Per Mr. D.R. Shirasao, Presiding Judicial Member

1.       Complainant has filed this consumer complaint against opponent for getting insurance claim in respect of his fishing boat.  Brief facts of the case are as under :

2.       Complainant is a fisherman and carrying on his activities on the coast of Ratnagiri district since last 25 years.  For carrying fishing activities, complainant has purchased an automatic fishing wooden vessel boat known as Zeeshan Ali.  Complainant is doing this work of fishing for earning his livelihood. The vessel boat Zeeshan Ali is duly registered in the office of Ratnagiri vide registration No. IND – MH – 4 – MM – 1047 from 12/8/2011.  For carrying on activities, complainant has also obtained permit from the office of Ratnagiri and the said permit was valid for the period from 27/12/11 to 26/12/14.  The complainant has insured his fishing boat with opponent and the insurance was valid during the period from 1/11/2013 to 31/10/2014.  Complainant had paid amount of premium of Rs.1,11,637/- for the same to the opponent. As per this insurance policy, the sum assured for the fishing boat was Rs.40,00,000/-.

3.       It is the contention of complainant that, unfortunately, the said fishing boat owned by him sank into the sea water on 26/11/2013 due to hole on the lower side of the boat.  On 26/11/2013, complainant approached police authorities to register the complaint in respect of the boat.  However, police informed him that as there are no casualties or loss of human life, they are unable to register the complaint and directed complainant to inform this fact of sinking of boat to the Port Trust office of Jaitapur.  Accordingly, the complainant had gone to the office of Port Trust of Jaitapur and had given information about his boat in that office and that office had informed this fact to the opponent on the same day.  On 27/11/2013, complainant had given letter to Maharashtra Maritime Board Jaitapur Port to make the Panchanama of the incident.  However, office told complainant that for that purpose, they need letter from insurance company.  Hence, on 20/1/14, complainant had given letter to the insurance company and requested to give letter to the Port Trust office for preparing Panchanama.  Complainant had given second letter to insurance company in that respect on 12/2/14.  On 3/4/2014, portal authorities Jaitapur had prepared Panchanama in respect of boat of complainant and had prepared the accidental report. Complainant had also collected all these documents from portal authorities Ratnagiri and had sent the same to opponent on 16/11/2014 and requested them to proceed with the claim.  It is the contention of complainant that, however, till filing of consumer complaint, opponent had neither accepted nor denied the claim of complainant.  It is also the contention of complainant that for preparing that boat, he had made expenditure of Rs.61,28,859/-.  As opponent had not considered the claim of complainant in respect of his boat, ultimately complainant had given legal notice to opponent on 14/3/2017 through his Advocate.  However, opponent insurance company failed to comply with the notice given by the complainant and had also not given amount of sum assured of the boat to the complainant.  In view of the same, the complainant has filed this consumer complaint for getting sum assured of the fishing boat of Rs.40,00,000/- from opponent alongwith interest on this amount @ 12 p.c.p.a. amounting to Rs.7,20,000/- till filing of consumer complaint. 

4.       Opponent contested consumer complaint by filing their written version on record.  It is the contention of opponent that the complaint filed by the complainant is premature, as opponent has never denied the claim of complainant.  It is also their contention that the complainant has not made any claim in respect of fishing boat with opponent.  It is the contention of opponent that there is delay in making claim with opponent.  Hence, complainant is not entitled to get the same.  It is also their contention that consumer complaint filed by complainant is not maintainable as it is filed beyond the period of limitation without application for condonation of delay.  In view of the same, it is the contention of opponent that consumer complaint filed by complainant be dismissed.

5.       Considering the fact and circumstances of the case, following points arise for my determination :

As to Points No. 1 to 3

6.       Heard learned Advocate appearing for complainant.  It is the contention of complainant that the complainant was doing fishing activities for earnng his livelihood and for that purpose, he had purchased the fishing boat.  The said fishing boat was duly insured with opponent and sum assured was Rs.40,00,000/-. During the subsistence of insurance policy, fishing boat of complainant had sunk in sea water.  In that respect, he had made correspondence with the portal authorities of Ratnagiri and filed his claim with opponent alongwith necessary documents.  However, opponent had neither given the claim to complainant nor rejected the same.  Hence, complainant has filed this consumer complaint for getting insurance claim in respect of fishing boat against opponent  It is his contention that as per IRDA rules, insurance company is liable to decide the insurance claim within six months from the date of claim made to them.  He further submitted that this Commission while deciding consumer complaint No. 152/2009 in the matter of Jyoti Impex Vs New India Assurance Co.Ltd. on 29/4/13 considered that if the claim of complainant is not decided by the insurance company, then the cause of action in that respect is continuous.  The learned counsel appearing for complainant also relied on the order passed by the Hon’ble Supreme Court in Civil Appeal No. 653/2020 Gurushinder Singh Vs. Shriram General Insurance Co. in which the Hon’ble court considered that mere delay in intimating the incident to insurance company cannot be a ground to deny he claim of complainant. He also relied on IRDA rules in which it has been directed that claim should not be rejected on the ground of delayed intimation or submission of documents at subsequent stage.  Hence, it is the contention of learned counsel appearing for complainant that complainant is entitled to get amount of sum assured of Rs. 40 lakhs from opponent in respect of fishing boat of complainant alongwith interest on that amount alongwith cost and compensation. 

7.       Heard learned Advocate appearing for opponent insurance company.  It is his submission that incident of sinking of boat had taken place on 26/11/2013.  Consumer complaint is filed in the year 2017.  The same is not within limitation.  He further submitted that the claim made by complainant in respect of boat with insurance company was late and hence, complainant is not entitled to get the insurance claim from opponent.  It is also his submission that, as complainant has not filed application for condonation of delay alongwith complaint, complaint cannot be taken into consideration, as it is barred by limitation. Hence, it is the contention of learned Adv. appearing for opponent that the consumer complaint filed by complainant be dismissed.

8.       In this case, it is admitted fact that the vessel boat Zeeshan Ali bearing Reg.No. IND – MH – 4 – MM – 1047 was owned by complainant.  Complainant was using the same for his fishing activities for earning his livelihood for doing fishing activities.  Complainant had obtained permission in that respect from the portal authority of Ratnagiri for the period from 27/12/11 to 26/11/14.  The fishing boat of complainant was insured with opponent for the period from 1/11/2013 to 31/10/14.  The sum assured in respect of boat was Rs.40,00,000/- and amount of premium of Rs.1,11,637/- was paid by complainant to opponent.  To prove this fact, complainant has produced necessary documents on record.  Opponent has also not denied the fact that boat of complainant was insured with them.  The fishing boat of the complainant sank on 26/11/2013 during the subsistence of insurance policy.  In that respect, complainant had given report in police station.  However, as there was no casualty in sinking of boat, the police had not accepted the report of complainant and directed complainant to give report in respect of sunk boat to portal authorities Jaitapur at Jaitapur.  Accordingly, on 27/11/2013, the complainant had given intimation in hat office in writing.  He had requested that authority to prepare panchanama of sunk boat and file report of accident in police station.  However, it was the contention of the portal inspector that, in that respect, they want letter from insurance company.  Accordingly, on 27/11/2013 itself, that office had given intimation to the office of opponent on telephone.  In this case, it appears that on 16/4/2014, Maharashtra Maritime Board Jaitapur had given report to Maharashtra Maritime Board Ratnagiri. At that time, they had given accidental report, Panchanama and statement of complainant alongwith their letter.  In all those documents, it has been mentioned that the boat of complainant was sunk on 26/11/2013 in sea water.  In respect of boat of complainant sunk in the sea water, Maharashtra Maritime Board Jaitapur had given letter to complainant on 7/5/2014 for removing the same from sea water as it is creating obstacle to other fishing boats. Hence, from all these documents, it has become clear that the boat of complainant had sunk in sea water on 26/11/2013. 

9.       The learned Advocate appearing for opponent has mainly taken objection on the ground that the report about the sunk boat was given by complainant very late.  However, as per IRDA regulations, no claim can be rejected for giving late intimation of the fact or subsequent filing of documents.  In this case, from documents filed on record, it has become clear that the boat of complainant sunk on 26/11/2013 and since that date, he was taking efforts in respect of making claim in respect of fishing boat.  The learned Advocate for opponent has also taken objection on the ground that the complaint filed by complainant is not within limitation as the incident of sinking of boat had taken place on 26/11/13 and consumer complaint is filed on 27/12/17.  In this case, it is admitted fact that opponent had not decided the claim of complainant in respect of his boat.  While giving decision by this Commission in the matter of M/s Jyoti Impex Vs, New India Assurance Co.Ltd., this Commission had come to the conclusion that in such cases, the cause of action is continuous.  As per IRDA rules also, in respect of the claim made by complainant, opponent insurance company has to take decision within 6 months from the date of filing claim with insurance company.  However, insurance company had not taken any decision on the claim of complainant, although complainant had made his claim in that respect with opponent on 16/4/14.   Under such circumstances, the cause of action for filing consumer complaint in respect of the claim of complainant is continuous.  Hence, the contention of opponent cannot be accepted that the consumer complaint filed by complainant is not tenable as it is filed beyond the period of limitation.  The contention of learned Advocate appearing for opponent also cannot be accepted that the claim of complainant is premature as opponent insurance company has not decided the claim of complainant within 6 months from making claim by complainant as per IRDA rules.  It appears that in respect of claim of complainant, complainant had sent legal notice to opponent on 14/3/2017 and when this notice remained non-complied by opponent, he filed this consumer complaint on 27/12/17.  Under such circumstances, the complaint filed by complainant is within limitation and tenable against opponent.

10.     In this case, it is admitted fact that the sum assured for boat is Rs.40,00/000/- as per insurance policy filed on record.  Complainant has claimed the said amount from opponent alongwith interest on this amount @ 12 p.c.p.a. amounting to Rs.7,20,000/- till filing of consumer complaint.  I am of the opinion that the amount claimed by the complainant is reasonable and hence, complainant is entitled to get the same from opponent.  As opponent has not decided the claim of complainant and complainant required to file consumer complaint for that purpose against opponent, complainant is also entitled to get compensation on that ground for mental pain and agony alongwith cost of litigation.  In view of the same, I answer the point No.1 to 3 in affirmative and proceed to pass the following order :

ORDER

1)      Consumer complaint filed by complainant against opponents is hereby partly allowed subject to cost of Rs.25,000/- to be paid by opponents to complainant.

2)      Opponent is hereby directed to pay amount of Rs.40,00,000/- to complainant alongwith interest on this amount @ 12 p.c.p.a. from the date of filing of claim till realisaiton of this amount by complainant from opponents.

3)      Opponent is further directed to pay amount of Rs.1,00,000/- to complainant as compensation in respect of mental pain and agony.

4)      Opponent is directed to pay the amount of cost and compensation to complainant within the period of one month from passing of this order. Otherwise, opponent will have to pay interest on this amount @ 12 p.c.p.a. from the date of filing of complaint by complainant till realization of amount by complainant.