Delhi

North

CC/95/2023

HUSAIN ANSARI - Complainant(s)

Versus

CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LTD - Opp.Party(s)

01 Aug 2024

ORDER

District Consumer Disputes Redressal Commission-I (North District)

[Govt. of NCT of Delhi]

Ground Floor, Court Annexe -2 Building, Tis Hazari Court Complex, Delhi- 110054

 

CONSUMER COMPLAINT NO. 95/2023

In the matter of

Husain Ansari,

S/o Usman Ansari, Khasra No.8

Gali No.6, Near Ayesha Masjid

Sangam Vihar, Wajirabad, Burari

North Delhi, Delhi-110064                            …                Complainant

VERSUS

Cholamandalam MS General Insurance Company Ltd.

Branch at Delhi:-

No.39, Second floor, Samyak Tower

Opp. Metro Pillar No.120, Pusa Road

New Delhi-110005

Registered Office :-

2^nd Floor, “Dare House”,

No.2, NSC Bose Road

Chennai-600001                                           ...                Opposite Party

 

ORDER

01.08.2024

(Divya Jyoti Jaipuriar)

1. By way of this complaint, the Complainant herein has challenged the repudiation letter dated 27.05.2022 issued by M/s Cholamandalam MS General Insurance Company Ltd. (Opposite Party), by which the said OP has repudiated the theft claim of the Complainant on the sole ground of delay in intimation about the theft to the OP Insurance Company.
2. The Complainant is the owner of the vehicle bearing registration no. DL8CAS4500 which was insured the OP Insurance Company for the period from 17.10.2021 to 16.10.2022. The Insured’s Declared Value (IDV) of the vehicle as per the insurance policy is Rs. 6,37,714/-. The said car was stolen from outside of the residence of the Complainant on 10.02.2022. First Information Report (FIR) was registered on the same day in the local police station i.e. Wazirabad PS vide FIR no. 003531. Thereafter the claim was lodged with the OP Insurance Company on 05.04.2022. It is stated that intimation was also given by way of telephonic communication to the customer care prior to the said date, but there is nothing on record to suggest that the information about the theft was given to the OP Insurance Company prior to the said date. Thereafter, after, examining the claim the OP Insurance Company has repudiated the claim of the Complainant vide its repudiation letter dated 27.05.2022 on the sole ground that there is a delay of 54 days in intimation to the OP insurance Company. In the repudiation letter, OP insurance Company has not taken any other ground of repudiation.
3. On filing of the complaint before this Commission by the Complainant, we issued notice to the OP. The OP has filed its reply, which was followed by filing of rejoinder by Complainant and evidence affidavit by both parties. We have heard the arguments of the parties.
4. The short question to be answered in this complaint is whether the repudiation by the OP insurance company on the ground of delay in intimation is correct or not. This issue has already been settled by Hon’ble Supreme Court in the matter of Gurshinder Singh v. Shriram General Insurance Co. Ltd [(2020) 11 SCC 612]. Hon’ble Supreme Court, while answering a reference in Gurshinder Singh (supra) case has held that if the insured has lodged the FIR in time, mere delay in intimating the insurance company about the theft cannot be ground for repudiating the claim. In the said judgment Hon’ble Supreme Court has held as under:

“18. We concur with the view taken in Om Prakash v. Reliance General Insurance [(2017) 9 SCC 724], that in such a situation if the claimant is denied the claim merely on the ground that there is some delay in intimating the insurance company about the occurrence of the theft, it would be taking a hypertechnical view. We find that this Court in Om Prakash has rightly held 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.

19. We find that this Court in Om Prakash has rightly held that the Consumer Protection Act aims at protecting the interest of the consumers and it being a beneficial legislation deserves pragmatic construction. We find, that in Om Prakash, this Court has rightly held that mere delay in intimating the insurance company about the theft of the vehicle should not be a shelter to repudiate the insurance claim which has been otherwise proved to be genuine.

20. We, therefore, hold that when an insured has lodged the FIR immediately after the theft of a vehicle occurred and when the police after investigation have lodged a final report after the vehicle was not traced and when the surveyors/investigators appointed by the insurance company have found the claim of the theft to be genuine, then mere delay in intimating the insurance company about the occurrence of the theft cannot be a ground to deny the claim of the insured.

21. We, therefore, answer the reference accordingly.”

5. While applying the same principle as laid down in Gurshinder Singh (supra) case, Hon’ble Supreme Court in the matter of Jaina Construction Co. vs Oriental Insurance Co. Ltd. [(2022) 4 SCC 527] has also held that if the insurance claim is not found to be “not genuine”, the insurance company cannot repudiate the claim merely on the ground of delay in intimation of the claim by the insured. In this context, Hon’ble Supreme Court in Jaina Constructions (supra) case held as under:

“12. In the opinion of the Court the aforestated ratio of the judgment clinches the issue involved in the case on hand. In the instant case also, the FIR was lodged immediately on the next day of the occurrence of theft of the vehicle by the complainant. The accused were also arrested and charge-sheeted, however, the vehicle could not be traced out. Of course, it is true that there was a delay of about five months on the part of the complainant in informing and lodging its claim before the Insurance Company, nonetheless, it is pertinent to note that the Insurance Company has not repudiated the claim on the ground that it was not genuine. It has repudiated only on the ground of delay. When the complainant had lodged the FIR immediately after the theft of the vehicle, and when the police after the investigation had arrested the accused and also filed challan before the court concerned, and when the claim of the insured was not found to be not genuine, the Insurance Company could not have repudiated the claim merely on the ground that there was a delay in intimating the Insurance Company about the occurrence of the theft.

6. In the case in hand, the Complainant has lodged the FIR on the same day of incident. There is no delay in filing the FIR. The delay of 54 days is only in filing insurance claim with the OP Insurance Company. Further, OP Insurance Company has only taken the ground of delay in intimation to the insurance company. It has not repudiated the claim on the ground that the insurance claim is “not genuine”. The ground of delay in intimation is not a valid ground in view of the judgments of Hon’ble Supreme Court in Gurshinder Singh (supra) and Jaina Construction (supra) cases.
7. Hence repudiation of the theft insurance claim of the Complainant by the OP Insurance on the ground of delay in intimation to OP Insurance Company is not justified and valid ground for repudiation. As a result, the said ground of repudiation as communicated vide letter dated 27.05.2022 is rejected.
8.  At this stage, we also clarify that as the OP Insurance Company has not taken any other grounds for repudiation of the claim in its repudiation letter dated 27.05.2022, OP Insurance Company is estopped from justifying repudiation on any other ground. In this context, reliance is placed on the judgment of Hon’ble Supreme Court in the matters of Galada Power & Telecommunication Ltd. v. United India Insurance Co. Ltd. [(2016) 14 SCC 161], Saurashtra Chemicals Ltd. v. National Insurance Co. Ltd. [(2019) 19 SCC 70], JSK Industries (P) Ltd. v. Oriental Insurance Co. Ltd., [IV (2022) CPJ 43 (SC): 2022:INSC:1104] and New India Assurance Co. Ltd. v. Mudit Roadways [(2024) 3 SCC 193] in which it has been repeatedly reiterated that the insurance company cannot take a new defence which did not form the basis of repudiation of the claim.
9. Hence, we are of the opinion that the OP Insurance Company is now estopped from taking recourse to any other new grounds of repudiation, which are not part of its repudiation letter dated 27.05.2022.
10. In view of the above discussion, we allow the complaint filed by the Complainant by setting aside the repudiation letter dated 27.05.2022 issued by OP Insurance Company as direct as under:
    1. OP is directed to pay the insurance claim of the IDV of the vehicle in question i.e. a sum of Rs. 6,37,714/- (Rupees Six Lakh Thirty Seven Thousand Seven Hundred and Fourteen Only) along with an interest @ 7% PA from the date of lodging insurance claim i.e. 05.04.2022, to the Complainant within a period of three weeks from the date of receipt of this order.
    2. OP is also directed to additionally pay a sum of Rs. 75,000/- (Rupees Seventy Five Thousand Only) as compensation on account of deficiency of service and litigation expenses to the Complainant within a period of three weeks from the date of receipt of this order.
    3. It is also ordered that if the OP Insurance Company does not make the payments within the stipulated time period as specified above, the entire amount payable to the Complainant at the expiry of three weeks period from the date of receipt of this order; shall carry interest @ 12 % PA till actual realisation.
11. Office is directed to supply the copy of this order to the parties as per rules. Thereafter, file be consigned to the record room.

 

 

 

 

___________________________

Divya Jyoti Jaipuriar, President

 

 

 

___________________________

Ashwani Kumar Mehta, Member

 

 

 

___________________________

Harpreet Kaur Charya, Member