Haryana

Yamunanagar

CC/780/2012

Prem Chand - Complainant(s)

Versus

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

Anil Kamboj

17 Feb 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA   NAGAR

                                                                                              Complaint No. 780  of  2012.

                                                                                              Date of institution: 23.07.2012.

                                                                                              Date of decision: 17.02.2016.

Prem Chand aged about 45 years son of Shri Jaddu Parshad, resident of House No. 472, Lajpat Nagar, Yamuna Nagar.

                                                                                                                                                                                                                                                                                                                                                      …Complainant.

                                                                     Versus

National Insurance Company Ltd. near Fountain Chowk, Yamuna Nagar through its Branch Manager.

 

                                                                                                                                                                  … Respondent. 

 

                         

CORAM:          SH. ASHOK KUMAR GARG, PRESIDENT

                        SH. S.C.SHARMA, MEMBER.

 

Present: Sh. Anil Kamboj, Advocate, counsel for complainant.   

              Sh. Rajiv Gupta, Advocate, counsel for OP. 

 

ORDER

 

1.                     Complainant Prem Chand 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. 42,000/- on account of theft of his motorcycle bearing registration No. HR-02U-9924 and further to pay Rs. 50,000/- as compensation and Rs. 3300/- as cost of proceedings.           

2.                     Brief facts of the complaint, as alleged by the complainant, are that he is the registered owner of motorcycle bearing registration No. HR-02U-9924, Model 2009 which was insured with the OP vide policy bearing No. 35100731116201222232 valid from 27.8.2011 to 26.8.2012 for a sum assured of Rs. 27,475/- and a premium of Rs. 762/- was paid in this regard to the OP.  It has been further stated that the aforesaid insurance policy covered the risk of theft also. It is further alleged that on 6.9.2011 the said motorcycle of complainant was stolen by somebody from the office of Bijli Nigam Saharanpur Road, Yamuna Nagar and an FIR bearing No. 461 dated 18.9.2011 (Annexure C-10) under section 379 IPC was got registered with police station Sadar Yamuna Nagar. The complainant informed the OP Insurance Company regarding the theft of his motorcycle and claim form was also filled up by the complainant.  The police tried their best level to trace out the motorcycle in question but failed. Ultimately, the Police submitted untraceable report of said motorcycle before the concerned competent court. The complainant visited the office of OP several times and requested for settlement of his claim but all in vain. On 23.2.2012 a letter (Annexure C-3) was received from the OP insurance company demanding the documents i.e. copy of invoice of motorcycle, copy of RC, copy of driving license, copy of invoice of motorcycle and also sought explanation for delay in lodging the FIR. All the documents were supplied to the OP. So far as delay in FIR is concerned, he immediately informed the police on toll free No.100 on the same day i.e. on 6.9.2011 and information regarding this was obtained under RTI Act (Annexure C-6). The complainant submitted the claim documents of said vehicle to the OP which are requested for passing the claim amount of motorcycle in question but the complainant has been running from pillar to post and also visited the office of OP but they did not pay any heed to the genuine request of the complainant and failed to settle the genuine claim, hence there is a great deficiency in service on the part of OP and complainant is entitled to get the insured amount alongwith compensation and litigation expenses as prayed above. Hence, this complaint.

3.                     Upon notice, OP appeared and filed its written statement by taking some preliminary objections such as complaint is not maintainable, no negligence or deficiency in service and on merit it has been mentioned that a claim intimation dated 19.9.2011 (Annexure R-1) was received by the Op Insurance Company from the complainant to the effect that the motorcycle bearing registration No. HR-02U-9924 insured with the OP Company for a sum of Rs. 27475/- was stolen on 6.9.2011. On receipt of intimation, the OP Insurance company issued letters dated 23.2.2012, 6.3.2012 and 26.3.2012 (Annexure R-2 to R-4)  in which complainant was asked to submit necessary documents for processing the claim in question, so, that insurance company was able to settle the claim at the earliest. On processing the claim it was observed and found by the insurance company that the alleged date of loss is 6.9.2011 but a belated intimation dated 19.9.2011 was given to the insurance company. Further the FIR (Annexure R-5) was registered in this case on 18.9.2011. Meaning thereby the insurance company was intimated after 13 days and FIR was registered after 12 days of the alleged theft. The insured was bound to give immediate intimation as per the terms and condition No.1 of the insurance policy. As such, it is a clear cut violation of terms and conditions of the insurance policy and the claim in question is not covered under the terms and conditions of the insurance policy being not payable. Therefore, the claim was legally and justifiably repudiated vide letter dated 30.8.2012 (Annexure R-6) and prayed for dismissal of complaint.

4.                     To prove his case, counsel for the complainant  has tendered into evidence affidavit of complainant as Annexure CW/A and documents such as Photo copy of letter dated 6.3.2012 as Annexure C-1, Photo copy of letter dated 26.3.2012 as Annexure C-2, Photo copy of letter dated 23.2.2012 as Annexure C-3, Photo copy of reply of letter dated 23.2.2012 as Annexure C-4, Photo copy of reply of letter dated 26.3.2012 as Annexure C-5, Photo copy of information sought under RTI Act as Annexure C-6, Photo copy of intimation letter written to Registering Authority, Jagadhri (Yamuna Nagar) as Annexure C-7, Photo copy of confirmation of 64VB Compliance as annexure C-8 & C-9, Photo copy of FIR as Annexure C-10, Photo copy of insurance cover note as Annexure C-11, photo copy of untraceable report as Annexure C-12,  Photo copy of untraceable order passed by Chief Judicial Magistrate as Annexure C-13, Photo copy of Form No.22 as Annexure C-14, Photo copy of retail invoice as Annexure C-15, Photo copy of sale certificate as Annexure C-16 and closed the evidence on behalf of complainant.

 5.                    On the other hand, counsel for the OP has tendered into evidence affidavit of Parveen Arora, Administrative Officer, National Insurance Company, as Annexure RW/A and documents such as Photo copy of intimation letter dated 19.9.2011 as Annexure R-1, Photo copy of letter dated 23.2.2012 as Annexure R-2, Photo copy of letter dated 6.3.2012 as Annexure R-3, Photo copy of letter dated 26.3.2012 as Annexure R-4, Photo copy of FIR as Annexure R-5, Photo copy of letter dated 30.8.2012 as Annexure R-6, Photo copy of insurance policy alongwith terms and conditions as Annexure R-7 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-02U-9924 and it was insured with the OP vide policy bearing No. 3510073116201222232 valid from 27.8.2011 to 26.8.2012 for a sum assured of Rs. 27,475/- and a premium of Rs. 762/- was paid in this regard to the OP which was stolen by some unknown person on 6.9.2011 during the currency of insured policy in question. It is also admitted that regarding theft of Motor Cycle an FIR No. 461 dated 18.9.2011 (Annexure C-10/ R-5) was lodged with the police of P.S. Sadar, Yamuna Nagar.

 8.                    The only plea of the insurance company is that the claim of the complainant has been rightly repudiated vide letter dated 30.8.2012 (Annexure R-6) as the alleged theft took place on 6.9.2011 whereas FIR bearing No. 461 dated 18.9.2011 under section 379 IPC, P.S. Sadar Yamuna Nagar was got registered on 18.9.2011 i.e. after near about 12 days and further the OP insurance company was intimated on 19.9.2011 i.e. after 13 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 The arguments raised on behalf of OPs are supported by case law titled as Bachan Singh vs. OIC ltd. 2014(3) CLT page 103 (N.C.), New India Assurance Co. Ltd. Vs. Ram Avtar 2013(4) CLT page 573 (N.C.),  Royal Sundram Alliance Insurance Co. Ltd. Versus Kanwal Jeet Singh Gil, 2015 (3) CLT page 90 (N.C) and another case law titled as H.D.F.C. Ergo General Insurance Co. Ltd. Versus Bhagchand Saini, 1(2015) CPJ page 206 (N.C.) have weight as 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. On this point, reliance can also be placed on judgment passed by the Hon’ble National Commission in case titled as 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.  

9.                     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 OPs insurance company. The motorcycle bearing registration No. HR-02U-9924 was stolen by somebody on 6.9.2011 and the complainant immediately informed the police of P.s. Sadar Yamuna Nagar on toll free No.100 which is evident from the report received under RTI Act (Annexure C-6). So, there is no fault on the part of the complainant, if there is any delay then it was due to the investigation or procedure of the police department. 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 vide letters Annexure C-4, C-5 and C-7 in which it has been specifically clear that as the police of P.S. Sadar Yamuna Nagar was not registered FIR promptly so he could not inform the insurance company immediately. This fact is evident from Annexure R-1 wherein it has been so recorded by the complainant. Further the learned counsel for the complainant draw our attention towards the untraceable report issued by Chief Judicial Magistrate, Yamuna Nagar vide its order dated 6.2.2012 (Annexure C-13). 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”

10.                   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 on the point that claim was lodged with the insurance company after 12 days from the alleged theft which is violation of the terms and conditions of the insurance policy. From the information collected under RTI Act Annexure C-6 by the complainant it is clearly evident that complainant intimated the police immediately on toll free number 100 regarding the theft of motorcycle bearing registration No. HR-02U-9924, so, the complainant cannot be held liable for any delay in lodging the FIR due to the fault of the police. The same view has been held by the Hon’ble National Commission in case titled as New India Assurance Co. ltd. Vs. Gurmeet Kaur & Others, 2015(3) CLT page 476 wherein it has been held that Insurance Claim- Theft of vehicle- Delay in FIR- Held- The complainants cannot be held responsible for the time taken by the police in registering the FIR- He discharged his contractual obligation under the policy for informing the concerned police station.

11.                   Further as the police of police station City Yamuna Nagar failed to register the FIR in time, so the complainant could not inform the OP Insurance Company in time and this clarification was duly conveyed to the OP Insurance company by the complainant which is evident from Annexure R-1.  

12.                   Further the arguments advanced by the counsel for the OP on the point of delay intimation is not tenable 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” 

13.                   In view of the aforesaid law which are fully applicable on the facts and circumstances of the case, it has been observed that the repudiation of the claim by the OP Insurance Company on the ground of delay intimation to the Insurance Company- Delay in FIR is not genuine and the OP Insurance Company is liable to pay the claim amount as per IDV of vehicle i.e. Rs. 27475/-.

14.                   Resultantly, we partly allow the complaint of complainant and direct the OP Insurance Company to pay the insured amount of Rs. 27475/- 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. 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: 17.02.2016.

                                                                                          ( ASHOK KUMAR GARG)

                                                                                           PRESIDENT

 

 

 

                                                                                          (S.C.SHARMA)

                                                                                           MEMBER