Haryana

Yamunanagar

CC/1043/2012

Rajbir S/o Jai Singh - Complainant(s)

Versus

National Insurance Co.Ltd. - Opp.Party(s)

Amit Bansal

11 Jul 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA   NAGAR

                                                                                          Complaint No. 1043  of  2012.

                                                                                          Date of institution:27.09.2012       

                                                                                          Date of decision: 11.07.2016.

Rajbir aged about 25 years son of Shri Jal Singh resident of Ratauli, P.O. Khera, Tehsil Jagadhri, District Yamuna Nagar.                                                                                                                                                                                                                                                                                           …Complainant.

                                               Versus

 

National Insurance Co. Ltd. New Fountain Chowk Yamuna Nagar, through its Divisional Manager.

 

                                                                                                                … Respondent. 

 

BEFORE:         SH. ASHOK KUMAR GARG, PRESIDENT

                        SH. S.C.SHARMA, MEMBER.

 

Present: Sh. Amit Bansal, Advocate, counsel for complainant.   

              Sh. Rajiv Gupta, Advocate, counsel for respondent.  

 

ORDER

 

1.                     Complainant Rajbir filed this complaint under section 12 of the Consumer Protection Act 1986 seeking directions to the respondent (hereinafter referred as OP) to pay an amount of Rs. 41,000/- on account of theft of his motorcycle bearing registration No. HR-02Z-4952 alongwith interest and further to pay compensation as well as litigation expenses.     

2.                     Brief facts of the present complaint, as alleged by the complainant, are that he is the registered owner of motorcycle bearing registration No. HR-02Z-4952, which was fully insured with the OP Insurance Company vide policy bearing No. 35100731116202417511 valid from 17.01.2012 to 16.01.2013 for a sum insured of Rs. 41,000/- and a premium of Rs. 1195/- was paid in this regard to the OP.  Unfortunately on 18.06.2012, the complainant was going to Yamuna Nagar from his residence on his motorcycle and about 10.30 AM when he reached ahead of Town Park, area Spring Field School, immediately from the Chowk, three young persons on a motorcycle came and they gave him an injury with a sword and other injuries and have taken away all the belongings of the complainant and has also snatched away the motorcycle of the complainant. Thereafter, complainant immediately reported the matter to the police on 18.06.2012 and police lodged an FIR  bearing No. 216 dated 18.06.2012 under section 392 IPC. The OP Company deputed the investigator who has also reported that the snatching of motorcycle is genuine but the OP and investigator has misinterpreted the FIR and has repudiated the claim of the complainant illegally and on flimsy ground vide letter dated 17.09.2012.   As such, there is a gross negligence and deficiency in service on the part of OP Insurance Company by not paying the claim insured amount and due to that negligent act, the complainant has been suffering mental agony, harassment as well as financial loss for which he is entitled for compensation besides the claim amount.  Hence, this complaint.

3.                     Upon notice, OP appeared and filed its written statement by taking some preliminary objections such as complaint is not maintainable; there is no negligence or deficiency in service on the part of OP Company and the complaint is liable to be dismissed. In this case a claim intimation was received on 25.06.2012 from the complainant but the motorcycle bearing registration No. HR-02Z-4952 has been stolen on 18.06.2012. On receipt of said intimation, the OP Insurance Company desired the complainant to submit necessary documents and the claim in question was processed and it was found that the complainant was using the said motorcycle in question for commercial purpose i.e. for carriage & Selling clothes on the said motorcycle and on the date of alleged incident i.e. on 18.06.2012, the complainant was using the said motorcycle for carriage & selling of clothes which is in utter violations of the terms and conditions of the insurance policy according to which the vehicle in question cannot be used for the purpose of hire or reward or for carriage of goods or for commercial purposes. Besides this, as per the policy condition No.1, the insured was bound to give immediate intimation to the insurance company in case of loss. The alleged date of loss in this case is 18.06.2012 but a belated intimation dated 25.06.2012 was given to the insurance company in utter violation of the terms and conditions of the insurance policy. As such, the claim is not payable under the terms and conditions of the insurance policy, so, the OP Insurance Company, vide its registered letter dated 17.09.2012, legally and justifiably repudiated the claim of the complainant.. On merit controverted the plea taken by the complainant and reiterated the stand taken in the preliminary objections and lastly prayed for dismissal of complaint.

4.                     To prove the case, counsel for the complainant  tendered into evidence affidavit of complainant as Annexure CW/A and documents such as Photo copy of ration card as Annexure C-1, Photo copy of insurance policy as Annexure C-2, Photo copy of FIR as Annexure C-3, Claim repudiation letter dated 17.09.2012 as Annexure C-4, Photo copy of news paper cutting as Annexure C-5 and closed the evidence on behalf of complainant.  

 5.                    On the other hand, counsel for the OP Insurance Company has tendered into evidence affidavit of Parveen Arora, Assistant Manager, NIC as Annexure RW/A and documents such as Photo copy of claim intimation letter dated 25.06.2012 as Annexure R-1, Photo copy of claim repudiation letter dated 17.09.2012 as Annexure R-2,  Photo copy of Insurance policy as Annexure R-3,  Photo copy of FIR as Annexure R-4 and closed the evidence on behalf of OP.

6.                     We have heard the learned counsel for both the parties and have gone through the pleadings as well as documents placed on file minutely & carefully.  Learned counsel for the complainant reiterated the averments made in the complaint and prayed for its acceptance whereas the counsel for the opposite party reiterated the averments made in the reply and prayed for its dismissal.

7.                     It is admitted fact that the complainant was registered owner of the motorcycle bearing registration No. HR-02Z-4952 and it was insured with the OP vide policy bearing No. 35100731116202417511 valid from 17.01.2012 to 16.01.2013 for a sum assured of Rs. 40,457/- and a premium of Rs. 1195/- was paid in this regard to the OP which was snatched by some unknown person on 18.06.2012 during the currency of insured policy in question. It is also admitted that regarding theft of Motor Cycle an FIR No. 216 dated 18.06.2012 (Annexure C-3/R-4) was lodged with the police of P.S. City, Jagadhri.

 8.                    The learned counsel for the OP Insurance Company argued that the claim of the complainant has been rightly repudiated vide letter dated 17.09.2012 (Annexure R-2/C-4) as the alleged theft took place on 18.06.2012 whereas OP insurance company was intimated on 25.06.2012 i.e. after 7 days of the alleged theft which is clearly violation of the terms and conditions No.1 of the insurance policy, according to which the insured was duty bound to give immediate intimation to the insurance company and referred the case law titled as Om New India Assurance Company Ltd. vs. Trilochan Jane, First Appeal No. 321 of 2005 decided on 9.12.2009 and the case titled as Om Parkash vs. National Insurance Company Ltd. 2012 (III) CPJ page 59 and further referred the another case law titled as H.D.F.C. Ergo General Insurance Co. Ltd. Versus Bhagchand Saini, 1(2015) CPJ page 206 (N.C.) wherein it has been held that delay in reporting to the insurer about the theft would be violation of condition of the policy as it deprives insurer of a valuable right to investigate as to commission of theft and to help in tracing the vehicle. Moreover, in the policy, it has been specifically mentioned that claim for theft of the vehicle not payable if theft not reported to the company within 48 hours of its occurrence.   

9.                     Further counsel for the OP Insurance Company argued that the complainant was using the said motorcycle in question for commercial purpose i.e. for carriage & selling clothes on the said motorcycle which is in utter violations of the terms and conditions of the insurance policy according to which the vehicle in question cannot be used for the purpose of hire or reward or for carriage of goods or for commercial purposes and the claim of the complainant has been rightly repudiated vide letter dated 17.09.2012.

10.                   On the other hand, counsel for the complainant hotly argued that the genuine claim of the complainant has been wrongly repudiated on the flimsy ground by the OP insurance company. The motorcycle bearing registration No. HR-02Z-4952 was snatched by somebody on 18.06.2012 and the complainant immediately informed the police of P.S. City Jagadhri which is evident from FIR No. 216 dated 18.06.2012. It has been further argued that all the information sought by the OP insurance company was duly clarified by the complainant from time to time. Lastly, argued that insurance companies cannot reject the genuine claims simply because of late intimation to the Insurance Company.   To substantiate the aforesaid version, the complainant’s counsel submitted the case law delivered by our Hon’ble State Commission, Haryana, Panchkula in case titled as Mohammad Ejaj Versus United India Insurance Company Ltd. & Others, reported in 2014(4) CLT page 161 wherein it has been held that “Insurance Claim-Repudiation- on the ground that there was delay of 15 days in lodging the FIR and 36 days in giving information to the Insurance Company-IRDA have given direction to the insurance companies not to reject genuine claims simply because of late registration of FIR and late intimation to the Insurance Company- Held-IRDA is the controlling authority of all Insurance Companies and being a statutory body, is competent to frame guidelines and issue instructions to Insurance Companies which are binding upon them. Appeal accepted. Learned counsel for the complainant further referred the Instruction of IRDA “That the insurer cannot reject claims amount for delay in intimation”

 11.                  Learned counsel for the complainant further argued that the complainant had gone to Yamuna Nagar from his village by riding on his motorcycle for his personal work and when he reached near Spring Field School three boys were standing there who snatched his motorcycle alongwith documents and Rs.5000/- from his pockets and run away. The counsel for the complainant further argued that at the time of incident the complainant was not carrying and selling any cloth on his motorcycle and the OP Insurance Company has wrongly repudiated the claim of the complainant.

12.                   After going through the above noted facts at length, we are of the considered view that arguments advanced by the counsel for the OPs is not tenable. The plea of the Op Insurance Company that the complainant was using the motorcycle in question for commercial purpose has no weightage as from the perusal of the contents of the FIR Ex. C-3/R-4 it is clearly evident that complainant was going from his village to Yamuna Nagar for his personal work and the three unknown persons snatched the motorcycle alongwith Rs. 5000/- from his pocket and ran away. Complainant nowhere has disclosed that the unknown persons also stolen the clothes, even, the complainant has not stated any iota of word that he was carrying clothes for selling on the motorcycle at that time. It may be the complainant used the motorcycle for carrying the clothes for selling previously, however, at the time of alleged occurrence it is nowhere mentioned that complainant was using the motor cycle in question for selling the clothes. When the complainant was not using the motorcycle in question for commercial purpose at the time of alleged occurrence then how the OP Insurance Company can repudiate the claim of the complainant.

13.                   Further the second plea of the OP Insurance Company is that the complainant intimated to the OP Insurance Company after 7 days from the theft  is also not tenable. From the perusal of FIR (Annexure C-3/R-4) it is clearly evident that complainant informed the police immediately on the same day for snatching his motorcycle bearing registration No. HR-02Z-4952. and lodged the FIR bearing No. 61 dated 22.01.2009 on the same day. Although the complainant intimated the OP Insurance Company after 7 days from the theft, however, OP Insurance Company cannot repudiate the claim of complainant as the IRDA has clearly mentioned in the instructions that the insurer cannot reject claims amount for delay in intimation” The authorities (supra) tendered by the OP are not disputed but not helpful in the present case whereas on the other hand the Hon’ble Delhi State Commission, New Delhi in case titled as Ridhi Gupta Vs. NIC, 2008(3) CPJ page 459 has held that theft information to the police in any form, including DD report, sufficient requirement-Once report lodged with the police in any form, Insurance Company barred from appointing investigator to investigate, whether theft took place or not. Even in another case titled as Manager New India Assurance Co. Ltd. Vs. Yadram 2014(2) CLT page 386 Hon’ble State Commission has also held that “ in case of theft of vehicle, breach of policy condition is not germane- A delay of 15 days is not significant in such a case”. As per case law titled as Shriram General Insurance Company Ltd. Vs. Rajesh Kumar, 2014(2) CLT page 390 Hon’ble State Commission Haryana, Panchkula has held that “ Delay of 12 days in intimation to the insurance company- there may be a condition in the policy regarding delay in intimation but that does not mean that the insurer can take the shelter under that condition and repudiate the claim, which is otherwise proved to be genuine”. Even Hon’ble Punjab & Haryana High Court 2011-4 PLR National Insurance Company Ltd. Vs. Ravi Dutt Sharma has held that “merely because there was a delay on the part of the insured to inform petitioner-Company would not be a reason enough to decline or repudiate the claim and it is further held that Insurance Companies are not acting fairly in all such matters after charging huge premium- Intention is always to repudiate the claim on one ground or the other” 

14.                   In the present case also there was only delay in intimation for 7 days whereas FIR was lodged on the same day. The case law referred above are fully applicable on the facts and circumstances of the case, so, we are of the considered view that the repudiation of the claim by the OP Insurance Company on the ground of delay intimation to the Insurance Company as well as motorcycle in question being used for commercial purpose is not genuine which constitute deficiency in service on the part of OP Insurance Company and the OP Insurance Company is liable to pay the claim amount as per IDV of vehicle i.e. Rs. 40457/-

15                    Resultantly, we partly allow the complaint of complainant and direct the OP Insurance Company to pay the insured amount of Rs. 40457/- to the complainant alongwith interest at the rate of 7% per annum from the date of filing of complaint till its realization and further to pay a sum of Rs. 2000/- as litigation expenses. It is also made clear that an amount of Rs. 40457/- on account of theft of motorcycle bearing registration No. HR-02Z-4952 will be released to the complainant subject to submitting the subrogation letter as well as indemnity bond in favour of OP Insurance Company. Order be complied within 30 days after preparation of copy of this order failing which complainant shall be entitled to invoke the jurisdiction of this Forum as per law. Copies of this order be supplied to the parties concerned free of costs as per rules. File be consigned to the record room after due compliance.

Announced: 11.07.2016.

                                                                                          ( ASHOK KUMAR GARG)

                                                                                           PRESIDENT

 

 

 

                                                                                          (S.C.SHARMA)

                                                                                           MEMBER