West Bengal

Siliguri

CC/16/72

MRS. BIJAYA ADHIKARI - Complainant(s)

Versus

BRANCH MANAGER - Opp.Party(s)

KAKOLI BOSE

09 May 2024

ORDER

Sri Ranjan Ray, Ld. Member

                          

FINAL ORDER/ JUDGEMENT

This complaint U/S 12 of C.P. Act, 1986 was initially filed against the Opposite Parties (O.P.s) – 1) The Branch Manager, Reliance General Insurance Co. Ltd., Siliguri Branch, Geetanjali Complex, 1^st Floor, Sevoke Road, Siliguri, West Bengal and 2) Divisional Manager, Reliance General Insurance Co. Ltd., Kolkata Branch, 38-B, 8^th Floor, Himalaya House, J. L. Nehru Road, Kolkata- 700071 who contested the case by filing Written Version (W.V.).

 

                        The brief complaint of the complainant is as follows-

The complainant was a registered owner of a truck/ vehicle being registration No.- NL 20L 3403 with National Permit, Model- TATA/LPT 2518 3STR/ 5883 cc, Engine No. 21B62968031, Chassis No. MAT448030BSJ40775, year of manufacture- March, 2012, insured declared value Rs. 15,56,300/- (Rupees Fifteen Lac Fifty Six Thousand and Three Hundred) only and the said vehicle was insured with O.P. No.1 (Reliance General Insurance Co. Ltd.), valid up to from 20:44 hours on 21.02.2014 to midnight of 20.02.2015. The said vehicle was white and red in colour and the left side colour of the said vehicle was yellow. The name of the driver of the said vehicle was Ranjit Singh, S/O Bhravan Singh, P/A Gulabbag, Dist.- Purnia, Bihar and the said vehicle used to carry goods enroots to Purnia (Bihar), Bengal, Assam and other places.

On 21.07.2014 the driver of the said vehicle proceeded from Siliguri with the said empty vehicle and reached at Sree Guru Dasmes Road, Bej transport, Barsoni, Bihar at about 10:00 a.m. where he parked the vehicle and locked it keeping all vehicle related papers/ documents like registration certificate, insurance certificate, tax token, pollution certificate, route permit and authorization letter etc. inside the vehicle and thereafter he went to the transport office for rest. At that time said vehicle was parked in front of the said transport office. On 22.07.2014 around 1:00 a.m. the driver woke up and noticed that the vehicle was not there where he parked it before going to rest. The driver then and there started searching the vehicle but failed to trace out and subsequently he informed the fact to the complainant over phone and the complainant rushed there and came to know everything from his driver and lodged a written complaint through her driver at Dagarua P.S. of Dist.- Purnia, Bihar. Subsequently Dagarua P.S. started a specific case being Case No. 229/2014, dated 22.07.2014, u/s 379 of I.P.C. The police authority took up the investigation but failed to recover the vehicle and also failed to apprehend anyone involved with the offence and finally submitted a Final Report before the Hon’ble C. J. M., Purnia, Bihar.

Since the vehicle was insured with O.P. No.1 and a valid policy of insurance was issued by the O.P.s, on payment of premium of Rs. 48, 501/- (Rupees Forty Eight Thousand Five Hundred and One) only including service tax etc. as required toward the insured value of the said vehicle amounting to Rs. 15,56,300/- (Rupees Fifteen Lac Fifty Six Thousand and Three Hundred) only against theft, missing, accidental damage etc. and said policy was valid from the period of 21.02.2014 to 20.02.2015 and the complainant also intimated said fact of missing of the vehicle to the O.P. No.1 with all relevant documents on 24.07.2014 and claimed the said insurance amount of Rs. 15,56,300/- (Rupees Fifteen Lac Fifty Six Thousand and Three Hundred) only. The complainant also made necessary correspondence and intimation to the District Transport Officer, Nagaland and got a reply letter from them on 16.09.2014 confirming the registration no. of the vehicle along with other particulars.

The complainant incompliance with all requirements of the O.P.s for settling the claim sent/ handed over all the relevant documents in respect of the vehicle to the O.P. No.1 but the O.P. No.1 refused to give any receipts of the same and the innocent aged complainant with little knowledge trusted the words of O.P. No.1. In spite of complying all formalities relating with the valid and genuine claim the O.P.s continued to issue different letters to him only for deferring and delaying or avoiding to settle the claim and finally on 26.03.2016 the O.P. No.2 issued a letter to the complainant refusing the claim of the complainant as closed, virtually denying the claim of the complainant on the ground of non submission of different documents. The complainant is an illiterate, aged and ailing woman with her old aged ailing and bed ridden husband of 82 years and finally, having no alternative the complainant filed this complaint.

The prayers of complainant are as follows :

 

1. To pass an order directing the O.P.s to pay Rs. 15,56,300/- (Rupees Fifteen Lac Fifty Six Thousand and Three Hundred) only to the complainant.
2. To pass an order directing the O.P.s to pay Rs. 30,000/- (Rupees Thirty Thousand) only to the complainant as harassment and mental agony.
3. To pass an order directing the O.P.s to pay Rs. 10,000/- (Rupees Ten Thousand) only and interest of 9% per annum from the date of missing the vehicle till realization.
4. Any other further order/ orders as the Ld. Commission may deem fit and proper.

List of Documents filed by the complainant:

1. Photocopy of formal F.I.R. of Dagarua P.S., dated 22.07.2014. (Annex.-1, Page 1)
2.  Photocopy of certified F.I.R. lodged by Ranjit Singh on 22.07.2014 before the Dagarua P.S. (Annex.-2, Page 2)
3. Photocopy of Final Report, dated 14.01.2015. (Annex.-3, Page 3 to 6)
4. Photocopy of petition for acceptance of Final Report. (Annex.-4, Page 7 to 8)
5. Photocopy of insurance certificate being Policy No.1507542334000092, valid up to from 20:44 hrs. on 21.02.2014 to midnight of 20.02.2015 of Reliance General Insurance Co. Ltd., Siliguri Branch, Geetanjali Complex, 1^st Floor, Sevoke Road, Siliguri, West Bengal. (Annex.-5, Page 9)
6. Photocopy of letter of the complainant addressed to the District Transport Officer, Nagaland. (Annex.-6, Page 10)
7. Photocopy of letter of Govt. of Nagaland, dated 16.09.2014. (Annex.-7, Page 11)
8. Photocopy of driving license in the name of Ranjit Singh. (Annex.-8, Page 12 and 13)
9. Photocopy of final closure dated 26.03.2016 of Reliance General Insurance Co. Ltd. vide reference No. 2141098002, addressed to the complainant. (Annex.-9, Page 14)
10. Original receipt of O.P. of Order Sheet, F.I.R. and Final Report.
11. One Certified copy (Total 9 pages) of original form.
12. Original insurance certificate.
13. Original Final Closure, dated 26.03.2016.

On behalf of the Opposite Parties (O.P.s)- 1) The Branch Manager, Reliance General Insurance Co. Ltd., Siliguri Branch, Geetanjali Complex, 1^st Floor, Sevoke Road, Siliguri, West Bengal and 2) Divisional Manager, Reliance General Insurance Co. Ltd., Kolkata Branch, 38-B, 8^th Floor, Himalaya House, J. L. Nehru Road, Kolkata- 700071 who contested the case by filing Written Version (W.V.) and as per their W.V. the case is as follows.

 

As per the W.V. of the O.P.s the vehicle in question was duly insured with them but the same was always subject to certain terms, conditions exclusions and definitions contained therein. The complainant lodged the intimation regarding the incident if there be any, to the O.P.s on 24.07.2014, i.e., after elapse of 2 (two) days without showing any reasonable cause therein, whereas as per Condition No.1 of the policy, it should have been lodged immediately upon the occurrence of any such incidence in the event of any claim arising out of the policy. Moreover, it is the prima- facie duty of the insured to give all such information and assistance as the Insurance Company shall require for processing the claim as per terms and conditions of the policy. Soon after receipt of intimation on 24.07.2014 from the complainant, the O.P.s immediately appointed the Investigator, namely Dipak Das to investigate to investigate the claim initially and also intimated about the same to the complainant vide letter dated 25.07.2014 and thereafter the O.P.s appointed the 2^nd Investigating Agency, namely, “PRISM” on 06.08.2014 for investigating into the matter who surveyed the matter and submitted his Final Report on 28.08.2014 to them. But after lodging a simple intimation on 24.07.2014 the complainant had never turned up to provide the relevant documents in support of her claim which were very much required by the company to process a claim of such type and kept silence for period and ultimately, the O.P. vide Letter/ Reminder dated 06.11.2015, 20.11.2015 and 18.02.2016 requested the complainant to furnish the requisite documents as mandatory to process a theft claim. Since there was no response given by the complainant to them towards aforesaid letters/ reminders on several times and as such the O.P.s having no alternative option and finally vide letter dated 26.03.2016 they informed the complainant that the Insurance Company could not keep a file open for an indefinite period for non-submission of the necessary requisite documents by the complainant/ insured and hence her claim was closed.            

 

List of documents filed by the O.P. No.1 are as follows :

 

1. Photocopy of the letter dated 25.07.2014 given by the O.P. to the complainant.

 

2. Photocopy of the letter dated 06.11.2015 (Reminder-1) given by the O.P.to the complainant.

 

3. Photocopy of the letter (Reminder-2) dated 20.11.2015 given by the O.P. to the complainant.

 

4. Photocopy of the letter (Reminder-3) dated 18.02.2016 given by the O.P. to the complainant.

 

5. Photocopy of the letter dated 26.03.2016 regarding “Final Closure of Claim” given by the O.P. to the complainant.

 

6. Copy of 2008 (2) CPR 232 (NC), Dijabar Sahoo Vs. The Branch Manager.

 

Having heard, the Ld. Advocate of both the side and on perusal of the Complaint, Written Version and documents filed by the parties the following points are taken to be decided by this Commission.

 

 

 

POINTS FOR CONSIDERATION

 

 

1) Whether the complainant is a consumer?

2) Whether the case is maintainable under the CP act 2019?

3) Whether this Commission has its jurisdiction to decide this case? 

4) Whether there is any deficiency in service in the part of the O.P. as alleged by the complainant?

5) Is the complainant is entitled to get any award and relief as prayed for? If so, what extent?

           

DECISION WITH REASONS

 

            All the points are taken up together for consideration and decision.

Seen and perused the complaint petition and Written Version filed by the parties which are supported by the affidavit, documents filed by the parties. We are also heard arguments of both the parties in full length.

 

The complainant presently residing at Netaji Pally, P.S.- Matigara, Dist.- Darjeeling, West Bengal (as mentioned in the complaint) and the O.P. No.1 is carrying his business in Sevoke Road, Siliguri,. Thus, the Commission has its territorial jurisdiction to decide this case as per the Consume Protection Act, 1986 and Consumer Protection Act- 2019. 

 

The complainant purchased a policy being Policy No.1507542334000092 from the O.P.s which was valid up to from 20:44 hrs. on 21.02.2014 to midnight of 20.02.2015 and thus, the Commission has no doubt that the complainant is a very much consumer as per the Consume Protection Act, 1986 and Consumer Protection Act- 2019.

 

At the time of argument Ld. Advocate of the Complainant submits that the Complainant has been able to prove its case against the O.P not only through his Written Deposition but also by producing documents.

 

In this case, copy of the insurance policy submitted by the complainant being Policy No. 1507542334000092for her vehicle and the validity period of the policy was from 20:44 hrs. on 21.02.2014 to midnight of 20.02.2015. On 21.07.2014 the driver of the said vehicle proceeded from Siliguri with the said empty vehicle and reached at Sree Guru Dasmes Road, Bej transport, Barsoni, Bihar at about 10:00 a.m. where he parked the vehicle and locked it keeping all vehicle related papers/ documents like registration certificate, insurance certificate, tax token, pollution certificate, route permit and authorization letter etc. inside the vehicle and thereafter he went to the transport office for rest. At that time said vehicle was parked in front of the said transport office. On 22.07.2014 around 1:00 a.m. the driver woke up and noticed that the vehicle was not there where he parked it before going to rest. The driver then and there started searching the vehicle but failed to trace out and subsequently he informed the fact to the complainant over phone and the complainant rushed there and came to know everything from his driver and lodged a written complaint through her driver at Dagarua P.S. of Dist.- Purnia, Bihar. Subsequently Dagarua P.S. started a specific case being Case No. 229/2014, dated 22.07.2014, u/s 379 of I.P.C. The police authority took up the investigation but failed to recover the vehicle and also failed to apprehend anyone involved with the offence and finally submitted a Final Report before the Hon’ble C. J. M., Purnia, Bihar.

Since the vehicle was insured with O.P. No.1 and a valid policy of insurance was issued by the O.P.s, on payment of premium of Rs. 48, 501/- (Rupees Forty Eight Thousand Five Hundred and One) only including service tax etc. as required toward the insured value of the said vehicle amounting to Rs. 15,56,300/- (Rupees Fifteen Lac Fifty Six Thousand and Three Hundred) only against theft, missing, accidental damage etc. and said policy was valid from the period of 21.02.2014 to 20.02.2015 and the complainant also intimated said fact of missing of the vehicle to the O.P. No.1 with all relevant documents on 24.07.2014 and claimed the said insurance amount of Rs. 15,56,300/- (Rupees Fifteen Lac Fifty Six Thousand and Three Hundred) only. The complainant also made necessary correspondence and intimation to the District Transport Officer, Nagaland and got a reply letter from them on 16.09.2014 confirming the registration no. of the vehicle along with other particulars.

The complainant incompliance with all requirements of the O.P.s for settling the claim sent/ handed over all the relevant documents in respect of the vehicle to the O.P. No.1 but the O.P. No.1 refused to give any receipts of the same and the innocent aged complainant with little knowledge trusted the words of O.P. No.1. In spite of complying all formalities relating with the valid and genuine claim the O.P.s continued to issue different letters to him only for deferring and delaying or avoiding to settle the claim and finally on 26.03.2016 the O.P. No.2 issued a letter to the complainant refusing the claim of the complainant as closed, virtually denying the claim of the complainant on the ground of non submission of different documents. The complainant is an illiterate, aged and ailing woman with her old aged ailing and bed ridden husband of 82 years and finally, having no alternative the complainant filed this complaint.

In support of their defense, the O.P.s argued in the W.V. that the vehicle in question was duly insured with them but the same was always subject to certain terms, conditions exclusions and definitions contained therein. The complainant lodged the intimation regarding the incident if there be any, to the O.P.s on 24.07.2014, i.e., after elapse of 2 (two) days without showing any reasonable cause therein, whereas as per Condition No.1 of the policy, it should have been lodged immediately upon the occurrence of any such incidence in the event of any claim arising out of the policy. Moreover, it is the prima- facie duty of the insured to give all such information and assistance as the Insurance Company shall require for processing the claim as per terms and conditions of the policy. Soon after receipt of intimation on 24.07.2014 from the complainant, the O.P.s immediately appointed the Investigator, namely Dipak Das to investigate to investigate the claim initially and also intimated about the same to the complainant vide letter dated 25.07.2014 and thereafter the O.P.s appointed the 2^nd Investigating Agency, namely, “PRISM” on 06.08.2014 for investigating into the matter who surveyed the matter and submitted his Final Report on 28.08.2014 to them. But after lodging a simple intimation on 24.07.2014 the complainant had never turned up to provide the relevant documents in support of her claim which were very much required by the company to process a claim of such type and kept silence for period and ultimately, the O.P. vide Letter/ Reminder dated 06.11.2015, 20.11.2015 and 18.02.2016 requested the complainant to furnish the requisite documents as mandatory to process a theft claim. Since there was no response given by the complainant to them towards aforesaid letters/ reminders on several times and as such the O.P.s having no alternative option and finally vide letter dated 26.03.2016 they informed the complainant that the Insurance Company could not keep a file open for an indefinite period for non-submission of the necessary requisite documents by the complainant/ insured and hence her claim was closed.   

From the evidence of the O. P.s it is very much clear that the insurance company has knowledge of this theft incident of said vehicle and in their W.V. they mentioned that they had appointed investigator/ investigating agency but no such investigating report was filed by the O.P.s.  In this case this Commission is of the view that if immediate action is taken informing the police about theft and some delay is caused in filing the claim the Insurance Company cannot close/ repudiate the claim.

 

This Commission finds that the C.P. Act aims at protecting the interest of the consumers and it being beneficial legislation deserves pragmatic construction. This Commission also finds that mere delay in intimating the Insurance Company about the theft of the vehicle should not be a shelter to close/ repudiate the insurance claim which has been otherwise proved to be genuine. The immediate notice/ intimation to the Insurance Company is in the context of occurrence of any accidental loss or damage and in the event of any claim. In case of theft or criminal act which may be the subject of a claim under this policy, the insured shall give immediate notice to the police and cooperate with the company in securing the conviction of the offender.

 

In this instant case, we can refer the decision of the Hon'ble NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI, IV (2023) CPJ 240 (NC) where it held that-

 

Consumer Protection Act, 1986 - Sections 2(1)(g), 14(1)(d), 21(b)- Insurance – Theft of vehicle – Repudiation of claim – Delay in intimation – Deficiency in service – When insured has lodged FIR immediately after theft of vehicle occurred and when police had lodged final report after vehicle was not traced and when surveyor/ investigators appointed by Insurance Company have found claim of theft to be genuine, mere delay in intimating Insurance Company about occurrence of theft cannot be ground to deny claim of insured – Condition of policy shows that immediate notice/ intimation to Insurance Company is in context of occurrence of any accidental loss or damage and in event of any claim – In case of theft or criminal act which may be subject of claim under this policy, insured shall give immediate notice to police and cooperate with company in securing conviction of offender – Repudiation of claim of respondent on sole ground that there was delay of 21 days in intimating Insurance Company is not valid -State Commission was right in allowing appeal and setting aside order of District Forum – No illegality or material irregularity or jurisdictional error in order of State Commission.

 

In this situation the Commission always follows the decision of the Hon’ble NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION and this Commission has no right to ignore the decision of the Hon’ble NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION of India.

 

In view of the above, we find that repudiation of the claim of the complainant on the sole ground that there was delay of 2 days in intimating the Insurance Company is not valid.

Hence, it is therefore,

 

O R D E R E D

 

That the Consumer Case No. 72/2016 be and same is allowed on contest against the O.P.s (Reliance General Insurance Company Limited). The O.P.s are jointly and severally liable in this case.

The O.P.s are directed to pay Rs 11, 67, 225/- (75 % of Rs. 15,56,300/-) (Rupees Eleven Lakhs Sixty Seven Thousand Two Hundred and Twenty Five) only to the complainant along with a simple interest @ 6% Per Annum from the date of filing of this case, i.e., 27/07/2016 by an Account Payee cheque in favour of the complainant within 45 days from the date of this order. The complainant is also entitled to get Rs. 5,000/- (Rupees Five Thousand) only for mental pain and agony and litigation cost and O.P. is also directed to deposit Rs. 5,000/- (Rupees Five Thousand) only to Consumer Legal Aid Account of this Commission within 45 days from the date of this order.     

Let a copy of this judgment be given to the parties directly or through their representative Ld. Advocate for compliance free of cost.