OFFICE OF THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, ANGUL
PRESENT:- SRI DURGA CHARAN MISHRA.
PRESIDENT
A N D
Sri K.K.Mohanty, MEMBER .
Consumer Complaint No.49 of 2013
Date of Filling : -03.06.2013.
Date of Order :- 28.03.2019 .
Amit Ku.Agarawalla,S/O.Gouri Shankar Agrawal,
Prop.Goel Agency,At-Durga Shankar road at present
Residing At- Bazarapada,P.O/P.S/,Dist.Angul.
____________________________________________Complainant.
Vrs.
- Branch Manager,Reliance Genral Insurance Com.Ltd.,
At-Angul Busstand,P.O/P.S/Dist.Angul.
- Divisional Manager, Reliance Genral Insurance Com.Ltd.,
2nd Floor, 5th Janapath, Unit-III,Bhubaneswar,Dist-Khurda
- Deputy General Manager,UCO Bank Jonal Office,
At- Ainthapali,Sambalpur.
________________________________________________________Opp. partiest.
For the complainant :- Sri Md.Azad & associates(Advs.).
For the opp.party No.1 :- Sri S.Mishra & associates(Advs.).
For the opp.party No.2 :- None
For the opp.party No.3 :- None
: J U D G E M E N T :
Sri D. C. Mishra, President.
The petitioner/ complainant has filed this case with prayer to direct the opp.parties to pay him the insurance claim amount of Rs. 7,50,000.00 only with bank rate of interest from the date of claim along with Rs. 1,00,000.00 towards mental agony and harassment and Rs. 10,000.00 towards cost of litigation on the grounds stated there in .
2. The petitioner’s case runs thus :-
That the petitioner/complainant has one cash credit account in UCO Bank ,Angul (Opp.party No.3 ) for Rs. 15,000,00.00 since the year 2005 and he was carrying on business of selling mobile cell phones. The said mobile shop of the petitioner was insured under the opp.party No.1 & 2 through opp.party No.3 for Rs. 20,000,00.00 only and the yearly premium was Rs. 8,824.00 only. It is averred that each year from 2005, opp.party No.3 was depositing the premium with opp.party No.1 & 2 , as because the insurance was made to secure the cash credit account amount. According to the petitioner his insurance was made for Rs. 20,000,00.00 only , covering for damage by fire, burglary ,theft and allied perils and accordingly for the year 2010-11 the policy was issued in his favour. For the year 2011-12 i.e 22.10.11 to 21.10.12 unlike previous year the premium was also credited to his cash credit account by opp.party No.3 and deposited to opp.party No.1 & 2 for insurance premium and during the valid insurance period i.e on 27,.12,11 in the night there was theft of mobile sets from the shop of the complainant, valued about Rs. 7,50,000.00 . The complainant came to know about this fact in the next morning and immediately reported the fact at Angul P.S on 28.12.11 and police has reported the fact of theft to be true. After reporting at P.S the petitioner also requested the opp.party No.1 & 2 to settle his claim but they refused payment on the ground that insurance was made only for damage by fire but not by theft and burglary. The complainant was astonished that when in the previous year his insurance was covering damage by theft , burglary as well as fire and allied perils , how his current period is only covered for damage by fire. The opp.parties never intimated him about limited coverage of damage by fire only. According to the complainant, if any change was made in the coverage of the insurance, the opp.parties should have intimated this fact to him but without intimating anything and without any fault of the complainant not settling the claim is illegal and arbitrary. So he has filed this case.
3. Opp.party No.2 &3 are set exparte on 27.7.2013. At a very later stage the opp.partyNo.1 has filed written version with prayer to dismiss the case of the petitioner on the grounds that the case is not maintainable , this forum has no jurisdiction to decide the matter and that the claim of the petitioner is for theft of mobile sets, where as the insurance was made for covering damages only on fire and allied perils.
4. In view of the rival pleadings of the parties ,the following issues arise for consideration:-
Issues:-
- Whether the case is maintainable or not, Whether there is cause of action to file this case and this forum has jurisdiction to decide the matter and Whether the case is barred by law of limitation.
- Whether there is consumer and service provider relationship between the parties or not ?
- Whether the petitioner is entitled to get the claim money with interest and other things from the opp.parties or not ?
- To what reliefs the parties are entitled to ?
: F I N D I N G S :
Issue No.(i):- Since within the valid insurance period the theft took place but the claim was not settled by the opp.parties, the complainant has cause of action to file the case.
The claim took place at Angul, for which the case is maintainable and this forum has jurisdiction to decide the matter.
The case has been filed within the time and it is not barred by limitation.
Issue No.(ii):- The insurance was made for the shop of the complainant and premium was paid to opp.party No.1 & 2 through opp.party No.3 Bank and opp.party No.3’s Bank was depositing the premium by crediting the amount to the Cash Credit Account of the complainant. Therefore the petitioner is a consumer/beneficiary and the opp.party No1,2 & 3 are the service providers.
Issue No.(iii) & (iv):- The shop of the complainant was insured and the premium was paid through opp.party No.3 by crediting the amount to the Cash Credit Account of the petitioner. In the previous year the insurance coverage was for theft, burglary, fire and allied perils with the same premium. The premium policy receipt for the previous period of this incident i.e for the period from 14.10.2010 to 13.10.2011 submitted by the complainant as Annexure-1 reveals that the policy was covering burglary and house breaking matter, as well as damage by fire and allied perils. When the previous year policy was covering theft and burglary matters, what made the opp.party No.1 & 2 to delete these coverage in the succeeding year i.e in 2011-12 when equal policy amount has been paid to them. If there was any change, they should have reported the fact to the complainant and after obtaining his consent, they could have deleted coverage for theft and burglary and issue the policy for fire and allied perils but the opp.parties have not intimated the complainant nor to the Banker(opp.partry No.3 ) who was paying the policy amount. Also it was the duty of the banker(opp.party No.3 ) to obtain the insurance coverage fully, unlike the previous year but they have not done it. Thus, the negligence or deficit in service is by opp.party No.1,2 & 3 but in no case the complainant can be held responsible for it. It is very important to mention here Para-2 of the Banking Ombudsman where opp.party No.3 is a party :-
“The Bank in its letter dated August,10,2012 , has stated that the representative of the Insurance Company uses to prepare the proposal of the insurance. The Insurance agent while renewing the policy of the complainant on 22.10.2012 did not cover the Burglary and House breaking clause whereas the same has been included in earlier policies, for reasons best known to him. Further, it is relevant that out of the seven policies renewed on that date only the policy of the complainant did not contain the above clause although the company has collected insurance premium at par with other six policies renewed on that day where the risk coverage of burglary and house breaking was covered. However the above institution is beyond the purview of the Banking Ombudsman Scheme, 2006.
The Bank was casual in its approach while remitting the renewal premium and failed to notice the non inclusion of the clause in the proposal form/insurance policy as admitted by it”.
This opinion of the Ombudsman very clearly proves that Bank (opp.party No.3 ) was casual in its approach while remitting the premium and failed to notice the non inclusion of the clause (theft, burglary ) in the proposal form of the insurance policy as admitted by. Further, it was the bounden duty of the insurance company, opp.party No.1 & 2 to clearly intimate the complainant as well as the banker(opp.party No.3 ) about non-inclusion of the coverage regarding theft and burglary but they have not done it. Therefore all the opp.party No.1,2 & 3 are negligent in their action and committed deficit In rendering service, for which the innocent and poor customer should not suffer . In the result opp.party No.1,2 & 3 should compensate the complainant properly towards insurance claim, mental agony, harassment and cost of litigation.
6. Hence the order:-
: O R D E R :
The case is disposed of exparte against opp.party No.2 & 3 and on contest against opp.party No.1. Opp.party No.1 & 2 are directed to pay the insurance claim amount of Rs. 7,50,000.00 (Rupees Seven Lakhs Fifty Thousand) to the complainant within 45(Fourty-Five) days of receiving this order along with 5% simple interest from the date of filing of this case i.e from 3.6.2013 till the payment is made. In case of any deviation of this order opp.party No.1 & 2 shall pay 12% quarterly compoundable interest on the award amount of Rs. 7,50,000.00 (Rupees Seven Lakhs Fifty Thousand) along with 5% simple interest from 46th day of this order till the actual payment is made. Oppp.party No.3 is directed to pay Rs.75,000.00 (Rupees Seventy-Five Thousand) towards mental agony and harassment and Rs. 10,000.00 (Rupees Ten Thousand) towards cost of litigation to the complainant within 45(Forty-Five) days of this order. In case of any deviation of this order by opp.party No.3 the above amount of Rs. 85,000.00 (Rupees Eighty-Five Thousand) will carry 12% quarterly compoundable interest from the 46th day of this order to till actual payment is made.
Order delivered in the open forum today the 28th March, 2019 with hand and seal of this Forum.
Typed to my dictation
and corrected by me Sd/-
(Sri D. C. Mishra)
Sd/- President.
(Sri D. C. Mishra)
President.
Sd/-
(Sri K.K.Mohanty)
Member
