O R D E R
SRI BIJAYA KUMAR DAS,PRESIDENT:-
Deficiency in service in respect of illegal repudiation of insurance claim of the complainant’s theft vehicle’ are the allegations arrayed against the Opp.Party
2. Briefly describing the complaint, it reveals that complainant is a owner of 10 wheeler TATA truck bearing Regd. No.OR-09L0961,its Chasis No. is 42603IJaRZ016009 and Engine No.80H62706634 by availing a loan from State Bank of India and complainant was paying the installments regularly. Complainant was insured his vehicle with OP-Insurance Company with a IDV of Rs.10 lakh by paying the requisite premium. The insurance of the vehicle was valid from dtd.11.10.12 to midnight of dtd.10.10.2013.Complaint petition also reveals that on dtd.22.04.13 at about 11 PM when the driver was parking the vehicle near Nehru Bungalows, Market complex, Paradeep went for dinner after finishing the dinner the driver located that the vehicle has been stolen. The theft of vehicle was reported to concerned Police station and insurance company and a complaint case was filed before JMFC,Kujanga(P) bearing No.ICC 129/2013 and Ld,.JMFC directed the IIC,Marine Police Station,Jagatsinghpur for investigation. Complainant also deposited all the relevant documents before OP-Insurance Company for settlement of his claim in support of receipt of the documents,OP issued a receipt on dtd.09.06.14.In the circumstances, complainant requested the OP to settle the claim for maintenance of his family and repayment of loan dues, but OP on dtd. 11.06.15 denied to comply the same and refused to return back the original documents, which compelled the complainant to institute the proceeding. The cause of action of the case arose on dtd.11.06.15. The complainant prays this Forum to get back the insured amount of Rs.10 lakhs along with the up-to-date interest and Rs.2 lakhs for mental agony and Rs.5,000/- as cost of litigation in Toto Rs.12 lakhs and five thousand only.
3. Being noticed OP-Insurance Company appeared through their Ld.Counsel and filed written statement admitting the fact that complainant gave a telephonic message on dtd.23.04.13 of theft of vehicle and on dtd.23.04.13 OP wrote a letter(Annexure-A) to complainant to produce certain documents and complainant submitted his claim form on dtd.09.06.14(Annexure-B) OP appointed a licensed investigator for making preliminary investigation. It is revealed from the written version that complainant filed a complaint case before the JMFC(P),Kujanga bearing I.C.C.No.129/2013 on the direction of the Hon’ble JMFC the complaint was registered as a F.I.R. and after due investigation the Investigating Officer submitted final report as true but no clue. The copy of the ICC and final report are marked as (Annexure-C and Annexure-D). Annexure-H is the report of the Investigator. Complainant was further asked to submit documents accordingly a letter was issued on dtd.09.06.14. It is further revealed from the written version that after scrutinizing the documents produced by the complainant, it is found that there was no confirmation regarding fixation of IDV, no confirmation of NCB and no explanation was given regarding delay of lodging of FIR. OP-Insurance Company wrote a letter(Annexure-E) to the complainant on dtd.27.02.15 by giving an opportunity to clarify the said questions raised for settlement of claim. As the complainant did not substantiate regarding false declaration of NCB eligibility the claim was rightly repudiated and was intimated to the complainant vide letter dtd.29.06.15. The letter is annexed as Annexure-F. It is further stated that complainant by making a false declaration availed the benefit of 25 per cent less payment of total premium more so complainant suppressed the fact that his policy was compelled for dishonor of cheque by the previous insurer i.e.New India Assurance Co.Ltd. The letter of New India Assurance dtd. 18.01.15 is marked as( Annexure-G). OP-Insurance Company further submits that after considering all the aspects, and suppression of material facts and as per GR 27 of India Motor Tariff Rules the OP has rightly repudiated the claim of the complainant. Hence, the complaint deserves to be dismissed with cost.
4. Heard the arguments advanced by Ld. Counsels for the parties, perused the Annexure and written notes on argument. The undisputed facts of the case are that complainant insured his vehicle bearing Regd. No.OR-09-L-0961 with the OP-Insurance Company and the insurance was valid from dtd.11.10.2012 to midnight of dtd. 10.10.2013. It is also undisputed that OP-Insurance Company on dtd.23.04.13 received a telephonic message regarding theft of complainant’s vehicle on dtd.22.04.13 at about 10 PM from Nehru Bungalow market complex, Paradeep. It is further admitted that the claim of the complainant has been repudiated. It is a fact that theft of vehicle on dtd.22.04.13 was registered as FIR U/S-379 IPC Dt.07.05.13 before Marine Police Station,Paradeep was on the direction of JMFC(P) Kujanga in the I.C.C. No.129/2013. Further, it is a fact that after receipt of direction of Ld. JMFC Investigating Officer inquired into the allegation and filed final report before JMFC(P) Kujanga with opinion ‘fact is true but no clue’(Annexure-D).
The repudiation of the claim of the complainant was on following grounds as cited by OP-Insurance Company in the written statement.
- No confirmation regarding fixation of IDV.
- No confirmation of NCB( No claim Baus) by suppressing material information as per GR.27 India Motor Tariff Rules.
- Delayed in lodging FIR before Police and no further investigation by police.
It is to be decided by this Forum that whether the grounds of repudiation as stated by the OP-Insurance Company are in accordance with Law or not ?
In settlement of claim in respect of ‘theft of vehicle’ paramount importance is given on two points 1st immediate information to police and lodging of FIR and 2nd timely intimation to the OP-Insurance Company about the theft of the vehicle. In the present
dispute complainant narrate the facts of lodging and Registration of FIR which is substantiated by the report of the Investigator in his observation(Annexure-H pg.29,para-20) opines that the fact of theft of the vehicle on dtd.22.04.15 and delay in lodging and registration of FIR on dtd.07.05.13 the ‘clarification of the complainant insured is a fact. Thus, disbelieving the version of the Investigator can not be far from the fact.
On second point intimation of theft of vehicle on dtd.22.04.13 had been communicated to OP on dtd.23.04.13 over telephone is an admitted fact. So in these valid points we do not find any latches on part of the complainant. OP-Insurance Company on repudiating the claim on other grounds that complainant-insured by giving a false declaration availed the NCB(No claim Benus) and there was no confirmation of IDV ( insured declared value). As per GR No.27 India Motor tariff the complainant is not entitled to any benefit under the policy. It is undisputed that the policy was valid from dtd.11.10.12 to midnight of dt.10.10.13 and the IDV of the vehicle is Rs.10 lakhs. The submission of OP-Insurance Company that as the complainant has suppressed material informations regarding insurance of vehicle, hence the claim was repudiated though intimation was given to complainant-insured to furnish the details of NCB through letter dtd. 27.02.15(Annexure-E). The acknowledgement of the said letter is disputed. OP-Insurance Company failed to produce any evidence that the said letter was delivered to the complainant-insured, when the acceptance of letter is disputed. Further regarding fixation of IDV it is our opinion that it is also the duty of the OP-Insurance Company that to verify the confirmation of IDV is the equal responsibility of the OP-Insurance Company, shifting the responsibility on the shoulder of complainant when settlement of the claim arises can not legally sustainable. The Policy was obtained on dtd.11.10.12 and theft of vehicle was occurred on dtd.22.04.13 in the meantime the OP-Insurance Company has not taken any steps to verify the confirmation of IDV. This plea of the OP-Insurance Company is not legally sustainable, rather it is an after thought expression to avoid the liability of settlement of claim. In number of decisions the Hon’ble National Commission has opined that if immediate intimation is not given to the police and insurance authorities which is a gross violation of insurance policy or contract, but in the instant case complainant has complied these legal obligations. When the occurrences of theft of vehicle was reported to the concerned police station and information was given to the Op-Insurance Company without any delay, in such a situation the other grounds of repudiation may be a fact of breach of contract, but the OP-Insurance Company can not repudiated the claim on a total loss basis. In this regard we rely on a decision of the Hon’ble Apex Court in case of National Insurance Co.Ltd.-Vrs- Nitin Khandelwala reported in 2008,CTJ 680(SC). It is important to mention paragraph 13 of the judgment “ the vehicle has been snatched or stolen. In the case of theft of vehicle breach of condition is not germane. The appellant Insurance Company is liable to indemnify the owner of the vehicle when the insurer has obtained comprehensive policy for the loss caused to the insurer. The respondent submitted that even assuming that there was a breach of condition of the insurance policy, the appellant insurance company ought to have settled the claim on non-standard basis. The Insurance Company can not repudiate the claim in Toto in case of loss of vehicle due to theft.” A similar facts of the case was disposed of by this Forum bearing C.C.No.46/2014.
On the above citations, it is clear that the repudiation of claim of the complainant in respect of the theft of vehicle bearing No.OR-09L-0961 is illegal and can not sustain in eye of law. It reveals from the Insurance policy that the vehicle was manufactured in the year 2008 and the IDV is of Rs.10 lakhs. Hence, by deducting 15 per cent of the IDV will be the legitimate claim of the complainant towards loss of the vehicle. Accordingly Rs.1.5 lakhs is deducted from the total IDV which comes to the tune of Rs.8.5 lakhs(Rupees Eight lakh and fifty thousand)only which is to be awarded to the complainant by the OP-Insurance Company.
Having our observation reflected above, it is directed that OP-Insurance Company will pay Rs.8.5 lakhs(Rupees Eight lakh and fifty thousand)only to the complainant along with 4.5 per cent simple rate of interest calculating from dtd.09.06.14 the date of lodging of claim application from till its realization, failing which 9 per cent interest will be charged for the delayed period. The order is to be carried out within one month of receipt of this order.
Complaint is allowed in part on contest.
No order as to cost.
Pronounced in the open Court, this the 20th January.2016.
