District Consumer Disputes Redressal Commission ,Faridabad.
Consumer Complaint No.554/2023.
Date of Institution:22.08.2023.
Date of Order: 25.10.2024.
Del Chand S/o Shri Harinder R/o House No. 43, Mohna(204), Mohna, Ballabgarh, District Faridabad (Haryana) – 121004.
…….Complainant……..
Versus
Universal Sompo General Insurance Ltd., At Ist floor, SCO-9, Sector-10, Panchkula, Haryana – 134109, through its Principal Officer/Managing Director/Authorized person.
…Opposite party……
Complaint under section-12 of Consumer Protection Act, 1986
Now amended Section 34 of Consumer protection Act 2019.
BEFORE: Amit Arora……………..President
Mukesh Sharma………..Member
Indira Bhadana………….Member.
PRESENT: Complainant in person.
Shri O.P.Gaur, counsel for opposite party.
ORDER:
The facts in brief of the complaint are that the complainant was absolute owner of motor cycle splendor bearing its registration No. HR-29AY-2242, Chassis No.HA11EYN4B32897, engine No. MBLHAW12XN4B35069,
model 2022. The complainant obtained insurance policy from the opposite party bearing policy NO. 2369/66769024/00/000 valid form 11.05.2022 to 10.5.2023 in respect of the aforesaid motor cycle splendor bearing its registration NO. HR-29AY-2242 for a sum of Rs.68,821/-. On 4.8.2022 at 8.00a.m. the complainant had come at his maternal uncle’s company Om Valley, Rajiv Colony, Faridabad wherein the complainant had parked his motor cycle splendor bearing its registration NO. HR-29AY-2242 at the said company gate and after parked the motor cycle the complainant had gone to inside company and when the complainant came outside the said company then aforesaid motor cycle splendor bearing its registration No. HR-29AY-2242 of the complainant was not found at the company gate. The complainant had kept the original aadhar card No. 702031891756, driving licence light, pan card and R.C of the said motor cycle were lying in the digging of the said motor cycle. The complainant reported the matter to the concerned police station Sector-58, Faridabad on the same day i.e.04.08.2022 with regard to theft of his said vehicle and the police of P.S.Sector-58, Faridabad lodged FIR No. 0603 dated 10.08.2022 u/s 379 IPC against the known person. The I.O/SHO P.S.Sector-58, Faridabad had submitted the untraced report of FIR No. 0603 dated 10.08.2022 u/s 379 IPC before the Hon’ble Illaqua Magistrate, Faridabad. Opposite party declined the claim of the complainant vide its letter dated 31.01.2023 with the reason that notice should 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 given all such information and assistance as the company shall require. Every letter claim writ summons and/or proves of copy thereof should be forward to the company immediately on receipt by the insured. Notice shall also be given in writing to the company immediately the insured shall have knowledge of any impending prosecution, inquest or fatal inquiry in respect of any occurrence which may given rise to a claim under this
policy. In the present case, the complainant immediately informed to the opposite party with regard to the said theft of the vehicle in question. The aforesaid act of opposite party amounts to deficiency of service and hence the complaint. The complainant has prayed for directions to the opposite party to:
a) award of Rs.68,821/- alongwith interest @ 18% p.a. in favour of the complainant and against the opposite party towards the claim insured amount of theft motor cycle of the complainant.
b) pay Rs.1,00,000/- as compensation for causing mental agony and harassment .
c) pay Rs. 21,000 /-as litigation expenses.
2. Opposite party put in appearance through counsel and filed written statement wherein Opposite party refuted claim of the complainant and submitted that as per insurance policy No. 2369/66769024/00/000 for the period 11.05.2022 to 10.05.2023 (motor two wheeler policy) read with registration certificate pertaining to motor cycle bearing its chassis No. MBLHAW12XN4B35069 and engine No. HA11EYN4B32897 was hypothecated with M/s. IDFC Bank Ltd. under the Hire Purchase Agreement. The complainant neither had any cause of action nor locus standi to file the present complaint. It was submitted that the insurance company received an intimation of occurrence on 19.08.2022 alleging theft motorcycle No. HR-29AY-2242 on 04.08.22. Accordingly, the insurance company deputed an independent, qualified and competent investigator in regard to the alleged occurrence of theft of the insured motor cycle. As a result, the investigator carried out its investigation and furnished his “investigation report to the insurance company inter alia observing as under:-
- There was 15 days delay in intimating the loss to the insurance company.
- FIR No. 603 dated 10.08.2022 u/s 379 IPC, P.S. Sector-58, Faridabad lodged the insured with delay of 6 days.
It was submitted that during course of investigation, the insured supplied delivered and provided the claim documents to the investigator inter-alia FIR No. 603 dated 10.08.2022 P.S.Sector-58, Faridabad, statement in writing dated 26.08.2022 alongwith ID proof thereto. It was submitted that the insurance company thoroughly and carefully investigated into the subject claim on the basis of the claim documents supplied by the insured alongwith the investigation report. Having had been forwarding inconsistent and contrary statements being of fraudulent nature, in addition to non supplying of requisite mandatory claim documents either to the investigator or the insurance company. As a result, the insurance company arrived at its conclusion that the complainant had reported the claim belatedly with inordinate delay of 15 days of the insurance company and of lodging of FIR with the police with delay of 6 days, which constitute fundamental breach of condition NO.1 and condition NO.4 as well as condition NO.8 in misrepresenting the true and material facts of the alleged occurrence in respect of the motor two wheeler policy. Accordingly, the insurance company arrived at itas decision in treating the subject claim as repudiated vide its letter of repudiation dated 31.01.2023, which decision could not be termed unconscionable at all.Opposite party denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
3. The parties led evidence in support of their respective versions.
4. We have heard learned counsel for the parties and have gone through the record on the file.
5. In this case the complaint was filed by the complainant against
opposite party– M/s. Universal Sompo General Insurance Company ltd. with the prayer to: a) award of Rs.68,821/- alongwith interest @ 18% p.a. in favour of the complainant and against the opposite party towards the claim insured amount of theft motor cycle of the complainant. b) pay Rs.1,00,000/- as compensation for causing mental agony and harassment . c) pay Rs. 21,000 /-as litigation expenses.
To establish his case, the complainant has led in his evidence Ex.CW1A – affidavit of Del Chand, Ex.C-1 – insurance policy, Ex.C-2 - untraced report, Ex.C-3 – repudiation letter, Ex.C-4 – RC,, Ex.R-5 – Personal Accident policy – certificate of insurance,Ex.C-6 RTI letter, Ex.R-7 - insurance policy fro, 11.5.2024 to10.05.2027, Ex.C-8 – pan card, Ex.R-9 - RTI letter, Ex.C-10 – Vehicle particulars (for internal use), Ex.C-11 –letter,, Ex.C-12 – statement.
On the other hand counsel for the opposite party strongly agitated and opposed. As per the evidence of the opposite party Ex.RW1/A – affidavit of Sh. Chandni Jariwala (Sr. Executive Legal), Universal Sompo General Insurance Co. Ltd., Unit No. 601-602, 6th floor, Reliable Tech Park, Cloud City Campus, Gate No. 31, Mouje, Altham, Thane Belapur Road, Airoli, Nave Mumbai, Annx. R/1 – insurance policy alongwith terms & conditions, Ex.R/2 & Ex.R/2A – investigation report and letter dated 30.08 2022 Annx.R/3 - Claim form, Annx.R/4 – RC particulars with temporary registration certificate, Anx.R/5 – Tax invoice dated 11.05.2022, Annx.R-6 – driving licence, Annx.R-7 – FIR, Annx.R-8 – statement of del Chand, Annx.R-9 – Banker A/c statement, Annx.R-10 - repudiation letter.
6. In this case, t As per Ex.C-1, he complainant obtained insurance policy from the opposite party bearing policy NO. 2369/66769024/00/000 valid form 11.05.2022 to 10.5.2023 in respect of the aforesaid motor cycle splendor bearing its registration NO. HR-29AY-2242 for a sum of Rs.68,821/-. On 4.8.2022 at 8.00a.m. the complainant had come at his maternal uncle’s company
Om Valley, Rajiv Colony, Faridabad wherein the complainant had parked his motor cycle splendor bearing its registration No. HR-29AY-2242 at the said company gate and after parked the motor cycle the complainant had gone to inside company and when the complainant came outside the said company then aforesaid motor cycle splendor bearing its registration No. HR-29AY-2242 of the complainant was not found at the company gate. As per Ex.C-2, the complainant lodged FIR No.0603 dated 10.08.2022 u/s 379 IPC before the Hon’ble Illaqua Magistrate, Faridabad, Opposite party declined the claim of the complainant vide its letter dated 31.01.2023 vide Ex.C-3 that Notice shall also 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 given all such information and assistance as the company shall require. Every letter claim writ summons and/or process or copy thereof shall be forward to the company immediately on receipt by the insured. Notice shall also be given in writing to the company immediately the insured shall have knowledge of any impending prosecution, inquest or fatal inquirty in respect of any occurrence which may give rise to a claim under this policy. In case of theft or criminal act which may be the subject of a claim under this policy the matter shall give immediate notice to the police and cooperate with the company n securing the conviction of the offender.
7. After going through the evidence led by the parties, the Commission is of the opinion that the complaint is allowed on non standard basis.
8. For the adjudication of the present complaint and the issue therein, we place reliance on the Supreme Court Authority Amalendu Sahoo Vs. Oriental Insurance Company in Civil Appeal NO. 2703/2010 decided on 25.3.2010.
In Amalendu Sahoo’s case, there was violations of the Terms &
conditions of the policy and the insurance benefits were denied by the insurance company. In the above mentioned case, further reliance was placed by the Supreme Court on:
a). New India Assurance Co. Ltd. Vs. Narayan Prasad Appa Prasad Pathak, and
b). National Insurance Company Vs. Nitin Khandelwal
Wherein it was observed by the Apex Court that the claim could have been settled on non standard basis in the event of minor breach of condition upto 20%. Once the Insurance Company has insured the vehicle for the loss caused to the insured, the insurance company is liable to indemnify the owner. When there is breach of the condition of the policy, the insurance company ought to have settled the claim on non standard basis.
9. Following the aforesaid guidelines, this Commission is of the opinion that the insurance company cannot repudiate the claim in toto. The complaint is allowed for claim to be settled on non standard basis.
IDV value of vehicle : Rs.67,821.00
Less Excess Clause : Rs. 1,000.00
: Rs.,66,821.00
Deduction 25% on non standard basis on total : - Rs. 16,705.25
Total : Rs. 50,115.75
10. The opposite party is directed to pay Rs. 50,115.75 alongwith interest @ 6% p.a to the complainant from the date of filing of complaint till its realization, The opposite party is also directed to pay Rs.3300/- as compensation on account of
mental tension, agony and harassment and Rs.2200/- as litigation expenses to the complainant. This payment will be subject to the condition that the complainant will furnish the subrogation letter, cancellation of RC, affidavit, Form 29,30 and Form 35. Compliance of this order be made within 30 days from the date of receipt of copy of order. File be consigned to the record room. Copy of this order be sent to the parties concerned free of costs
Announced on:25.10.2024 (Amit Arora)
President
District Consumer Disputes
Redressal Commission, Faridabad.
(Mukesh Sharma)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
(Indira Bhadana)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
