DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II
Udyog Sadan, C-22 & 23, Qutub Institutional Area
(Behind Qutub Hotel), New Delhi-110016
Case No. 321/2012
Shri T.V. Radhakrishnan,
R/o 123-B, Pocket-C1,
Mayur Vihar-III, Delhi-110096.
….Complainant
Versus
- Shriram General Insurance,
Through
its Manager/ Concerned officer,
E-8, EPIP, RIICO, Sitapura,
Jaipur (Raj.) 302022
- Shriram General Insurance
K-18, Lajpat Nagar-II,
New Delhi.
….Opposite Parties
Date of Institution : 18.06.2012 Date of Order : 01.11.2018
Coram:
Sh. R.S. Bagri, President
Ms. Naina Bakshi, Member
Ms. Kiran Kaushal, Member
ORDER
Ms. Kiran Kaushal, Member
Brief facts as stated by the complainant are that:
- The complainant, T.V. Radhakrishnan was the owner of Tavera Chevrolet, bearing registration No. DL1V-B4846 and was duly insured by Shri Ram General Insurance (OP) which was valid from 10.02.2011 to 09.02.2012.
- The said vehicle was parked at Scope Minar, Laxmi Nagar on 25.01.2011. When the complainant returned back to collect his vehicle, he found that the vehicle was missing. The complainant telephonically informed the OP regarding the missing vehicle and thereafter, he lodged the complaint with police station Preet Vihar, Delhi. Later untraced report was filed and thereafter, the complainant submitted all the documents with OP and filed the insurance claim. The complainant visited OP’s office several times but all in vain. The complainant later issued notice to OP on 04.03.2012.
- Being aggrieved, the complainant filed complaint before this Forum with the prayer to direct OP to pay the claim amount of Rs.3,00,000/- as per the IDV at the time of insurance. Next it is prayed that the OP should pay Rs.1,00,000/- towards compensation and cost of the complaint.
2. OP resisted the complaint inter-alia stating that the written notice or letter of intimation regarding the theft of vehicle was served upon the OP for first time after 9-10 days of theft, consequently, OP was deprived of the right to carry on proper inquiry at the spot of theft of vehicle among other things.
2.1 OP has quoted following judgments to support his case:-
(i) The Hon’ble Supreme Court while dealing with the issue in United India Insuracne Vs. M/s Harchand Rai Chandan Lal, JT 2004(8) S.C. 8 held that the terms of the contract has to be read strictly.
(ii) Further while dealing with the issue of delay in intimation to the company, Hon’ble National Commission in the case reported as Davinder Singh Vs. New India Assurance Co. Ltd. III(2003) CPJ 77 (NC), a delay of four days in intimation to the insurer was held to be in violation of the policy conditions.
(iii) The said legal position has further been reaffirmed by the National Commission in New India Assurance Co.Ltd. Vs. Dharam Singh & Anr.,III(2006) CPJ 240 (NC), and New India Assurance Co. Ltd., Vs. Trilochan Jane, (F.A. 320/05 decided on 09.12.2009). Thus OP stated that in view of the settled legal position, the present complaint is squarely covered by the above said judgments and therefore is liable to be dismissed.
2.3 It is next averred by the OP that the complainant himself violated the terms and conditions of the policy by not informing the Insurance Company immediately regarding theft of vehicle whereas it is clearly provided in the policy that :
“Notice shall be given in writing to the company immediately upon the occurrence of any accidental loss or damage in the event of any claim and thereafter the insured shall give all such information and assistance as the company shall require.”
2.4 It is further stated by the OP that the complainant willfully violated the terms and conditions of the insurance policy by parking the vehicle unsafe, without any locks, in no-parking area, left unattended, with the keys in the vehicle. Therefore the complaint is liable to be dismissed.
3. Replication and evidence by way of affidavit has been filed on behalf of the complainant reiterating the averments made in the complaint.
4. Affidavit of Sh. Vikas Goyal, Assistant Manager (Legal), Shriram General Insurance Co. Ltd. has been filed on behalf of the OP.
5. Written arguments have been filed by the parties.
6. We have considered the submissions of the Ld. Counsels and perused the material placed on record.
7. Admittedly, the complainant was the owner of Tavera Chevrolet bearing registration No. DL1V-B4846 which was insured by OP and the insurance policy was valid from 10.02.11 to 09.02.12. The complainant along with his driver Mr. Gopa Kumar parked the vehicle at Scope Minar, Laxmi Nagar on 25.01.2011. After 28 days i.e. on 22.02.2011, when he came to collect the vehicle he saw that the vehicle was missing from the place where he had parked. He tried to search the vehicle but to no avail. The complainant telephonically informed the OP about theft of his vehicle. Thereafter he immediately called on 100 number PCR on the same day and along with police team searched for the vehicle but could not find the vehicle. On the next day, an FIR was registered regarding theft of the vehicle. Police made efforts to trace the vehicle but were unable to find it, finally untraced report was filed. The complainant consequently filed for insurance claim and provided the necessary documents for the same.
8. Pursuant to the said claim, OP appointed an investigator who after verification confirmed the factum of theft. A detailed investigation report has been filed by the investigator exhibited as Ex.OPW-1/D. Finally untraced report submitted by the insured states as under:-
“As such you may please process the claim of the Insured as per the terms and conditions of the policy and payment should be made in the favour of insured Mr. T.V. Radhakrishanan after clarification of above observations.”
9. OP in its written statement has stated that the complainant has violated the terms and conditions of the policy by parking the vehicle unsafe, without any locks, in no-parking area, left unattended, with the keys in the vehicle. Whereas the investigator appointed by the OP has mentioned in its report that the original two used keys were in possession of the insured. Similarly, it is further found by the investigator ‘mostly people used to park their vehicle in the area’ where it was last parked by the complainant. Hence, OP’s allegation that the vehicle was parked in unsafe area with the keys in the vehicle are unfounded and therefore rejected. Despite the recommendation by the investigator OP rejected the claim on ground of delay.
10. Regarding the delay of formal written notice and letter of intimation of theft of the vehicle that was delayed for 9 or 10 days, there have been guidelines in Circular No. IRDA/HLTH/MISC./CIR/216/09/2011 dated 20.09.2011 issued by IRDA in this respect. The said circular to the extent it is relevant, reads as under:-
“The Authority has been receiving several complaint that claims are being rejected on the ground of delayed submissions 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.
The insurers decision to reject a claim shall be based on sound logic and valid grounds. It may be noted that such 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 technical grounds in a mechanical fashion will result in policy holders losing confidence in the insurance industry giving rise to excessive litigation.
Therefore, it is advised that all insurers needs to develop a sound mechanism of their own to handle such claims with utmost care and caution. It is also advised that the insurers must not repudiate such claims unless and until the reasons of delay are specifically ascertained, recorded and the insurers should satisfy themselves that the delayed claims would have otherwise been rejected even if reported in time.”
The said legal position has been further affirmed in a case titled “Om Parkash vs. Reliance General Insurance” Civil Appeal No.15611 of 2017 by Hon’ble Supreme Court. The relevant portion reads as under:-
“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.”
11. It is, thus, evident that the genuine claim is not to be rejected by the insurer only on account of delay in its submission. Further in the present case, it would not be fair and reasonable to reject the genuine claim which has already been verified and found to be correct by the investigator.
12. However, in the instant case the complainant was negligent to some extent in as much as that he kept the vehicle parked in the Scope Minar, Laxmi Nagar for 28 days. Leaving the vehicle unattended in the parking area does amount to some negligence on the part of the complainant. Though the forum holds this view yet the claim was rejected only on the ground of delay. Therefore, this Forum is of the opinion that OP is deficient in service for repudiating the claim on delay of intimation of just 9 days. OP is directed to pay the Insured Declared Value (IDV) i.e. Rs.3,00,000/- alongwith interest @ 6% p.a. from the date of filing of the complaint till realization within two months from the date of receipt of copy of this order.
Failing which OP shall be liable to pay Rs.3,00,000/- with interest @ 9% per annum from the date of filing of the complaint till realization.
Let a copy of this order be sent to the parties as per regulation 21 of the Consumer Protection Regulations. Thereafter file be consigned to record room.
Announced on 01.11.18.
