(Passed on 1/3/2023)

Per Mr. Atul D. Alsi, Hon’ble President

1. The complainant filed a complaint case against non disbursement of insurance claim against the theft of truck  Rs. 10,00,000/- along with compensation of Rs. 1,00,000/- with cost of litigation  of Rs. 20,000/-
2. The story in short are as under.
3. The complainant purchased 12 wheels truck bearing No. MH40-N3222 and insured with OP/ICICI Lombard General Insurance under the policy bearing No. 3003/163235046/00/B00 for the period between 18/01/2019 to 17/01/2020. On 7/8/2019, the complainant’s driver carried truck from Chandrapur to Jharkhand for transportation of goods but due to serious health condition of truck driver who admitted in hospital the where about of truck driver was not known and the complainant could not contacted on mobile. But after 4-5 days, the complainant contacted with the driver on mobile but  he had told that he would  come shortly to Chandrapur but after 2 months, driver could not came back,  therefore the complainant reported the matter for missing of truck by the driver with Korapna Police Station, District Chandrapur on 10/01/2020. Thereafter the complainant filed insurance claim for missing of truck for the IDV value of Rs. 10,00,000/- with relevant documents to OP. But the OP has arbitrarily closed the insurance claim for non submission of the documents as per demand letters issued to claimant.  Therefore the complainant has filed the present complaint.
4. The OP filed reply and denied allegations and admitted the insurance  policy of truck and submitted in the reply that the complainant failed to submit the documents as per demand made to the complainant on 24/02/2020 and thereafter on 23/03/2020, for the adjudication of claim, the documents are very necessary. Therefore non submission of required documents from the complainant, the complainant’s insurance claim is closed. Hence there is no negligency of the service on the part of OP.
5. The counsel for complainant argued that the complainant has submitted the documents as per demand made by OP as per letter dated 24/02/2020 and 23/03/2020 and the copy of those documents  are also filed along with complaint as per list of documents dated 5/8/2021 on record. The complainant reported the matter to the Police Station for missing of vehicle after the deceptive act  of driver of complainant was known.  Therefore there is no delay in registration of FIR. Therefore complainant is entitled for insurance claim as per IDV of truck.

          The counsel for complainant relying as per judgment of National Consumer Disputes Redressal Commission, New Delhi in New India Insurance Company Vs. Nirja Singh, 2018 CPJ Vol 4, holding that the driver of the truck committed breach of trust, covered of loss under the policy disputed- claim repudiated. Such act of driver will amounted to malicious act and loss would be covered under insurance policy- insurer cannot be allowed to travel beyond the repudiation letter issued by it and cannot be allowed to contest the claim on the ground which was not the ground of repudiation. Similarly, the counsel for complainant relied on the judgment of National Consumer Disputes Redressal Commission, in First Appeal No. 1034/2015, New India Assurance  Company Ltd. and Anr.  Vs. Tirath Singh Awatarsingh  Bhatia holding that the insurere’s decision to reject the claim shall be based on sound logic and valid grounds. It may be noted that such limitation clause does not work in isolation and is not absolute and one needs to see the merits and good sprit of the clause without compromising on bad claims. Rejection of claims on purely technical ground in a mechanical manner will result in policy holders losing confidence in the insurance industry, giving rise to excessive litigation.”

6. The counsel for OP argued that the offence came to be registered under Section 408, 409 of IPC and not under 379 of IPC for the theft of vehicle.  The complainant failed to submit the documents as per demand made by OP as per letter dated, 24/02/2020 and 23/2/2020. Therefore the complainant’s file is closed. Hence there is no negligence on the part of OP.

REASONING

7. The complainant owned truck bearing No. MH-40/N3222 of 12 wheels and insured with OP for the period between 18/01/2019 to 17/01/2020. On 7/8/2019, the truck driver of complainant while carrying the truck from Chandrapur to Jharkhand for transportation of goods did not come back and therefore after searching   of truck and where about of the truck driver which could not be traced and hence the complainant lodged the complaint on 17/01/2020 in Korapna Police Station, District Chandrapur for missing of truck and fraud committed by truck driver. Therefore an offence under Section 408,409 of IPC came to be registered vide FIR No. 7/20 against the truck driver. The complainant filed insurance claim with OP along with relevant documents but due to non submission of  documents as per demand letter issued to OP on 24/02/2020 and 23/03/2020, the complainant’s claim has been closed. The basic dispute between the parties is in respect of non submission of documents as per demand letter. The complainant has filed documents as per demand  made in letters along with complaint in the present case. The OP has not filed a proof of receipt of demand letter from complainant for submission of documents for adjudication of claim of dated 24/02/2020 and 23/03/2020 on record. Therefore there is deficiency on the part of OP in adjudication of claim. The reason for late registration of FIR  in respect of missing of vehicle and not known of the where about of truck driver is bonafide and truck driver committed breach of trust covered under insurance policy and insurer can’t go beyond the reason mentioned in repudiation letter as per judgment of National Consumer Disputes Redressal Commission, New Delhi in New India Company Ltd. Vs. Niraj Singh, 2018 CPJ, Vol – 4.  Therefore the complainant is entitled to receive compensation 50% of IDV of Rs. 10,00,000/- that is Rs. 5,00,000/-without awarding any interest cost or compensation to the complainant as per following order.

ORDER

1. The complaint is partly allowed.
2. The OP/insurance company is liable to pay 50% of IDV value of Rs. 10,00,000/- amounted to  Rs. 5,00,000/- on non standard basis of claim of policy No. 3003/163235046/00/B00  without awarding any cost, interest and compensation to the complainant.
3. Copy of order be furnished to both parties, free of cost.