Delhi

North East

CC/109/2021

Sh. Om Prakash - Complainant(s)

Versus

M/s Go Digi General Insurance Ltd. - Opp.Party(s)

23 Feb 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION: NORTH-EAST

GOVT. OF NCT OF DELHI

D.C. OFFICE COMPLEX, BUNKAR VIHAR, NAND NAGRI, DELHI-93

Complaint Case No. 109/21

 

		Sh. Om Prakash Aggarwal, R/o A-30, Gali No. 1, Near J.R Public School, Millan Garden, Sabhapur, Delhi 110094		Complainant
		Versus
	1.             2.	M/s Go Digit General Insurance Ltd., Through its Director/Authorized Representative Sh. V.D. Gupta, Atlantis, 95, 4th B Cross Road, Karamangala Industrial Layour, 5th Block, Bengaluru, Karnataka 560095   M/s Go Digit General Insurance Ltd., Delhi Business Centre, Spring Board,  67-68, Chandra Bhawan Building, 3rd Floor, Nehru Place, New Delhi 110019		Opposite Parties
			DATE OF INSTITUTION:      JUDGMENT RESERVED ON:                        DATE OF ORDER:		26.08.2021 24.11.2023 23.02.2024

 

CORAM:

Surinder Kumar Sharma, President

Anil Kumar Bamba, Member

Adarsh Nain, Member

 

ORDER

Ms. Adarsh Nain, Member

The Complainant filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the Opposite Parties which is M/s Go Digit General Insurance Co. Ltd. having office at Banglore and M/s Go Digit General Insurance Co. Ltd. having office at Nehru Place, Delhi.

Case of the Complainant

1. The case of the Complainant as revealed from the record is that on 25.12.2019, the Complainant purchased an insurance policy from the Opposite Parties for his vehicle i.e. E-rickshaw bearing no. DL 5ER 5453 for an amount of                 Rs. 95,000/-, effective from 25.12.2019 till midnight of 25.12.2020. Complainant stated that at the time of taking the policy, Opposite Parties did not provide to him any documents regarding the terms and conditions of the policy, however, the representative of Opposite Parties had taken the signature of the Complainant on various papers without explaining anything. On 22.10.2020, the said vehicle was stolen and an E-FIR bearing no. 027389/2020 dated 22.10.2020 was lodged at E-Police station M.V. Theft, New Usmanpur. Complainant stated that on the same day, this fact was also disclosed to the Opposite Party No. 1. Complainant stated that he handed over one key of the said vehicle to the agent of the Opposite Party as another key was misplaced but he did not lodge any report in this regard. Complainant stated that he filed his claim before the Opposite Party No. 1 but Opposite Parties did not pay any claim to the Complainant. The Complainant  submits that Opposite Party No. 1 assured the Complainant that his claim would be released only after untraced report was filed before the competent court. On 11.02.2021, Complainant received the untraced report from the competent court. Complainant stated that after verification and confirmation, representative of the Opposite Party had received all the documents in respect of the said vehicle but claim was not paid despite several requests. It came as a shock to the Complainant when he came to know that the Opposite Party is not clearing his claim. It is submitted that since his vehicle was duly covered under the Insurance cover of Rs. 95,000/-, the Opposite Party cannot decline his claim without any just cause and reason which shows the deficiency on the part of Opposite Party. Hence, the present complaint has been filed by the Complainant with prayer for Rs. 95,000/- i.e. insurance amount of the vehicle. Complainant also prayed for Rs. 1,50,000/- on account of mental harassment and Rs. 31,000/- on account of litigation expenses.

Case of the Opposite Parties

2. Notice was served upon both the Opposite Parties, common vakalatnama was filed representing both the Opposite Parties while the written statement has been filed on behalf of Opposite Party No. 1. However, the counsel of Opposite Party No. 1 submits that the reply may be read on behalf of both the Opposite Parties.
3. In the reply filed by the Opposite Parties, the subject policy in the name of the Complainant has been admitted, however, it has been contended that the same was issued subject to terms and conditions. It has been contended that the Complainant’s claim was repudiated by the Opposite Party for the reason that there was self-act of negligence on the part of the Complainant. This fact is evident from the Complainant’s statement in writing given to the surveyor submitting that the OEM keys were lost with insured vehicle while FIR was registered under Section-379 of IPC i.e. Simple theft. The Opposite Party submits that it is violation of condition 4 of the policy which provides that insured shall take reasonable steps to safeguard the vehicle for loss or damage.  

Rejoinder to the written statement of Opposite Parties

4. The Complainant filed rejoinder to the written statement of Opposite Parties wherein the Complainant has denied the pleas raised by the Opposite Parties and has reiterated the assertions made in the complaint.

Evidence of the Complainant

5. The Complainant in support of his complaint filed his evidence by way of affidavit, wherein he has supported the averments made in the complaint.

Evidence of the Opposite Parties

6. In order to prove their case, Opposite Parties have filed affidavit of   Sh. Sandeep Kumar Mohanty, wherein the averments made in the written statement of Opposite Parties have been supported.

Arguments & Conclusion

7. We have heard the Ld. Counsel for the Complainant. The Opposite Parties neither filed written arguments nor did they address the arguments orally. We have also perused the file and the written arguments filed by the Complainant.
8. The case of the Complainant is that the subject vehicle duly insured with Opposite Parties was stolen and matter was reported to police through e-FIR and untrace report was also filed by the police pertaining to said FIR. It is alleged by the Complainant that despite the vehicle being insured with the Opposite Parties under a valid policy, the claim was denied amounting to deficiency in services towards the Complainant.
9. On the other hand, Opposite Parties have contended that though the policy is admitted, yet the claim is not payable due to breach of the terms and conditions of the policy. The Complainant’s claim was repudiated by the Opposite Parties on the ground of self-act of negligence on the part of the Complainant which is allegedly evident from the Complainant’s statement in writing given to the surveyor submitting that the OEM keys were lost with insured vehicle while FIR was registered under Section-379 of IPC i.e. Simple theft.
10. On perusal of the record including the pleadings of the parties, it is revealed that it is not in dispute that the Complainant had taken an insurance policy for the vehicle in question nor is it in dispute that the theft took place during subsistence of the policy which was valid on the date of the incident.
11. The perusal of the record also shows that police after due investigation had filed untrace report before the Court of law as the vehicle could not be traced. The record also shows that the claim has been repudiated on account of breach of condition no. 4 as there was self-act of negligence on the part of the Complainant.  It has been contended by Opposite Parties that at the time of survey, Complainant had given his statement in writing submitting that the OEM keys were lost with insured vehicle while FIR was registered under Section-379 of IPC i.e. Simple theft.
12. The Opposite parties have repudiated the claim of the Complainant on ground of condition no. 4 of the terms and conditions of the policy. It is worth to note that the Complainant has taken the stand in the complaint itself that he was not provided with the terms and conditions of the policy. The Opposite Parties, in their reply, has simply denied the said averment but has not led any evidence, whatsoever, in proof that the terms and conditions of the policy were supplied to the Complainant at the time of issuing the subject policy.
13. In M/s Texco Marketing Pvt. Ltd. vs TATA AIG General Insurance Company Ltd. & Other, 2022 SCC Online SC 1546, the Hon’ble Supreme Court of India highlighted the duty of insurance companies to disclose all material terms of the policy to the insured, in accordance with the Insurance Regulatory and Development Authority (Protection of Policyholders’ Interests) Regulations, 2002 (Regulations) and the doctrine of ‘uberrimae fidei’ or utmost good faith and issued a ‘word of caution’ to all the insurance companies to comply with the IRDA Regulations which mandate fair and open disclosure of all material terms of the policy, non-compliance of the which will leave the insurer remediless when denying and/or rejecting a claim. 
14. In view of above, the Opposite parties are not justified in rejecting the claim for breach of certain condition of the policy which was not brought to the knowledge of the insured Complainant. Moreover, the Complainant has denied to have given any such statement regarding loss of OEM keys was given by him at the time of survey and the Opposite Parties i. e. Insurance Company has failed to rebut that. The Opposite Party No. 1 has not led any evidence such as surveyor’s affidavit proving the survey report upon which Opposite parties are relying heavily. Therefore, the said contention cannot be believed as true.
15. In view of above case law and discussion held, we are of the considered view that Opposite Parties have been deficient in services by wrongly repudiating Complainant’s valid claim under the effective Policy in force at the time of incident.
16. Thus, we hold Opposite Parties liable of deficiency of services jointly and severally and direct the Opposite Parties to pay jointly and severally to the Complainant Rs. 95,000/-. (Rs. Ninety five Thousands only), the insured amount under the policy along with interest @ 9 % p.a. from the date of filing the complaint till its recovery, upon completion of requisite documentation formalities by the Complainant. The Opposite Parties are further directed to pay jointly and severally an amount of Rs. 15,000/- towards compensation and litigation cost along with interest @ 9 % p.a. from the date of this order till its recovery.
17. Order announced on 23.02.2024.

 

Copy of this order be given to the parties free of cost.

 

File be consigned to Record Room.

 

(Anil Kumar Bamba)          Member

(Adarsh Nain) Member

(Surinder Kumar Sharma) President