DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-II

Udyog Sadan, C-22 & 23, Qutub Institutional Area

(Behind Qutub Hotel), New Delhi- 110016

Case No.66/2018

SIDDHARTH GUPTA

Proprietor

M/S Global Opportunities

HS-27, Second Floor,

Main Market Kailash Colony,

New Delhi-110048

….Complainant

Versus

IFFCO-TOKIO GENERAL INSURANCE COMPANY LIMITED

Regd. Office

IFFCO Sadan,

C-1, District Centre, Saket,

New Delhi-110017

        ….Opposite Party

 Date of Institution    :  01.03.2018   

 Date of Order            :  30.06.2022  

Coram:

Ms. Monika A Srivastava, President

Ms. Kiran Kaushal, Member

Sh. U.K. Tyagi, Member

ORDER

Member: Sh. U.K. Tyagi

Complainant has requested to pass an order directing M/s  IFFCO - Tokio General Insurance to pay the insurance claim amount on insured Declared Value (IDV) i.e Rs.15,66,000/- alongwith interest @24% per annum from the date of theft till its realization; to pay Rs.1,00,000/- towards compensation for mental agony etc; to pay Rs. 20,000/- as legal cost etc.

Brief facts of the case are as under:-

        The Complainant was the owner of a vehicle SUV make Toyota Fortuner bearing Registration No. DL-9CAE-1774. The Complainant had got the above said vehicle insured with M/s Bharti Axa General Insurance Co. Ltd. During the currency of the insurance with above mentioned Company the windshield of the said vehicle was broken and a claim of Rs.22,215/- on 27.08.2016. Thereafter the said vehicle was got insured with IFFCO - Tokio General Insurance (hereinafter referred to as OP) on 03.03.2017 for the period 08.03.2017 to 07.03.2018. It was also averred by the Complainant that the insurance Form was neither filed nor signed by him. Copy of same is endorsed at Annexure ‘A’. Therefore, he was oblivious of the fact that the agent had not mentioned the No Bonus Claim in the said form as the same was availed by him with the previous Insurance Company.

        Unfortunately, the said vehicle was got stolen on 02.04.2017 and the same was reported to OP. An e-FIR was lodged vide No.9951/17 dated 03.04.2017. It is also averred that the No Bonus Claim was availed by the Complainant only after the said vehicle has been stolen. Hence, the same could not be basis of repudiation.  No prejudice would have been caused with present cause of action. The Complainant also maintained that the No Bonus Claim for the repair of vehicle should not come in the way for loss of vehicle.

        OP, on the other hand, has stated that the said vehicle was registered under the name of M/s Global Opportunities who had obtained a private car package policy for Toyota Fortuner 3.0 car. On the receipt of intimation of lost of vehicle, the Insurance Company appointed independent investigator namely M/s Claim Investigation Agency for verifying the facts of the insured vehicle. The said agency submitted its report stating that one key of said vehicle was stolen from his shirt- pocket on the said day of theft of the vehicle and further stated that No Claim Bonus was availed by the Complainant. The OP maintained that       “Notwithstanding anything to the contrary contained in the policy, it is hereby agreed, understood and warranted that No Claim Bonus (NCB) allowed under the Policy is subject to the fact that the own damage claim experience of your insured vehicle or your earlier vehicle (in case of transfer of No Claim Bonus from the earlier vehicle) in previous year policy(s) was NIL. Accordingly you give the consent and accept that “No Claim Bonus” (NCB) allowed under this current Policy for Insured Vehicle is based on the above NIL Claim history. However, if we find that the basis of availing the “No Claim Bonus” (NCB) under the current policy is incorrect; then we will impose suitable damages at the time of claim under Own Damage Section of the policy, which may at our discretion include forfeiture of all benefits under the Own Damage Section of the Policy. In case you find that the No Claim Bonus (NCB) under the present policy is not correct, then you may please deposit amount for No Claim Bonus (NCB) to us within 10 day(s) from the date of issuance of the policy for the continuation of the benefits under the own Damage Section of the Policy.”

        It was contended by OP that the Complainant had also filled  up the claim Form and aforesaid undertaking was made by him in the claim form “I/we  hereby understand, agree and submit that No Claim Bonus (NCB) allowed to me/us under the Policy for which the Claim is being preferred/lodged is subject to the fact that the own damage claim experience for the insured vehicle or my/our earlier insured vehicle (in case of transfer of No Claim Bonus from earlier insured vehicle) in previous year policy(s) was NIL.

        Accordingly I/we once again submit/undertake that the “No Claim Bonus” (NCB) allowed under the current year Policy for the insured Vehicle for which the Claim is preferred is based on the above NIL Claim history. Further I/we undertake and submit that in case the basis of availing the NO Claim Bonus (NCB) under the current policy is incorrect, then the company may at its discretion impose suitable damages on the preferred claim which may include forfeiture of all benefits on own damage section of policy.”  It was also confirmed from the website of Insurance  Information Bureau Portal of India that an OD claim amounting to Rs.19,764/- had already been availed via Bharti Axa General Insurance Co. Ltd. for accidental loss on 19.08.2016. Hence, it was concluded that there was gross misrepresentation and withholding of material facts on the part of the Complainant.  Hence, the forfeiture  of the benefits accruing from the policy.

Both the parties filed Written Submissions and evidence-in- affidavits. Written Statement is on record so is the rejoinder. Oral arguments were heard & concluded.

        This Commission has gone into the entire gamut of issue as well as oral arguments. The Complainant also stated that M/s Global Opportunities Pvt. Ltd. is a sole proprietorship concern with the sole proprietor. The Complainant also stated that the policy form was neither filled up nor signed by him. It was the agent who did the entire exercise. The Insurance Company had mentioned in its reply as well as policy form that No Claim Bonus allowed under this current policy for  insured vehicle is based on the above NIL Claim history. However, if we find that the basis of availing the “No Claim Bonus under the current policy is incorrect; then we will impose suitable damages at the time of claim under Own Damage Section of the Policy, which may at our discretion include forfeiture of all benefits under the Own Damage Section of the Policy. In case you find that  the No Claim Bonus under the present policy is not correct, then you may please deposit amount for No Claim Bonus to us  within 10 days from the date of issuance of the policy for continuation of the benefits under Own Damage Section of the Policy”

        From the above, it is evident that above mentioned that the No Bonus Claim could have been deposited at later date as well. Since, as maintained by the Complainant the policy form was not filled up by him, hence, this important advisory escaped from his notice. For the above, he cannot be penalized. Moreover, the undertaking as mentioned above and provided in policy form was not signed by the Complainant. It can be seen from the  Annexure ‘A’, mentioned here and Considering the above narrations and provision of deposition of amount for No Claim Bonus, this Commission feels that there had been some degree of deficiency in service, therefore, OP is directed to reconsider the claim of the Complainant after having deduction of amount of No Claim Bonus within three months from the date of its receipt.

        No order as to costs.

File be consigned to the record room after giving a copy of the order to the parties as per rules. Order be uploaded on the website.