Haryana

Kurukshetra

255/2016

Gurdeep Singh - Complainant(s)

Versus

NIC - Opp.Party(s)

Sandeep Tiwana

17 Jan 2018

ORDER

BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL FORUM, KURUKSHETRA.

 

                                                        Complaint no. 255/16

                                                        Date of instt.  9.9.16

                                                        Date of Order: 17.1.18.

 

Gurdeep Singh son of Baldev Raj, resident of Guru Nanak Colony, Ismailabad, Tehsil Pehowa, District Kurukshetra.       

       

                                                                        …….complainant

                          Vs.

 

1.  National Insurance Company Limited, Branch Office at Railway Road, through its Branch Manager/authorized signatory.
2. National Insurance Company Limited, Hero Vertical 101 106, BMC House NI Can-naught Place, New Delhi through its authorized signatory.

 

                                                                        ….OPs.

 

Complaint under section 12 of Consumer Protection Act.

 

Before:       Sh. G.C. Garg, President.    

                 Dr. Jawahar Lal Gupta, Member.

                 Smt. Viraj Pahil, Member

                       

Present:         Sh. Sandeep Tiwana, Adv. for complainant.

                    Sh. R.K.Singhal, Adv. for the Ops.

ORDER:

 

                This is a complaint under Section 12 of the Consumer Protection Act, 1986 moved by complainant Gurdeep Singh against National Insurance Company Limited through its Branch Manager and another, the opposite parties.

2.            It is stated in the complaint that the complainant is registered owner of a motor cycle bearing No.HR-41-F/7877 and the said motor cycle was insured from the Ops vide policy bearing No.35100731126201233517 valid from 8.8.12 to 7.8.13. On 17.4.2013 the above said motor cycle was used by the brother of the complainant and he parked the same in front of gate of Sanoh plot No.332, Sector-3 IMT Bawal and when his brother came out from the company he found that motor cycle was not there and in this regard FIR No.83 dated 21.4.2013 was registered in police station Kasola. After registration of FIR, the complainant and his brother gave information to the Ops but they have not given any intimation to the complainant except letter dated 28.3.2016. The police also not submitted any report regarding the tracing of motor cycle and complainant approached the Ops many a times but they postponed the matter on one pretext or the another. Thus, it amounts to deficiency in service on the part of Ops. Hence, the present complaint was moved by the complainant claiming the insured amount of Rs.41,990/- the motor cycle in question and to pay Rs.30,000/- towards harassment and mental agony.

3.                   Upon notice, opposite parties appeared and contested the complaint by filing written statement taking preliminary objections that the complaint is not maintainable. The true facts are that the theft of vehicle allegedly stolen on 17.4.2013 whereas the intimation to the police was given on 21.4.2013 i.e. after four days and the intimation to the company was given on 10.7.2013 i.e. after 81 days and it is clear cut violation of the terms and conditions of the policy. Hence, in view of the facts and circumstances mentioned above, there is no deficiency in service on the part of answering Ops and as such, the complaint of the complainant is liable to be dismissed with costs. On merits, contents of the complaint were denied. Preliminary objections were repeated. Prayer for dismissal of the complaint was made.

4.             Both the parties have led their respective evidence.

5.             We have heard the ld. Counsel for the parties and have gone through the record available on the file carefully.

6.            Learned counsel for the complainant has contended that opposite parties have illegally repudiated the claim of the complainant on false ground of late intimation to the insurance company, whereas the complainant informed the opposite party and the police immediately after the theft of the vehicle in question.

7.             On the other hand, learned counsel for the opposite party contended that opposite parties have rightly not released the claim of the complainant as the complainant has violated the terms and conditions of the policy as intimation to the insurance company was given by complainant after 81 days of theft, whereas claim for theft of vehicle is not payable if the same is not reported to company within 48 hours of its occurrence, so the claim of the complainant has rightly been repudiated on this ground.

8.             We have considered the rival contentions of the parties. In the present case, it is an admitted case that the theft had taken place on 17.4.2013 and FIR bearing No.83 was registered on 21.4.2013 which fact is evident from the copy of FIR. The opposite parties repudiated the claim of the complainant on the ground that insurance company was informed after 81 days from the date of theft of the vehicle in question. The plea of delay in giving information to the insurance company is not relevant because the complainant lodged his complaint in Police Station vide FIR No.83 dated 21.4.2013. Moreover, the Insurance Regulatory Development Authority (for short ‘IRDA’) which controls and regulates the Insurance Companies has given direction to the Insurance Companies not to reject the genuine claims simply because of delay in registration of the FIR and intimation to the Insurance Company. It has been observed that “The Authority has been receiving several complaints that claims are being rejected on the ground of delayed submission of intimation and documents. The current contractual obligation imposing the condition that the claims shall be intimated to the insurer with prescribed documents within a specified number of days is necessary for insurers for effecting various post claim activities like investigation, loss assessment provisioning, claim settlement etc. However, this condition should not prevent settlement of genuine claims, particularly when there is delay in intimation or in submission of documents due to unavoidable circumstances. The insurer’s decision to reject a claim shall be based on sound logic and valid grounds. It may be noted that such limitation clause does not work in isolation and is not absolute. One needs to see the merits and good spirit of the clause, without compromising on bad claims. Rejection of claims on purely technical grounds in a mechanical fashion will result in policy holders losing confidence in the insurance industry, giving rise to excessive litigation. Therefore, it is advised that all insurers need to develop a sound mechanism of their own to handle such claims with utmost care and caution. It is also advised that the insurers must not repudiate such claims unless and until the reasons of delay are specifically ascertained, recorded and the insurers should satisfy themselves that the delayed claims would have otherwise been rejected even if reported in time.” These observations are fully applicable to the present case. In the present case, the claim of the complainant has only been repudiated on the technical ground of delay in informing the insurance company and the same has been repudiated in a mechanical fashion. No other reason whatsoever has been rendered by the insurance company. The Hon’ble Punjab & Haryana High Court in an authority cited as Bharti Axa General Insurance Company Limited Versus Ms. Monu Yadav and another, 2014 (4) PLR 861, has held that “ when theft of car took place and there was delay in lodging claim with insurance company of 54 days, it was held that the instructions dated 20.9.2011, issued by Insurance Regulatory and Development Authority to all the insurance companies are applicable to the insurance companies. It has further been held that as per the said instructions, this condition should not prevent the settlement of genuine claims particularly, when there is delay in giving intimation or in submission of documents due to unavoidable circumstances. The companies were advised that they must not repudiate such claims on the ground of delay, especially when the police has been promptly informed in this regard.”   The facts of the above said authority are applicable to the present case as in the present case, the FIR was lodged on the very next day when the accident took place.

9.            So far as the question of the claim amount is concerned, the Ops declared the value of the vehicle including accessories, estimated to the tune of Rs.41,990/-. So, we are of the view that the complainant is entitled to the said amount of Rs.41,990/-.

10.            Thus, as a sequel to our above discussion, since the complainant has informed the police regarding the theft of the vehicle in question to the Insurance Company as per the direction of the IRDA and also got the FIR lodged, the OPs could not reject genuine claim of the complainant on purely technical ground. So, the repudiation of the claim of complainant is not correct.  So, in such like circumstances, we accept the present complaint and direct the opposite party to pay the amount of Rs.41,990/-to the complainant. This order should be complied within a period of two months, failing which penal action under Section 27 of the Consumer Protection Act, 1986 would be initiated against the opposite party and in that case also the Ops shall be liable to pay the simple interest @ 6% per annum on the amount of Rs.41,990/- from the date of order till its payment. File be consigned to record after due compliance.

                 Copy of this order be communicated to the parties.

Announced:             

Dt. 17.1.18.                                               (G.C.Garg)

                                                                President,

                                                District Consumer Disputes                                                            Redressal Forum, Kurukshetra.

 

 

       (Dr. Jawahar Lal Gupta)            (Viraj Pahil)

         Member                                 Member