PER:

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 has purchased one two wheeler vehicle i.e. Hero Electric Optima / CX bearing its registration No. PB-46-AH-4390, Chassis No. MEPHEHPSA08AL0682, Engine No. HENY2207482820, Model 2022. The above said vehicle was financed by the HDFC Bank and complainant has cleared the whole loan amount and bank has also issued one No Objection Certificate in favour of the complainant. The complainant had taken one insurance from the opposite parties bearing its policy No. D074874956/01092022, issued on 1^st September 2022 and effective up to 31^st August 2023, bearing invoice No. IA073216593 and invoice date is 1^st September 2022 and complainant paid Rs. 4490.45 Paise to the opposite parties as premium amount and insured declared value of vehicle is Rs. 62,190/-. The opposite parties have not provided the terms and conditions of the insurance policy to the complainant nor the same were ever read over and explained to the complainant and unexplained, undelivered terms and conditions of insurance policy are not binding upon the complainant.  On 29.3.2023 at about 6.00 PM the complainant parked his above said vehicle on the front side of his office and same was stolen by some unknown persons and in this regard the complainant moved one application bearing No. 60/30.3.2023 to the police of police station City Patti and police has mentioned the above said stolen property in case / FIR No. 53/2023 u/s 379 of IPC registered at Police Station City Patti. After that the complainant informed to the opposite parties, then on 24.4.2023 the surveyor of the opposite parties came in the house of the complainant and surveyor made demand of relevant documents from the complainant then the complainant provided the demanded documents i.e. name printed Cancel cheque, Pan Card, Adhaar Card, I.D. Proof, photographs, policy current year, Policy previous year, RTO information, Police complaint FIR original, form No. 28, 29, 30, purchase Invoice of vehicle, service record of vehicle, stamp paper 500/-, stamp paper 200/-, statement of last Driver, Copy of R.C., Keys, Bank Statement, Photo of Loss Location etc. and surveyor assured to the complainant that the company will provide insurance claim to the complainant within short span, but later on the opposite parties insurance company did not provide insurance claim to the complainant. The complainant number of times approached to the office of opposite party No. 2 with the request to provide insurance claim amount to the complainant but earlier the opposite parties linger on the matter under one pretext or other and now the opposite parties company have finally refused to provide insurance claim amount to the complainant. The opposite parties arbitrarily and without any reason have repudiated the claim of the complainant vide repudiation letter dated 29.6.2023 and ground mentioned in the repudiation letter is wrong, baseless and not correct.  The complainant has prayed the following relieves:-

1. To pay Rs. 62,190/- i.e. Insured Declared Value of the vehicle.
2. To pay Rs. 50,000/- as damages and compensation.
3. To pay Rs. 30,000/- as litigation expenses.

Alongwith complaint, the complainant has placed on record his affidavit Ex. C-1, Copy of Adhar Card Ex. C-2, Copy of Insurance Policy Ex. C-3, Copy of application No. 60/30.3.2023 Ex. C4, Copy of document given by the police is Ex. C-5, copy of Invoice Ex. C-6, Copy of Loan clouser letter Ex. C-7, Copy of No objection Certificate Ex. C-8, Copy of List of demanded documents Ex. C-9, Copy of Repudiation Letter Ex. C-10, Copy of Form No. 35 Ex. C-11, Copy of application to Insurance Company regarding deposit of documents Ex. C-12, photogrpahs of screen shots through which the documents have been provided through whatsapp Ex. C-13.

2        Notice of this complaint was sent to the opposite parties and opposite parties appeared through counsel and filed written version by interalia pleadings that the present complaint is legally not maintainable and is liable to be dismissed. The complainant has not come to this commission with clean hands and has concealed the material facts from this commission, therefore, the complainant is not entitled for any relief as claimed. The complainant approached the opposite parties for claim of his theft vehicle bearing No. PB46-AH-4390, Chassis No. MEPHEHPSA08AL0682, Engine No. HENY2207482820 stolen on 29^th March 2023. The said vehicle was insured with the opposite parties under policy No. D074874956. After that the opposite parties appointed investigator to investigate the alleged theft claim and during investigation the opposite parties found the following discrepancies:-

(i)      There is inordinate delay while lodging FIR in matter: Vehicle theft FIR has been lodged post twenty three material days (23) to the concerned Police Stations, however, no call made on 100/112 dial, which is excessive in itself and is a clear violation of the standard T & C of the policy condition No. 1, making the claim ineligible to be accepted on the part of opposite parties with No documentary evidence being provided on part of complainant to support his timely visit to the Police Station.

          Policy condition No. 1

          Notice shall be given in writing to the company immediately to upon the occurrence of any accident or loss or damage and in the event of any claim and thereafter the insured shall give all such information and assistance as the company shall require. Every letter claim writ summons and / or process or copy thereof shall be forwarded to the company immediately on receipt by the insured. Notice shall also be given in writing to the company immediately the insured shall have knowledge of any impending prosecution inquest or fatal injury in respect of any occurrence which may give rise to a claim under this policy. In case of theft or criminal act which may be the subject of the claim under the policy the insured shall give immediately notice to the police and co-operate with the company in securing the conviction of the offender.

The complainant failed to provide the following documents inspite of reminder letter dated 17.6.2023 issued to him

1. Purchase Invoice
2. Original RC
3. Service History
4. Loan account statement
5. Non-repossession letter/ Foreclosure report
6. FIR Copy

As the complainant failed to provide/ supply he required documents, his claim was repudiated as per terms and conditions of the policy for non-cooperation on the part of the complainant and the intimation in this regard was given to him vide letter dated 29.6.2023. The complainant has violated the terms and conditions of the Policy, therefore, he is not entitled for any claim as mentioned in the complaint. The complainant is himself negligent as he has failed to safeguard his vehicle, therefore, indirectly contributed in theft of his vehicle. The terms and conditions of the policy were explained to the complainant at the time of proposing policy and the same was served to the complainant alongwith the policy schedule. The complainant is estopped by his own act and conduct from filing the present complaint, as the complaint has been filed without any cause of action.  The complainant has got no locus standi to file the present complaint. The complainant or insured never complained regarding non-supply of terms and conditions, now the complainant has denied regarding receiving the terms and conditions, just to take undue benefits. The terms and conditions of the policy were explained to the insured/ complainant at the time of proposing policy and the same were served to the insured/ complainant alongwith the policy schedule. 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 Mir Junaid Fzyaz Ex. OP1, 2/1 alongwith documents i.e. Self attested copy of authority letter Ex. OP1, 2/2, Self attested copy of policy Ex. OP1, 2/3, self attested copy of terms and conditions Ex. OP1, 2/4, Self attested copy of reminder letter dated 17.6.2023 Ex. OP1, 2/5, Self attested copy of repudiation letter dated 29.6.02023 Ex. OP1, 2/6, Self attested copy of investigation report Ex. OP1, 2/7, Self attested copy of affidavit of investigator Ex. OP1, 2/8.

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

4        Ld. Counsel for the complainant contended that the complainant is owner of two wheeler vehicle i.e. Hero Electric Optima / CX bearing its registration No. PB-46-AH-4390, Chassis No. MEPHEHPSA08AL0682, Engine No. HENY2207482820, Model 2022. The complainant had taken one insurance policy from the opposite parties bearing its policy No. D074874956/01092022, issued on 1^st September 2022 and effective up to 31^st August 2023, bearing invoice No. IA073216593 and invoice date is 1^st September 2022 and complainant paid Rs. 4490.45 Paise to the opposite parties as premium amount and insured declared value of vehicle was Rs. 62,190/-. The opposite parties have not provided the terms and conditions of the insurance policy to the complainant nor the same were ever read over and explained to the complainant and unexplained, undelivered terms and conditions of insurance policy are not binding upon the complainant.  On 29.3.2023 at about 6.00 PM the complainant parked his above said vehicle on the front side of his office and same was stolen by some unknown persons and in this regard the complainant moved one application bearing No. 60/30.3.2023 to the police of police station City Patti and police has mentioned the above said stolen property in case / FIR No. 53/2023 u/s 379 of IPC registered at Police Station City Patti. After that the complainant informed to the opposite parties, then on 24.4.2023 the surveyor of the opposite parties came in the house of the complainant and surveyor made demand of relevant documents from the complainant then the complainant provided the demanded documents i.e. name printed Cancel cheque, Pan Card, Adhaar Card, I.D. Proof, photographs, policy current year, Policy previous year, RTO information, Police complaint FIR original, form No. 28, 29, 30, purchase Invoice of vehicle, service record of vehicle, stamp paper 500/-, stamp paper 200/-, statement of last Driver, Copy of R.C., Keys, Bank Statement, Photo of Loss Location etc. and surveyor assured to the complainant that the company will provide insurance claim to the complainant within short span, but later on the opposite parties insurance company did not provide insurance claim to the complainant.  Ld. Counsel for the complainant further contended that the opposite parties finally repudiated the genuine claim of the complainant vide repudiation letter dated 29.6.2023 and prayed that the present complaint may be allowed.

5        On the other hands, Ld. Counsel for the opposite party contended that the present complaint is legally not maintainable and is liable to be dismissed. The complainant has not come to this commission with clean hands and has concealed the material facts from this commission, therefore, the complainant is not entitled for any relief as claimed. After receiving the insurance claim request the opposite parties appointed investigator to investigate the alleged theft claim and during investigation the opposite parties found the following discrepancies:-

(i)      There is inordinate delay while lodging FIR in matter: Vehicle theft FIR has been lodged post twenty three material days (23) to the concerned Police Stations, however, no call made on 100/112 dial, which is excessive in itself and is a clear violation of the standard T & C of the policy condition No. 1, making the claim ineligible to be accepted on the part of opposite parties with No documentary evidence being provided on part of complainant to support his timely visit to the Police Station.

          Policy condition No. 1

          Notice shall be given in writing to the company immediately to upon the occurrence of any accident or loss or damage and in the event of any claim and thereafter the insured shall give all such information and assistance as the company shall require. Every letter claim writ summons and / or process or copy thereof shall be forwarded to the company immediately on receipt by the insured. Notice shall also be given in writing to the company immediately the insured shall have knowledge of any impending prosecution inquest or fatal injury in respect of any occurrence which may give rise to a claim under this policy. In case of theft or criminal act which may be the subject of the claim under the policy the insured shall give immediately notice to the police and co-operate with the company in securing the conviction of the offender.

The complainant failed to provide the following documents inspite of reminder letter dated 17.6.2023 issued to him

1. Purchase Invoice
2. Original RC
3. Service History
4. Loan account statement
5. Non-repossession letter/ Foreclosure report
6. FIR Copy

He further contended that as the complainant failed to provide/ supply the required documents, his claim was repudiated as per terms and conditions of the policy for non-cooperation on the part of the complainant and the intimation in this regard was given to him vide letter dated 29.6.2023.  The terms and conditions of the policy were explained to the complainant at the time of proposing policy and the same was served to the complainant alongwith the policy schedule and prayed that the present complaint may be dismissed.

6        From the combined and harmonious reading of documents and pleadings on record is going to prove that insurance in the present case is not disputed and theft is also not disputed. The opposite party has repudiated the claim of the complainant as per repudiation letter Ex. C-10 whereby it is stated that due to lapse on the part of the complainant and non-cooperation on the part of the complainant, the insurance claim was closed as the complainant has failed to supply the requisite documents to the opposite parties to settle the insurance claim. But we are not agreed with the opposite party regarding non co-operation on the part of the complainant as the complainant has placed on record Ex. C-12, Ex. C-13 (Colly) whereby it stands proved that he has supplied all the documents time to time as and when he is asked to provide the same. The complainant has supplied the documents to the opposite party through letters as well as Whats’app. So the opposite party cannot say that the necessary documents have not been provided by the complainant for settling the insurance claim.  7       Upon intimation, of theft, the opposite party has appointed investigator and as per report of investigator in the conclusion remarks he has stated that on investigation it is concluded that, theft occurred on reported date and time. It seems that theft location mentioned by insured is genuine. We also visited theft location, No CCTV available at theft location. As such, it is crystal clear from the investigation report of investigator who was appointed by opposite party itself. Now the opposite parties cannot raise this point that there is delay of 23 days in filing the FIR and intimation to insurance company, as the surveyor report is conclusive proof to establish the fact of theft and its day and time. The investigator of the opposite party has also annexed the list of documents submitted by the complainant to him whereby the complainant has submitted all the documents except purchase invoice, D/L of person and original R.C.  It is pertinent to mention here that the complainant has already stated that original RC has been stolen alongwith the theft of scooter and other formalities have been fulfilled by the complainant which is duly proved by the complainant vide Ex. C-12 and C-13.

7        The opposite party has also taken the objection that there is inordinate delay while lodging FIR in the said matter but we are not agreed with the opposite party because as per Ex. C-4 the complainant has duly written the letter to SHO Police Station City Patti regarding the theft on very next date of occurrence i.e. on 30.3.2023. As such, insurance company cannot repudiate the claim on this ground.  Secondly, all the requisite documents have already been supplied by the complainant as and when he is asked for the same and this fact is very much clear from the report of investigator.  Moreover, the opposite party cannot dispute the occurrence of theft regarding its date and time as the investigator has proved the theft as genuine one.

8        Furthermore, It is usual with the insurance company to show all types of green pastures to the customer at the time of selling insurance policies, and when it comes to payment of the insurance claim, they invent all sort of excuses to deny the claim. In the facts of this case, ratio of the decision of Hon’ble Apex Court in case of DharmendraGoel Vs. Oriental Insurance Co. Ltd., III (2008) CPJ 63 (SC) is fully attracted, wherein it was held that, Insurance Company being in a dominant position, often acts in an unreasonable manner and after having accepted the value of a particular insured goods, disowns that very figure on one pretext or the other, when they are called upon to pay compensation.  This ‘take it or leave it’, attitude is clearly unwarranted not only as being bad in law, but ethically indefensible.  It is generally seen that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. In similar set of facts the Hon’ble Punjab & Haryana High Court in case titled as New India Assurance Company Limited Vs. Smt.UshaYadav& Others 2008(3) RCR (Civil) Page 111 went on to hold as under:-

“It seams that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. All conditions which generally are hidden, need to be simplified so that these are easily understood by a person at the time of buying any policy.        The Insurance Companies in such cases rely upon clauses of the agreement, which a person is generally made to sign on dotted lines at the time of obtaining policy. Insurance Company also directed to pay costs of Rs.5000/- for luxury litigation, being rich.

By withholding the genuine claim of the complainant, it amounts to deficiency in service and unfair trade practice on the part of the opposite party.

9        In light of the above discussion, the complaint succeeds and the same is hereby allowed with costs in favour of the complainant. The opposite Parties are directed to make the payment of Rs. 62,190/- to the complainant. The complainant has been harassed by the opposite parties unnecessarily for a long time. The complainant is also entitled to Rs. 7,500/- as compensation on account of harassment and mental agony and Rs 5,000/- as litigation expenses. Opposite Parties are directed to comply with the order within one month from the date of receipt of copy of the order, failing which the complainant is entitled to interest @ 9% per annum, on the awarded amount, from the date of complaint till its realisation.  Copy of order be supplied to the parties free of costs as per rules. File be consigned to record room.

Announced in Open Commission

30.10.2024