Madhya Pradesh

StateCommission

A/14/1045

SMT.DRAUPATI SHAKYA - Complainant(s)

Versus

NEW INDIA ASSU.CO. - Opp.Party(s)

11 Jul 2024

ORDER

M. P. STATE  CONSUMER  DISPUTES  REDRESSAL  COMMISSION,                         

PLOT NO.76, ARERA HILLS, BHOPAL

 

FIRST APPEAL NO. 1045 OF 2014

(Arising out of order dated 03.06.2014 passed in C.C.No.107/2014 by District Commission, Gwalior)

 

SMT. DRAUPADI SHAKYA,

W/O SHRI OM PRAKASH SHAKYA,

R/O ASHOK COLONY ROAD,

NEAR GANGARAM AATA CHAKKI,

MURAR, GWALIOR (M.P.)                                                                                  …     APPELLANT.

 

                  Versus

 

THE NEW INDIA ASSURANCE CO.LTD.

THROUGH DIVISIONAL MANAGER,

DIVISION OFFICE NO.2, F-4, FIRST FLOOR,

CITY CENTRE, NEAR GDA OFFICE,

RAVI NAGAR, KILA GATE, GWALIOR (M.P.)                                                      ….   RESPONDENT.

 

BEFORE :

            HON’BLE SHRI A. K. TIWARI                : ACTING PRESIDENT

            HON’BLE DR. SRIKANT PANDEY        :          MEMBER

                                   

COUNSEL FOR PARTIES :

                Shri Hemant Sharma, learned counsel for the appellant.

            Ms. Preetima Shrivastava, learned counsel for the respondent.

          

 

O R D E R

(Passed On 11.07.2024)

         The following order of the Commission was delivered by A. K. Tiwari, Acting President:

                         The complainant/appellant being dissatisfied by the order dated 03.06.2014 passed by the District Consumer Disputes Redressal Commission, Gwalior (for short ‘District Commission’) in C.C.No.107/2014, whereby the complaint filed by him has been dismissed.

2.                Facts of the case in brief are that the complainant’s vehicle Bolero bearing registration number MP-08 CA-1554 was insured with the

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opposite party-insurance company for the period w.e.f. 28.05.2012 to 27.05.2013 for IDV of Rs.3,60,000/-.  During the insurance cover in the intervening night of 30-31.03.2013, the subject vehicle was stolen of which FIR was lodged with the police on 31.03.2013 and intimation was given to the insurance company on 01.04.2013. It is submitted that the investigator appointed by the insurance company found that the subject vehicle was stolen. It is submitted by her that in order to get Final Report (FR) the complainant compromised the matter in criminal complaint in Lok Adalat. It is alleged that the insurance company by letter dated 04.02.2014 unilaterally repudiated the claim on the ground of violation of policy terms and conditions no.1 and 2.  The complainant therefore by filing the instant before the District Commission sought relief of IDV of the subject vehicle Rs.3,00,000/- with interest @ 15% along with compensation of Rs.50,000/- and costs Rs.15,000/-.

3.                The District Commission holding that there has been no deficiency in service or unfair trade practice on behalf of the insurance company in repudiating the claim of the complainant, dismissed the complaint. Hence, this appeal by the complainant.  

4.                Heard learned counsel for the parties. Perused the record.

5.                Learned counsel for the appellant argued that the theft of vehicle committed on 30-31.03.2013 of which FIR was lodged with the

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police on 31.03.2013 and the insurance company was also informed on 01.04.2013. In the criminal complaint, the police arrested 3 accused and 6 accused are remaining to be arrested, the vehicle was also not recovered from them. She tried to get the vehicle and when the vehicle was not recovered, the police filed challan in the court. The insurance company for settling the claim asked to produce FR. Meanwhile she received notice from the Lok Adalat and in order to get FR she compromised the matter in Lok Adalat on 30.11.2013 with the 3 arrested accused. He argued that the insurance company unilaterally repudiated the claim on the ground of violation of policy terms and conditions. He argued that the District Commission also considering the compromise in Lok Adalat as violation of policy terms and conditions has held that the insurance company has not committed deficiency in service in repudiating the claim and dismissed the complaint. He therefore prayed for setting aside the impugned order.

6.                Learned counsel for the opposite party-insurance company argued that in the criminal complaint the police filed challan against the three accused who were arrested as remaining 6 accused were not arrested and the vehicle was also not recovered. Despite that the complainant in order to harm the interests of the insurance company without seeking permission from the insurance company compromised the matter with three accused/offenders, which amounts to violation of policy

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terms and conditions no.1 and 2 and as such the claim was not payable. There has been no deficiency in service on part of the insurance company in repudiating the claim. The District Commission rightly holding so dismissed the complaint. She prayed for dismissal of appeal.

7.                The complainant has filed her affidavit along with documents C-1 to C-15 in support of her complaint. On behalf of insurance company an affidavit of Shri Sanjay Vijayvargiya, Divisional Manager along with documents R-1 to R-12 has been filed.           

8.                Having heard learned counsel for the parties and on careful perusal of the record as also the impugned order we find that the complainant has submitted that in order to get FR which is necessary for deciding the claim, he got the matter compromised in Lok Adalat and the insurance company has committed deficiency in service in repudiating the claim on the ground of violation of policy terms and conditions. On the other hand the defence of the insurance company was that since the complainant compromised the matter with the accused without seeking permission from the insurance company which amounts to deficiency in service and therefore the insurance company has rightly repudiated the claim and hence there has been no deficiency in service.

9.                Here it is necessary to mention the relevant provisions of the insurance policy which reads thus:

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1. 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 by 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 the Policy the insured shall give immediate notice to the police and co-operate with the Company in securing the conviction of the offender.

 

                                    2. No admission offer promise payment or indemnity shall be made or given by or on behalf of the insured without the written consent of the Company which shall be entitled if it is desires to take over and conduct in the name of the insured the defence or settlement of any claim or to prosecute in the name of the insured for its own benefit any claim for indemnity or otherwise and shall have full discretion in the conduct of any proceedings or in the settlement of any claim and the insured shall give all such information and assistance as the Company may require.

 

                   On bare perusal of the aforesaid conditions it is clear that no compromise or settlement of any claim can be made without written consent of the insurance company. Also it is specifically mentioned that the insurer co-operate with the insurance company in securing the conviction of the offender. The aforesaid conditions are binding on the insured.

10.              Here in the present case, admittedly the complainant’s husband with the complainant’s consent made compromise with the offenders in the Lok Adalat without seeking written consent or permission from the insurance company and did not co-operate the insurance company in conviction of the offender. Instead the complainant in collusion

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with the offenders, by making compromise helped the offenders more particularly when the subject vehicle was not recovered. The details of compromise made in Lok Adalat (C-12) is as under:

MkWdsV yksd vnkyr

le>kSrs dk laf{kIr fooj.k %&  tIr lEifRr izkIr djuh gS gekjs chp jkthukek gks x;k ge yksxksa dks dksbZ fdlh izdkj dh vkifRr ugha gSa cxSj fdlh /kksl ncko dk dkj.k ugha gS jkthukek gksus ls ge yksx larq"V gSA ge viuk izdj.k vc ugha pykuk pkgrs gSaA

 

11.              In view of the above discussion we find that the complainant did not co-operate the insurance company and has violated condition no.1 and 2 of the insurance policy which amounts to violation of policy terms and conditions. In such circumstances, the insurance company has rightly repudiated the claim of the complainant.  The District Commission has rightly held that there has been no deficiency in service on part of the insurance company and has rightly dismissed the complaint. We do not find any illegality or infirmity in the impugned order passed by the District Commission. Accordingly, the impugned order is hereby affirmed.

12.              In the result, this appeal fails and is hereby dismissed. No order as to costs.

                     (A. K. Tiwari)                  (Dr. Srikant Pandey)  

                  Acting President                          Member