JUSTICE V.K.JAIN, PRESIDING MEMBER (ORAL)

IN RP/2920/2015

The complainant/respondent got his vehicle insured with the petitioner company for the period from 23.02.2011 to 22.02.2012.  The vehicle having met with an accident, in November 2011, intimation was given to the insurer and a surveyor was appointed who assessed the loss to the complainant at Rs.311000/-.  The claim however, was repudiated on the ground that a false no-claim bonus of 20% was taken by the complainant while obtaining the insurance policy. 

2.      Being aggrieved, the complainant approached the concerned District Forum by way of a consumer complaint. 

3.      The complaint was resisted by the insurance company primarily on the ground on which the claim had been repudiated. 

4.      The District Forum vide its order dated 02.07.2014, dismissed the complaint.  Being aggrieved, the complainant company approached the concerned State Commission by way of an appeal.  Vide impugned order dated 08.07.2015, the State Commission allowed the appeal and directed the insurer to pay a sum of Rs.259823.47/- exclusive of the salvage valued at Rs.15,000/-, meaning thereby the surveyor recommended payment of Rs.244823.47 to the complainant alongwith interest @ 8% per annum, compensation quantified at Rs.20,000/- and the cost of litigation quantified at Rs.2,100/-. 

5.      Being aggrieved from the order passed by the State Commission, the insurer is before this Commission by way of this revision petition. 

6.      The claim has been contested solely on the ground that though the complainant was not entitled to any no-claim bonus, he had claimed the same while taking the insurance policy for the period in question.  The aforesaid issue came up for consideration of a Three-Members Bench of this Commission in United India Insurance Company Ltd. Vs. M/s Jindal Poly Buttons Limited and Branch Manager, National Insurance Company Ltd. Vs. Naresh Kumar, RP No.2920 of 2015 & RP No.1836 of 2016 vide order dated 20.02.2017 and the following view was taken:

“a.         The cases in which it is established that the insured by making wrongful declaration has taken benefit of No Claim Bonus and the insurer had means to verify the correctness of the declaration of the insured seeking No Claim Bonus by exercising ordinary diligence of verifying the truthfulness of the claim from the insurer’s own record, Exception to 19 of Indian Contract Act would come into play and the insurer would not be justified in repudiating the insurance claim on the ground of misrepresentation or concealment of fact.  However, because the insured had taken benefit of No Claim Bonus and paid less premium, the insurance claim would be reduced proportionately.

b.         In cases of the insured taking the insurance policy of the vehicle from new insurance company and it is established that the insured by making wrongful declaration has taken benefit of No Claim Bonus and where the insurer had failed to seek confirmation regarding correctness of the declaration submitted by the insured in support of plea for No Claim Bonus within the stipulated period as provided in GR 27 of Indian Motor Tariff, the insurer would  not be justified in repudiating the insurance claim.  However, because the insured had taken benefit of No Claim Bonus by making false declaration his insurance claim would be reduced proportionately.”

          In view of the decision of the larger Bench, the complainant is entitled to payment of the amount assessed by the surveyor after making a deduction of 20% from the said amount.  The revision petition is therefore, partly allowed by directing the insurer to make deduction of 20% from the amount of Rs.244823.47/- and pay the balance amount to the complainant within four weeks from today alongwith interest on that amount @ 8% per annum from the date of filing of the complaint.  The revision petition stands disposed of.

IN RP/1836/2016

          The complainant/respondent got his vehicle insured with the petitioner company for the period from 24.10.2012 to 23.10.2013.  During the currency of the said policy, the vehicle met with an accident on 05.06.2013.  A surveyor was appointed to assess the loss to the complainant and he assessed the said loss at Rs.1,74,955/-.  The claim however, was repudiated on the ground that the complainant had claimed a false no-claim bonus of 20% while taking the insurance policy in question.  Being aggrieved from the rejection of the claim, the complainant approached the concerned District Forum by way of a consumer complaint. 

2.      The complaint having been dismissed by the District Forum, he approached the concerned State Commission vide impugned order dated 15.03.2016, the State Commission allowed the appeal filed by the complainant and directed the insurer to pay a sum of Rs.248445/- to the complainant alongwith interest @ 8% per annum from the date of filing of the complaint, compensation quantified at Rs.10,000/- and cost of litigation quantified at Rs.5,000/-.  Being aggrieved from the order of the State Commission, the insurer is before this Commission by way of this revision petition.

3.      The claim has been contested solely on the ground that though the complainant was not entitled to any no-claim bonus, he had claimed the same while taking the insurance policy for the period in question. 

          In view of the earlier referred decision of the larger Bench, the complainant is entitled to payment of the amount assessed by the surveyor after making a deduction of 20% from the said amount.  The revision petition is therefore, partly allowed by directing the insurer to make deduction of 20% from the amount of Rs.1,74,955/- and pay the balance amount to the complainant within four weeks from today alongwith interest on that amount @ 8% per annum from the date of filing of the complaint.  The revision petition stands disposed of.