Karnataka

Bangalore 4th Additional

CC/15/1675

A.V. Vijaya Bhaskar Reddy, S/o. P.R. Venkataramaiah, - Complainant(s)

Versus

HDFC ERGO General Insurance Company Ltd, - Opp.Party(s)

15 Jun 2018

ORDER

Complaint filed on: 29.09.2015

                                                      Disposed on: 15.06.2018

 

BEFORE THE IV ADDL DISTRICT

CONSUMER DISPUTES REDRESSAL FORUM, BENGALURU

 1^ST FLOOR, BMTC, B-BLOCK, TTMC BUILDING, K.H.ROAD, SHANTHINAGAR, BENGALURU – 560 027       

 

 

CC.No.1675/2015

DATED THIS THE 15^th JUNE OF 2018

PRESENT

 

 

SRI.S.L.PATIL, PRESIDENT

SMT.N.R.ROOPA, MEMBER

 

	Complainant/s	V/s	Opposite party/s
	A.V.Vijaya Bhaskar Reddy, S/o P.R.Venkataramaiah, Aged about 33 years, Office at No.19/1, F-7, KCD Complex, CSI Compound, Mission Road, 3rd Cross, Bengaluru-27.   By.Adv.B.S.Ravi Kiran	1	HDFC ERGO General Insurance Company Ltd., No.6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East) Mumbai-400 059.
		2	The Regional Manager, Claims-South HDFC ERGO General Insurance Company Limited., No.25/1, 2nd Floor, Building No.2, Shankarnarayana Building, M.G.Road, Bengaluru-560 001.   By.Adv.S.Krishna Kishore

 

PRESIDENT: SRI.S.L.PATIL

1.       This complaint has been filed by the complainant as against the Opposite Party directing to pay Rs.2,28,000/- towards compensation as per policy, to pay Rs.1,50,000/- as compensation towards mental agony and financial loss, to grant the costs of the proceedings

2.       The brief facts of the case of the complainant are that he is the owner of four wheeler vehicle “TATA Indica V2”, 2008 model and the same is registered before Regional Transport Officer, Bangalore (South) having registration No.KA-05-MF-5892 (hereinafter referred as the said car). The Complainant purchased the vehicle for his own use. The vehicle insured from time to time and during the relevant point of time, the same was insured with the Opposite Party Insurance Company and the same was effective from 5.6.2013 to 4.6.2014 midnight, under Policy No.2311200273449601001. The Complainant has paid in total a sum of Rs.4,542/- towards insurance premium and it covers total sum assured insured declared value is Rs.2,28,000/-. The said insurance policy issued by the Opposite Party has covered all risks including that of theft and other risks as per provisions Motor Vehicles Act, 1988. On 26.10.2013, the Complainant drove the said vehicle to native place and returned on the same day evening and while returning from his native place also visited his brother-in-law’s house situated at Mulbagal Town and reached Mulbagal Town at about 8.00 p.m. Since the Complainant did not wish to drive at night and also on the suggestion of the other family members, the Complainant on 26.10.2013 intended to left the car in his brother-in-law’s house and further the Complainant’s brother-in-law’s house was renovating, the Complainant had to park the vehicle in his brother-in-law’s friend’s house, which is situated nearby the Complainant’s brother-in-law’s house. The Complainant after parked the car on 26.10.2013 left to Bangalore in a bus. After 26.10.2013 because of his hectic schedule, did not return to Mulbagal where his car was parked and to drive back the same to Bangalore. On 29.10.2013, the Complainant received a call from his brother-in-law and also his friend that the Complainant’s vehicle which was parked in front of brother-in-law’s friend’s house was stolen on 28.10.2013 night. The Complainant immediately rushed to the Mulbagal town and enquired about the incident with his brother-in-law and his friend. After he rushed to the spot on 29.10.2013, he and his brother-in-law and others searched the Complainant stolen car in and around the Mulbagal and also surrounding areas of Mulbagal. When, the Complainant did not trace out the vehicle on 29.10.2013, immediately on the next day i.e. on 30.10.2013 lodged a police complaint before the jurisdiction police at Mulbagal Police Station at Mulbagal requesting the jurisdictional police to trace out the stolen vehicle. After lodged a complaint before the jurisdiction police at Mulbagal Police Station, the Complainant also called the Opposite Parties Insurance Company i.e. through its agents Basanth Kumar having given the number in the policy itself issued by the Opposite Parties and also other numbers, the call received by one Ms/Mrs.Nirmala who in turn informed the Complainant that sent all relevant papers such as RC Book, Insurance Policy, complaint and FIR to her through the Email address. The jurisdiction police at Mulbagal Police Station after due search were unable to trace out the Complainant’s vehicle. Since the jurisdictional police did not trace out the Complainant’s vehicle and hence issued C- report to the Complainant. After C-report is submitted by the police on 18.7.2014, the Complainant contacted the Opposite Parties and requested for claim form and the Complainant was submitted the claim form and sought for release of sum assured under the insurance policy. After the receipt of the Complainant’s form, issued a claim No.C230014043901, vehicle No.KA05/MF5892. After receipt of the Complainant’s claim instead of allowing the Complainant’s claim on 17.12.2014 issued a claim rejection letter, wherein the Opposite Party rejected the claim of the Complainant. The Complainant submits that the Opposite Parties bound to pay sum assured amount covered under the policy issued by them in respect of the vehicle of the Complainant. There is no dispute with the insurance company that the theft was taken place during the effective date of the insurance i.e., on 28.10.2013. The Opposite Parties allegedly observed in his letter dt.17.12.2014 that the Complainant reported the claim on 18.07.2014 i.e. almost 258 days from the date of accident. The above observation of the Opposite Parties is false. The Complainant followed all formalities immediately after the theft of the vehicle. The Complainant as per advice given by the call-center of the Opposite Parties submitted a claim form after receipt of the report i.e., C-report from the jurisdictional police at Mulbagal. The Complainant received the C-report from the jurisdictional police on 17.7.2014 and immediately i.e., on 18.7.2014 submitted a claim form before the Opposite Parties. Thus, there is no delay attributed to the Complainant in submitting the claim form before the Opposite Party. The Complainant is entitle for amount i.e., sum assured from the Opposite Parties. The Opposite Parties are bound to pay the same to the Complainant as per insurance policy. The Complainant is a consumer as defined under the consumer act. Hence, this complaint filed for recovery of sum assured under the policy issued by the Opposite Parties to the Complainant and also for damages.      

3.       After the issuance of the notice, the Opposite Parties 1 and 2 did appear and filed the version denying the contents of the complaint filed by the Complainant. The Opposite Party never denied the issuance of policy. Further, it is not in dispute at the time of theft of the said car, the policy was in force. The only contention taken by the Opposite Party is that the Complainant was informed about the so called theft of his car on 28.10.2013 to the Opposite Parties till 18.7.2014. Further there is delay of 10 days to report the theft to the police.  Hence, the police submitted the B-report on the basis of the complaint filed by the Complainant. As the Complainant violated the terms and conditions, immediately not reporting the theft to the concerned police as well as the Opposite Party. In this context, the claim is repudiated by it, is just and proper.  On these grounds and other grounds, prays for dismissal of the complaint.

4.       The Complainant to substantiate his case, filed his affidavit evidence. The Opposite Party has also filed affidavit evidence. Though documents produced by both the parties, did not mark. The Complainant as well as the Opposite Parties has filed their written arguments. Heard both sides.

           5. The points that arise for our consideration are:

       1) Whether the Complainant proves the deficiency in service on

            the part of the OPs, if so, whether he is entitled for the relief

            sought for?

        2) What Order?

                  

6.  Our answers to the above points are as under:

Point No.1 : Negative

Point No.2 : As per the final order for the following

REASONS

7. POINT NO.1 :   We have briefly stated the contents of the complaint as well as the version of the Opposite Parties. Looking to the available material on record, the declared value of the said car was about 2,28,000/-.

8.       On 26.10.2013, the Complainant parked the said car in front of the brother-in-law friend’s house at Mulbagal. On 29.10.2013, the Complainant received a call from his brother-in-law and also his friend that the Complainant’s said car which was parked in front of brother-in-law friend’s house was stolen on 28.10.2013 night. In this context, he lodged the complaint before jurisdictional police on 30.10.2013. The concerned police after due inspection submitted the C-report stating that the said car is not traced.  It is also the case of the Complainant that he called the representative of the insurance company i.e. through its agents Basanth Kumar having given the number in the policy itself issued by the insurance company i.e.telephone No.91-9845378678 and also other numbers. According to the Complainant, the said call received by one Mrs.Nirmala who in turn informed the Complainant that sent all relevant papers such as RC book, insurance policy, complaint and FIR to her through the e-mail. In this context, the learned counsel for the Opposite Party submits that when exactly the Complainant has telephone to the insurance company in respect of informing the theft is not disclosed by the Complainant. After submitting the claim petition, the Opposite Party by its letter dt.17.12.2014 rejected the claim and sent a letter. In this context, we place reliance on the claim rejection letter found at list of documents at Sl.No.6 of green ink page No.22 wherein it has been specifically stated that “you reported the claim at our call centre on 18.7.2014 i.e.almost 258 days from the date of accident.”  In that regard, condition No.1 of the policy has been violated. In this context, we would like to extract the condition No.1 as incorporated in the rejection letter dt.17.12.2014 which read thus:

“Notice shall be given to the company immediately upon the occurrence of any accidental or loss or damages and in the event of any claim and thereafter the insured shall give all such information and Assistance as the company shall require”

Referring to this, we place reliance on the decision cited by the learned counsel for the Opposite Party reported in

1.       First Appeal No.321/2015 in the case of New India Assurance Company Ltd., V/s Trilochand Jane, held by Hon’ble National Commission and

2.       First Appeal No.141/2009 in the case of New India Assurance Company Ltd., V/s Ram Avtar

We place reliance on the said decisions. In the said decisions, the word “immediately” incorporated in the terms and conditions has been elaborately discussed. In the said decision, delay in reporting the police in respect of the theft as well as to the insurance company has been meticulously considered. Even in delay in reporting the theft after 9 days to the insurance company is fatal. Hence, claim has been repudiated. In the instant case, the theft was reported on the next day and informed to the Opposite Party after 258 days. If the theft has been reported to the Opposite Parties, they could have assisted to the police to trace the said car. Hence, the said decision squarely applicable to the contents taken by the Opposite Party in repudiating the claim. In view of this matter, we come to the conclusion that the claim repudiated by the Opposite Party is just and proper and also there is no deficiency of service on the part of the Opposite Parties. Accordingly, this point is answered in the negative.

9.       POINT NO.2: In the result, we pass the following:

ORDER

The complaint filed by the Complainant is dismissed.

Looking to the circumstances of the case, we direct both the parties to bear their own cost.

Supply free copy of this order to both the parties.

          (Dictated to the Stenographer, got it transcribed, typed by her/him and corrected by me, then pronounced in the open Forum on 15^th June 2018).

(ROOPA.N.R)     MEMBER	(S.L.PATIL)  PRESIDENT

 

 

1. Witness examined on behalf of the complainant/s by way of affidavit:

A.V.Vijaya Bhaskar Reddy., who being the Complainant was examined. 

 

Copies of Documents produced on behalf of Complainant/s:

 

Doc-1	Original RC book dt.6.6.2008
Doc-2	Original insurance policy dt.5.6.2013
Doc-3	Complaint dt.30.10.2013
Doc-4	Original FIR dt.30.10.2013
Doc-5	Original C-report dt.17.7.2014
Doc-6	Original claim rejection letter dt.17.12.2014

 

 

2. Witness examined on behalf of the Opposite party/s by way of affidavit:

 

S.Sanjay Kumar, Manager-Claims., who being the Opposite Party was examined.

 

Copies of Documents produced on behalf of Opposite Party

 

Doc-1	Copy of the policy
Doc-2	Copy of letter of repudiation

 

 

(ROOPA.N.R)      MEMBER

(S.L.PATIL)     PRESIDENT