as he use to get the vehicle plied for cultivation purposes. He has hired the services of labourer for earning profit from the financial assistance given by O.P. No.2. Hence, the present complaint is liable to be dismissed on this score alone. The present complaint is no maintainable against the replying O.P.as there is no deficiency on the part of replying O.P. as alleged or at all. Hence, the present complaint is liable to be dismissed on this very ground with exemplary cost.  The present complainant has no prima facie case against the replying opposite party. The replying opposite party posses goodwill and have an established market and have assumed a good reputation in respect of its business. The allegations mentioned in the complaint against the replying opposite party are vague and general in nature and that no specific averment, giving rise to filed the present complaint is made against the replying opposite party. Hence, the present complaint is liable to be dismissed qua replying OP on this ground with exemplary cost.  The complainant being defaulter of the replying OP No.2, is not entitled to any relief from this Commission. After getting financial assistance from the OP No.2 has committed substantial default in the repayment of the loan amount and interest thereon as per the repayment schedule. The complainant has got financial assistance for a sum of Rs.4,78,078/- from the OP No.2 vide loan agreement No.11936879 dated 17.08.2020 for the purchase of vehicle bearing No.PB46-AE-8192. Said amount along with interest thereon was repayable in 16 installments in 48 months payable after each quarter of the year. First 12 installments were agreed to be for Rs.45,000/- each whereas last 4 installments were agreed to  be of Rs.26,000/- each payable from 15.11.2020 to 15.08.2024. At the time of agreement, it was also agreed that present complainant shall be liable to pay Rs. 750/- plus Taxes for each cheque Bounce, cheque Swapping Charges, ACH, ECS, SI. Besides these, it was agreed that the complainant shall be liable to pay late payment interest @3% per month of unpaid EMI plus Taxes. Further it was also agreed that in case the present complainant wishes to pre close the loan account after six months of the loan agreement but between 7 to 36 months thereof, he will have to pay prepayment Charges @4% of Principal outstanding plus applicable Taxes and in case the complainant wishes to pre close the loan account after 36 months of the loan agreement, he will have to pay prepayment Charges @ 2% of Principal Outstanding Plus Applicable Taxes. All the Charges were duly agreed to be paid by the present complainant as per the schedule attached with the Loan Agreement. At the time of the loan agreement, he singed the loan agreement and schedule in token of their admission and correctness. However, the complainant remained irregular in making payment as per repayment. As on 21.05.2022, a sum of Rs.2,72,025/- is due against the complainant as Overdue Charges with 5 overdue installments alongwith Rs.3,29,000/- in lieu of future installments in respect of the aforesaid loan account and prayed that the present complaint may be dismissed.

9        In the present case, insurance and theft of vehicle is not disputed between the parties. It is also not disputed that after the theft of the vehicle the same was not traced out. 

10      As per Ex. C-6 the opposite party No. 1 has repudiated the claim on two grounds one is delay of 22 days and second is regarding the keys submitted by the complainant. As per their repudiation letter one key is original manufacturer made and second is not original manufacturer made.

11      Now we have to see the first ground of reputation i.e. delay of 22 days in intimating the theft of vehicle to the insurance company. The perusal of record shows that the theft of vehicle occurred on 15.2.2021 and the complainant has immediately intimated the said incident to the Police authority on 16.2.2021 i.e. very next day from the theft and to support his version, the complainant has placed on record Rapat Ex. C-4 and C-5 which clearly proved that the police authority was intimated by the complainant on the very next day of the occurrence. Otherwise also, it is admitted fact that intimation about theft was given to the Opposite Party with minor delay. This delay in the opinion of this commission is not such a delay which could compel the insurance company to close or repudiate the claim of the complainant. Otherwise also, a circular dated 20.9.2011 was issued by IRDA, referred to all the insurance companies, which reads as under:-

“Circular

To:    All Life Insurers and non-life insurers

Re:    Delay in claim intimation/ documents submission with respect to

i)       All life insurance contracts and

ii)      All Non-life individual and group insurance contracts.

          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 intimation clause does not work in 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 policy holders 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.

The insurers are advised to incorporate additional wordings in the policy documents, suitably enunciating insurers’ stand to condone delay on  merit for delayed claims where the delay is proved to be for reasons beyond the control of the insured.

                                                          J. Harinarayan

                                                            Chairman”:

A bare reading of circular shows that if the claim is otherwise payable then it should not be repudiated or rejected simply on the ground of delay and delay is only to be considered when claim is otherwise not made out and is liable to be rejected even if the matter has been reported in time. In case titled as National Insurance Company Limited Vs. Kulwant Singh 2014(IV) CPJ page 62 (NC) the Hon’ble National Commission  observed that the insurance company should not have repudiated the claim merely on account of delay in giving the information to insurance company particularly when there was absolute no delay in lodging the FIR with the police. In the case in hand also, the theft took place on 16.9.2014 and intimation to the police was also given on the same day i.e. 16.9.2014 and as such, there was no delay at all for giving the intimation to the police. Moreover, in similar case titled as Reliance General Insurance Company Limited- Petitioner Vs. Sri Avvn Ganesh-Respondent 2012(1) CPJ page 176  in case under Consumer Protection Act, 1986 the intimation of death was given to the insurer with delay and claim was repudiated on the ground that death of insured was intimated after 4 months as against stipulated period of one month. The complainant filed complaint on the allegation of deficiency in service by insurance company, but the same was dismissed, but appeal filed by the complainant was allowed by Hon’ble State Commission. On revision, the Hon’ble National Commission, New Delhi observed that all the conditions for acceptance of insurance claim except point of reporting loss within one month of its occurrence had been substantially  fulfilled and delayed intimation of death of insured due to injuries he suffered on account of accident could not be held to be destructive to insurance claim because the facts and circumstances of death were clearly established on the basis of medical on records as well as  deposition of doctor who attended the insured and it was observed that like in case of theft of moveable insured property, delay in intimation was not prejudicial to the insurer because in such cases, Insurance company was not prevented, because of delay, from carrying out any investigation into the facts and circumstances as to whether the accident and consequent loss fell within the substantive condition of insurance policy and no infirmity  was found in the order and revision petition was dismissed. In the case in hand also, the theft of vehicle in question was reported to the police on the very next day by the complainant and as such, the complainant has substantially fulfilled the condition of the policy as intimation to police was immediate and as per version of the opposite party intimation even to the insurance company was only with a delay of 22 days as claimed by the Opposite Party which is not material in the case in hand for closing or repudiating the claim case of the complainant and as such, the complainant is entitled to claim the insurance amount of the vehicle in question.    

12      The second ground on which the opposite party No. 1 has repudiated the claim of the complainant is that one key out the two keys submitted to the opposite party No. 1 is not of original manufacturer made.  But we are not agreed with the opposite party No. 1 as they have failed to establish on record that the tractor was stolen by someone with that key only. It is pertinent to mention here that so many vehicles are stolen in the country even the owners have both the original manufacturer made keys with them. In the present case, the complainant has admitted that he reached his aunty’s house at 3.30 P.M. and he and his cousin reached at the place of tractor at about 4.25 P.M.  So he came to the place of incident before passing one hour. So we cannot say that the tractor was left unattended.  It was the duty of the opposite party No. 1 to establish on the record that theft of the vehicle has been committed by using the lost key of the tractor which was not done by the opposite party in their stand.   

13      Furthermore, It is usual with the insurance company to show all types of green pastures to the customer at the time of selling insurance policies, and when it comes to payment of the insurance claim, they invent all sort of excuses to deny the claim. In the facts of this case, ratio of the decision of Hon’ble Apex Court in case of DharmendraGoel Vs. Oriental Insurance Co. Ltd., III (2008) CPJ 63 (SC) is fully attracted, wherein it was held that, Insurance Company being in a dominant position, often acts in an unreasonable manner and after having accepted the value of a particular insured goods, disowns that very figure on one pretext or the other, when they are called upon to pay compensation.  This ‘take it or leave it’, attitude is clearly unwarranted not only as being bad in law, but ethically indefensible.  It is generally seen that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. In similar set of facts the Hon’ble Punjab & Haryana High Court in case titled as New India Assurance Company Limited Vs. Smt.UshaYadav& Others 2008(3) RCR (Civil) Page 111 went on to hold as under:-

“It seams that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. All conditions which generally are hidden, need to be simplified so that these are easily understood by a person at the time of buying any policy.        The Insurance Companies in such cases rely upon clauses of the agreement, which a person is generally made to sign on dotted lines at the time of obtaining policy. Insurance Company also directed to pay costs of Rs.5000/- for luxury litigation, being rich.

14      In light of the above discussion, the complaint succeeds and the same is hereby allowed with costs in favour of the complainant and against the Opposite Party No. 1. The opposite Party No. 1 is directed to make the payment of Rs. 6,08,000/- (i.e. IDV Value) i.e. insurance claim of vehicle in question to the complainant subject to fulfilling  the necessary requirement for the transfer of the vehicle in question in the name of Opposite Party No. 1 (Insurance Company) and filing the subrogation letter. The complainant has been harassed by the opposite party No. 1 unnecessarily for a long time. The complainant is also entitled to Rs.20,000/- as compensation on account of harassment and mental agony and Rs 11,000/-  as litigation expenses. Opposite Party No. 1 is directed to comply with the order within one month from the date of receipt of copy of the order, failing which the complainants are entitled to interest @ 9% per annum, on the awarded amount, from the date of complaint till its realisation.  The present complaint is dismissed against the opposite party No. 2. Copy of order be supplied to the parties free of costs as per rules. File be consigned to record room. Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Commission.

Announced in Open Commission

13.07.2023