Order by:
Sh.Amrinder Singh Sidhu, President
1. This Consumer Complaint has been received by transfer vide order dated 26.11.2021 of Hon’ble President, State Consumer Disputes Redressal Commission, Punjab at Chandigarh under section 48 of CPA Act, vide letter No.04/22/2021/4 C.P.A/38 dated 17.1.2022 from District Consumer Commission, Ludhiana to District Consumer Commission, Moga to decide the same in Camp Court at Ludhiana and said order was ordered to be affected from 14th March, 2022.
2. The complainant has filed the instant complaint under section 12 of the Consumer Protection Act, 1986 (now section 35 of Consumer Protection Act, 2019) on the allegations that he purchased a mobile make SAMSUNG A9PRO, IMEI: 352944080312070, Colour gold from Opposite Party No.1 vide Invoice No. 2970 dated 13.11.2016 for a sum of Rs.31,450/- and said mobile was fully insured with Opposite Party vide policy No.IM0280850 through its authorized dealer Bajaj Finance of 2nd Floor, Opp.P.S.Sarabha Nagar, SCO 35-G, B.R.S.Nagar, Ludhiana. Further alleges that on 17.02.2017 at about 7.30 PM, some unidentified person took the mobile from the shop of the complainant, when the complainant was busy in her work. The complainant traced the same here and there, but could not succeed. Thereafter, the complainant lodged a complaint with P.S.Shaheed Bhagat Singh Nagar, Ludhiana who lodged FIR No.10 dated 05.03.2017 under section 379 IPC. Since the Mobile Set in question was fully insured with the Opposite Parties vide all risk, hence the complainant lodged the claim with the Opposite Party for the claim of the price of Mobile Set in question, but the Opposite Party No.2 did not pay any heed to the request of the complainant and as such, there is deficiency in service on the part of Opposite Party No.2. Vide instant complaint, the complainant has sought the following reliefs.
a) Opposite Party No.2 be directed to pay the price of Mobile Set in question worth Rs.31,450/- alongwith compensation i.e. Rs.40,000/- for loss of business and Rs.22,000/- as counsel fee and any other relief to which this District Consumer Commission may deem fit be also granted.
3. Opposite Party No.2 appeared through counsel and contested the complaint by filing the written version taking preliminary objections therein inter alia that the complaint filed by the complainant is not maintainable and is liable to be dismissed as the complainant has attempted to misguide and mislead this District Consumer Commission. It is not disputed that the complainant opted for the membership of CPP Assistance Services Private limited vide Membership No.IM0280850 to secure his Samsung A9Pro for protection service and security of the Mobile Set in question for the period 14.11.2016 to 13.11.2017. Further alleges that the intimation regarding the theft of the Mobile Set in question was given by the complainant to the police on 5.3.2017 vide GD No.021 and the information to the answering Opposite Party was given on 07.04.2017, but the benefits under the policy are governed by the terms and conditions of the policy and the liability of the Opposite Party is limited to the insured perils occurring within the policy period subject to conditions and exceptions as mentioned in the terms and conditions of the policy. Under the policy payment of depreciated value of the equipment which shall be calculated after adjustment of compulsory deductible and applying depreciation and based on the age of equipment on the date of theft/ damage as per rates specified in the policy. As such, in terms of the policy, the claim of the complainant was closed on the ground of delay in intimation to the police and the insurance company. The answering Opposite Party has provided full services to the complainant and there is no material on record to show any deficiency of the insurance company as alleged. On merits, Opposite Party No.2 took up the same and similar pleas as taken up by them in the preliminary objections and hence, there is no deficiency in service on the part of the Opposite Party No.2 and the complaint may be dismissed with costs.
4. In order to prove her case, the complainant has tendered into evidence his affidavit Ex.CA alongwith copies of documents Ex.C1 and Ex.C2 and closed the evidence on behalf of the complainant.
5. On the other hand, to rebut the evidence of the complainant, Opposite Party No.2 tendered into evidence the affidavit of Mss.Palwi Roy Ex.RA alongwith copies of documents Ex.R1 to Ex.R3 and closed the evidence.
6. We have heard the ld.counsel for the parties, perused the written submissions of Opposite Party No.2 and also gone through the documents placed on record.
7. Ld.counsel for the Complainant as well as ld.counsel for Opposite Party No.2 have mainly reiterated the facts as narrated in the complaint as well as in their written statements respectively. We have perused the rival contention of the ld.counsel for the parties. The only contention of the complainant is that he fully insured her mobile make SAMSUNG A9PRO, IMEI: 352944080312070, Colour gold with Opposite Party vide policy No.IM0280850 through its authorized dealer Bajaj Finance of 2nd Floor, Opp.P.S.Sarabha Nagar, SCO 35-G, B.R.S.Nagar, Ludhiana and further contended that on 17.02.2017 at about 7.30 PM, some unidentified person took the mobile from the shop of the complainant, when the complainant was busy in her work. The complainant traced the same here and there, but could not succeed. Thereafter, the complainant lodged a complaint with P.S.Shaheed Bhagat Singh Nagar, Ludhiana who lodged FIR No.10 dated 05.03.2017 under section 379 IPC. Since the Mobile Set in question was fully insured with the Opposite Parties vide all risk, hence the complainant lodged the claim with the Opposite Party for the claim of the price of Mobile Set in question, but the Opposite Party No.2 did not pay any heed to the request of the complainant and as such, there is deficiency in service on the part of Opposite Party No.2. On the other hand, ld.counsel for Opposite Party No.2 has repelled the aforesaid contention of the complainant on the ground that the intimation regarding the theft of the Mobile Set in question was given by the complainant to the police on 5.3.2017 vide GD No.021 and the information to the answering Opposite Party was given on 07.04.2017, but the benefits under the policy are governed by the terms and conditions of the policy and the liability of the Opposite Party is limited to the insured perils occurring within the policy period subject to conditions and exceptions as mentioned in the terms and conditions of the policy. As such, in terms of the policy, the claim of the complainant was closed on the ground of delay in intimation to the police and the insurance company. The answering Opposite Party has provided full services to the complainant and there is no material on record to show any deficiency of the insurance company. But we do not agree with the aforesaid contention of the ld.counsel for the Opposite Party No.2. Admittedly, the Mobile Set in question of the complainant was stolen on 17.02.2017 when she was busy in her shop and in this regard, complainant lodged a complaint with P.S.Shaheed Bhagat Singh Nagar, Ludhiana who lodged FIR No.10 dated 05.03.2017 under section 379 IPC. The main ground of the Opposite Party No.2 is that the intimation regarding the theft was not given to the Opposite Party as well as police immediately after the occurrence of the theft. In this regard, we rely upon the judgement of Hon’ble Punjab & Haryana High Court at Chandigarh in case National Insurance Company Limited, Gurgaon versus Ravi Sutt Sharama & Another, Civil writ Petition No. 9716 of wherein Hon'ble Justice Ranjit Singh in a similar situated case has pleased to held that;
“ I have my doubts whether the Insurance company can act as a super investigator once the complaint was lodged with the police about the theft. The responsibility to investigate or to ascertain the cause of theft or whether it was there or not would really be that of the police. Merely because there was a delay on the part of the insured to inform the petitioner-company would not be a reason enough to decline or repudiate the claim. Hon'ble Justice further held that the Lok Adalat has rightly appreciated this aspect and has negated the plea raised by the petitioner Insurance Company on the ground that the respondent-insured had immediately informed the police about the theft and hence the delay would be immaterial in such cases. The Insurance Companies, in my view, are not acting fairly in all such matters after charging huge premium. Intention is always to repudiate the claim on one ground or the other. The conditions of the Insurance agreements are so minutely printed that person gets hardly any time to go through such conditions to make it legally binding in any appropriate manner.
8. Not only this, Insurance Regulatory and Development Authority, vide its order No.IRDA/HLTH/MISC/ CIR/216/ 09/2011 dated 20.09.2011 has clearly held to the following effect:-
“The Insurers’ decision to reject a claim shall be based on sound logic and valid grounds. It may be noted that such limitation 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 policyholders 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.”
9. In such a situation the repudiation made by Opposite Party-Insurance Company regarding genuine claim of the complainant have been made without application of mind. It is usual with the insurance company to show all types of green pasters 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 Dharmendra Goel 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.Usha Yadav & 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.
10. In view of the aforesaid facts and circumstances of the case, we partly allow the complaint of the Complainant and direct the Opposite party No.2 to make the payment of insurance claim i.e. price of the Mobile Set in question amounting to Rs.31,450/- (Rupees thirty one thousands four hundred fifty only) to the Complainant alongwith interest @ 8% per annum from the date of filing the present complaint i.e. 06.11.2017 till its actual realization. The compliance of this order be made by Opposite Party No.2 within 60 days from the date of receipt of this order, failing which the complainant shall be at liberty to get the order enforced through the indulgence of this District Commission. Copies of the order be furnished to the parties free of cost by District Consumer Commission, Ludhiana and thereafter, the file be consigned to record room after compliance.
11. Reason for delay in deciding the complaint.
This Consumer Complaint was originally filed at District Consumer Disputes Redressal Forum (Now Commission) at Ludhiana and it keep pending over there until Hon’ble State Consumer Disputes Redressal Commission, Punjab vide letter No.04/22/2021/4 C.P.A/38 dated 17.1.2022 has transferred the instant Consumer Complaint alongwith Other Complaints to District Consumer Commission, Moga with directions to work on this file onward from 14th March, 2022 and accordingly District Consumer Commission, Moga has decided the present complaint at Camp Court, Ludhiana, as early as possible as it could decide the same
Announced in Open Commission at Camp Court, Ludhiana.
