Punjab

Ludhiana

CC/20/250

Baljit Kaur - Complainant(s)

Versus

National Insurance Co. - Opp.Party(s)

V.S.Mand

12 Sep 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                Complaint No:250 dated 19.10.2020.                                                         Date of decision: 12.09.2023.

 

Baljit Kaur widow of Balbir Singh son of Shri Fateh Singh, resident of Village Ajnaudh, District Ludhiana.                                                                                                                                                              ..…Complainant

                                                Versus

1. National Insurance Company Limited, Regional Office Grand Walk, Mall, Ferozepur Road, Ludhiana through its Regional Manager.
2. National Insurance Company Limited, branch Office No.IV, Feroze Gandhi Market, Ludhiana through its Branch Manager.                                                                                                        …..Opposite parties 

Complaint Under section 35 of the Consumer Protection Act, 2019.

QUORUM:

SH. SANJEEV BATRA, PRESIDENT

SH. JASWINDER SINGH, MEMBER

MS. MONIKA BHAGAT, MEMBER

 

COUNSEL FOR THE PARTIES:

For complainant             :         Sh. V.S. Mand, Advocate.

For OPs                          :         Sh. R.K. Chand, Advocate.

 

ORDER

PER SANJEEV BATRA, PRESIDENT

1.                Briefly stated, the facts of the case are that the complainant is the widow and legal heir of Sh. Balbir Singh son of Sh. Fateh Singh, who was owner of truck bearing registration No.PB-10-CR-0201 being plied by him for his livelihood. The said truck was fully insured with opposite parties vide policy No.40450231176300002900 by paying premium. The complainant stated that on the intervening night of 01/02.11.2017 at about 09.00 PM Hari Singh, driver of the truck parked the same in front of Govt. Primary School, near Indian Gas Agency, Basti Jodhewal, Ludhiana as usual. On the next morning on 02.11.2017, Hari Singh, Driver came at the place to take the said truck but the said vehicle was not there where it was parked. On making search Hari Singh could not found the truck and he informed Balbir Singh owner of the truck, who also tried to search the vehicle but the same was not found despite best efforts. Theft of the said truck was reported to the Police Station Daresi, Ludhiana who lodged a rapt No.24 dated 02.11.2017. Balbir Singh, husband of the complainant also gave intimation of theft to the insurance company and supplied the documents. The opposite parties asked Balbir Singh to supply copy of FIR but did not register the claim. The police also tried to trace the vehicle but the stolen truck was not found and then an FIR No.152 dated 11.11.2017 under Section 379 IPC was registered against unknown person. Thereafter, police also submitted untraced report  to the Ilaqa Judicial Magistrate, Ludhiana which was accepted by the court. Balbir Singh lodged the claim along with all the documents with the opposite parties and also submitted driving license of driver Hari Singh along with relevant documents but the opposite parties lingered on the matter in settling the claim despite repeated requests and reminders of husband of the complainant. Sh. Balbir Singh also served a legal notice dated 20.03.2020 upon the opposite parties through his counsel to which the opposite parties sent a reply dated 02.06.2020 disclosing that the claim has been repudiated vide letter dated 22.10.2018 on the ground of non-submission of required documents. However, the said letter dated 22.10.2018 was not received by Sh. Balbir Singh. The complainant further stated that her husband Sh. Balbir Singh expired on 19.03.2020 and she has filed the present complaint being his widow and legal heir. The complainant stated that the repudiation of the claim is illegal, arbitrary and against al the cannon of justice which amounts to deficiency in service and unfair trade practice on the part of the opposite parties which has caused mental tension, pain and agony to the complainant for which the complainant is entitled to compensation of Rs.5,00,000/-. In the end, the complainant has prayed for directing the opposite parties to pay Rs.5,00,000/- being insured value of the truck along with monetary loss of Rs.1000/- per day and future  loss of Rs.1000/-. The complainant further claimed compensation of Rs.2,00,000/- and litigation expenses of Rs.33,000/-.

2.                Upon notice the opposite parties appeared and filed their joint written statement and by taking preliminary objections, assailed the complaint on the ground of maintainability of the complaint; lack of jurisdiction; mis-joinder and non-joinder of necessary parties; the complainant is estopped by her own act and conduct from filing the complaint, concealment of material facts, complaint being barred under section 26 of the Consumer Protection Act etc. The opposite parties stated that the insured/husband of the complainant lodged the claim on 22.11.2017 regarding theft of his truck No.PB-10-CR-0201 and immediately on receipt of the claim, it was duly registered and processed. Mr. Mandeep Sharma, Advocate was deputed for investigation of the matter who collected documents, investigated the mater and submitted his investigation report dated 20.03.2018. The opposite parties further averred that the insured/husband of the complainant lodged the claim on 22.11.2017 but the truck was stolen 02.11.2017 and there is delay of about 21 days for intimation of theft to them. The insured/husband of the complainant has also not intimated the police authorities immediately on occurrence of theft and has reported the matter to the police on 11.11.2017 and there is delay of 10 days in reporting the matter to the police. The delay in intimating the opposite parties and police regarding incident amounts to breach and violation of policy condition No.1 of Commercial Vehicle Package Policy, which reproduced as under:-

“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. Every letter claim writ summons and/or process or copy thereof shall be forwarded to the Company immediately on receipt of 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 injury in respect of any occurrence which may give rise to a claim under this policy. In case of theft or other criminal act which may be the subject of a claim under this policy the insured shall give immediate notice to the police and co-operate with the Company in securing the conviction of the offender.”

The opposite parties further stated that insured/husband of the complainant or the complainant has also not supposed the request documents as demanded through letter dated 24.07.2018 to supply the following documents:-

1. Set of original keys (Two keys)
2. Documentary proof to inform the Police Station for the theft of vehicle 01-02/11/2017 (call to no.100).
3. Purchase invoice of the vehicle/proof of existence of Vehicle before theft.
4. Engine No. and Chasis No. must be added in FIR.
5. Copy of PAN card and Adhar card.
6. Claim Form completed in all respect.
7. NCRB report.
8. Final Untraceable Police Report U/s.173 Cr.P.C. duly accepted by the court.

Vide said letter dated 24.07.2018, the insured/husband of the complainant was called to explain s to why subject matter claim should not be entertained in view of gross violation of policy condition No.1 with request to submit his comments/documents within 15 days from the date of receipt of letter dated 24.07.2018. The said letter was duly replied by the insured but he did not submit the documents nor gave any explanation in this respect. The insured was again requested to submit the documents and his explanation vide letter dated 03.09.2018 and reminder dated 18.09.2018 but he did not respond to the said letters and thus, the opposite parties repudiated the claim as “NO CLAIM” vide letter dated 22.10.2018. The claim has been rightly repudiated by the competent authority of the opposite parties as per terms and conditions of the policy.

                   On merits, the opposite parties reiterated the crux of averments made in the preliminary objections and facts of the case. The opposite parties have denied that there is any deficiency of service and have also prayed for dismissal of the complaint.   

3.                In support of her claim, the complainant tendered her affidavit Ex. CA in which she reiterated the allegations and the claim of compensation as stated in the complaint. The complainant also tendered documents Ex. C1 is the copy of certificate of insurance cum policy schedule w.e.f. 30.09.2017 to 29.09.2018, Ex. C2 is the copy of registration certificate, Ex. C3 is the copy of letter dated 02.11.2017 written to the police, Ex. C4 is the copy of goods carriage permit of the vehicle, again Ex. C4 is the copy of certificate of fitness, Ex. C5 is the copy of legal notice dated 20.03.2020, Ex. C6 is the copy of reply dated 02.06.2020, Ex. C7 is the copy of death certificate of Balbir Singh, Ex. C8 is the copy of Aadhar card of the complainant, Ex. C9 is the copy of Aadhar card of Balbir Singh, Ex. C10 is the copy of PAN card of Balbir Singh and closed the evidence.

4.                On the other hand, counsel for the opposite parties affidavit Ex. RW1/A of  Sh. Vinod Kumar, Divisional Manager of the opposite parties as well as affidavit Ex. RW1/B of Sh. Mandeep Sharma, Advocate along with documents Ex. R1 is the copy of insurance policy w.e.f. 30.09.2017 to 29.09.2018, Ex. R2 is the copy of legal notice dated 20.03.2020, Ex. R3 is the copy of reply dated 02.06.2020 and closed the evidence.

5.                We have heard the arguments of the counsel for the parties and also gone through the complaint, affidavit and annexed documents and written reply along with affidavit and documents produced on record by both the parties.

6.                 In this case, the theft of the vehicle No.PB-10-CR-0201 took place on the intervening night of 01/02.11.2017. According to the complainant, after the theft, Hari Singh, driver of the truck  lodged a complaint Ex. C3 with the police on the same day i.e. 02.11.2017. Initially, the police registered a report No.24 dated 02.11.2017and then tagged the theft of the vehicle in question with FIR No.152 dated 11.11.2017, which had been registered in respect of the theft of some other vehicles also. The complainant has further claimed that her husband Balbir Singh informed the opposite parties, but in this regard, no written record has been placed on the file.  However, it is the definite case of the opposite parties that on the receipt of the claim, it was registered and Sh. Mandeep Sharma, Advocate was deputed to investigate the matter, but no report of investigator has been placed on record either by the complainant or by the opposite parties. From the perusal of record, it reveals there is no inordinate delay on the part of the husband of the complainant Sh. Balbir Singh in informing the police about the theft of the vehicle. In Gurshinder Singh Vs Shriram General Insurance Co. Ltd. and another  in Civil Appeal No.653 of 2020 decided on 24.01.2020, it has been held by the Hon’ble Supreme Court of India that when an insured has lodged an FIR immediately after the theft of a vehicle occurred and when the police after investigation have lodged a final report after the vehicle was not traced and when the surveyors/investigators appointed by the insurance company have found the claim of the theft to be genuine, then mere delay in intimating the insurance company about the occurrence of the theft cannot be a ground to deny the claim of the insured.   Recently the Hon’ble Supreme Court of India in Ashok Kumar Vs New India Assurance Co. Ltd. (2023 Live Law (SC) 583) has also endorse the same view.

7.                Initially, due to non-submission of certain documents, the claim file was closed treating it to be “NO CLAIM” vide letter dated 22.10.2018 as per condition No.1 of Commercial Vehicle Package policy. But no such letter dated 22.10.2018 was placed on record by either of the parties.   However, vide their reply dated 02.06.2020 submitted in response to legal notice dated 20.03.2020, the opposite parties called upon husband of the complainant Sh. Balbir Singh to submit the following documents for settlement of the claim:-

1. Set of original keys (Two keys)
2. Documentary proof to inform the Police Station for the theft of vehicle 01-02/11/2017 (cal to no.100).
3. Purchase invoice of the vehicle/proof of existence of Vehicle before theft.
4. Engine No. and Chasis No. must be added in FIR.
5. Copy of PAN card and Adhar card.
6. Claim Form completed in all respect.
7. NCRB report.
8. Final Untraceable Police Report U/s.173 Cr.P.C. duly accepted by the court.

8.                In this regard, reference can be made to 2022(2) Apex Court Judgment 281 (SC) in case title Gurmel Singh Vs Branch Manager National Insurance Company Ltd. whereby it has been held by the Hon’ble Supreme Court of India that the insurance company has become too technical while settling the claim and has acted arbitrarily. The appellant has been asked to furnish the documents which were beyond the control of the appellant to procure and furnish. Once, there was a valid insurance on payment of huge sum by way of premium and the Truck was stolen, the insurance company ought not to have become too technical and ought not to have refused to settle the claim on non­submission of the duplicate certified copy of certificate of registration, which the appellant could not produce due to the circumstances beyond his control. In many cases, it is found that the insurance companies are refusing the claim on flimsy grounds and/or technical grounds. While settling the claims, the insurance company should not be too technical and ask for the documents, which the insured is not in a position to produce due to circumstances beyond his control.

9.                Under the circumstances, in our considered view, it would be just and proper if the complainant is directed to submit the documents referred to in reply dated 02.06.2020 Ex. R3 with the opposite parties within a  period of 30 days from the date of receipt of copy of the order and on receipt of the said documents, the opposite parties shall settle and reimburse the claim strictly in accordance with terms and conditions of the insurance policy within a period of 30 days from the date of submission of documents by the complainant.

10.              As a result of above discussion, the complaint is partly allowed with a direction to the complainant to submit the documents referred to in reply dated 02.06.2020 Ex. R3 with the opposite parties within a  period of 30 days from the date of receipt of copy of the order and on receipt of the said documents, the opposite parties shall settle and reimburse the claim strictly in accordance with terms and conditions of the insurance policy within a period of 30 days from the date of submission of documents by the complainant. It is made clear that the opposite parties will not insist upon for submission of documents which the complainant is not in position to produce due to circumstances beyond her control. Keeping in view the peculiar circumstances of the case, there shall be no order as to costs. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room.         

11.              Due to huge pendency of cases, the complaint could not be decided within statutory period.

 

 

(Monika Bhagat)          (Jaswinder Singh)                     (Sanjeev Batra)

Member                         Member                                       President         

 

Announced in Open Commission.

Dated:12.09.2023.

Gobind Ram.