Delhi

New Delhi

CC/273/2009

Anil Bamba - Complainant(s)

Versus

M/S. Oriental Insurance Company Ltd. - Opp.Party(s)

27 May 2016

ORDER

 

 

CONSUMER DISPUTES REDRESSAL FORUM-VI

(DISTT. NEW DELHI),

 ‘M’ BLOCK, 1^STFLOOR, VIKAS BHAWAN, I.P.ESTATE,

 NEW DELHI-110001

 

Case No.C.C./273/2009/                                       Dated:

In the matter of:

 

SHRI ANIL BAMBA,

S/o Sh. O.P. Bamba,

R/o 24/105, 2^nd Floor, Back Entrance,

West Patel Nagar,

New Delhi-110 008

 

        ……..COMPLAINANT

VERSUS

THE DIVISIONAL MANAGER,

The Oriental Insurance Co. Ltd.,

(A Govt. of India Underaking),

Divisional Office-21, Code No.272300)

K-37, Chaudhary Building,

Connaught Circus,

New Delhi-110 001.

               .... OPPOSITE PARTY

 

PRESIDENT: S.K. SARVARIA

ORDER

The present complaint is filed under section 12 of The Consumer Protection Act, 1986 (in short Act) by the complainant alleging in, in brief, that complainant got insured his golden and silver jewellery, articles and household goods etc. with the OP insurance company vide policy bearing No. 272300/48/2007/1065 on 16/12/2007. The complainant along with his wife and two kids went to New Delhi Railway Station along with one big bag containing golden and silver jewellery, video camera and other costly articles, goods etc to board the train to his wife and two kids from New Delhi to Amritsar as his wife had to attend the marriage of her sister to be solemnised at Amritsar, Punjab on 28/1/2008. The bag containing ornaments, jewellery etc. worth more than Rs. 3,55,000/- was stolen by some unknown thief.

The complainant immediately reported the matter to the Police Station, New Delhi Railway Station and a case FIR No. 0242/2007 under section 379 was registered. The complainant immediately informed the OP in this regard without any delay on his part. He thereafter, lodged the insurance claim in respect of his stolen jewellery, costly appliances, etc by claim number 48/8/000040. The Surveyor and Loss Assessor of the OP wrote a letter dated 23/5/2008, seeking certain documents and clarification from the complainant and complainant immediately complied with this letter. The police submitted untraced report, dated 28/3/2008 issued by as SHO PS, New Delhi Railway Station.

The complainant has served a legal notice upon the OP through registered AD post as well as UPC post on 18/12/2008 calling upon the OP to settle and pay the insurance claim to the complainant within 15 days of receipt of the legal notice, but in vain. The complainant has claimed the following reliefs:

(i)     Direct the OP to settle and pay the insurance claim to the       complainant in the sum of Rs. 4,80,000/- together with upto date       interest @24% p.a. (on account of stolen costly jewellary, costly       articles, goods, bag and baggage of the complainant).

(ii)    Direct the OP to pay a compensation of Rs.50,000/- to the complainant for inflicting mental pain, agony, harassment, torture and financial suffering upon this innocent complainant.

(iii)    Direct the OP to pay litigation expenses of Rs. 11,000/- to the complainant.

(iv)   Pass any other order or relief in favour of the complainant and against the OP which this Hon’ble court deems fit and proper. 

 

The notice of the complaint was issued to the OP insurance company who contested the complaint and filed reply/written statement admitting that the OP has issued Household Package Policy No. 272300/48/200 7/1065 in the name of complainant, his wife and children under the terms and conditions of the said policy OP has denied that the big bag of the complainant with full of ornaments, jewellery and video camera, etc. worth Rs. 3,55,000/- was stolen by some unknown thief on 16/12/2007. According to OP, the said big bag was within the range of CCTV camera installed in the New Delhi Railway Station.

According to OP, the complainant has not been able to prove the alleged theft and loss of articles to the satisfaction of the investigator appointed by the OP. The OP has alleged that it has appointed Shri Sudesh Kumar Rathee Insurance Surveyor and Loss Assessor for investigating the matter on 19/12/2007 and to submit report as to the baggage theft claim against the Householder Policy and the said surveyor after 40 investigation of the matter has concluded that said claim of the complainant is not payable. After receipt of the Survey Report, the OP has repudiated the claim of the complainant, by its letter dated 15/1/2009, on the basis of findings in report of the surveyor that complainant failed to produce any eyewitness of the case, incident was well within the range of CCTV camera fitted in the Railway Station, but no such incident is reported in those cameras, the complainant and his family acted in gross negligence and left the bag containing such a valuable items unattended, thus a breach of policy conditions in this regard.

The main ground of repudiation of the claim of the complainant by the OP insurance company based on survey report is that:

The jewellary and valuable section HHPP is an agreed Value Section i.e. the identity and values are agreed at the time of inception of the policy.  The complainant submitted the valuation report of M/S Ratna Jewellers, Karol Bagh dated 9/1/2007 alongwith details identification i.e. Weight of the items, cost of the insured items.  A perusal of the file particularly the valuation report as stated above, claim form, FIR, list of left out items (after the reported incident) submitted by the complainant, it is very much clear that the claimed items were not insured with the OP. The detailed comparison is as under:  

 

S.No	ITEM DISCRIPTION	WEIGHT AS PER VALUATION REPORT	CLAIMED WEIGHT
1.	6 Bangles Radium Polish	89.530 gms	95 gms
2.	2 Kadas	49.850 gms	55 gms
3.	1 Set (3 pieces)	42.150 gms	50 gms
4.	3 Rings (consolidated weight) 39items 81.5 less 65 (left out)	16.500 gms	10 gms

 

        So in view of the above facts it is very much clear that the insured items have not been stolen.  The description of the insured items and items claimed are absolutely different.  Hence there is no liability of the insurance company in view of the agree value clause of the particular section of the policy.

 

The OP has denied other facts stated in the complaint and has prayed for its dismissal.

In support of his case, the complainant has filed his affidavit in evidence. On behalf of the OP insurance company, the affidavit in evidence of Mr Chotu Ram, Divisional Manager of the OP insurance company is filed. Both parties have also filed written arguments.

The basic facts in this complaint case are not disputed. Admittedly, the complainant got insured his golden and silver jewellery, articles and household goods etc. with the OP insurance company vide policy bearing No. 272300/48/2007/1065. The complainant lodged an FIR regarding theft of his jewellery and other articles from New Delhi Railway Station on 16/12/2007 at Police Station, New Delhi Railway Station. The case was recommended to be filed by SHO concerned. The complainant lodged insurance claim against the said insurance policy with the OP insurance company, which was repudiated by the OP insurance company by its letter dated 15/1/2009 issued through Divisional Manager, mainly on the basis of Surveyor Report, referred before.

In the backdrop of the above admitted position the complainant has alleged that the theft in question took place during the currency of the insurance policy in question. So complainant is entitled to reimbursement of the amount claimed. On behalf of the OP insurance company the report of the surveyor and the grounds taken in it are heavily relied upon to justify repudiation of the insurance claim of the complainant.

No doubt the alleged theft in question took place during the currency of the insurance policy in question. An insured is entitled to get the insurance claim against the insurance policy from the insurance company in question to the said claim which falls within four corners of the terms and conditions attached to it. Only genuine claims are required to be allowed. In the present case, the golden jewellery which was insured against the insurance policy and the insurance claim made differ, as is obvious from the following table:

 

S.No	ITEM DISCRIPTION	WEIGHT AS PER VALUATION REPORT	CLAIMED WEIGHT
1.	6 Bangles Radium Polish	89.530 gms	95 gms
2.	2 Kadas	49.850 gms	55 gms
3.	1 Set (3 pieces)	42.150 gms	50 gms
4.	3 Rings (consolidated weight) 39items 81.5 less 65 (left out)	16.500 gms	10 gms

 

Four types of gold items are shown in the above, Table and against each item there is noticeable variation in the weight of the golden items leading to the irresistible inference that the gold items insured against the insurance policy in question and the alleged golden items stated to be stolen from the New Delhi Railway Station are not the same. Had this difference been, with regard to one or two items then it would have been possible ignored by way inference of typographical error or weighing error, but when in each and every golden item there is variation in the weight of gold the only inference seems to be that the insurance claim is not made with regard to the same golden items which were insured by the complainant.

There is also weight in the argument on behalf of the OP insurance company that there was negligence on the part of the complainant and his family members due to which the alleged theft in question took place. In this regard reliance is placed upon the new India assurance Co. Ltd versus TV Sarathi 2009 (2) CPR 26 (N C) wherein the insured failed to take proper steps to safeguard his property and repudiation of claim by insurance company was held to be justified. Although non availability of the witness or its nonproduction by the complainant before the surveyor is no ground for repudiation of the claim of the complainant and there are rival contentions of the parties as to whether the scene of theft, was within CCTV coverage or not but we do not find these grounds are sufficient for repudiation of the insurance claim of the complainant. However, the variation in each and every golden item about weight from what gold items were insured and what was shown in the insurance claim by the complainant and also negligence on the part of complainant and his family members in attending to the bag in question containing jewellery and other items in our view, are sufficient ground for repudiation of the claim made by complainant with the OP insurance company against the insurance policy in question.

In view of the above discussion, we do not find any merit in the present complaint. The complaint is dismissed. The parties are left to bear their own cost of litigation. Copy of the order be sent to each of the parties free of cost by registered post. This order be sent to server (www.confonet.nic.in ).

 

File be consigned to record room.    

Pronounced in open Forum on ________________.

 

 

(S K SARVARIA)

PRESIDENT

 

                                             (H M VYAS)

                                    MEMBER