Punjab

StateCommission

A/10/2080

Reliance General Insurance Company Ltd. - Complainant(s)

Versus

Harleen Kaur - Opp.Party(s)

Rajneesh Malhotra

17 Apr 2015

ORDER

                                                               FIRST ADDITIONAL BENCH

 

STATE  CONSUMER  DISPUTES  REDRESSAL  COMMISSION, PUNJAB

          SECTOR 37-A, DAKSHIN MARG, CHANDIGARH.

                                     

                   First Appeal No.2080 of 2010

 

 

                                                          Date of Institution: 08.12.2010

                                                          Date of Decision:  17.04.2015

 

 

Reliance General Insurance Company Limited, having its Branch Office at SCO 122, Ranjit  Avenue, Opposite Amritsar Improvement Trust Complex, Amritsar through its Branch Manager/Principal Officer (Through its Manager Legal) Reliance General Insurance Company, SCO No.212-214, First Floor, Sector 34-A, Chandigarh 1600034.

                                                                                                                                                                   …..Appellant/Opposite party

         

                                      Versus

 

Harleen Kaur wife of Sh.Navjot Singh r/o 133, Defence Colony, Jalandhar presently at 3-A, Kashmir Avenue, Amritsar, Punjab

 

                                                          …..Respondent/Complainant

 

         

First Appeal against order dated 11.10.2010 passed by the District Consumer Disputes Redressal Forum, Amritsar

Quorum:-

 

          Shri J. S. Klar, Presiding Judicial Member.

          Shri Vinod Kumar Gupta, Member

          Shri Harcharan Singh Guram, Member

 

Present:-

 

          For the appellant              :         Sh.Rajneesh Malhotra, Advocate.

          For the respondent          :         Sh.Munish Goel, Advocate

 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

 

J.S KLAR, PRESIDING JUDICIAL MEMBER :-

         

          The appellant (the opposite party in the complaint) has directed this appeal against  the respondent of this appeal (the complainant in the complaint), challenging  order dated 11.10.2010 of District Consumer Disputes Redredssal Forum Amritsar, accepting the complaint of the complainant by directing the OP now appellant to pay the insured amount to the complainant together with compensation of Rs.5,000/- thereupon. The instant appeal has been preferred against the same by the OP now appellant.

2.      The complainant Harleen Kaur has filed the complaint U/s 12 of the Consumer Protection Act, 1986 (in short, "the Act") against the OP on the averments that she insured her Ford Fiesta Car bearing registration No.PB08-BA-0133 with the OP for insured amount of Rs.5,80,000/- for the period from 31.12.2008 to 30.12.2009 against premium of Rs.13,880/-, as the complainant hired the services of the OP for consideration and, thus, became its consumer. The above-referred  car of the complainant was unfortunately stolen by some unknown persons on 09.01.2009 resulting into FIR No.10 dated 09.01.2009 lodged by the complainant at Police Station Sadar Amritsar U/s 379 of IPC. The vehicle was not traced and complainant sent intimation to the OP regarding fact of theft of the vehicle with request to disburse the insured amount of Rs.5,80,000/- to the complainant. The complainant visited the OP but to no effect. The OP is under contractual obligation to indemnity the complainant for the loss value of the car on account of its theft.  The complainant has accordingly filed the consumer complaint directing the OP to pay the insured declared value of the car, which is of the amount of Rs.5,80,000/- to the complainant, besides compensation along with interest, besides Rs.20,000/- as costs of litigation.

3.      Upon notice, OP appeared and filed written reply raising preliminary objections that the claim of the complainant has been repudiated on the ground that there is no deficiency in service on the part of the OP. The OP sent a letter dated 04.01.2010 to the complainant asking her to state the previous policy submitted by the complainant at the time of applying for this insurance.  The complainant had declared when she insured her vehicle with the OP, that it was already insured with the other insurance company. The complainant did it just to avoid the pre-inspection of the insured vehicle. The complaint of the complainant was not found genuine being in breach of the terms and conditions of the insurance contract. Notice was issued to the complainant on 04.01.2010 by giving 10 days time, as to why the insurance claim be not repudiated. There is violation of condition no.8 of the insurance policy on the part of the complainant in this case thereby rendering the contract of insurance as invalid. The date of loss of the vehicle is 01.08.2009, but the complainant lodged the insurance claim with the OPs on 28.01.2009 after a delay of 20 days therefrom and thereby deprived the OP to conduct the enquiry into the matter. The complaint of the complainant is alleged to be frivolous and vexatious and merited dismissal under Section 26 of the Act. It was admitted by OP that OP insured the car of the complainant against payment of premium. No previous insurance policy was produced despite declaration of the complainant to this effect that the car was already insured, when the complainant insured the vehicle with the OP and it was done with the sole aim of avoiding the pre-inspection of the insured vehicle. There is, thus, delay in intimating the loss of the car to the OP and thereby the complainant violated condition no.8 of the insurance policy and hence OP prayed for dismissal of the complaint.

4.      The complainant tendered in evidence the affidavit of complainant Ex.C-1, copy of the report ExC-2, copy of FIR Ex.C-3, copy of report Ex.C-4, copy of report Ex.C-5, copy of letter Ex.C-6, copy of insurance policies Ex.C-7 and Ex.C-8.  As against it, OPs tendered in evidence affidavit of Sh. Suresh Chandra Bishnoi, Manager of the OP Ex.R-1, copy of final notice dated 08.02.2010 Ex.R-2, letter dated 04.01.2010 Ex.R-3, insurance document Ex.R-4, detail of cover note Ex.R-5, cover note of Reliance General Insurance Ex.R-6, letter dated 04.12.2009 Ex.R-7, letter dated 29.06.2009 Ex.R-8, claim form Ex.R-9, policy document of Reliance General Insurance Ex.R-10, Reliance Private Car Package Policy Ex.R-11. On conclusion of evidence and arguments, the District Forum, Amritsar  accepted  the complaint of the complainant directing the OP to pay the insured amount of the vehicle to the complainant, besides compensation of Rs.5000/-. Dissatisfied with the order of District Forum Amritsar dated 11.10.2010, the OP now appellant carried this appeal against the same.  

5.      We have heard learned counsel for the appellant and have also examined the record of the case.

6.      This fact is undisputed in this case that the complainant insured the Ford Fiesta Car bearing registration No.PB08-BA-0133  with the OP, vide cover note no.94528 by paying the premium. The complainant is a consumer of the OP, as complainant has paid the premium for the insurance of the car. The foremost submission of the counsel for the appellant is that the complainant showed previous cover note Ex.R-4 issued by the United India Insurance Company for the period from 31.12.2007 to 30.12.2008 and thereby got carried the insurance policy from the OP for the vehicle. On seeing old cover note issued by the United Insurance Company, the OP issued the cover note Ex.R-10 insuring the vehicle of the complainant for the period from 31.12.2008 to 30.12.2009 for insured declared value of Rs.5,80,000/-. It was submitted that the complainant did it manipulatively just to avoid any pre-inspection of the car by the OP. We have carefully examined the submissions on this point in the light of evidence on the record. Ex.C-1 is affidavit of Harleen Kaur complainant on the record in support of her averments, Ex.C-2 is the intimation regarding sending the untraced report with regard to theft of the car by the police, Ex.C-3 is copy of the FIR dated 09.01.2009 and complainant lodged this First Information Report regarding theft of her car bearing No.PB08 BA 0133 ON 09.01.2009, Ex.C-4 is the untraced report sent by the SHO Police Station Sadar about this case, Ex.C-5 is statement of HC Balwant Singh regarding sending case as untraced, Ex.C-6 is application of the complainant to DTO intimating the fact of theft of the car, Ex.C-7 and Ex.C-8 are the policy documents issued by the OP on the record. OP tendered in evidence the affidavit of Sh. Suresh Chandra Bishnoi, Assistant Manager of OP Ex.R-1 on the record. Ex.R-2 is letter addressed to the complainant on 08.02.2010, Ex.R-3 is letter addressed to the complainant on 04.01.2010 by the OP, Ex.R-4 is cover note issued by United India Insurance Company of the car of the complainant. Ex.R-4 is vital document on the record and it has made it clear that car of the complainant with Engine/Chassis No.40497 with manufacturing year of the car as 2007 has been insured with United India Insurance Company Limited for the period from 31.12.2007 to 30.12.2008 in the name of the complainant Harleen Kaur. Ex.R-4 has, thus, made it clear that this cover note pertains to Series No.B 94525. The contention of the OP now appellant falls on the ground that the vehicle was not previously insured with United India Insurance Company and complainant only avoided any pre-inspection of the vehicle, when she took the policy from the OP. Ex.R-5 is policy issued by the OP for the period 31.12.2008 to 30.12.2009 of the vehicle of the complainant, Ex.R-6 is policy document of the OP, Ex.R-7 is letter dated 04.12.2009 issuing show-cause to complainant, why her insurance claim be not repudiated, Ex.R-8 is letter dated 29.06.2009 calling the complainant to produce the documents, Ex.R-9 to Ex.R-11 are policy documents. On the basis of the previous cover note Ex.R-4 proving the fact of previous insurance of the vehicle, the contention of the OP now appellant falls to the ground that vehicle was not previously insured.

7.      The next submission of the OP now appellant is the delay in submission of the insurance claim by the complainant with the OP, alleged to be breach of the terms of the insurance policy. We find that the car of the complainant was stolen on 08.01.2009 and FIR was lodged just thereafter by the complainant with the Police Station Sadar Amritsar on 09.01.2009, vide Ex.C-3. The car was stolen by some indentified persons and they were not apprehended by the police and consequently the untraced report was sent by the police regarding the factum of theft of the car, vide Ex.C-4 and Ex.C-5. Copy of statement of HC Balwant Singh on the record. The complainant also intimated  the District Transport Officer about the theft of the car. Now what is the effect of late intimation regarding theft of the car sent by the complainant to the OP has to be examined by us. The submission of the OP as raised before us is that complainant intimated the theft of car to OP after 20 days, as pleaded in Para No.3 of the written reply on merits for the loss of the vehicle. The forceful submission of the OP now appellant is that they have been deprived of the right to enquire into the matter due to delayed intimation. The OP sought repudiation of the contract of the insurance on the above-referred grounds in this case, Clause No.8 of the Contract of Insurance is alleged to have been violated by the complainant in this case. We find that there is only 20 days delay in this case in reporting the matter to the insurance company, as per pleaded case of the insurance company/OP. FIR was lodged about this theft without any amount of delay on the part of the complainant. Had the vehicle been not stolen, there was no question on the part of the complainant in reporting the police about the theft of the vehicle just thereafter. Our attention has also been drawn to the Circular dated 22.09.2011 issued by the Insurance Regulatory and Development Authority, which is to the extent and is relevant and reads as under :

"INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY

Ref: IRDA//HLTH/MISC/CIR/216/09/201

Date : 20.09.2011

CIRCULAR

To : All life insurers and non-life insurers

Re : Delay in claim intimation/documents submission with respect to

i. All life insurance contract and

ii. All Non-life individual and group insurance contracts.

The Authority has been receiving several complaints that claims are being rejected on the ground of delayed submission of intimation and documents. The Insurance Regulatory & Development Authority advised all the insurers need to develop a sound mechanism of their own to handle such claims with utmost care and caution. It is also advised that the insurers must not repudiate such claims unless and until the reasons of delay are specifically ascertained, recorded and the insurers should satisfy themselves that the delayed claims would have otherwise been rejected even if reported in time.

8.      The gist of the circular issued by the Insurance Regulatory & Development Authority has, thus, pinpointed such type of claims should not be rejected mechanically and they should be repudiated only, where the insurance company is of the view that even on merits, there is no claim of the insured. We, thus, find that above-referred circular enjoins upon the insurance company to settle the genuine claim, when there is delay of intimating the loss of them due to some unavoidable circumstanced. There is delay of 20 days in this case and FIR was lodged forthwith by the complainant, intimation regarding theft of the vehicle and intimation was also given to District Transport Officer. Consequently, we do not find any reason that genuine claim of the complainant should be thrown out on account of some delay of 20 days in reporting the matter to the insurance comapny.

9.      As a result of our above discussion, we have not come across any illegality in the order of the District Forum calling for any interference therein. The order of the District Forum Amritsar dated 11.10.2010 is, thus, affirmed in this appeal. Finding no merits in the appeal, the same is hereby dismissed.

10.    The appellant has deposited an amount of Rs.25,000/- with this Commission at the time of filing the appeal. This amount with interest, if any, accrued thereon, be refunded by the registry to the complainant by way of crossed cheque/demand draft after  45 days from receipt of copy of this order.

11.    Arguments in this appeal were heard on 10.04.2015 and the order was reserved. Now the order be communicated to the parties.

120.  The appeal could not be decided within the statutory period due to heavy pendency of court cases.

 

                                                                          (J. S. KLAR)

                                                             PRESIDING JUDICIAL MEMBER

                       

 

                                                                (VINOD KUMAR GUPTA)

                                                                             MEMBER

 

 

 

                                                            (HARCHARAN SINGH GURAM)

                                                                             MEMBER

 

April 17   2015.                                                              

(ravi)