BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SIRSA.
Consumer Complaint no. 626 of 2019.
Date of Institution : 18.10.2019.
Date of Decision : 18.03.2024.
Mandeep Kumar aged about 54 years son of Shri Hans Raj, resident of village Alipur Titukhera, Tehsil and District Sirsa.
……Complainant.
Versus.
1. Iffco Tokio General Insurance Company Ltd. Registered Office Iffco Sadan, C-1, District Center, Saket, New Delhi- 110017 through its Managing Director/ authorized/ responsible person.
2. Mr. Sudhir Punia, Authorized Agent/ Representative of Iffco Tokio General Insurance Company Ltd., C/o M/s One Way Insurance and Marketing Co. 27 SCF 1st Floor, Opposite State Bank of Patiala, Anaj Mandi, Sirsa.
...…Opposite parties.
Complaint under Section 12 of the Consumer Protection Act, 1986.
Before: SH. PADAM SINGH THAKUR ………………PRESIDENT
MRS.SUKHDEEP KAUR……………………….MEMBER.
Present: Sh. Ashish Singla, Advocate for complainant.
Sh. Madan Goyal, Advocate for opposite party no.1.
Opposite party no.2 already exparte.
ORDER
The complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 (after amendment u/s 35 of C.P. Act, 2019) against the opposite parties (hereinafter referred to OPs).
2. In brief, the case of complainant is that complainant was owner in possession of Elantra Car bearing registration No. HR-24H-1110 Model 2005 which was purchased by him from its previous owner namely M/s Sirsa Felts Pvt. Ltd. The registration certificate was transferred in the name of complainant on 29.11.2011 and vehicle was insured with the op no.1 vide insurance policy No. 93696030 for the period 19.08.2015 to 18.08.2016 with an IDV of Rs.4,25,000/-. It is further averred that on 03.12.2015 the vehicle was taken away by a family friend of complainant namely Shri Mohit Mehta son of Sh. Madan Lal Mehta, resident of village Karamgarh, Tehsil and District Sirsa as he had gone to his friend Manish Kumar at Gurgaon and in the night he had parked the vehicle in the parking area of main street near his house after locking the same properly. It is further averred that in the morning at about 10.00 a.m on 04.12.2015 said Mohit Mehta found that car is not there in the street and has been stolen by some mischievous person. They searched the vehicle but could not find the same and ultimately FIR No. 1499 dated 06.12.2015 was registered in this regard at P.S. City Gurgaon. That the police also could not trace out the vehicle and submitted untraced report which was accepted by the Court of Ld. CJM, Gurgaon on 04.07.2016. The information regarding theft was immediately given to op no.2 by complainant and Shri Rajesh Sharma was appointed as Investigator by op no.1 who thoroughly investigated the matter and after collecting various documents from complainant submitted his report with op no.1. It is further averred that surprisingly on 16.10.2017 a letter was issued by op no.1 to the complainant stating that claim file has been closed being rejected on the grounds that firstly the vehicle was stolen on 04.12.2015 but the insurance company was informed about the same on 28.01.2016 and secondly two keys of the vehicle are not matching with each other which amounts to fabrication. That repudiation of claim of complainant by insurance company is unlawful, illegal and arbitrary as police authorities were informed about the theft immediately i.e. within 48 hours of theft and matter has been thoroughly investigated by the police authorities and the Ld. Court has accepted the untraced report in this regard. The insurance company was also informed about theft immediately on telephone by complainant through op no.2 and the key which is regularly used by the vehicle owner is generally depreciated as vehicle is being used since 2005 to 2016 by the same key and comparison of the same with alternative untouched key will certainly amounts to non matching from edge to edge. It is further averred that complainant even after receipt of repudiation letter made a number of written requests to the ops but they did not pay any heed to the same and have caused deficiency in service, unfair trade practice and unnecessary harassment to the complainant. Hence, this complaint.
3. On notice, op no.1 appeared and filed written version raising certain preliminary objections regarding maintainability, suppression of true and material facts and estoppal. It is submitted that complainant himself is responsible for non payment of his insurance claim. As a matter of fact on receipt of intimation of theft of vehicle on 28.01.2016 allegedly stolen on 04.12.2015, the op insurance company immediately appointed Sh. Rajesh Sharma an independent insurance claims Investigator to investigate into the reported claim and collection of claim documents. The said investigator submitted his report dated 04.05.2016 to op no.1 alongwith documents and keys of the stolen vehicle as submitted by complainant. On perusal of investigation report and documents on records, the claim of complainant was repudiated by the company on the ground that there is considerable delay in intimation of claim to the insurance company. The vehicle was allegedly stolen on 04.12.2015 and intimation to this effect was given to op no.1 only on 28.01.2016 after a delay of about 55 days by violation of condition no.1 of insurance policy. That in case of theft, it is also obligatory on the part of insured to inform the police authorities about the theft immediately otherwise valuable time would be lost to trace out the stolen vehicle. The FIR was lodged on 06.02.2015 after a delay of two days and complainant intimated about theft to op no.1 on 28.01.2016 after crucial delay of about 55 days, whereby the insurance company deprived from its legitimate right to get the enquiry conducted immediately after the occurrence of theft of insured vehicle. Further, in case of theft, it is mandatory to submit both the original keys of stolen vehicle as provided by manufacturer. It has been noted that both the keys of the vehicle which were handed over to the Investigator by complainant during the course of investigation found different from each other which is clear case of misrepresentation and fabrication on the part of complainant and hence the company decided to repudiate the liability under the policy. The claim of complainant was justifiably repudiated by the company which was conveyed to him on 16.10.2017. It is further submitted that complainant earlier filed a complaint before Insurance Ombudsman Chandigarh for redressal of his grievances vide complaint no. CHD-G-023-1718-0599 and as per order of Ombudsman dated 26.04.2019, the complaint of complainant was dismissed on merit and no relief was granted to the complainant and repudiation of claim was held justified. The said order was concealed by complainant, hence complaint is liable to be rejected on this score alone. That answering op has decided the matter according to terms and conditions of insurance policy, norms and guidelines. On merits, the pleas taken in the preliminary objections are reiterated, contents of complaint are denied to be wrong. It is also submitted that op no.2 is not the authorized agent of op no.1 insurance company and policy in question was purchased through agent Pawan Kumar and not through Sudhir Punia. Moreover, the agents are not authorized to receive any intimation and intimation should have been provided to op no.1 and prayer for dismissal of complaint made.
4. Initially op no.2 appeared through counsel but thereafter none appeared on behalf of op no.2 and as such op no.2 was proceeded against exparte.
5. The complainant in evidence has tendered his affidavit Ex.C1, affidavit of Mohit Mehta as Ex.C2 and documents Ex.C3 to Ex.C9.
6. On the other hand, op no.1 has tendered affidavit of Ms. Gurvinder Kaur, authorized signatory & General Manager as Ex. RW1/A and documents Ex.R1 to Ex.R7.
7. We have heard learned counsel for the parties and have gone through the case file.
8. From the policy schedule Ex.C4, it is evident that vehicle in question of complainant was insured with op no.1 for the period 19.08.2015 to 18.08.2016 for the insured declared value of Rs.4,25,000/-. There is also no dispute of the fact that vehicle of complainant was stolen on 03/04.12.2015 from Gurgaon and matter was reported o the police and a FIR bearing No. 1499 dated 06.12.2015 for the offence under Section 379 IPC was registered in Police Station City Gurgaon against unknown person and copy of the FIR is placed on file by complainant as Ex.C5. The police also submitted untraced report which was accepted by the Court of Ld. CJM, Gurgaon as is evident from copy of the order dated 4.7.2016 Ex.C7. The claim submitted by complainant has been repudiated by op no.1 vide letter dated 16.10.2017 on the ground of delay in intimation and keys are not matching with each other. However, we are of the considered opinion that ground taken by op no.1 are hypothetical and technical and are not justified because police was informed about the theft of vehicle in time and after due investigation, the police registered FIR on 06.12.2015 and complainant also claims that agent of the insurance company was also informed about the theft in time. So when the police was already informed by complainant in time which after due investigation registered FIR and thereafter also investigated the matter and even agent of op no.1 was also informed in time, therefore, it cannot be said that any prejudice is caused to the op no.1. Moreover, Bench of Hon’ble three Judges of Supreme Court in case titled as Gurshinder Singh vs. Sriram General Insurance Company Ltd. (supra) has held that “Mere delay in intimating insurance company about occurrence of theft cannot be a ground to deny claim of insured.” The other ground of op no.1 for rejection of claim of complainant is also baseless because key which is regularly used in the vehicle for such a long period certainly changes its shape than the other key which is not being used. So the repudiation of the claim of complainant on such baseless grounds is hereby set aside and complainant is entitled to insured declared value of the vehicle i.e. Rs.4,25,000/- from op no.1.
9. In view of our above discussion, we allow the present complaint and direct the opposite party no.1 insurance company to make payment of claim amount of Rs.4,25,000/- to the complainant within a period of 45 days from the date of receipt of copy of this order, failing which complainant will be entitled to receive the said amount of Rs.4,25,000/- alongwith interest at the rate of @6% per annum from the date of this order till actual payment. We also direct the op no.1 to further pay a sum of Rs.10,000/- as compensation for harassment and Rs.5000/- as litigation expenses to the complainant within above said stipulated period. A copy of this order be supplied to the parties as per rules. File be consigned to the record room.
Announced. Member President
Dt. 18.03.2024. District Consumer Disputes
Redressal Commission, Sirsa.
