Haryana

StateCommission

A/137/2015

UNITED INDIA INSURANCE CO. - Complainant(s)

Versus

BALBIR SINGH - Opp.Party(s)

NITIN GUPTA

23 Nov 2015

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

First Appeal No  :      137 of 2015

Date of Institution:      10.02.2015

Date of Decision :       23.11.2015

 

United India Insurance Company Limited Rohtak, through its Divisional Manager.

Now represented through the authorized signatory of Regional Office SCO No.123-124, Sector 17-B, Chandigarh.

                                      Appellant/Opposite Party

Versus

 

Balbir Singh s/o Sh. Ran Singh, Resident of House No.1617/31, Kamla Nagar, Rohtak, Haryana.

                                      Respondent/Complainant

 

CORAM:             Hon’ble Mr. Justice Nawab Singh, President.

                             Mr. B.M. Bedi, Judicial Member.

                                                                                                         

Present:               Shri Nitin Gupta, Advocate for appellant.

                             Shri Sudhir Hooda, Advocate for respondent.

 

                                                   O R D E R

 

B.M. BEDI, JUDICIAL MEMBER

 

                   United India Insurance Company Limited (for short ‘the Insurance Company’)-Opposite Party, is in appeal against the order dated 11^th December, 2014 passed by District Consumer Disputes Redressal Forum, Rohtak (for short ‘the District Forum’) whereby complaint filed by Balbir Singh-Complainant (respondent herein) was allowed and the Insurance Company was directed to pay 75% of Rs.3,06,500/-, that is, Insured Declared Value (IDV) alongwith interest at the rate of 9% per annum from the date of filing of the complaint till its actual payment on account of theft of car and Rs.2200/- litigation expenses, within one month from the date of completion of formalities by the complainant, that is, transfer of Registration Certificate and Subrogation Letter etcetera to the opposite party failing which the awarded amount shall carry interest at the rate of 12% per annum from the date of decision.

2.      Indica Car bearing No.HR12G-7161 owned by the complainant/respondent was insured with the Insurance Company for Rs.3,06,500/- for the period from July 11^th, 2006 to July 10^th, 2007 vide Insurance Policy Exhibit C-2. During the intervening night of 2/3-02-2007, the car was stolen by some unknown person while it was parked in front of complainant’s house in Palam Vihar, Gurgaon. F.I.R. No.131 dated 03.02.2007 (Exhibit C-4) under Section 379 of the Indian Penal Code was registered in Police Station, Palam Vihar, Gurgaon.  The Insurance Company was informed. The Police submitted untraced report Exhibit C-5. Claim being filed, the Insurance Company repudiated the same vide letter dated 6^th September, 2007 (Exhibit R-2) on the ground stated as under:-

“You have enjoying N.C.B. 20% in this policy, but you have reported 2 claim in your previous policy from N.I.A. CO. Ltd. Hence the file is closed as same ground for as per your previous file No.31/18906”.

3.      The complainant filed complaint under Section 12 of the Consumer Protection Act, 1986.

4.      The Insurance Company/opposite party contested complaint by filing reply taking plea mentioned in the repudiation letter.

5.      On appraisal of pleadings of the parties and the evidence brought on the record, the District Forum accepted complaint and issued direction to the Insurance Company as detailed in paragraph No.1 of this order.

6.      Learned counsel for the appellant/Insurance Company has challenged the impugned order interalia on the grounds that (i) the Insurance Company was informed about the occurrence on 22^nd March, 2007 whereas theft took place during the intervening night of 2/3-2-2007 (ii) prior to the purchase of the insurance policy the complainant had taken the benefit of ‘No Claim Bonus’ (NCB) did not disclose at the time of purchasing the present insurance policy that he had taken two claims during previous policy period.  

7       We do not subscribe to the contention raised by learned counsel for the appellant.  So far as the delay in informing the Insurance Company is concerned, the same is not significant in view of circular Ref: IRDA/ HLTH/ MISC/ CIR/ 216/ 09/ 2011 dated September 20^th, 2011 issued by Insurance Regulatory Development Authority (for short ‘IRDA’). It has been specifically mentioned by IRDA that there may be a condition in the policy regarding delay in intimation but that does not mean that the insurer can take the shelter under that condition and repudiate the claim of the claimant, which is otherwise proved to be genuine.  The operative part of the circular reads as under:-

“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.”

8.      Now coming to the other contention that the complainant had concealed about taking claims during the period of previous policy, the provisions of GR.27 of the Indian Motor Tariff need to be taken into consideration which deas with ‘No Claim Bonus’ of the insured vehicle.  As per GR.27 of the M.V. Act, the Insurance Company was under a legal obligation to collect information from the previous Insurance Company by writing letter within 21 days from the date on which the complainant had obtained the policy from the appellant. The relevant part of GR.27 of the Indian Motor Tariff is reads as under:-

          “GR.27. No Claim Bonus

1. No Claim Bonus (NCB) can be earned only in the Own Damage section of Policies covering all classes of vehicles but not on Motor Trade Policies (Road Transit Risks/Road Risk/Internal Risks) and policies which cover only Fire and/or Theft Risks. For policies covering Liability with Fire and/or Theft Risks, the NCB will be applicable only on the Fire and/or Theft components of the premium. An insured becomes entitled to NCB only at the renewal of a policy after the expiry of full duration of 12 months.
2. No Claim Bonus, wherever applicable, will be as per the following table.

Xxx

3. xxx
4. xxx
5. xxx
6. In the event of the insured, transferring his insurance from one insurer to another insurer, the transferee insurer may allow the same rate of NCB which the insured would have received from the previous insurer. Evidence of the insured’s NCB entitlement either in the form of a renewal notice or a letter confirming the NCB entitlement from the previous insurer will be required for this purpose.

Where the insured is unable to produce such evidence of NCB entitlement from the previous insurer, the claimed NCB may be permitted after obtaining from the insured a declaration as per the following wording.

“I/We declare that the rate of NCB claimed by me/us is correct and that no claim as arisen in the expiring policy period (copy of the policy enclosed). I/we further undertake that if this declaration is found to be incorrect, all benefits under the policy in respect of Section 1 of the Policy will stand forfeited.”

Notwithstanding the above declaration, the insurer allowing the NCB will be obliged to write to the policy issuing office of the previous insurer by recorded delivery calling for confirmation of the entitlement and rate of NCB for the particular insured and the previous insurer shall be obliged to provide the information sought within 30 days of receipt of the letter of enquiry failing which the matter will be treated as a breach of Tariff on the part of the previous insurer. Failure of the insurer granting the NCB to write to the previous insurer within 21 days after granting the cover will also constitute a breach of the Tariff.”

9.      Indisputably, in the instant case the Insurance Policy (Exhibit C-2) was obtained by the complainant from the appellant for the period from July 11^th, 2006 to July 10^th, 2007 on June 25^th, 2006. The accident took place during the night of February 2^nd/3^rd, 2007 i.e. after more than seven months.

10.    As per GR.27 of the Indian Motor Tariff, the insured can take benefit of ‘No Claim Bonus’ if he provides information that he had not taken any claim during the period of previous policy. However, if the insured does not furnish any such information, the Insurance Company can take declaration of the insured in this regard and thereafter can collect information from the concerned office of the previous Insurance Company by writing a letter within 21 days after granting the cover on failure of which it will constitute a breach of the Tariff on the part of insurer and not insured.  But in the instant case the appellant/Insurance Company failed to produce any evidence that declaration was taken from the complainant at the time of issuing the policy and that any letter was written to the previous insurer of the vehicle within 21 days from the date of issuing the instant Insurance Policy. Thus, the appellant/Insurance Company failed to adhere to the provisions of GR.27 of the Indian Motor Tariff.  In this view of the matter it is established that neither the appellant/Insurance Company obtained declaration from the complainant at the time of issuing insurance policy nor had written letter to the previous insurer, to collect information in this regard within the prescribed period of 21 days, which constitute a breach of the Tariff in view of GR.27 of the Indian Motor Tariff.  So, the complainant cannot be made to suffer for the default on the part of the appellant.

11.    In view of the above, no case for interference in the impugned order is made out. Hence, the appeal fails and is hereby dismissed.

12.    The statutory amount of Rs.25,000/- deposited at the time of filing the appeal and Rs.3,11,834/- deposited on September 9^th, 2015 be refunded to the complainant alongwith interest accrued thereon, against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.

 

Announced: 23.11.2015

(B.M. Bedi) Judicial Member

(Nawab Singh) President

 

CL