BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FEROZEPUR.
C.C. No. 78 of 2015 Date of Institution: 13.2.2015
Date of Decision: 24.9.2015
Raj Krishan, Son of Sh. Mangat Ram, Resident of Gobind Nagri, Opposite Bajaj Petrol Pump, Near Sahni Di Shop, Street No.1, Jalalabad (W), District Fazilka, now resident of House No.C,1444, Gobind Nagri, Opposite Bajaj Petrol Pump, Jalalabad(W), District Fazilka. Mb. 9878111549.
....... Complainant
Versus
- Oriental Insurance Company Limited, Ist Floor Building, Oriental Bank of Commerce, Jalalabad(W), District Fazilka, through its Branch Manager.
- Oriental Insurance Company Limited, Head Office A-25/27, Asaf Ali Road, New Delhi-110002, through its Chairman/Managing Director.
........ Opposite party
Complaint under Section 12 of
the Consumer Protection Act, 1986.
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PRESENT :
For the complainant : Sh. Navdeep Soi, Advocate.
For the opposite party : Sh. Ashwani Kumar Sharma, Advocate
QUORUM
S. Gurpartap Singh Brar, President
Mrs. Inderjeet Kaur, Member
ORDER
GURPARTAP SINGH BRAR, PRESIDENT:-
Brief facts of the complaint are that Manjinder Singh, Son of Paramjit Singh, resident of village Bachre, District Tarn Taran was the owner of truck bearing registration No. PB-46F-9589. The complainant had purchased the above said truck from Manjinder Singh and the said truck was transferred in the name of the complainant by the Transport Authority. Manjinder Singh previous owner of the truck had purchased an insurance policy from Reliance General Insurance which was valid for the period from 1.4.2009 to 31.3.2010 . After purchasing the vehicle, the complainant applied for transfer of insurance policy in the name of the complainant. The insurance policy was transferred in the name of the complainant
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vide Endorsement No.72001 and the said endorsement became effective from 30.4.2009. After 31.3.2010. Therefore, the complainant purchased the insurance policy of the truck from opposite party No.1 for the period from 1.4.2010 to 31.3.2011. Opposite party No.1 issued a cover note bearing No.777511, dated 1.4.2010 to the complainant. The said cover note was duly signed by Sh. Anil Handa of opposite party No.1. The complainant had submitted all the details to Sh. Anil Handa and Anil Handa after completing all the formalities, issued cover note dated 1.4.2010 to the complainant. Thereafter, opposite parties issued a policy No.233707/31/2011/15 to the complainant. On 11.8.2010, the complainant had parked his truck in question at Bajaj Petrol Pump, Jalalabad in the night. However, in the morning, when the complainant visited Bajaj Petrol Pump at Jalalabad(w), the truck-tralla was not at the spot. The complainant tried to locate his truck in the neighborhood. However, the complainant could not trace the truck. The complainant immediately reported the matter to the police and got registered a Rapat with the police of Police Station City Jalalabad on 12.8.2010. The complainant had also informed in writing to the opposite parties and gave in writing to Sh. Anil Handa and Sh. Anil Handa assured the complainant that he would do the needful. Lateron the police made the investigation and after
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investigation, the police of Police Station City Jalalabad registered FIR No.137, dated 28.9.2010, U/s 379 of IPC. The complainant lodged the claim with the opposite parties, which was repudiated by opposite party No.1 vide letter dated 2.5.2013. There was no delay on the part of the complainant in intimating opposite party No.1 about the theft. The policy was transferred in the name of the complainant from 30.4.2009 and the policy was valid for the period from 1.4.2009 to 31.3.2010. The complainant did not conceal anything from Sh. Anil Handa at the time purchase of the policy. The opposite parties had wrongly observed that the complainant was not eligible for “No Claim Bonus”. The complainant has not made any false declaration at the time of purchase of the policy. The opposite parties had wrongly and illegally repudiated the claim of the complainant. After the repudiation of the claim of the complainant, the complainant made repeated requests to the opposite parties to admit the claim of the complainant and to pay the amount of Insurance alongwith interest to the complainant, but the opposite parties refused to admit the claim of the complainant. Pleading deficiency in service on the part of the opposite party, the complainant has prayed that the opposite party be directed to pay Rs.8,00,000/- as price of the truck insured with the opposite parties alongwith interest @18% per annum, from the date of theft, till
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realization of the entire amount. Further a sum of Rs.1,00,000/- as compensation for harassment caused to the complainant and Rs.45,000/- as litigation expenses.
2. Upon notice, the opposite party appeared and filed their joint written reply to the complaint, In its written reply, the opposite parties took some preliminary objection interalia that there is no deficiencies in rendering service on the part of the opposite parties at any point of time; that the complainant has suppressed material facts from this Forum and is not entitled to any relief. The claim of the complainant has been repudiated on the following legal and valid grounds:-
“(i) That as per the intimation letter, the loss is alleged to have taken place on the intervening night of 11-12/8/2010, but the intimation to the company was given on 16.8.2010. As per the policy terms and conditions, the loss should have been reported to the company immediately and there was no sufficient reason of delay.
(ii) That the complainant availed No Claim Bonus vide giving declaration in the proposal form at the time of purchasing the insurance policy. Lateron it has been
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revealed that the complainant had got the policy transferred in his name and as such the policy after the transfer had not been continued in his name for a period of one year and hence the complainant was not eligible to claim No Claim Bonus. As per the declaration, if any fact is found incorrect, then all the benefits under the policy in respect of section 1 of the policy shall stand forfeited and hence the benefit of the present claim cannot be given as it stood forfeited on account of filing of wrong declaration by the complainant. “
; that the complicated questions of law and evidence are involved in the present complaint; that the complainant has no right, locus-standi or cause of action to file the present complaint against the opposite parties; that the claim of the complainant is based upon the insurance policy. The parties are bound by terms and conditions of the policy and the complaint is not maintainable before this Hon’ble Forum. On merits, it has been pleaded that the complainant was not self employed person and was not earning his livelihood from the said truck. The truck in question was being used for commercial purpose. It is admitted by the opposite
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parties that the policy was purchased by the complainant from the opposite parties, but the complainant availed No Claim Bonus vide giving declaration in the proposal form at the time of purchasing the insurance policy. Later on it has been revealed that the complainant had got the policy transferred in his name and as such the policy after the transfer had not been continued in his name for a period of one year. So, the complainant was not eligible to claim No Claim Bonus. As per the declaration, if any fact is found incorrect, then all the benefits under the policy in respect of Section 1 of the policy shall stand forfeited on account of filing of wrong declaration by the complainant. The complainant intimated the company about the alleged loss for the first time on 16.8.2010. The complainant had not informed in writing and gave any writing to Sh. Anil Honda who assured the complainant that he would do the needful. The complainant had not given correct facts at the time of purchasing of the policy. Other allegations of the complaint have been denied and dismissal of the complaint has been prayed for.
3. Ld. Counsel for the complainant tendered into evidence Ex. C-1 to Ex. C-17 and closed evidence on behalf of the complainant. On the other hand, learned counsel for the opposite parties tendered into evidence affidavit Ex. OP-1&2/1,
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documents Ex. OP-1&2/2 to Ex. OP-1&2/9 and closed evidence on behalf of opposite parties.
4. We have heard the learned counsel for parties and have also gone through the file.
5. So far as the objection raised by the opposite parties in the preliminary objection in Para No.6 of the written reply that the vehicle for which the claim has been sought for was used for commercial purpose, the complainant does not fall within the definition of the Consumer Protection Act, 1986. The complainant has pleaded in Para No.1 of the complaint that he was earning his livelihood from the said truck and purchased the said truck for his self-employment. The opposite parties have not placed on record any evidence to prove that the complainant has purchased the said truck for commercial purpose. So, the complainant falls under the definition of a consumer as defined under the Consumer Protection Act, 1986.
6. The accident of the vehicle is admitted by both the parties. The grievances of the complainant is that the opposite parties repudiated the claim of the complainant wrongly and illegally, on the ground that the complainant has concealed the facts from the opposite parties at the time of obtaining the insurance
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policy from the opposite parties. Opposite party No.1 sent a letter to the complainant on 2.5.2013 vide which the claim of the complainant was repudiated is which is reproduced as under:-
“In reference to some noted claim on close scrutiny of the claim file, the competent authority has repudiated your claim on the inter alia grounds:-
- That as per the intimation letter the loss is alleged to have taken place on the intervening night of 11-12/8/2010, but the intimation to the company was
given on 16.8.2010. As per the policy terms and conditions the loss should have been reported to the company immediately. You have failed the explain the reason of delay.
- That you availed No Claim Bonus vide giving declaration in the proposal form at the time of purchasing the insurance policy. Later on it has been revealed that your had got the policy
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transferred in your name and as such policy after transfer had not been continued in your name for the period of one year and hence you are not eligible to claim No Claim Bonus. As per the declaration if any fact is found incorrect then all the benefits under the policy in respect of section of the policy shall be stand forfeited and hence the benefit of the present claim cannot be given as its stood forfeited on account of your filing wrong declaration. Hence your claim stands repudiated. “
7. The complainant has placed on file copy of letter dated 7.9.2014 Ex.C-12 which is written by Chief Manager Motor Department Head Office 88, Janpath, New Delhi, which is reproduced as under:-
“ The insured had stated in the proposal form that he is entitled to NCB and had given the insurance policy of Reliance General Insurance Co. which shows that the policy was transferred in his name after twenty eight days of the inception of the
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policy. Our Dev. Officer apparently saw this policy as he has mentioned the same in the cover note and has then allowed the NCB. Even though the insured stated that he is entitled to NCB, but from the policy document it was evident that he was not entitled, as such our Dev. Officer should not have allowed the NCB.
Had the insured not submitted the policy document and claimed the NCB, then we could have faulted him. Now the fault lies on our part for allowing the
NCB even though the document in our possession does not permit it. We cannot penalize the insured for our shortcomings. It will go against the principle of Utmost Good Faith and our decision to repudiate will be legally not sustainable.
There is however serious shortcoming in underwriting procedure. NCB was allowed even when the insured was not entitled and vehicle’s
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inspection was not carried out in a proper manner. It appears that since the Dev. Officer was insuring the other vehicles of the insured by allowing NCB and inspecting the vehicle himself. Necessary explanation of the Development Officer has to be taken and action should be initiated against his misconduct, if established.
2. As confirmed by our BO vide their letter dated 9.6.2011, the claim intimation was received by them on 16.8.2010 as 14th and 15 the August 2010 were holidays, whereas the theft took
place in the night of 11/12th August 2010. The matter to the Police was reported on 28.9.2010 as revealed from the FIR. Late intimation to Police and to us is ground enough for repudiating the claim.
3. The name as given in the proposal and other documents differ. The identity of the insured
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and that of the owner of the vehicle has to be the same. The controversy surrounding the name needs explanation from the insured and thorough probe. The basis of your recommendation for repudiating the claim does not seems to be valid. However, you may look at the other aspects as noted in point 2 and 3 above and then decide liability. We are herewith returning the claim file for your doing the needful. “
7. The first reason of repudiating the claim in the letter Ex. C-9 dated 2.5.2013 is with regard the late intimation. In the letter it has been mentioned that loss have been taken place in the intervening night of 11-12/8/2010, but the intimation to the company was given on 16.8.2010. In the letter Ex. C-12 in para No.2 it is mentioned as under:-
“as confirmed by your BO vide their letter dated 9.6.2011 the claim intimation was received by them on 16.8.2010 as 14th and 15 the August 2010 were holidays, whereas the theft took place in the
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night of 11/12th August 2010. The matter to the Police was reported on 28.9.2010 as revealed from the FIR. Late intimation to Police and to us is ground enough for repudiating the claim. “
8. From the pleading and the letter Ex. C-12 it is proved that theft took place in the night of 11-12/8/2010 and there was holiday on 14-15/8/2010 and the complainant inform the insurance company on 16.8.2010. There was no delay in giving intimation to the company regarding the theft of the vehicle. In the investigation report Ex. C-14 it is mentioned that the insurance company was informed about the theft on 12.8.2010. The opposite parties have also placed on file copy of letter dated 16.8.2010 Ex. OP-1&2/5 in which it is mentioned by the opposite party that we would like to inform you that we have received a claim intimation dated 13.8.2010 for theft of truck. But we have not received FIR for the
same alongwith claim intimation. So you are requesting to submit the FIR, so that we may proceed further. From letter Ex. OP-1&2/5 and Ex. C-12 it is proved that the complainant inform the insurance company immediately after the theft of the vehicle. The complainant has also placed on file copy of FIR Ex. C-6 from which it is proved that the complainant has also informed the Police Station and Police
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registered the FIR. The complainant pleaded in the complaint that the complainant immediately reported the matter to the Police and got registered a Rapat in the Police Station Jalalabad on 12.8.2010. Lateron the police made the investigation and after investigation, the police of Police Station City Jalalabad registered FIR No.137, dated 28.9.2010, U/s 379 IPC and there is no fault of the complainant if the Police Station Jalalabad registered the FIR on 18.9.2010. The claim of the complainant could not be repudiated on this ground that the complainant has not informed the company and Police immediately. From the evidence and pleading it is proved that the complainant immediately informed the police and insurance company. The claim of the complainant cannot be repudiated on the ground of delay intimation. Reliance can be made in the judgment relied upon the Hon;ble Haryana State Consumer Disputes Redressal Commission, Panchkula “SHRIRAM GENERAL INSURANCE COMPANY LIMTIED Vs. MANOJ” First Appeal No. 555of 2014.
9. The second ground of the repudiating of the claim which is mentioned in letter Ex. C-9 dated 2.5.2013 that the complainant availed ‘No Claim Bonus’ vide giving declaration in the proposal form at the time of purchasing the policy. Later on it has been revealed that the complainant has got the policy
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transferred in his name and as such policy after the transfer had not been continuing in the name of the complainant.
10. From the evidence and pleading, it is proved that the opposite parties cannot repudiate the claim of the complainant on the ground that the complainant availed ‘No Claim Bonus’ vide giving declaration in the proposal form at the time of insurance policy as mentioned in letter Ex. C-12. The opposite parties are also guilty of rendering deficient service to the complainant.
11. In view of what has been discussed above, this complaint is accepted and the opposite parties are directed to pay Rs.8,00,000/- to the complainant along with interest @9% per annum from the date of repudiation of claim till realization. Further the opposite parties are also directed to pay a sum of Rs.10,000/- as compensation for mental agony, pain and harassment and Rs.5,000/- as litigation expenses to the complainant. This order is directed to be complied with by the opposite parties within a period of thirty days from the date of receipt of its copy. File be consigned to the record room.
Announced (Gurpartap Singh Brar)
24.9.2015 President
(Inderjeet Kaur) Member
