Chandigarh

StateCommission

A/170/2019

The Oriental Insurance Company Ltd. - Complainant(s)

Versus

Iqbal Singh Shergill - Opp.Party(s)

Vinod Chaudhri Adv.

08 Dec 2020

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

U.T., CHANDIGARH

The Oriental Insurance Company Limited, Regional Office, SCO No.109-110-111, Sector 17-D, Chandigarh through its Authorized Signatory.

…..Appellant /Opposite Party.

Versus

Iqbal Singh Shergill aged about 52 years son of Sh.Jagir Singh, presently resident of H.No.785, Himshikha Colony, Pinjore (Haryana).

                                                …Respondent /Complainant.

BEFORE:   JUSTICE RAJ SHEKHAR ATTRI, PRESIDENT.

                MRS. PADMA PANDEY, MEMBER.

                MR. RAJESH K. ARYA, MEMBER.

Argued by:

Sh. Vinod Chaudhari, Advocate for the appellant.

Sh. Ferry Sofat, Advocate for the respondent.

PER  PADMA PANDEY, MEMBER

                This appeal is directed against the order dated 11.06.2019, rendered by District Consumer Disputes Redressal Forum-II (now District Commission), UT, Chandigarh (in short ‘the Forum’ only), vide which, it allowed Consumer Complaint bearing No.102 of 2018, which reads as under :-

“12.        In view of the above discussion, the present complaint deserves to be allowed and the same is accordingly allowed. The OP is directed as under ;-

1. To refund Rs.9,00,000/- i.e. the IDV of the vehicle in question to the complainant alongwith interest @ 9% p.a. from the date of repudiation of the claim i.e. 24.10.2017 till its realization.
2. To pay Rs.7,000/- as compensation to the complainant for mental agony and physical harassment.
3. To pay Rs.5,500/- as litigation expenses.

This order be complied with by the OP, within 30 days from the date of receipt of its certified copy, failing which the amount at Sr.No.(ii) shall also carry interest @9% per annum from the date of this order till its actual payment besides compliance of other directions.”

 2.            In the complaint case before the Forum (now District Commission), only dispute was that vehicle i.e. Tata Safari Storme was insured with the Opposite Party/insurance company for the period from 06.04.2016 to 05.04.2017 and when on 05.09.2016, the complainant parked his vehicle outside the hotel at Balachaur,  it was not found there, after sometime, therefore, FIR was lodged with the police and intimation in this regard was given to the insurance company but after inspection, the claim was repudiated by the insurance company vide letter dated 24.10.2017.

3.             Aggrieved against the aforesaid order passed by the Forum (now District Commission), the instant appeal has been filed by the appellant/Opposite Party.

4.             We have heard Counsel for the parties, and have gone through the evidence and record of the case, carefully.

5.           Counsel for the appellant/Opposite Party – insurance company has submitted that the Forum while deciding the said issue, failed to appreciate that after missing of the vehicle, the FIR was lodged, in which, it has been clearly stated that he forgot the key inside the vehicle and there was no mention of other vehicle and as the claim was hit by condition No.4 of the policy, the same was rejected. He has further submitted that leaving the key in the dashboard is an open invitation to lose the insured vehicle and some unscrupulous people, insuring the vehicle, can also play foul with the insurance company and raise a false claim. He has further submitted that the complainant had failed to take due care of the vehicle and the claim was hit by clause No.4, then the complainant changed his statement and said that key was available with him, apparently the key must have been manufactured to hoodwink the insurance company. He has further submitted that the insured failed to intimate the loss immediately on the occurrence of the same to the police and the insurer. He prayed for setting aside the impugned order and allowing the appeal filed by the Opposite Party.

6.             Counsel for the respondent/complainant has submitted that the complainant had informed the police authorities immediately on 05.09.2016, however, the FIR was lodged on 07.09.2016. He has further submitted that statements were not changed by the complainant and the same were made after looking the situations around. He further submitted that both the keys were submitted to the Opposite Party  - insurance company then how the vehicle was stolen due to the reason of leaving the keys inside the car, as such, the claim was wrongly repudiated by the Opposite Party. He has further submitted that the Forum has rightly passed the impugned order and prayed for dismissal of the appeal filed by the Opposite Party.

7.             After going through the evidence and record of the case, we are of the considered opinion, that the appeal is liable to be dismissed, for the reasons to be recorded, hereinafter.

8.             The core question that falls for consideration before us is as to whether the Forum has rightly passed the impugned order.  Annexure C-3 is a copy of Motor Insurance Certificate cum Policy Schedule. From this document, it is proved that vehicle of the complainant i.e. Tata Safari Storme bearing registration No.CH-01-AW-8899 was insured with the appellant/Opposite Party for the period from 06.04.2016 to 05.04.2017 and Insured’s Declared Value is also mentioned as Rs.9,00,000/-. Annexure C-4 is a copy of letter dated 09.09.2016. From this document, it is proved that intimation was given by the complainant to the Opposite Party regarding theft of the vehicle. Annexure C-5 is a copy of letter dated 08.11.2016. From this document, it is proved that intimation regarding theft of the vehicle was also given to The Regional Transport Officer, Sector 17, Chandigarh. Annexure C-6 is a copy of letter dated 27.04.2017. From this document, it is proved that the insurance company informed the complainant that “As per policy condition No.4, the insured shall take all reasonable steps to safeguard the vehicle from loss or damage. Since you have left the keys inside the vehicle which jeopardized the safety of the vehicle” and in the said letter, the insurance company gave one opportunity to the complainant to substantiate the claim in view of grounds of repudiation mentioned in the said letter. Annexure C-7 is copy of reply to the said letter dated 27.04.2017. Annexure C-8 is a copy of email dated 12.09.2017, which was sent by the complainant to customer care of Tata Motors, in which, it has been mentioned that “the insurance company had rejected the claim saying the keys are not authenticated by the local dealer as the agency was closed long back and no records are available. Insurance Company says that keys were sent to Pune to manufacturing unit of TATA MOTORS for authentication of keys. No reply or result of the authentication was received by the insurance company from Tata Motors. So they rejected my insurance claim on the basis of no authentication of car keys.”  Annexure C-10 is a copy of repudiation letter dated 24.10.2017, the relevant portion of the said letter reads as under:-

“This is with reference to your intimation letter dated 09.09.2016 received on 01.11.2016 wherein you informed about the theft of your vehicle on 05.09.2016 from near Shivalik Hotel, Balachaur. After the loss, you lodged a FIR with the concerned Police Station on 07.09.2016 and narrated the facts of the case. It was informed to the police that at about 4.30 P.M., you went to the hotel for taking meals and left the keys inside the vehicle and after taking meals, when you came out at about 5.15 PM, you found the vehicle missing. Necessary search was made but it could not be traced out. On the basis of your statement a FIR was registered on 07.09.2016.

The company appointed an investigation Sh.S.K.Jain to find out the genuineness of the claim. Necessary facts of occurrence were also narrated by you to the investigator. You also submitted an affidavit dated 10.11.2016 stating therein that one key of the vehicle had already been lost earlier and could not be traced inspite of best efforts. As mentioned above, one key was left inside the vehicle on the date of occurrence of the loss and the other was lost earlier and no efforts were made to get the lock replaced with new lock and keys. Keeping in view these facts, it was found that condition No.4 of the policy has been violated by you as you failed to take reasonable steps to safeguard the vehicle. A letter dated 24.07.2017 was written to you to explain the reasons for not adhereing to the terms and conditions of the policy. Though reply was received but it was found that you have failed to give satisfactory reply. Still further you have managed another set of keys which have now been handed over to the company in order to show that keys were never lost or was not kept in the vehicle at the time of the occurrence. By doing so, you are not only managing the facts but also contradicting the facts.

Since you have also failed to intimate the loss to the police as well as to the company immediately on the occurrence and therefore, also violated condition No.1 of the policy. In view of the above mentioned facts, the claim stands repudiated by the competent authority.”

9.                Firstly, the objection taken by the appellant/Opposite Party – insurance company regarding the changing of statement by the complainant and non mentioning of other vehicle in the FIR is concerned, the complainant has clearly mentioned in  his letter dated 01.05.2017 (Annexure C-7), the  relevant  portion  of the said letter reads as under :-

“x x x x you have told in the letter that you have received report from the investigator in which it was found that I have left the key of the vehicle and this fact is also disclosed in the FIR which was registered at police station balachaur and you made it the excuse for repudiating the claim.

But here I want to submit necessary fact that the version which I have mentioned in the FIR was at the moment when I lost the control over my thinking and I was under shock due to the stolen of the vehicle and I disclosed the version to the police in hurry.

While the real fact was that the key of the vehicle was not left in the vehicle. But it was in another vehicle of my friend sainik singh who was with me at the time when my vehicle was stolen. The key was found by my friend Sainik Singh from his car and handed over to me. And same was deposited with your investigator.

And I also disclosed the fact to your investigator that the second key is in my possession for which I had given affidavit of lost key and he asked me to submit the same in the office.

Now here is the point that in case I left the key in the vehicle then how both the keys in my possession.

Second key is also handed over to your office along with this reply letter.

Sir here I want to disclose that I am a retired person from INDIAN NAVY and I purchased this vehicle from hard earned money. X x x”

It has been clearly mentioned in the aforesaid letter that key of the vehicle was not left in the vehicle but it was in another vehicle of his friend Sainik Singh, who was with him at the time when his vehicle was stolen and the key was found by his friend Sainik Singh from his car and handed over to him and the same was deposited with your investigator. Even the second key of the vehicle was also handed over to the office of the insurance company. So, we find no ground in the objection taken by the appellant/insurance company, therefore, the same stands rejected.

10.           With regard to the repudiation of the claim of the complainant is concerned, it is, no doubt, true that the insurance company repudiated the claim of the complainant vide letter dated 24.10.2017 (Annexure C-10). It is relevant to note that the said incident of theft took place on 05.09.2016 and the complainant in his rejoinder clearly mentioned that he approached the police authorities on the same date i.e. 05.09.2016 but the said authority lodged FIR No.128 on 07.09.2016 with Police Station, Balachaur. If the police lodged the FIR late, what was the fault of the complainant.  The complainant had no control over the police authorities.  Moreover, the complainant informed the insurance company as well as RTA on 09.09.2016 regarding the theft of the vehicle.  Therefore, the plea taken by the insurance company that the claim of the complainant was repudiated due to late intimation has no value at all because after going through the record, we find that the Forum while passing the impugned order rightly mentioned in para No.6, the instructions dated 21.09.2011 issued by Insurance Regulatory and Development Authority (IRDA) and we find that the Forum rightly held in para Nos.7 to 9, which are as under :-

“7.        It is very clear from the above circular that the insurance company cannot repudiate the bonafide claims on technical grounds like delay in intimation and submission of some required documents. The decision of insurers to reject a claim of the claimant should be based on sound logic and valid grounds. The limitation clause does not work in isolation and is not absolute. One needs to see the merits and good spirit of the clause, without compromising on bad claims. Rejection of claims on purely procedural grounds in a mechanical fashion will result in policy holders losing confidence in the insurance industry, giving rise to excessive litigation. It has been further advised in the above said letter that the insurers must not repudiate such claims unless and until the reasons of delay are specifically ascertained, recorded. Had the Insurance Company followed the above said guidelines issued by the statutory authority, present unwarranted litigation would have been easily avoided. However, in spite of the above said positive guidelines issued by IRDA, there is hardly any visible improvement in the working of the insurance companies and the OP is no exception. The end result of this arbitrary working of the insurance companies is that even poor and genuine-citizens insured are being made to suffer and most of the times, for none of their fault, defeating the very purpose of insurance policies.

8.           What is the spirit of Insurance Policy, should be kept in mind by the officials dealing with the genuine claims of the sufferers and the same should not be rejected on methodological grounds in a mechanical manner. The tendency of Insurance Companies in rejecting genuine claims is the reason of increasing litigation between the insurers and the insured/their legal heirs.

9.          Thus, the repudiation of the claim was contrary to the guidelines of the IRDA, stated above because the intimation to the police after one day and to insurance company after 3 days is not significant in genuine claim of the complainant. A person who lost his vehicle which was being used by him for personal use straightway may not go to the Insurance Company to claim compensation. At the first instance he himself makes efforts to search the vehicle. Filing of claim with the Insurance Company is the last resort. Moreover, the police used to register the FIR only after verifying the details of the case. Under these circumstances, it was indeed a deficiency in service on the part of the OP for repudiating the claim on flimsy ground. It be fair or reasonable to reject even the genuine claims of the insured. There may be a condition in the policy regarding delay in intimation but that does not mean that the insurer can take the shelter under that condition and repudiate the claim of the claimant, which is otherwise proved to be genuine.”

                With regard to the authentication of the keys are concerned, it is relevant to mention here that the complainant sent email dated 12.09.2017 (Annexure C-8) to the

11.           For the reasons recorded above, we are of the opinion that the order passed by the Forum (now District Commission), being based on the correct appreciation of evidence and law, on the point, does not suffer from any illegality. Hence, the appeal filed by the Opposite Party, being devoid of merit, must fail, and the same stands dismissed, with no order as to costs. The order of the Forum (now District Commission) is upheld.

12.           Certified copies of order be given to the parties/their Counsel free of charge.

Pronounced.

08.12.2020

[RAJ SHEKHAR ATTRI]

PRESIDENT

(PADMA PANDEY)

        MEMBER

(RAJESH  K. ARYA)

MEMBER

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