Challenge in this First Appeal, under Section 19 of the Consumer Protection Act, 1986 (for short “the Act”), by Shriram General Insurance Co. Ltd. (for short “the Insurance Company”), the sole Opposite Party in the Complaint under the Act, is to the order dated 08.04.2015, passed by the Maharashtra State Consumer Disputes Redressal Commission at Mumbai (for short “the State Commission”) in Consumer Complaint No. CC/13/05. By the impugned order, while allowing the Complaint, filed by Respondent No.1 herein, alleging deficiency in service on the part of the Insurance Company in repudiating the claim made for indemnification of the loss suffered by her in respect of the insured Dumper, the State Commission has directed the Insurance Company to pay to the Complainant the cost of the Dumper, i.e. ₹22,76,000/-; interest @ 9% p.a. on the said amount from the date of repudiation of the claim, i.e. 01.08.2012, within 45 days from the date of the order, with a default stipulation of payment of interest @ 12% p.a. on the said amount; ₹50,000/- as compensation for the mental agony; and costs, quantified at ₹25,000/-. 2. Briefly stated, the material facts giving rise to the present Appeal are as follows: 3. The Complainant had obtained from the Insurance Company a Miscellaneous Class D Vehicles – Tippers – Package Policy in respect of the Dumper, owned by her, for the assured sum of ₹22,76,000/-, covering the period from 13.01.2012 to 31.12.2012. The vehicle was hypothecated with a Bank for raising the loan for purchase of the vehicle. Unfortunately, on 16.07.2012 the vehicle got stolen while it was parked on the road side. According to the Complainant, the incident of theft was reported to the Police as well as to the Insurance Company on the very next day, i.e. 17.07.2012. On filing of the closure report by the Police, on 27.07.2012 the Complainant preferred her claim under the policy with the Insurance Company. However, the said claim was repudiated by the Insurance Company, vide their letter dated 01.08.2012, on the sole ground that there was a delay of six days in intimating the Insurance Company about the theft of the vehicle. As per the letter of repudiation, the alleged theft had taken place on 16.07.2012 but the intimation about the occurrence was received by the Insurance Company only on 21.07.2012. Thus, according to the Insurance Company, the said delay amounted to breach of a policy condition, which stipulates that the notice for such a contingency shall be given in writing to the Insurance Company immediately upon the occurrence of any accidental loss or damage. 4. Being aggrieved, the Complainant filed the Complaint, in which the afore-stated order has been passed. Hence, the present Appeal. 5. Questioning the legality of the order impugned in the Appeal, Ld. Counsel appearing for the Insurance Company submits that in arriving at the conclusion that there was deficiency in service on the part of the Insurance Company in repudiating the claim on the afore-stated ground, the State Commission has failed to take into consideration the scope and purport of the afore-noted condition in the policy. It is urged that the delay of six days in informing the Insurance Company about the occurrence was a clear breach of the policy conditions and, therefore, the Insurance Company was justified in repudiating the claim. 6. Per contra, while asserting that there was no delay in intimating the Insurance Company about the occurrence, Ld. Counsel appearing for the Complainant has submitted that in the Complaint there was a specific averment that the intimation with regard to the theft was given to the Insurance Company on phone on 17.07.2012 and the Complaint Number, being 102526, was generated, but the said averment had not been rebutted in the Written Version filed on behalf of the Insurance Company, and, therefore, it stood proved that there was no delay in intimation of incident. It is argued that even if it is assumed for the sake of argument that there was delay of six days, as alleged by the Insurance Company, yet the claim could not be rejected merely on the ground of delay without examining the question whether the vehicle had actually been stolen or not. It is submitted that having failed to hold any enquiry on this aspect, in the light of the decision of the Hon’ble Supreme Court in Om Prakash v. Reliance General Insurance & Anr., (2017) 9 SCC 724, no fault can be found with the view taken by the State Commission. 7. Having perused the documents on record, including the Written Version filed on behalf of the Insurance Company, and examined the case on the touchstone of the law laid down by the Hon’ble Supreme Court on the point at issue, viz. whether the claim in question could be repudiated on the short ground of alleged delay of six days in intimating the Insurance Company about the theft, we are inclined to agree with the submissions made on behalf of the Complainant. 8. In Om Prakash’s case (supra), while holding that repudiation of an insurance claim merely on the ground of delay in intimation to an insurance company would be bad, the Hon’ble Supreme Court has observed as follows: “11. It is common knowledge that a person who lost his vehicle may not straightaway go to the Insurance Company to claim compensation. At first, he will make efforts to trace the vehicle. It is true that the owner has to intimate the insurer immediately after the theft of the vehicle. However, this condition should not bar settlement of genuine claims particularly when the delay in intimation or submission of documents is due to unavoidable circumstances. The decision of the insurer to reject the claim has to be based on valid grounds. Rejection of the claims on purely technical grounds in a mechanical manner will result in loss of confidence of policy-holders in the insurance industry. If the reason for delay in making a claim is satisfactory explained, such a claim cannot be rejected on the ground of delay. It is also necessary to state that it would not be fair and reasonable to reject genuine claims which had already been verified and found to be correct by the Investigator. The condition regarding the delay shall not be a shelter to repudiate the insurance claims which have been otherwise proved to be genuine. It needs no emphasis that the Consumer Protection Act aims at providing better protection of the interest of consumers. It is a beneficial legislation that deserves liberal construction. This laudable object should not be forgotten while considering the claims made under the Act.” (Emphasis supplied) 9. In the present case, admittedly the Insurance Company has not found any thing fishy about the occurrence, in as much as, no such averment or even a doubt about the theft had been made in the Written Version. The claim was repudiated on the sole ground of delay. At the cost of repetition, it is also pertinent to note that in the Written Version there was no specific denial by the Insurance Company to the stand of the Complainant that “Complaint No. 102526” had been generated on 17.07.2012 itself, on the basis of oral intimation over the phone about the theft of the vehicle in question. In that view of the matter, even the alleged delay of six days in intimating in writing also stands explained. Hence, on facts and in light of the afore-noted authoritative pronouncement of the Hon’ble Supreme Court, we do not find any illegality, factual or legal, in the impugned order. Accordingly, the afore-noted finding returned by the State Commission is affirmed. 10. Having arrived at the said conclusion, the next question for consideration is as to whether the State Commission was justified in awarding interest @ 9% p.a. on the principal amount of ₹22,76,000/-, in favour of the Complainant? Regard being had to the fact that because of the theft of the vehicle, purchased by the Complainant for earning her livelihood, and repudiation of the claim, the Complainant was unable to discharge the debt of the Bank, resulting in auction of the house of the Complainant by the Bank for realization of its dues from the Complainant, who had raised the loan to purchase the vehicle in question, we are of the view that award of interest @ 9% p.a. is in order and does not warrant interference. However, having regard to the fact that 50% of the amount awarded has already been deposited by the Insurance Company, as directed by this Commission, the default stipulation of payment of interest @ 12% p.a. is deleted. 11. In the final result, the Appeal is partly allowed and the impugned order is modified to the extent indicated above. 12. The amount already deposited by the Insurance Company shall be released to the Complainant forthwith. The balance amount due in terms of this order shall be remitted by the Insurance Company to the Complainant within four weeks from the date of receipt of a copy of this order, failing which the said amount shall carry interest @ 12% p.a. from the date of this order till actual realization. 13. The Appeal stands disposed of in the above terms with no order as to costs. |