Haryana

StateCommission

A/803/2014

National Insurance Company Limited - Complainant(s)

Versus

Mahipal - Opp.Party(s)

19 Feb 2016

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

First Appeal No  :      803 of 2014

Date of Institution:      12.09.2014

Date of Decision :       19.02.2016

 

National Insurance Company Limited, Branch Office-1, 5C-1 & 2, B.P. Road, Neelam Chowk, Faridabad, through its Divisional Manager, now through its authorized signatory, Puja Dhawan, A.O. Regional Office-II, SCO No.337-340, Sector 35-B, Chandigarh.

                                      Appellant/Opposite Party No.1

Versus

1.      Mahipal s/o Sh. Bhajan Lal, Resident of Village Kairaka, Tehsil and District Palwal.

Respondent/Complainant

2.      Hari Finance Bhawan Kund Chowk, Palwal, through its Proprietor.

                                      Respondent/Opposite Party No.2

 

CORAM:             Hon’ble Mr. Justice Nawab Singh, President.

                             Mr. B.M. Bedi, Judicial Member.

                                                                                                         

Present:               Shri J.P. Nahar, Advocate for appellant.

                             Respondent No.1 in person.

                             None for respondent No.2. 

 

                                                   O R D E R

 

NAWAB SINGH J.(ORAL)

 

Mahipal-complainant/respondent No.1, was owner of Motor Cycle bearing registration No.HR-30G-7657, Hero Honda Splendor make. It was insured with National Insurance Company Limited (for short ‘the Insurance Company’) for the period February 7^th, 2009 to February 6^th, 2010, vide Insurance Policy Exhibit C-1. The Insured Declared Value (IDV) of the motor cycle was Rs.37,335/­-.

2.      On November 8^th, 2009, the motor cycle was stolen in the area of Palwal. The complainant informed the Police on the same day, that is, November 8^th, 2009, vide application Exhibit C-2, whereby he requested to lodge F.I.R. The Police of Police Station Palwal City, registered F.I.R. No.384 (Exhibit C-3) on November 30^th, 2009. National Crime Records Bureau (NCRB), submitted report Exhibit C-4 stating that “As per information available with NCRB till date (based on data received from States/UTs Police) the above mentioned vehicle is not recovered yet.” The complainant filed claim with the Insurance Company but the same was repudiated vide letter Exhibit C-5.

3.      The complainant filed complaint under Section 12 of the Consumer Protection Act, 1986 before District Consumer Disputes Redressal Forum, Narnaul (for short ‘the District Forum’).

4.      The Insurance Company in its reply pleaded that there was delay of 22 days in lodging of the F.I.R. and 51 days in giving intimation to the Insurance Company. Since, the complainant violated the terms and conditions of the Insurance Policy, so his claim was repudiated.

5.      After evaluating the pleadings and evidence of the parties, the District Forum vide order dated April 29^th, 2014, allowed complaint directing the Insurance Company to pay Rs.37,235/-, Rs.2200/- compensation on account of harassment etc and Rs.1100/- litigation expenses.

6.      Aggrieved of the impugned order, the Insurance Company has filed the instant appeal.

7.      Learned counsel for the Insurance Company has urged that the motor cycle was stolen on November 8^th, 2009; F.I.R. (Exhibit C-3) was lodged on November 30^th, 2009 and intimation to the Insurance Company was given on December 21^st, 2009. Thus, there was delay of 22 days in lodging the F.I.R. and 51 days in giving intimation to the Insurance Company. So, the Insurance Company was not liable to indemnify the complainant.

8.      At this juncture, before adverting to the facts at hand, it would be appropriate to refer to Circular Ref: IRDA/ HLTH/ MISC/ CIR/ 216/ 09/ 2011 dated September 20^th, 2011 issued by Insurance Regulatory Development Authority (for short ‘IRDA’). It has been specifically mentioned in the above said circular by IRDA that 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.  The operative part of the circular reads as under:-

 “The Authority has been receiving several complaints that claims are being rejected on the ground of delayed submission of intimation and documents.

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 intimation or in submission of documents due to unavoidable circumstances.”

9.      Indisputably, the motor cycle was stolen on November 8^th, 2009. The complainant immediately informed the Police vide application Exhibit C-2 on the same day, that is, November 8^th, 2009. The Police recorded F.I.R. (Exhibit C-3) on November 30^th, 2009. The delay in recording the F.I.R. is not the fault of the complainant and it was for the Police to register the F.I.R. immediately.  The complainant had given intimation to the Insurance Company on the next day, that is, November 9^th, 2009. National Crime Records Bureau submitted report Exhibit C-4. Since the information was given immediately to the Police, the delay in lodging of the FIR by the Police is no ground to repudiate the claim of the complainant.  No cogent evidence has been produced by the Insurance Company to prove that there was delay in giving intimation by the complainant. 

10.    Another important aspect of the case is that in para No.2 of its reply, the Insurance Company has pleaded that the complainant never submitted the claim with it.  The reply is dated December 16^th, 2010. The Insurance Company repudiated complainant’s claim vide letter dated December 30^th, 2009 (Exhibit C-5), that is, prior to the filing of the reply. Thus, the plea taken by the Insurance Company that claim was never filed with it, is baseless. This act of the Insurance Company shows that they were not willing to pay the benefits of insurance to the complainant on one pretext or the other.

11.    Hon’ble Supreme Court in Madras Port Trust Vs. Hymanshu International, (1979) 4 SCC 176, deprecated the practice often adopted by the Insurance Companies of denying claims on technical pleas, even though the claims lodged with them are otherwise well founded. It is unfortunate that the insurer takes such a plea to defeat the genuine claim of the insured. The insurer should not rely upon technical pleas for the purpose of defeating legitimate claims of claimants.

12.    In view of the above, the Insurance Company is liable to indemnify the loss suffered by the complainant. No case for interference in the impugned order is made out.

13.    Hence, the appeal is dismissed being devoid of merits.

14.    The statutory amount of Rs.18,618/- deposited at the time of filing the appeal be refunded to the complainant against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.

 

Announced: 19.02.2016

(B.M. Bedi) Judicial Member

(Nawab Singh) President

 

CL