Haryana

Kurukshetra

07/2016

Kuljeet Singh - Complainant(s)

Versus

Bharti Axa Ins - Opp.Party(s)

Ravinder Ranga

21 Dec 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL FORUM, KURUKSHETRA.

 

                                                        Complaint no. 7/16

                                                        Date of instt.  7.1.2016

                                                        Date of Decision 21.12.17.

 

Kuljeet Singh son of Pritam Chand, resident of village and post office Amupur Karnal, District Karnal, now residing at House No.1026, Sector-5, Urban Estate, Kurukshetra.   

       

                                                                        …….complainant

                          Vs.

 

Bharti AXA General Insurance Company Limited, Durga Market, 1^st Floor, in front of Harsh Cinema Red Road, Kurukshetra, through its Branch Manager.

 

                                                                        ….OP.

 

Complaint under section 12 of Consumer Protection Act.

 

Before:       Sh. G.C. Garg, President.    

                 Dr. Jawahar Lal Gupta, Member.

                       

Present:        Sh. Ravinder Ranga, Adv. for complainant.

                   Sh. Jai Ram Saini, Adv. for the Op.

ORDER:

 

                This is a complaint under Section 12 of the Consumer Protection Act, 1986 moved by complainant Kuljeet Singh against Bharti AXA General Insurance Company Limited through its Branch Manager, the opposite party.

2.            It is stated in the complaint that the complainant is registered owner of a motor cycle bearing No.HR-05AL/1610 engine No.JC36E73292468 and chassis No.ME4JC 36JBE7798866, Model-2014 and the said motor cycle was insured from the Op vide policy/cover note bearing No.S3163337 No.6299999184 valid from 7.4.2014 to 6.4.2015. On 3.4.2015 the above said motor cycle met with road side accident and the complainant lodged DDR bearing No.13 dated 12.4.2015. The complainant approached the OP and gave intimation verbally regarding the accident of his motor cycle and on the asking of OP the complainant submitted the requisite documents on 15.7.2015. The complainant visited the office of many a times and requested to pay the insured amount but the OP flatly refused to compensate the complainant. Thus, it amounts to deficiency in service on the part of Ops. Hence, the present complaint was moved by the complainant claiming the insured amount of Rs.48,260/- and Rs.1,00,000/- towards harassment and mental agony.

3.                   Upon notice, opposite party appeared and contested the complaint by filing written statement taking preliminary objections that the complaint is not maintainable because according to complainant the accident occurred on 3.4.2015 and DDR was registered on 12.4.2015 after nine days delay and the complainant not intimated to the answering OP. Moreover, the answering OP requested the complainant to submit the relevant documents but the complainant has failed to submit the same, so the complainant is not entitled for any compensation. Hence, in view of the facts and circumstances mentioned above, there is no deficiency in service on the part of answering Op and as such, the complaint of the complainant is liable to be dismissed with costs. On merits, contents of the complaint were denied. Preliminary objections were repeated. Prayer for dismissal of the complaint was made.

4.             Both the parties have led their respective evidence.

5.             We have heard the ld. Counsel for the parties and have gone through the record available on the file carefully.

6.            Learned counsel for the complainant has contended that opposite party illegally repudiated the claim of the complainant on false ground of late intimation to the insurance company, whereas the complainant informed the opposite party and the police immediately after the theft of the vehicle in question.

7.             On the other hand, learned counsel for the opposite party contended that opposite party has rightly not released the claim of the complainant as the complainant has violated the terms and conditions of the policy as the complainant has not intimated to the insurance company, whereas claim for theft of vehicle is not payable if the same is not reported to company within 48 hours of its occurrence, so the complainant is not entitled for any compensation.

8.             We have considered the rival contentions of the parties. In the present case, it is an admitted case that the theft had taken place on 3.4.2015 and DDR bearing No.13 was registered on 12.4.2015 which fact is evident from the copy of DDR. The plea of delay in giving information to the insurance company is not relevant because the complainant lodged his complaint in Police Station vide DDR No.13 dated 12.4.2015. Moreover, the Insurance Regulatory Development Authority (for short ‘IRDA’) which controls and regulates the Insurance Companies has given direction to the Insurance Companies not to reject the genuine claims simply because of delay in registration of the FIR and intimation to the Insurance Company. It has been observed that “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 insurer’s 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 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.” These observations are fully applicable to the present case. In the present case, the claim of the complainant has only been repudiated on the technical ground of delay in informing the insurance company and the same has been repudiated in a mechanical fashion. No other reason whatsoever has been rendered by the insurance company. The Hon’ble Punjab & Haryana High Court in an authority cited as Bharti Axa General Insurance Company Limited Versus Ms. Monu Yadav and another, 2014 (4) PLR 861, has held that “ when theft of car took place and there was delay in lodging claim with insurance company of 54 days, it was held that the instructions dated 20.9.2011, issued by Insurance Regulatory and Development Authority to all the insurance companies are applicable to the insurance companies. It has further been held that as per the said instructions, this condition should not prevent the settlement of genuine claims particularly, when there is delay in giving intimation or in submission of documents due to unavoidable circumstances. The companies were advised that they must not repudiate such claims on the ground of delay, especially when the police has been promptly informed in this regard.”   The facts of the above said authority are applicable to the present case as in the present case, the FIR was lodged on the very next day when the accident took place.

9.            So far as the question of the claim amount is concerned, the Ops declared the value of the vehicle including accessories, estimated to the tune of Rs.48,260/-. However, as per document Ex.R2 the insured declared value of the vehicle is Rs.48,260/- less salvage value Rs.12,000/- and compulsory excess clause Rs.100/-. The total net liability comes to Rs.36,160/-. So, we are of the view that the complainant is entitled to the said amount of Rs.36,160/-.

10.            Thus, as a sequel to our above discussion, since the complainant has informed the police regarding the theft of the vehicle in question to the Insurance Company as per the direction of the IRDA and also got the FIR lodged, the OPs could not reject genuine claim of the complainant on purely technical ground. So, the repudiation of the claim of complainant is not correct.  So, in such like circumstances, we accept the present complaint and direct the opposite party to pay the amount of Rs.36,160/-to the complainant. This order should be complied within a period of two months, failing which penal action under Section 27 of the Consumer Protection Act, 1986 would be initiated against the opposite party and in that case also the Ops shall be liable to pay the simple interest @ 6% per annum on the amount of Rs.36,160/- from the date of order till its payment. File be consigned to record after due compliance.

                 Copy of this order be communicated to the parties.

Announced:             

Dt. 21.12.2017.                                          (G.C.Garg)

                                                                President,

                                                       District Consumer Disputes                                                            Redressal Forum, Kurukshetra.

 

 

       (Dr. Jawahar Lal Gupta)           

         Member