PRESENT:-
Complainant by Adv. Wankhede present.
O.P.by representative Shri. Prakash Kasbale present.
ORDER
(Per- Shri. S.V.Kalal, Hon’ble Memebr.)
1. The Complainant has filed this complaint under Section 12 (1) (a) of C.P. Act,1986 against the Opponent, alleging deficiency in service and unfair trade practice on the part of part of Opponent.
2. The brief facts of the complaint are that it is the contention of complainant that he had purchased one vehicle insurance policy of Opponent insurance company through the insurance Agent & paid premium of Rs. 23,194/- and the policy period was 12.01.2011 to 11.01.2012. It is submitted by the complainant had on 02.09.2011 while the vehicle was running on road towards Jolgoan along with same passenger the driver stopped the vehicle at Shirpur for urinating and suddenly the passenger who were sitting inside the vehicle runway along with the vehicle & the theft of vehicle took place. The complainant reported the fact of theft to the concerned insurance Agent and requested him to lodge the claim to Opponent. But the said insurance Agent did not respond properly therefore the complainant straight away lodged the claim to Opponent on 13.09.2011. But Opponent repudiated the said claim vide their letter dated 25.07.2012 stating the reason of breach of policy condition No. 5. It is contended by the complainant that the policy conditions were not given to the complainant at the time of insurance of the policy therefore Opponent is guilty of deficiency of service and unfair trade practice by repudiating the claim. Hence complainant has filed the complaint against Opponent . The complainant has prayed for settlement of his vehicle theft insurance claim from O.P. for the amount of ID value of Rs.8,56,197/- and requested to direct the O.P. to pay Rs.1,00,000/- as compensation for inconvenience , and Rs.50,000/- towards cost of the litigation.
3. Complainant has filed their AOE, Policy document, Insurance claim acknowledged by Opponent, Repudiation letter of Opponent dated 25.07.2012 , FIR report etc. on record.
4. On the contrary Opponent has filed their Written Statement. It is contended by Opponent that the complainant filed by complaint is frivolous , bad in law, and there is no cause of action against the Opponent. Further complainant is guilty of gross violations of terms of policy i.e. the driver of complainant left the vehicle in custody of stranger passenger who fled with the vehicle. Therefore the claim of complainant is not admissible and there is no deficiency in service and unfair trade practice followed by Opponent.
5. Opponent has filed their AOE and written Argument & other paper on record.
6. Forum perused the record and in view of the contentions of both parties and supporting documents and argument the matter has been adjudicated as under.
7. It is admitted fact that the complainant has paid premium as consideration to Opponent. Further it is admitted that theft of vehicle has taken place.
8. The point of dispute or grievance that Opponent has repudiated the claim of complainant stating the reasons 1) breach of policy condition No.5 which insist for the insured to take reasonable steps to safeguard the vehicle from the loss & 2) breach of policy conditions as to immediate/prompt notice to be given to insurance company.
9. It is contended by the complainant that the policy was purched through the insurance agent and complainant reported the theft to the insurance Agent on the same day of theft, but the insurance Agent did not respond to the complainant. Further it is seen from the record that FIR was lodged at Shirpur police satation on the same day, and claim was submitted to Opponent just within 10 days and it was acknowledged by Opponent on 13.09.2011. More over the repudiation letter does not show the reason of breach of condition about immediate/prompt notice to be given to insurance company. There fore the forum does not find any merit in the contention of Opponent about breach of policy condition of immediate / prompt notice to be given to O.P.
10. Further it is contended that O.P. that complainant has also breached the policy condition No.5 as to take reasonable steps to safeguard the vehicle from the loss. In this regard O.P. has filed one National Commission Judgment in the case of Batta Valji Laxman V/s I.C.I.C.I. Lombard journal Insurance Company. On the contrary the complainant contends that the terms and conditions of the policy were not given to him at the time of issuance of policy.
11. It is admitted that the Driver of the vehicle left the vehicle just for a moment of Urination and the vehicle was not left for very long time of few minutes. The passengers in side the vehicle were strangers and it was not expected by the driver that, the stranger passengers would fled away along with the vehicle. Therefore the forum is of the view that the incidence of theft of vehicle is an unexpected event. We have pursed the land mark judgment filed by Ld. Advocate Mr. Wankhede on record in the matter of National Insurance Company Ltd. V/s Nitin Khandalwal wherein the Hon’ble Apex court allowed the vehicle theft insurance claim on ‘ Non slandered basis’.
12. As regard to clam rejected by O.P. the forum is of the view that complainant has purchased insurance policy from O.P. The act of O.P. of rejecting the insurance clam hits the basic principal and the original concept of insurance. Even though the driver left the vehicle for a moment of urination the un excepted event of theft of vehicle is happened . therefore the complainant has suffered a heavy financial loss which can be regarded as contingency and in such event the policy holder is excepted to be indemnified by the insurance company. In this case O.P. has totally neglected the concept of insurance by repudiating the claim filed by complainant, which amount s to deficiency in service and adopting unfair tread practice by O.P. Therefore it is concluded that O.P. has indulged deficiency in service and adopting unfair tread practice in settling the insurance claim of the complainant. We are of the opinion that the afore said landmark judgment of the Hon’ble Apex Court is logically applicable in present case and the matter can be adjudicated accordingly.
13. In view of the above facts and circumstances the forum pass following order.
ORDER
RBT Complaint No. 454/2012 is partly allowed.
2. It is here by declared that the Opponent has indulged deficiency of
service and unfair trade practice by not settling the vehicle theft
Insurance claim submitted by the complainant.
- Opponent is directed to pay 75% ofID valueofthevehiclei.e.
Rs.6,42,148/- within 30 days from the date of receipt of this order.
failing Which the penalty of interest @ 9 % p.a. from the date of
filing this Complaint shall be charged till realization of the entire
amount along with the interest.
- The Opponent is directed to pay Rs. 5,000/-to the Complainant towards
the cost of the Complaint and Rs.10,000/- towards mental and physical
harassment litigation expenses.
- Certified copies of this order be furnished to both the parties.
