Per Smt Jayashree D Yengal, Hon’ble Member

The present appeal is filed by the original opponent  challenging the order dtd.30.11.2009 passed by the District Consumer Forum, Akola in CC No.143/2009 partly allowing the complaint, thereby awarding the insurance claim of `83,571/- with interest thereon and litigation charges of `500/-.

The facts to the extent material to dispose of the appeal are as under:-

1.      The respondent herein / original complainant had purchased passenger carrying vehicle – Tata Indigo VS model, bearing registration No. MH-30-P-7525.  At the time of purchase the dealer had got the insurance for the vehicle from Reliance General Insurance Co Ltd under policy no.1708372324200012 valid for the period from 26.04.2007 to 25.04.2008. The respondent thereafter purchased vehicle insurance policy namely “Package Policy” from the appellant on 23.04.2008 covering the period from 26.04.2008 till midnight of 25.04.2009, bearing policy no.16/000/31/08/01/00000202. The respondent also availed of 20% discount on the premium by claiming “No Claim Bonus” (NCB).

2.      The respondent by letter dtd. 01.08.2008 intimated to the appellant that the insured vehicle got damaged due to accident which occurred on 29.07.2008. The respondent also intimated that since there was no casualty or injury to anybody no FIR or complaint was lodged with the police. 

3.      The appellant immediately appointed a surveyor to conduct the survey and assessed the losses to settle the claim of the respondent. 

4.      The surveyor assessed the damages to the extent of `55,774/-. On further scrutiny of the insurance claim filed by the respondent, the appellant repudiated the claim on 12.12.2008 by informing the respondent as:-

“With reference to above, on going through the PROPOSAL FORM submitted by you at the time of insurance, it is observed that you have claimed No Claim Bonus (NCB). But after confirmation of NCB from the previous Insurer, it is observed that there was a claim on the previous policy, hence your information is incorrect, hence, as per Motor Tariff provisions all the benefits under the policy in respect of Section-I of the Policy stands forfeited, which please note.  Therefore, your above claim is not payable, which stands repudiated.”

5.      It is the contention of the appellant that after due verification, scrutiny and investigation of the claim put forth by the respondent it was found that policy obtained by the respondent was by suppression and misrepresentation of fact by furnishing incorrect information.

7.      The respondent had availed 20% NCB on the premium by representing to the appellant that there was no claim against the previous policy he had taken for the vehicle from previous insurance company. 

8.      The previous insurer i.e. Reliance General Insurance Co Ltd., had endorsed on the reminder letter dtd. 30.08.2008 issued by the appellant and confirmed the fact that the respondent had lodged one claim for the aforesaid vehicle of `43,000/- under the previous policy, claiming damage sustained to the said vehicle.

9.      This resulted into breach of policy condition and suppression of material fact with a fraudulent intention to make wrongful gain. Therefore, the claim is not admissible and payable and hence, it was rightly repudiated.  Hence, the complaint being frivolous is liable to be rejected with cost.

10.    Being aggrieved by the repudiation of the claim by the appellant, respondent lodged a consumer complaint, which was partly allowed  awarding the reliefs as aforesaid.

11.    The Forum observed that since there is no declaration of the insured regarding the NCB claimed and since the second insurer company is under an obligation to write to the policy issuing office of the previous insurer by recorded delivery calling for confirmation of the entitlement and rate of NCB for the particular insured and the previous insurer shall be obliged to provide the information sought within 30 days of receipt of letter of enquiry, failing which the matter will be treated as a breach of Tariff on the part of the previous insurer. 

12.    Failure of the insurer granting the NCB to write to the previous insurer within 21 days after granting the cover will also constitute a breach of the Tariff.  Therefore, the Forum held the breach of Tariff being committed by the appellant – insurer and hence, partly allowed the complaint.

13.    Being aggrieved the appellant / original opponent has filed the instant

appeal.

14.    Heard the counsel for the appellant. Perused the documents, affidavits filed by both the parties on record.

15.    The proposal form filed on record by the respondent clearly makes a mention of a declaration, “I declare NCB claimed by me, is correct,” and the said proposal form is duly endorsed by the signature of the respondent, therefore, the No Claim Bonus was claimed by the respondent is not disputed. 

16.    Furthermore the letter dtd. 30.08.2008 filed by the appellant is the endorsement received by the appellant from the first / previous insurer informing that the respondent had registered a claim with the first / previous insurer vide claim no. 2071062053 for an amount of `43,000/-.  The only inference that can be drawn on perusal of these documents is that the insured had furnished incorrect information in the proposal form and therefore, the appellants / insurance company have rightly repudiated the claim of the respondent.

17.    The respondent was well aware of the fact that he had furnished incorrect information in the proposal form is substantiated by the letter dtd.22.01.2009 written by the respondent to the appellant requesting and intimating the appellant to impose penalty or any charges against the NCB of previous year.

18.    The insured has not left any opportunity to procure undue gain namely at the time of purchasing the insurance policy by furnishing incorrect information. The policy holder procured 20% discount on the premium but when the claim involved higher stake due to accident he was ready and willing to pay for the penalty charges to procure further undue benefit from the policy.  Therefore, in our opinion respondent has not come before the appellant with clean hands and appellant has rightly repudiated the claim.  The order passed by Forum below is not sustainable in law and is illegal, unjust and bad in law.  In the circumstances we pass the following order:-

ORDER

1.      Appeal is allowed.

2.      The order dtd.30.11.2009 passed in CC No.143/09 by DCDRF Akola is quashed and set aside.

3.      The CC No.143/09 stands dismissed.

4.      Parties are left to bear their own costs.

5.      Inform the parties accordingly.

          Pronounced on 27.04.2011

sj