Haryana

Ambala

CC/252/2018

Vijay Pal - Complainant(s)

Versus

Iffco Tokio Gen Inss Co ltd - Opp.Party(s)

03 Sep 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMBALA.

 

                                                          Complaint Case No.:  252 of 2018.

                                                          Date of Institution :   09.08.2018.

                                                          Date of decision    :   03.09.2019.

Vijay Pal, Prop. of Shri Sai Enterprises, s/o Shri Harish Chander Gupta, r/o H.No.82/1, Anand Vihar, Nanhera Road, Ambala Cantt. Haryana.

                                                                              …. Complainant.                                                              Versus

1. IFFCO TOKIO General Insurance Company Ltd., above Dena Bank, Punjabi Mohalla, Ambala Cantt.
2. IFFCO TOKIO General Insurance Company Ltd., Regd. Office IFFCO Sadan, C-1, District Centre, Saket, New Delhi-110017 through its Chairman.

                                                                        ….Opposite Parties.

         

Before:        Smt. Neena Sandhu, President.

                   Smt. Ruby Sharma, Member.

Shri Vinod Kumar Sharma, Member.          

                            

Present:       Shri S.S. Walia, Advocate, counsel for complainant.

Shri R.K. Vig, Advocate, counsel for the OPs.

         

Order:        Smt. Neena Sandhu, President.

Complainant has filed this complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’) against the Opposite Parties (hereinafter referred to as ‘OPs’), praying for issuance of following direction to them:

1. To settle his claim according to the terms & conditions of the insurance policy and release the amount at the earliest possible.  
2. To pay Rs.50,000/- as compensation for the mental agony and physical harassment suffered by him.
3. To pay cost of Rs.15,000/-.
382.  

Any other relief which this Hon’ble Forum may deem fit.

 

Brief facts of the case are that the complainant is the registered owner of Hero Honda Splendor Plus motorcycle bearing Registration No.HR-01AE-4653, which was insured with the OPs vide Insurance Policy No.93438179, for the period from 29.07.2015 to 28.07.2016. On 26.06.2016, at about 09:00 PM, he parked the said motorcycle in front of his own Dhaba namely “Pal Dhaba” and thereafter, he got busy in serving food to the persons sitting in his dhaba. After sometime, when he came out to serve food to the persons sitting there, he found that his motorcycle got stolen from the parking place of the dhaba. He immediately went to the police for lodging an FIR/DDR, but the police did not lodge any FIR/DDR, rather suggested him to wait for 2-3 days and if could not found his motorcycle, then lodge the FIR/DDR. As the complainant could not found his motorcycle and accordingly, he lodged the FIR bearing No.160 dated 02.07.2016 u/s 379 of IPC, PS Parao, against the unknown person. He informed the OPs and also filled up a claim form. The police submitted untraced report of the motorcycle. He submitted all the relevant documents with the OPs on 28.11.2016. On 30.10.2017, he received a registered letter from the office of the OPs mentioning therein that his claim has been rejected on the ground that there is a delay in lodging the FIR and the insurance company has been informed about the incident after 25 days. The incident took place on 26.06.2016 and the FIR was lodged on 02.07.2017 i.e. just six days delay. The delay was on the part of the police, who told him to wait about a week. The OPs by not paying his genuine claim, have committed deficiency in service. Hence, the present complaint.

2.                Upon notice, the OPs appeared through counsel and has filed written version raising preliminary objections regarding maintainability. On merits, it is stated that it is the duty of the insured to inform to the insurer in writing immediately upon the occurrence of any accidental loss or damage in the event of any claim and the same has duly been incorporated in the policy conditions issued to the public at large. The OPs and the complainant are bound to follow the terms & conditions of the policy issued for insuring the vehicle. The facts of the case are that the motorcycle in question owned by the complainant was stolen and intimation was given to the OPs insurance company on 21.07.2016 i.e. after delay of about 25 days. The complainant lodged the FIR No.0160 dated 02.07.2016 in PS Parao, Ambala Cantt, meaning thereby, the police authorities also informed delayed by six crucial days. Till date, the untrace report has not been confirmed by the Court of JMIC, Ambala. The insurance company wrote letters dated 15.09.2016, 30.09.2016, 06.10.2016, 18.10.2016 & 08.11.2016 in connection with the claim in question asking the complainant to submit requisite documents, but the complainant did not bother to submit the same and finally closed the claim as No Claim vide registered letter dated 30.10.2017. The complainant himself violated the terms & conditions of the policy, as such, no claim is payable to him. There is no deficiency on the part of the OPs and the present complaint may be dismissed with heavy costs.

3.                The learned counsel for the complainant tendered affidavit of complainant as Annexure CA alongwith documents as Annexure C-1 to C-11 and closed the evidence on behalf of complainant. On the other hand, learned counsel for the OPs tendered affidavits of Shri Rajiv Ranjan, Authorized Signatory for the OPs company and Shri R.N. Sharma, Investigator as Annexure OP-A & OP-B respectively alongwith documents Annexure OP-1 to OP-17 and closed the evidence on behalf of OPs.

4.                We have heard the learned counsel of the parties and carefully gone through the case file and also the case laws referred by the ld. counsel for the OP.

5.                The learned counsel for the complainant has argued that duly insured motorcycle of the complainant was stolen on 26.06.2016. The complainant got registered an FIR with the police and also lodged the claim with the OPs and also submitted all the relevant documents, but they vide letter dated 30.10.2017 (Annexure C-11) refused to pay the claim amount and treated his claim as “No Claim”.

6.                Contrary to it, the learned counsel for the OPs has argued that the motorcycle in question was stolen on 26.06.2016, for which FIR was lodged on 02.07.2016 i.e. after a delay of about six days and intimation was given by the complainant to the OPs on 21.07.2016 i.e. after a delay of 25 days, from the date of occurrence of the incident. Moreover, the insurance company wrote letters dated 15.09.2016, 30.09.2016, 06.10.2016, 18.10.2016 & 08.11.2016 asking the complainant to submit requisite documents, but the complainant had not submitted the same. There is breach of terms & conditions of the policy and no amount is payable to the complainant. In support of his contention, the learned counsel for the OPs has placed reliance on the cases, titled as Reliance General Insurance Co. Ltd. Vs. Harbhajan Khaira, IV (2016) CPJ 150 (NC); Reliance General Insurance Co. Ltd. Vs. Arun Kumar Singh & Anr., Revision Petition No.1054 of 2016 (NC) and P. Khamar Pasha Vs. BM, Oriental Insurance Co. Ltd., Revision Petition No.724 of 2018 (NC).

7.                From the perusal of policy document dated 30.07.2015 (Annexure C-3/OP-17), it is evident that the motorcycle in question was duly insured with the OPs for a sum assured of Rs.28,000/- for the period from 29.07.2015 to 28.07.2016. While going through the FIR dated 02.07.2016 (Annexure C-9), it is revealed that the said motorcycle was stolen on 26.06.2016 from the parking place of the dhaba of the complainant. However, the OPs vide letter dated 30.10.2017 (Annexure C-11/OP-15), refused to pay the claim amount on the ground that FIR was lodged after a delay of six days and intimation has been given to the OPs after a delay of more than 25 days from the date of occurrence of the incident. It may be stated here that in the case of Om Parkash Vs. Reliance General Insurance and another, Vol IV 2017 CPJ-10 (SC), the Hon’ble Supreme Court of India has held that condition regarding delay shall not be shelter to repudiate insurance claims which have been otherwise proved to be genuine. Even the Insurance Regulatory and Development Authority (IRDA) has issued guidelines to the insurance companies that “The current contractual obligation imposing the condition that the claims shall be intimated to the insurer with prescribed documents within a specified number of days is necessary for insurers for effecting various post claim activities like investigation, loss assessment, provisioning, claim settlement etc. However, this condition should not prevent settlement of genuine claims, particularly when there is delay in intimating or in submission of documents due to unavoidable circumstances. In view of the law laid down by the Hon’ble Supreme Court of India and instructions of IRDA, it would not be fair and reasonable on the part of the OPs to reject the genuine claim, which had already been verified and found to be correct. It is not out of place to mention here that the case laws relied upon by the learned counsel for the OPs are not applicable to the present case. Since the motorcycle in question was insured for Rs.28,000/-, therefore, the complainant is entitled to get the said amount. The complainant is also entitled to get compensation for the mental agony and physical harassment suffered by him, alongwith the litigations expenses.

8.                In view of the aforesaid discussion, we hereby allow the present complaint and direct the OPs in the following manner:-

1. To pay the claim amount of Rs.28,000/- alongwith interest @ 7% per annum w.e.f. 30.10.2017 i.e. the date of the repudiation of claim, till its realization.
2. To pay Rs.3,000/- as compensation for mental agony and physical harassment suffered by the complainant.
3. To pay Rs.2,000/- as litigation expenses.

 

                   The OPs are further directed to comply with the aforesaid directions within the period of 30 days from the date of receipt of the certified copy of this order. Certified copy of this order be supplied to the parties concerned, forthwith, free of cost as permissible under Rules. File be indexed and consigned to the Record Room.

Announced on: 03.09.2019.

 

          (Vinod Kumar Sharma)            (Ruby Sharma)     (Neena Sandhu)

              Member                                  Member             President