Punjab

Sangrur

CC/327/2016

Kishan Chand - Complainant(s)

Versus

Oriental Insurance Co. Ltd, - Opp.Party(s)

Shri S.S.Ratol

14 Oct 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR.

                                                      

                                                Complaint No.  327

                                                Instituted on:    16.03.2016

                                                Decided on:       14.10.2016

 

Kishan  Chand  son of Shri Tagga Ram, R/o H.No.158, Jain Street, Sangrur.

                                                        …Complainant

                                Versus

Oriental Insurance Co. Ltd. through its Branch Manager, Nabha Gate, Sangrur.

                                                        …Opposite party

 

For the complainant  :               Shri S.S.Ratol, Adv.

For OP                     :               Shri Ashish Garg, Adv.

 

 

 

Quorum:   Sukhpal Singh Gill, President

                K.C.Sharma, Member

                Sarita Garg, Member

               

Order by : Sukhpal Singh Gill, President.

 

 

1.             Shri Kishan Chand, complainant (referred to as complainant in short) has preferred the present complaint against the opposite party (referred to as OP in short) on the ground that the complainant obtained the services of the Op by getting insured his Bollero Jeep bearing registration number PB-13-AF-9797 vide policy number 233502/31/2015/1420 for the period from 26.7.2014 to 25.7.2015 by paying the requisite premium of Rs.14,338/-.

 

2.             The case of the complainant is that the jeep in question was stolen on the intervening night of 28/29.12.2014 when the same was parked in front of the shop of son of the complainant.  The intimation of the loss of the jeep was given to the Op and FIR number 388 dated 29.12.2014 was also recorded in PS City Sangrur.  The complainant tried his best to find out the jeep in question, but he failed to do so.  The case of the complainant is that he approached the OP a number of times to settle the claim, but nothing happened despite serving of legal notice dated 4.12.2015 upon the OP. Thus, alleging deficiency in service on the part of the OP, the complainant has prayed that the OP be directed to settle the claim and pay Rs.5,00,000/- along with interest @ 18% per annum from the date of its loss till realisation and further claimed compensation and litigation expenses.

 

3.             In reply filed by OP, it is admitted that the jeep in question was insured with the OP. it is also admitted that the Op received an intimation from the complainant regarding the theft of the vehicle and after receipt of the intimation, the Op appointed M/s. Bee  Vee Investigation Agency for investigation of the claim, who submitted his report dated 5.1.2015 to the OP.  Further case of the OP is that the complainant submitted a proposal for insurance and as such the same was insured and the proposer further declared regarding no claim bonus availed by him.  The complainant declared that no claim has arisen under the expiring policy, as such, no claim bonus of 20% was allowed to the complainant, for which the complainant was not entitled as he had claimed the claim from that company.  It is stated further that previously the vehicle was insured with the Iffco Tokio Co. Ltd. for the period from 15.7.2013 to 14.7.2014. It is stated further that the complainant got the insurance by concealing the true facts only to take undue benefit.  As such,  it is stated that the claim of the complainant was repudiated vide registered letter dated 25.3.2016.  It is stated that the claim has rightly been repudiated and any deficiency in service on the part of the OP has been denied.

 

4.             The learned counsel for the complainant has produced Ex.C-1 copy of letter dated 25.3.2016, Ex.C-2 copy of policy, Ex.C-3 copy of FIR, Ex.C-4 copy of report, Ex.C-5 copy of legal notice, Ex.C-6 copy of registration certificate and Ex.C-8 affidavit of the complainant and closed evidence. On the other hand, the learned counsel for OP has produced Ex.Op-1 copy of proposal form, Ex.OP-2 copy of intimation, Ex.OP-3 copy of investigation report, Ex.OP-4 to Ex.OP-7 copies of photographs, Ex.OP-8 copy of policy, Ex.OP-9 copy of NCB confirmation, Ex.OP-10 copy of repudiation letter, Ex.OP-11 affidavit,  Ex.C-12 copy of insurance policy and Ex.OP-13 copy of terms and conditions and closed evidence.

 

5.             We have carefully perused the complaint, version of the opposite parties and heard the arguments of the learned counsel for the parties. In our opinion, the complaint merits acceptance, for these reasons.

 

6.             It is not in dispute that the complainant had got insured his Bollero Jeep bearing registration number PB-13-AF-9797 from the OP vide policy in question for the period from 26.7.2014 to 25.7.2015, a copy of which on record is Ex.C-2.  It is further not in dispute that the vehicle in question was stolen on the intervening night of 28/29/12.2014, of which FIR number 388 dated 29.12.2014 was recorded in PS City, Sangrur, as is evident from the copy of FIR Ex.C-3. It is also not in dispute that the OP has repudiated the claim of the complainant on the ground that the complainant had concealed the material fact of having received the insurance claim from the previous insurer i.e. Iffco Tokio Insurance Co. Ltd, with whom the vehicle of the complainant was earlier insured.   The Op has taken the stand that the claim has been repudiated as the complainant has got the claim earlier under the insurance policy, but he wrongly claimed 20% no claim bonus at the time of getting the insurance policy from the OP by concealing the material and true information.

 

7.             On the other hand, the learned counsel for the complainant has contended vehemently that at the time of issuing the policy, the Op should have verified this fact from the previous owner and now the Op has wrongly repudiated the claim of the complainant. At the most, the Op can deduct the amount of no claim bonus from the claim of the complainant.  The complainant in support of his claim has cited clause GR-27 with regard to the policy in which it is mentioned that where the insured is unable to produce such evidence of NCB entitlement from the previous insurer, the claimed NCB may be permitted after obtaining from the insured as declared as per the following wording:

"I/we declare that the rate of NCB claimed by me/us is correct and that no claim has arisen in the expiring policy period. I/we further undertake that if this declaration is found to be incorrect, all benefits under the policy in respect of section 1 of the policy will stand forfeited."

"Not withstanding the above declaration, the insurer allowing the NCB will be obliged to write to the policy issuing office of the previous insurer by recorded delivery calling for confirmation of the entitlement and rate of NCB for the particular insured and the previous insurer shall be obliged to provide the information sought within 10 days of receipt of the letter of enquiry falling which the matter will be treated as a breach of tariff on the part of the previous insurer. Failure of the insurer granting the NCB to write to the previous insurer within 21 days after granting the cover will also constitute a breach of the Tariff".

 

8.             Even if the complainant had given the undertaking as mentioned above it was the duty of the Ops to have confirmed from the previous insurer and their failure to get the confirmation from the previous insurer also constitute a breach of tariff.  There is nothing on the file to show that the OP ever approached the previous insurer of the vehicle i.e. Iffco Tokio General Insurnce Co. Ltd. to get the information whether any claim was paid/settled or not in respect of the vehicle in question, as the Op was duty bound to confirm from the previous insurer i.e. Iffco Tokio General Insurance Co. Ltd. within a period of 10 days of the date of insurance, but the Op did not do so. 

 

9.             Further the OP has produced on record only a document Ex.OP-9, wherein it has been stated that one claim has been reported under this policy period.  But, there is nothing on record what kind of the claim and date of accident was reported and what was the amount settled/paid to the complainant against that claim. No affidavit of the official of the Iffco Tokio General Insurance Company Limited has been filed to authenticate the document Ex.OP-9. There is explanation why the Op has not produced any supporting evidence to establish the previous claim, such as survey report and the amount paid to the complainant.  As such, we are unable to go with such contention of the learned counsel for the OP that there was any previous claim with the insurer i.e. Iffco Tokio General Insurance Co. Ltd.

 

10.           Further we have also perused the copy of investigation report dated 5.1.2015 issued by Bee Vee Investigating Agency, Patiala, which is on record as Ex.OP-3 and a bare perusal of it shows that the agency was at the conclusion that on the basis of their overt and covert inquiries and also in view of insured statement, FIR, they were of the opinion that Mahindra Bolero Camper bearing number PB-13-AF-9797 had been stolen on the intervening night of 28/29.12.2014 from outside insured’s bakery shop at Patiala Gate, Sangrur. Theft claim of Bolero Camper as lodged by the insured was found to be genuine and may be settled subject to the terms and conditions of the insurance policy and also subject to the completion of claim formalities.  But, the learned counsel for the OP has vehemently argued that even if, the OP had not confirmed from the previous insurer then also the complainant cannot deny the declaration made by him and the claim has been repudiated rightly on the ground of fake declaration made by the complainant.    Further the learned counsel for the Op has cited the judgment of the Hon'ble National Commission New Delhi, namely Tata AIG General Insurance Company Limited and another versus Gulzari Singh, II (2010) CPJ 272 (NC), wherein the Hon'ble National Commission has observed that the attempt not to disclose details of the claim obtained from the previous insurance company is clearly visible.  When this is to be considered against the declaration given that if at any stage the statement contained in the application form are found to be untrue and inaccurate all the benefits under the policy will stand forfeited.

 

11.           On the other hand, the learned counsel for the complainant has contended vehemently that the claim of the complainant cannot be rejected on this ground alone, as the Op is also itself negligent in not adhering the instructions contained in GR.27.  After perusal of the file, it is clear that the Op has also failed to adher the instructions contained in GR-27. To support such a contention, reliance can be placed on the judgment of the Hon’ble National Commission pronounced in United India Insurance Co. Ltd. versus Er.Trav Aids Pvt. Ltd. 2016(3) CLT 603 (NC), wherein it has been stated that the insurance company is under obligation to write to the previous insurer within 21 days after granting insurance cover to confirm whether the complainant was entitled to the grant of NCB.  Further it has been held that if insurance company writes this letter much after the expiry of the prescribed period of 21 days and hence, as laid down in GR-27, it constitutes a breach of the Tariff on their part. But, the Op has failed to show that any such letter was ever written to the previous insurer in view of GR-27 or not, as no such letter is on the file produced by the OP.  In the circumstances of the present case, we further feel that the claim of the complainant can be settled on non standard basis.   To support such a contention, we find support from United India Insurance Co. Ltd. versus Bhupinder Singh 2013(2) CPJ335 (NC), wherein the insured vehicle was stolen and the insurance company repudiated the claim on the ground of wrongly availing no claim bonus @ 25% on renewal of policy, thus, there is a breach of policy condition. But the State Commission partly allowed the appeal holding that in case of theft of vehicle, breach of condition is not germane and the insurance company was held to be liable to identify the insurance company and directed the insurance company to settle the claim on non standard basis and pay 75% of amount. Since in the present case, the vehicle of the complainant was insured for Rs.5,00,000/-, as such, we are of the considered opinion that ends of justice would be met if the OP is directed to pay to the complainant 75% of the value of the insured vehicle i.e. Rs.3,75,000/-.

 

 

 

12.           In view of our above discussion, we allow the complaint and direct the OP to pay to the complainant an amount of Rs.3,75,000/- along with interest @ 9% per annum from the date of filing of the complaint i.e. 16.03.2016 till realisation. OP is further directed to pay to the complainant an amount of Rs.5000/- in lieu of litigation expenses. 

 

 

13.           This order of ours be complied with within a period of thirty days of its communication. A copy of this order be issued to the parties free of cost. File be consigned to records.

                Pronounced.

                October 14, 2016.

 

                                                (Sukhpal Singh Gill)

                                                     President

                               

 

                                                   (K.C.Sharma)

                                                        Member

 

 

                                                  (Sarita Garg)

                                                         Member