Orissa

Cuttak

CC/51/2016

Mahani Behera - Complainant(s)

Versus

Chairman,National Insurance Company - Opp.Party(s)

R C Nayak & associates

21 Oct 2022

ORDER

IN THE COURT OF THE DIST. CONSUMER DISPUTES REDRESSAL COMMISSION,CUTTACK.

      C.C.No.51/2016

Mahani Behera,

S/O:Nakula Behera,

At:Kentalo,Mallipur,P.O:Asureswar,

P.S:Nischintakoili,Disty:Cuttack.                                                        ... Complainant.

 

                                                Vrs.

1.        Chairman,National Insurance Company,

3, Midleton Street,P.B.No.9229,Kolkatta-700071.

 

2.        Branch Manager,

National Insurance Company,

Dhenkanal Branch Office,South Madhuban Kunja Kanta,

Dhenkanal-750001.                                                                     ... Opp. Parties.

 

 

Present:               Sri Debasish Nayak,President.

                                Sri Sibananda Mohanty,Member.

 

Date of filing:    19.04.2016

Date of Order:   21.10.2022

 

For the complainant:          Mr. R.C.Nayak,Adv. & Associates.

For the O.Ps              :           Mr. B.N.Udgata,Adv. & Assocites.

 

Sri Debasish Nayak,President                          

            Case of the complainant as made out from the complaint petition in short is that he had insured his vehicle bearing Regd. No.OR-04G-5127 which was stolen on 17.04.2009.  The G.R.case was initiated through his FIR vide G.R.Case no.209 of 2009 but unfortunately, the same was closed due to insufficiency of evidence.  The petitioner had claimed for insurance since because he had a valid policy bearing no.163801/31/08/6300000821 even though he had complied to all the queries as made by the O.P insurance company, his claim was repudiated for which he had approached several Forums like the Ombudsan, the Hon’ble High Court and ultimately has also filed this case seeking compensation to the tune of Rs.20,00,000/- towards his vehicle bearing Regd. No. OR-04G-5127which has been stolen away.

            The complainant has filed copies of his insurance papers, the report of the Ombudsman etc in order to prove his case.

2.         On the other hand, the O.Ps have contested this case and have filed their written version jointly wherein they have urged that the case of the complainant is not maintainable which is liable to be dismissed, the same is barred by limitation, bad for non-joinder of necessary parties and mis-joinder unnecessary parties, hit by principles of estopel,acquisance and waiver.  The O.Ps admit about the Tata LPT 15T truck of the complainant bearing Regd. No. OR-04G-5127 which was insured with effect from 26.6.2008 to 25.6.2009.    On 22.4.2009, the O.Ps were intimated about the theft of the said vehicle for which as per procedure surveyor-cum-loss assessor was deputed who had submitted his report on 30.12.2009 wherein he had submitted that on 17.4.2009, the vehicle of the complainant while parked near his residence at Village:Kental which was stolen and the matter was reported at Nischintakoili police station.  In the morning of 18.4.2009 the complainant had found the truck to be missing for which he had lodged FIR at Nischintakoili P.S on 18.4.2009.  It appears from the written version of the O.Ps, the complainant was asked to provide the related documents of the vehicle in question vide letter dt.2.2.11 but since because the complainant had failed to provide those, the O.Ps through their letter dt.9.5.11 had intimated the complainant about the closure of the account.  Thus, they have prayed to dismiss the case of the complainant.

            The O.Ps have filed several copies of documents in order to prove his case.

3.         Keeping in mind the averments as made in the complaint petition together with the contents of the written version, this Commission is of a view to settle the following issues in order to arrive at a proper conclusion.

i.          Whether the case of the complainant is maintainable ?

            ii.         Whether there was any deficiency in service on the part of the O.Ps ?

            iii.        Whether the complainant is entitled to the reliefs as claimed ?

            In order to further their case, the O.Ps have filed evidence affidavit of one Kailash Chandra Nayak wherein the contents of the written version are reiterated only.

Issue no.ii.

            Out of the three issues, issue no.ii being the pertinent one is taken up first for consideration here in this case.

            Admittedly, the complainant had insured his truck bearing No. OR-04G-5127 with the O.Ps and the said truck was stolen while being parked at his Village:Kental in the night of 17.4.2009.  The fact of theft was known to the complainant in the morning on 18.4.2009 and he had filed FIR to that effect at Nischintakoili P.S.  Though G.R.Case was initiated it was closed due to insufficiency of evidence.  There is no dispute that the policy was in force during the theft of the said vehicle of the complainant.  On perusal of the letter of the O.Ps as regards to the closure of the claim, the same indicates that the complainant had not provided the documents as required for settling his claim for which the O.Ps had to close his claim amount.  On the other hand, the complainant has stated to have provided all the necessary documents in order to initiate and settle his claim.    The complainant has relied upon a decision of Hon’ble Supreme Court in Civil Appeal no.15611 of 2017 in the case of Om Prakash Vrs. Reliance General Insurance & Anr. wherein it is held that it is common knowledge that a person who lost his vehicle may not straightaway go to the Insurance Company to claim compensation.  At first, he will make efforts to trace the vehicle.  It is true that the owner has to intimate the insurer immediately after the theft of the vehicle.  However, this condition should not bar settlement of genuine claims particularly when the delay in intimation or submission of documents is due to unavoidable circumstances.  The decision of the insurer to reject the claim has to be based on valid grounds.  Rejection of the claims on purely technical grounds in a mechanical manner will result in loss of confidence of policy-holders in the insurance industry.  If the reason for delay in making a claim is satisfactorily explained, such a claim cannot be rejected on the ground of delay.  It is also necessary to state here that it would not be fair and reasonable to reject genuine claims which had already been verified and found to be correct by the Investigator.  The condition regarding the delay shall not be a shelter to repudiate the insurance claims which have been otherwise proved to be genuine.  It needs no emphasis that the Consumer Protection Act aims at providing better protection of the interest of consumers.  It is a beneficial legislation that deserves liberal construction.  This laudable object should not be forgotten while considering the claims made under the Act.  Be that as it may, law is well settled and the Hon’ble Apex Court has categorically observed that the insured can only provide the documents those which are in his possession and the demand of the documents those which are not in possession of the insured will not entitle to repudiate the claim.  It would be pertinent to mention here about the decision In the case of Gurmel Singh Vrs. Branch Manager,National Insurance Co.Ltd. 2022 LiveLaw(S.C) 506 wherein their lordships  have held that Insurance companies refusing claim on flimsy grounds and/or technical grounds- While settling the claims, the insurance company should not be too technical and ask for the documents, which the insured is not in a position to produce due to circumstances beyond his control.  Accordingly, here in this case as it seems that the complainant had provided all the documents those which were in possession for settling his insurance claim and the documents those which were not in his possession and were out of reach of his possession; should not have been demanded by the O.Ps of this case.  Thus, closing the insurance claim account as made due to want of documents appears to be unilaterally and arbitrarily done and this signifies the deficiency in service on the part of the O.Ps.  Accordingly, this issue is answered.

Issues no.i & iii.

            From the discussions as made above, it is noticed that when the complainant could not get his genuine claim amount he had to file this case and the case is definitely maintainable and the complainant is entitled to the reliefs as claimed by him.  Hence it is so ordered;

                                                            ORDER

            The case is decreed on contest against the O.Ps who are found to be jointly and severally liable here in this case.  The O.Ps are thus directed to pay the claim amount of Rs.20,00,000/- to the complainant with interest thereon @ 12% per annum with effect from 22.4.2009 till the total amount is quantified.  This order is to be carried out within a period of 30 days from the date of receipt of copy of this order.

Order pronounced in the open court on the 21^st day of   October,2022 under the seal and signature of this Commission.           

                                                                                                                                Sri Debasish Nayak

                                                                                                                                            President

                       

                                                                                                                                                             Sri Sibananda Mohanty

                                                                                                                                                Member