Per : Mr. V. P. Utpat, President Place : PUNE
// J U D G M E N T //
(02/05/2014)
This complaint is filed by the consumer against the insurance company for deficiency in service under section 12 of the Consumer Protection Act, 1986. The brief facts are as follows.
1] The complainant is resident of Phursungi, Tal. Haveli, Dist. Pune. The opponent is insurance company. The complainant had purchased one goods vehicle bearing no. MH-12, CT – 8299, which was insured with the opponent. On 22/5/2011, the said vehicle was stolen in between 2.00 a.m. to 8.00 a.m. when it was parked in front of open space of house of the complainant. He approached to police chowki, Urali Devachi and Loni Kalbhor Police Station and lodged FIR as well as intimated the incidence orally. The police took search of the vehicle. The complainant himself also searched the vehicle as per the directions of the Police at Pune, Solapur, Ahmednagar, Vijapur, Kolhapur, Satara, Sangli, Jamkhed etc., but could not find the same. Ultimately, on 31/05/2011 he lodged FIR. The complainant had also intimated this fact to the opponent by filing insurance claim. The documents, such as intimation to RTO, consent, letter dtd.15/10/2011 issued by Loni Kalbhor Police Station, FIR, copy of statement, spot panchnama, insurance cover note, RCTC book etc. were submitted to the insurance company along with the claim. The opponent no. 1 repudiated the insurance claim by stating that there was negligence on the part of the complainant to intimate the incidence of theft to police as well as insurance company promptly.
2] It is the case of the complainant that, he searched the vehicle as per directions of the police. He had informed about the incidence of theft to police immediately. But as per the directions of police, he searched the vehicle and ultimately lodged the FIR; hence delay was caused for lodging FIR. He has also informed the incidence to the insurance company but the insurance company wrongly repudiated his claim and caused deficiency in service. Hence, he has claimed insurance claim of Rs. 7,50,000/-, Rs. 4,00,000/- for loss of business Rs.20,000/- towards costs and expenses incurred by him and an amount of Rs. 1,00,000/- towards compensation for mental pain and suffering and interest on the said amount. The total claim of the complainant is Rs. 13,67,400/-.
3] The opponent has resisted the claim by filing written version, in which it has denied the contents of the complaint. However, there is no dispute between the parties as regards insurance of stolen vehicle. It is further contended that the complainant had in formed about the theft to insurance company on 6/6/2011. The opponent has appointed the investigator, who had investigated the facts and submitted report and it was disclosed that the vehicle was stolen on 22/5/2011, FIR was lodged on 31/5/2011 and intimation was given to the insurance company on 6/6/2011. According to the insurance company as per the terms and the conditions of the policy, the complainant has intimated about the theft of vehicle to nearest police station and insurance immediately. The complainant has committed breach of terms and conditions of the policy; hence insurance company has rightly repudiated the claim of the complainant. The opponent has prayed for the dismissal of the complaint.
4] After scrutinizing the documentary evidence, which is produced before this Forum, hearing the arguments of both the counsels and considering pleadings, the following points arise for my determination. The points, findings and the reasons thereon are as follows-
Sr.No. | POINTS | FINDINGS |
1. | Whether complainant has established that the opponent has caused deficiency in service by wrongly repudiating the insurance claim? | In the affirmative. |
2. | What order? | Complaint is partly allowed. |
REASONS :-
5] The undisputed facts in the present proceeding are that the stolen vehicle was belonging to the complainant and it was insured with the opponent for the relevant period. The insurance was valid on the date of commission of theft. The insurance company has repudiated the claim on the ground of delay in lodging FIR as well as intimation to the insurance company. In that context, the insurance company has strongly relied upon the terms and conditions of the policy and as per the terms and conditions of the policy, notice shall be given in writing to the insurance company immediately upon occurrence of any accidental loss or damage and in the event of any claim and thereafter the insured shall give such information as company shall require. It has been disclosed that the theft of the vehicle was committed on 22/5/2011, FIR was lodged on 31/5/2011 and intimation to the opponent was given on 6/6/2011. The learned Advocate for the opponent argued that the delay in lodging FIR as well as giving intimation violates the terms and conditions of the policy. Hence, repudiation is justified. The learned Advocate for the opponent has strongly relied upon judgment of “Devendra Singh V/S New India Assurance Co. Ltd. & Ors.” Reported in III (2003) CPJ 77 (NC). In that proceeding it is observed that there is delay of 4 days for reporting incidence to Police and one month to insurance company. In that context the claim was dismissed. It reveals from the documentary evidence in the present proceeding that the complainant had informed about the theft within 24 hours to police station but there is some delay caused to intimate the incidence to insurance company. It is not the case of the opponent that the theft of the vehicle was not committed and the complainant has filed false claim. Even the report of investigator is also not disclosing that, theft was not committed. It is significant to note that even though there are certain breach of condition of the policy, the insurance company can not reject the claim in toto and the insurance company should have settled the claim on the principle of ‘non-standard basis’. This principle is laid down in recent Ruling, which is reported in 2013(3) CPR 718 (NC) between “New India Assurance Co. Ltd. V/S M/S B. Mangatram & Co.” and 2013(2) CPR 462 (NC) between “New India Assurance Co. Ltd. V/S Smt. Malti Bhikhabhai Bhoya”. In both these rulings it has been observed by Hon’ble National Commission that even though there is certain breach in terms and conditions of the policy, the claim can not be rejected in toto. But it should be settled on the principle of ‘non-standard basis and the compensation to the extent of 75% of admissible claim should be given.
6] In the light of the above discussion, it is the considered opinion of this Forum that the complainant is entitled for insurance claim to the extent of 75% of the insurance value of the stolen vehicle. The insured declared value of the stolen vehicle as per the policy is Rs.4,27,000/-. Hence the complainant is entitled for the claim to the extent of that much amount. The complainant is also entitled for the compensation on the ground of mental and physical suffering to the tune of Rs.10,000/- and Rs. 5,000/- towards cost of the litigation. In the result the Forum answers the points accordingly and pass the following order.
** O R D E R **
1. The complaint is partly allowed.
2. It is hereby declared that the opponent
has caused deficiency in service by
wrongly repudiating the claim of the
complainant.
3. The opponent is directed to pay an amount
of Rs. 3,20,250/- (Rs. Three Lac Twenty
Thousand Two Hundred and Fifty only),
towards claim amount, an amount of
Rs.10,000/- (Rs. Ten Thousand only)
towards compensation for mental and
physical suffering and an amount of
Rs.5,000/- (Rs. Five Thousand only)
towards cost of the litigation i.e. total
amount of Rs.3,35,250/- (Rs. Three Lac
Thirty Five Thousand Two Hundred and
Fifty only) to the complainant within six
weeks from the date of receipt of copy of
this order.
4. Copies of this order be furnished to
the parties free of cost.
5. Parties are directed to collect the sets,
which were provided for Members within
one month from the date of order, otherwise
those will be destroyed.
Place – Pune
Date- 02/05/2014
