Charanjit Singh, President

1        The complainant has filed the present complaint by invoking the provisions of Consumer Protection Act under Section 34, 35 and 36 against the opposite party on the allegations that the complainant is owner in possession with respect to one residential house built on plot No. 496, Khewat/ Khatoni No. 89/135, Khasra No. 271, situated in the area of Holy City, Nalagarh, Tarn Taran. On 5.4.2022, the complainant got insured his above said residential house/ building from the opposite party, after paying the premium of insurance policy to the tune of Rs. 5,477/- vide policy No. 2160/00307467/000/00 for a period of 10 years w.e.f. 5.4.2022 up to 4.4.2032. As per the said policy, the value of total sum insured in respect of the above said residential building/ house belonging to the complainant was assessed by the opposite party to the tune of Rs. 17,00,000/-. As the complainant has paid the premium of the above said insurance policy to the opposite party and as such is beneficiary of the services provided by the opposite party and complainant is consumer of the opposite party and he is legally entitled to receive the benefits as per the terms and conditions of the insurance policy being consumer of the opposite party. In the midnight of 21/22 May 2022 some valuable household articles i.e. R.O. having Price of Rs. 12,500/-, LED having price of Rs. 27,000/- Oven/ Microwave having price of Rs. 9500/-, Inverter & Battery having price of Rs. 18,500/- and watch having price of Rs. 2000/-  lying in the said residential house / building of the complainant were stolen / theft by some unknown persons in the absence of the complainant because the complainant went to his village Kot Dharam Chand Kalan Tehsil and District Tarn Taran and a FIR No. 112/2022 dated 24.5.2022 was also got lodged at Police Station City Tarn Taran U/s 380/457 IPC to this effect. On 22.5.2022 the complainant immediately informed/ intimated insurance company through Jaspal Singh employee of the opposite party, telephonically on his mobile Number 85560-53785. Further the complainant also submitted certain documents with the opposite party and as such the complainant has complied all the terms and conditions of the policy and has not violated any term and condition. The opposite party has not been disbursing  the sum insured to the complainant without any reason or fault on the part of the complainant for which the opposite party is legally duty bound to pay the same to the complainant. The complainant approached the concerned authorities many a times with the request to disburse the whole amount of sum insured to the complainant as per the insurance policy but the opposite party did not put ears to the requests of the complainant. The complainant approached the opposite party for settlement of the claim but the opposite party is not interested for settlement of the claim and they are finding ways to decline the insurance claim of the complainant on one false pretext or the other. The occurrence of theft of the house of articles of the complainant took place during the operation of the insurance policy and as such the complainant is entitled to insurance claim. Moreover a legal notice dated 25.11.2022 was also served upon the opposite party, by the complainant through his counsel from Tarn Taran, whereby the opposite party was again requested to disburse the claimed amount within the period of 15 days from the date of receipt of the said legal notice failing which the opposite party was notified that necessary action under the amended provisions of relevant Act and law would be initiated. The said notice was duly served upon the opposite party on correct address but inspite of service of the notice, the opposite party has failed to do needful as required till date.  The complainant has prayed that the present complaint may kindly be allowed by granting the following relieves in favour of complainant.

1. That the opposite parties may kindly be directed to disburse the whole claim amount/ insured amount to the tune of Rs. 1 Lack as stated above alongwith interest at the rate of 18% P.A. from the date of occurrence.
2. The opposite parties further may kindly be directed to pay an amount of Rs. 1,00,000/- as compensation on account of suffering physical as well as mental agony, torture, stress, loss to his reputation in the society caused to the complainant at the hands of opposite parties and Rs. 11,000/- as litigation expenses in the interest of justice, equity and fair play.

Alongwith the complaint, the complainant has filed affidavit of complainant Ex. C-1, Self attested copy of Insurance Policy Ex. C-2, Self attested copy of FIR Ex. C-3, self attested copy of legal notice Ex. C-4, Self attested copy of postal receipt Ex. C-5, Self attested copy of Adhar Card Ex. C-6, self attested copies of bills Ex. C-7 to Ex. C-10

2        Notice of this complaint was sent to the opposite party and opposite party appeared through counsel and filed written version by interalia pleadings that the complaint filed by the complainant is not maintainable and is liable to be dismissed as the complainant has attempted to misguide and mislead this commission. Infact complainant has suppressed material facts from this commission, as such the complaint is liable to be dismissed. The complainant has not intimated the loss to the company nor the complainant has ever lodged the claim with the opposite party as such the present complaint is pre mature and liable to be dismissed on this simple score. Insurance contracts are complainant based on ‘Utmost Good Faith’ and that the deceased/ Proposer being a party to the contract is bound to disclose all material facts known to him at the time of proposal. The Proposer/ deceased under a legal and solemnly obligation to disclose all material facts correctly,  honestly and truthfully to the insurance company at the time of obtaining the policy, failing which the contract is rendered void. The contract of insurance is based on the Doctrine of Uberrimae Fide and even if any due diligence is done by the insurance company, it does not change the basic element of an insurance contract. The insured is obliged to give full and correct information on all matters, which would influence the judgment of a prudent insurer in determining whether he will accept the risk and if he would at what rate of premium and subject to what conditions.  The complainant has concealed and has suppressed the material and relevant facts of the case. The complaint has been filed with malafide and dishonest intention and has not only concealed the material facts from this Commission but has also twisted and distorted the same to suit their own convenience and to mislead this Commission. The complainant has acted in bad faith with respect to subject of this complaint and has approached this commission with unclean hands, hence in view of doctrine of clean hands ‘one who comes up to equity must come with clean hands’. The complaint deserves no fate other than out right dismissal. As no claim has ever been lodged by the complainant but in order to succeed in the present case the complainant has distorted the facts.  The complainant has filed the captioned complaint with the sole motive to gain illegally at the cost of opposite party. The complaint is therefore liable to be dismissed in limine. The complainant has unnecessarily dragged the opposite party in to uncalled litigation under the garb of Consumer Protection Act and as such the complaint is liable to be dismissed with heavy costs. The present complaint is not maintainable for want of cause of action as from a simple perusal of the whole complaint it is clear that there no cause of action has arisen in favour of the complainant and against the opposite party. The policy issued to the complainant was subject to certain terms and conditions. The alleged occurrence has taken place on 22^nd May, 2022 and the FR was lodged on 24.5.2022 which creates doubt about the alleged incident even no intimation has been given to the opposite party as per the terms of the policy. The opposite party has denied the other contents of the complaint and prayed for dismissal of the same. Alongwith the written version, the opposite party has placed on record affidavit of legal Manager of OP Ex. OP1/A, copy of insurance policy Ex. OP2.

3        We have carefully gone through the record and heard Ld. counsel for complainant and opposite party.

4        Without touching the merits of the case, we have to see the objection taken by the opposite party that the present complainant has not intimated the loss to the company nor the complainant has ever lodged the claim with the opposite party, as such, the present complaint is pre-mature.

5        From the perusal of the file, neither the complainant nor the opposite parties have placed on record any document i.e. repudiation letter which reveals that the claim of the complainant has been decided. Infact the claim has not been decided so far and the same is still pending.  In case Balu Waman Kadam vs. ICICI Lombard General Insurance Co. IV (2013) CPJ 16A (CN) (Mah.), the matter was similar, wherein the Insurance Company was asking the complainant to submit the documents again and again and the complainant was alleging that he had already submitted the requisite documents to the Insurance Company. In such circumstances, the Hon’ble State Consumer Disputes Redressal Commission Maharashtra disposed of the matter, by directing the Insurance Company to reconsider the claim of the complainant within one month on receipt of the required documents from the complainant. 

6        While relying upon the above said authority, the Hon’ble State Commission, Punjab, Chandigarh passed the similar orders in case M/s Trends, through its Proprietor vs The Oriental Insurance Company Limited & Anr. Consumer Complaint No.245 of 2015 decided on 04.08.2017; and M/s Gurbir Rice Mills v. United India Insurance Company Ltd. & Ors. Consumer Complaint No.404 of 2016, decided on 09.10.2017, directing the Insurance Company to reconsider the claim of the complainant after submission of requisite documents by the complainant to it. 

7        In view of our above discussion as well as keeping in view the ratio of above said judgments, we are of the opinion that the ends of justice would be met, if the Insurance Company be directed to decide the claim of the complainant, after the complainant submit all the requisite documents and lodge his claim.

8        In view of the above discussion, the present complaint is disposed of with the direction to the complainant to submit the claim to the opposite party-Insurance Company for deciding the claim within a period of 15 days from the date of receipt of copy of order and on approaching the complaint for supplying the requisite documents, the opposite party will issue proper receipt acknowledging the same. The opposite party shall decide the claim of the complainant within a further period of two months therefrom and in case of failure on the part of the opposite party, the claim case of the complainant deemed to have been accepted.  Copies of the order be furnished to the parties as per rules. File is ordered to be consigned to the record room.

Announced in Open Commission

31.1.2024