BEFORE THE PRESIDENT, DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SAMBALPUR
C.C NO-17/2020
Present-Sri Dipak Kumar Mahapatra, President, Smt. Smita Tripathy, Member (W).
Biswakarma Prasad,aged about 38 years,
S/O- Ramji Prasad,
At/P.O- Bishnu Mandir Pada,
Daily Market, Burla City,Sambalpur. …..Complainant
Vrs.
National Insurance Co. Ltd,
Divisional Office,Sarlakani,Sakhipada,
Sambalpur-768001,Odisha. ……O.P
Counsels:-
- For the Complainant:- Sri P.P.Panigrahi, Advocate.
- For the O.P :- Sri B.K. Purohit, Advocate & Associates.
DATE OF HEARING : 22.03.2021, DATE OF ORDER : 13.04.2021
SRI DIPAK KUMAR MAHAPATRA,PRESIDENT:-Brief facts of the case is that the Complainant is a owner of a Maruti Swift Dezire duly insured with the O.P. on dt.09.102017 at about 7 P.M while returning from Thawe Mandir Gopal Ganj proceeding towards Patna two unknown person requested for lift at a place named Sihai mode and for the sake of humanity and social consideration the Complainant allowed them in his vehicle . After that the two people threw a handkerchief on the face of the Complainant due to which he started feeling dizziness and after travelling some distance he stopped his vehicle and became unconscious. After regaining his consciousness he found himself lying on the road. The two people were committed theft by the means of sedation/ Toxic/poison. The matter was reported to the Police at Gopalganj and FIR was filed. As providing lift is not an offence neither illegal nor impossible under any law. The Complainant informed the matter to the Insurance company and lodged a claim for compensation but he falsely asserted that the vehicle was used for carrying passengers and being used for commercial purposes in spite of having a private Car policy and the claim was repudiated by the Company on this ground. The Vehicle was insured with the Insurance company for a sum assured of Rs.7,20,449/-.
As per the O.P the Complainant had availed a Private Car Package Insurance Policy bearing no- 35101031166139341694 to cover the own damage of the vehicle. So also the third party of the new Maruti Swift Dezire bearing Engine No- 2983515 and chassis no-A53752 and the policy was valid from 18.01.2017 to 17.01.2018 subject to the terms and conditions of the Policy. The O.P also highlighted the contents of the Section-I relating to the “Loss or Damage To the Vehicle Insured” and a calculation sheet on depreciation basing on the age of the vehicle. He also focused some “LIMITATION TO USE” of the vehicle for which the Complainant avail the benefit of Insurance Cover. According to the above he has given emphasis on the POLICY CONDITION -4 of the Policy which speaks that the insured shall take all reasonable steps to safeguard the vehicle from loss or damage and to maintain it in efficient condition and the Company shall have at all times free and full access to examine the vehicle or any part thereof or any driver or employee of the insured. In the event of any accident or breakdown, the vehicle shall not be left unattended without proper precautions being taken to prevent further damage or loss and if the vehicle be driven before the necessary repairs are effected any extension of the damage or any further damage to the vehicle shall be entirely at the insured's own risk. As per the version of the Complainant two unknown persons put handkerchief on the face of the Complainant for which the Complainant felt dizziness and got down from the Car to wash his face. The Claim form was filed after 42 days of the occurrence and the FIR was lodged after 30 days after the occurrence. The police carried out investigation u/s-379/328 and submitted charge sheet u/s-379 showing that the matter was true. The Insurance Company was also accepted the police report. But the Insurance Company states that the policy condition was violated as the information was given after 42 days. Thus violated the policy condition-4 and a repudiation letter were sent to the Complainant. The O.P relies on the decision of NCDRC,Delhi in the matter of “P.Khamar Pasa vrs. Branch Manager Oriental Insurance Co. Ltd.” and another case of “Oriental Insurance Co. Ltd vrs. Parvesh Chandar Chadha decided by Hon’ble Supreme Court of India”. Again it states that the Limitation to use Clause speaks that the Policy covers the use of vehicle for any purpose other than Hire or Reward. And the Complainant should not carry passengers in it.
POINTS OF DETERMINATION:-
- Whether the Complainant is comes under the purview of Consumer Protection Act-2019?
- Whether the O.Ps has committed any Deficiency in Service to the Complainant?
From the above discussion and materials available on records we inferred that the Complainant comes under the purview of Consumers as he has purchased a new Maruti Swift Dezire and got it insured with the O.P on payment of Premium as consideration amount. Again 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. If the reason for delay in making a claim is satisfactorily explained, such a claim cannot be rejected on the ground of delay. It is also necessary to state here that it would not be fair and reasonable to reject genuine claims which had already been verified and found to be correct by the Investigator. The condition regarding the delay shall not be a shelter to repudiate the insurance claims which have been otherwise proved to be genuine. It needs no emphasis that the Consumer Protection Act aims at providing better protection of the interest of consumers. In the instant case, the appellant has given cogent reasons for the delay of 42 days in informing the O.P about the incident. This matter has been well settled in the case of Om Prakash vs Reliance General Insurance on 4th October, 2017 Supreme Court - Again reliance is placed on the decision of Supreme Court of India in the matter of Gurshinder Singh vs Sriram General Insurance Co. Ltd. on 24 January, 2020. In the case of “National Insurance Company v. Nitin Khandelwal”, reported in IV (2008) CPJ 1 (SC) = 2008 (7) SCALE 351 this Court held :- “The appellant Insurance Company is liable to indemnify the owner of the vehicle when the insurer has obtained comprehensive policy for the loss caused to the insurer. The respondent submitted that even assuming that there was a breach of condition of the insurance policy, the appellant Insurance Company ought to have settled the claim on non-standard basis.". Hence we order as under:-
ORDER
The Complaint petition is allowed. The O.P is directed to pay a sum of Rs. 7,20,449/- to the Complainant which is the Insured Declared Value (IDV) of the Maruti Swift Dezire Car as per the Policy copy expired on dtd.17.01.2018 with interest @ 9% per annum from the date of filing of the claim petition till the date of payment. Further the O.P is directed to pay a sum of Rs.10,000/-(Rupees Ten Thousand) to the Complainant as Cost of litigation. All the payment, as above, shall be made within a period of 8 weeks from today.
Order pronounced in the open Court today i.e, on 13th day of April 2021 under my hand and seal of this Commission.
Office is directed to supply copies of the Order to the parties free of costs receiving acknowledgement of the delivery thereof.
I agree,
-Sd/- -Sd/-
MEMBER(W) PRESIDENT
Dictated and Corrected
by me.
-Sd/-
PRESIDENT.
