Punjab

Ludhiana

CC/19/387

Dharminder Pal - Complainant(s)

Versus

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

Bhawandeep Adv.

23 Feb 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                Complaint No:387 dated 14.08.2019.                                                        Date of decision: 23.02.2023.

 

Dharminder Pal son of Sh. Ram Ajor Pal, R/o. H. No.29/536/12-A/1A, Makkar Colony, Sua Road, Giaspura, Dhandari Kalan, Ludhiana.                                                                                                                          ..…Complainant

                                                Versus

1. The Oriental Insurance Company Ltd., Sona Complex, Near Fire Brigade, G.T. Road, Miller Ganj, Ludhiana through its authorized signatory.
2.  The Oriental Insurance Company Ltd., Reg. and Head Office at A-25/27, Asaf Ali Road, New Delhi-110002 through its authorized signatory.                                                                                                                                                                    …..Opposite parties 

Complaint Under Section 12 of the Consumer Protection Act.

QUORUM:

SH. SANJEEV BATRA, PRESIDENT

SH. JASWINDER SINGH, MEMBER

MS. MONIKA BHAGAT, MEMBER

 

COUNSEL FOR THE PARTIES:

For complainant            :         Sh. Bhawandeep Kaura, Advocate.

For OPs                         :         Sh. Rajeev Abhi, Advocate.

 

ORDER

PER SANJEEV BATRA, PRESIDENT

1.                In brief, the facts of the case are that on 12.12.2015, the complainant purchased one Motor Cycle Bajaj CTT 100 Spoke bearing registration No.PB-10-FN-5740 from Dada Motors, G.T. Road, Near Dholewal Chowk, Ludhiana which was got financed from M/s. Shriram City Union Ltd., SBI Building, Rani Jhnasi Road, Ludhiana. The complainant insured the above said motor cycle from the opposite parties vide policy No.233905/31/2016/10906 having validity from 12.12.2015 to 11.12.2016. On 31.01.2016 in the area of P.S. Daba, Ludhiana the said vehicle was stolen and complainant lodged FIR No.21 dated 13.02.2016 under Section 379 I.P.C. at P.S. Daba, Ludhiana. The complainant stated that however, he intimated the policy immediately about the incident but the police delayed in registration of FIR and later on registered the FIR on 13.02.2016. The complainant lodged claim with the opposite parties on 23.02.2016  along with requisite documents demanded by the officials of opposite parties. In April 2016, the complainant received letter dated 21.04.2016 from opposite party No.2 demanding some documents. The complainant approached the office of opposite party No.1 but its officials again demanded some documents which the complainant again supplied but the opposite parties have failed to release the claim amount. Moreover, after the incident, the complainant stopped to make payment to M/s. Shriram Finance Company Ltd. who got a decree of award under Arbitration Case No.SCUF/PJB/K.C./JUNE/312/2018 dated 20.06.2019. The complainant has suffered mental agony, financial loss and physical harassment due to unfair trade practice committed by the opposite parties. In the end, the complainant has prayed for issuing direction to the opposite parties to pay an amount of Rs.2,00,000/- as compensation for causing harassment, mental pain and agony.

2.                Upon notice, the opposite parties appeared and filed joint written statement by taking preliminary objections that the complaint is barred under Section 26 of the Consumer protection Act, the complaint is not maintainable, the complainant estopped by his act and conduct, concealment of material facts etc. The opposite parties alleged that on receipt of cashless authorization, it was duly registered, entertained and processed. The complainant had obtained Two Wheeler Package Policy from the Oriental Insurance Co. Ltd., CBO 5, 146, Industrial Area-A, Ludhiana bearing policy No.233905/31/2016/10906 valid from 12.12.2015 to 11.12.2016 bearing engine No.J32691 and chassis No.J26813 without registration number make Bajaj CT 100 KS (Spoke wheel). The opposite parties alleged that the insurance policy is a contract in itself and the parties are bound by the terms and conditions of the policy. Nothing can be added or subtracted out of it. It is one of the conditions No.1 in the policy that the claim must be lodged with the police and the insurance company immediately. The relevant condition No.1 is reproduced as under:-

“Notice shall be given in writing to the company immediately upon the occurrence of any accidental loss or damage and 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 forward to the company immediately on receipt by the insured. Notice shall also be given in writing to the comp0any immediately the insured shall have knowledge of any impending prosecution inquest for fatal inquiry in respect of any occurrence which may give rise to a claim under this policy. In case of major loss/theft of other criminal act which may be the subject of a claim under this Policy the insured shall gave immediate notice to the policy and co-operative with the company in securing the conviction of the offender.”

The complainant has lodged the claim regarding the alleged theft of his motorcycle on 31.01.2016 with the opposite partied on 23.02.2016 after the gap of 22 days and has lodged the FIR with the police on 13.02.2016 after the gap of 12 days and there is violation of condition No.1 of the policy. The opposite parties further alleged that Mr. Zora Singh Deol, 194-C, Rajguru Nagar, Ludhiana was appointed as investigator to investigate the theft of motor cycle No.PB-10-FN-5740 who made through investigation, took the documents, recorded the statement and prepared his report dated 19.03.2016 and submitted the same with the opposite parties along with enclosures and annexures clearly stating under the head Conclusion drawn from the investigator which is reproduced as under:-

• The insured was driving the motorcycle at that time and its key was with the motor cycle.
• The insured has not submitted his driving license to me.
• Police station Daba registered the FIR in which three theft cases were clubbed. The insured motorcycle has been shown as stolen and no details have been provided in the FIR.

The investigation Zora Singh Deol had moved an application dated 03.03.2016 with the District Transport Officer, Ludhiana for verification of the registration certificate of motorcycle No.PB-10-FN-5740 who after verification of their records had submitted report. Thereafter Zora Singh had prepared his report dated 19.03.2016 and submitted the same with the opposite parties. After receipt of reports of investigator Sh. Zora Singh dated 19.03.2016 and after scrutinizing the documents placed in the claim file and after due application of mind by the officials of the opposite parties, the complainant was called upon by the opposite parties vide their letter dated 04.04.2016 followed with reminders dated 21.04.2016 and 27.06.2016 to submitted the documents and to give reply to the query raised therein which is reproduced as under:-

• Your vehicle was stolen on 31.01.2016 but FIR was lodged on 13.02.2016 and intimation to the insurance company on 23.02.2016. Give reasons for delay.
• Untraced report U/s.173 in original.
• Latest NCRB report.
• U/s.379 mentioning the engine number and chassis number of vehicle.
• Letter to Commissioner of Police regarding theft
• Letter to Municipal Corporation regarding theft
• As per FIR an intimation vehicle was stolen whereas as per statement in the investigation report the vehicle was snatched. Please correct it in FIR and also mention engine and chassis number in FIR
• You have not provided the driving license to the investigator. Please submit the copy of the same with original for verification.
• Copy of newspaper cutting in which snatching incident was circulated.

The opposite parties further alleged that the complainant has failed to submit the aforesaid material documents and information and he was again called upon to submit the said documents vide letter dated 10.04.2017 within 7 days to enable the opposite parties will process the claim failing which the claim file will be closed as no claim. The complainant failed to submit the documents and the claim was closed as ‘No claim” vide letter dated 10.04.2017. The claim has been rightly closed as no claim.

                   On merits, the opposite parties reiterated the crux of averments made in the preliminary objections. The opposite parties alleged that as per averments in the complaint and as per FIR No.21 dated 13.02.2016 U/s.379 IPC the vehicle was stolen on 31.01.2016 but as per the statement given to the investigator Sh. Zora Singh by the complainant and also as mentioned in the claim form, the vehicle was snatched on 31.01.2016 at 09.30 PM. The investigator has confirmed that the vehicle was not stolen as mentioned in the FIR rather it was snatched while the complainant was driving the vehicle. The complainant had not lodged the FIR immediately and there is delay of 12 days in informing the police and lodging the FIR. No reasonable and cogent evidence has been produced on record of the Commission to show that the complainant had immediately informed the police or that the police had delayed the matter in lodging the FIR of the complainant. The opposite parties further alleged that the insured never called or visited the policy issuing office or the claim service centre for the status or requirements related to his theft loss. The opposite parties denied any deficiency in service on their part and in the end have prayed for dismissal of the complaint.

3.                In support of his claim, the complainant tendered his affidavit Ex. CA in which he reiterated the allegations and the claim of compensation as stated in the complaint. The complainant also tendered documents Ex. C1 is the copy of order dated 20.06.2019 passed by the Arbitrator, Ex. C2 is the copy of FIR No.21 dated 13.02.2016, Ex. C3 is the copy of registration certificate No.PB-10-FN-5740, Ex. C4 is the copy of retail invoice, Ex. C5 is the copy of motor claim intimation, Ex. C6 is the copy of motor insurance certificate cum policy schedule, Ex. C7 is the copy of letter dated 21.04.2016 written by opposite parties to the complainant, Ex. C8 is the copy of noting of Incharge, District Saanjh Kendra, Ludhiana and closed the evidence.

4.                On the other hand, counsel for the opposite parties tendered affidavit Ex. RA of Sh. Sukhwinder Singh, Senior Divisional Manager of the opposite parties and affidavit Ex. RB of Sh. Zora Singh Deol, Investigator along with documents Ex. R1, Ex. R4, Ex. R7, Ex. R10 are the copies of letters/reminders dated 10.04.2017, 27.06.2016, 21.04.2016, 04.04.20156 respectively written by the opposite parties to the complainant, Ex. R2, Ex. R6, Ex. R8 are the copies of registered envelops, Ex. R3, Ex. R5, Ex. R9 are the copies of postal receipts, Ex. R11, Ex. R12 are the copies of reports of even date 19.03.2016 of the investigator Zora Singh Deol, Ex. R13 is the copy of fee receipt of Punjab Motor Vehicle Department, Ex. R14 is the copy of letter dated03.03.2016 written by the investigator to District Transport Officer, Ludhiana, Ex. R15 is the copy of letter written by the complainant to the investigator, Ex. R16 and Ex. R17 are the copies of statements of Varinder Kumar and Krishna respectively, Ex. R18 is the copy of Aadhar card of the complainant, Ex. R19 is the copy of registration certificate No.PB-10-FN-5740, Ex. R20 and Ex. R21 are the copies of retail invoice dated 12.12.2015, Ex. R22 is the copy of letter written by the complainant to District Transport officer, Ex. R23 is the copy of letter written by the complainant to SHO, P.S. Daba, Ludhiana, Ex. R24 is the copy of postal receipt, Ex. R25 and Ex. R30 are the copies of FIR No.21  dated 13.02.2016, Ex. R26 is the copy of motor claim form, Ex. R27 is the copy of insurance policy from 12.12.2015 to 11.12.2016, Ex. R28 is the copy of photograph, Ex. R29 is the copy of motor claim intimation, Ex. R31 is the copy of motor insurance certificate cum policy schedule, Ex. R32 is the copy of two wheeler package policy and closed the evidence.

5.                We have heard the arguments of the counsel for the parties and also gone through the complaint, affidavit and annexed documents and written reply along with affidavit and documents produced on record by both the parties.     

6.                The complainant an owner of motor cycle bearing registration No.PB-10-FN-5740 availed insurance policy from the opposite parties having its validity from 12.12.2015 to 11.12.2016. On 31.01.2016, in the area of Police Station Daba the motorcycle was snatched by unknown persons and he field complaint Ex. R23 on 04.03.2016 before SHO, P.S. Daba. Later on, FIR No.21 dated 13.02.2026 Ex. C2 was registered under Section 379 IPC. The complainant preferred a claim with the opposite parties who appointed Mr. Zora Singh Deol as investigator to investigate the theft of the motor cycle. He submitted his reports of even date 19.03.2016 Ex. R11 and Ex. R12. During the investigation, vide letter dated 04.04.2016 Ex. R10, the following documents were demanded from the complainant:-

1. Your vehicle was stolen on 31.01.2016 but FIR was lodged on 13.02.2016 and intimation to the insurance company on 23.02.2016 give reason for delay.
2. Untraced report U/s.173 in original.
3. Latest NCRB report.
4. U/s.379 mentioning the engine no and chassis no of vehicle.
5. Letter to Commissioner of Police regarding theft
6. Letter to Municipal Corporation regarding theft

7.                 Again vide letter dated 27.06.2016 Ex. R4 and letter dated 21.04.2016 Ex. R7 these documents were again and again demanded from the complainant. Ultimately, due to non-submission of documents demanded vide letter dated 10.04.2017 Ex. R1, the opposite parties again demanded the cogent documents within 7 days failing which the case file will be closed as no claim.

8.                Perusal of the investigation report of Sh. Zora Singh Deol, Investigator found the occurrence with regard to theft to be genuine and he also verified the factum of lodging of FIR by the complainant. He also verified the registration certificate of the motor cycle in the name of the complainant and also examined the documents with regard to identity of the complainant.

9.                During the course of arguments, the counsel for the opposite parties contended that the complainant had not lodged the FIR immediately and there is delay of 12 days in informing the police and lodging the FIR. Moreover, the complainant had also not informed the opposite parties immediately after the occurrence of theft of the motor cycle. He took 22 days to intimate the opposite parties that too without any plausible explanation. He did not submit his driving license and other documents with the investigator and his claim was rightly closed as ‘No Claim’.

10.              In this regard, reference can be made to the case titled as Reliance General Insurance Company Limited Vs Rajender in 2017(2) CLT 183 of Hon’ble Haryana State Consumer Disputes Redressal Commission, Panchkula, whereby it has been held that the genuine claims should not be rejected on account of delay in intimation and the insurer’s decision to reject the claim must be based on sound logic and valid grounds. Further reference can be made to the case titled as Shriram General Insurance Company Limited Vs Rajesh Kumar in 2014(2) CLT 390 of Hon’ble Haryana State Consumer Disputes Redressal Commission, Panchkula, whereby it has been held that there may be a condition in the policy regarding the delay in intimation, but that does not mean that the insurer can take the shelter under that condition and repudiate the claim, which is otherwise proved to be genuine. As such, Moreover, non-submission of the documents cannot be made a sole ground to close the claim of the complainant. The insurance companies are required to be more liberal in their approach without being too technical.

11.              In this regard, reference can be further made to 2022(2) Apex Court Judgment 281 (SC) in case title Gurmel Singh Vs Branch Manager National Insurance Company Ltd. whereby it has been held by the Hon’ble Supreme Court of India that the insurance company has become too technical while settling the claim and has acted arbitrarily. The appellant has been asked to furnish the documents which were beyond the control of the appellant to procure and furnish. Once, there was a valid insurance on payment of huge sum by way of premium and the Truck was stolen, the insurance company ought not to have become too technical and ought not to have refused to settle the claim on non­submission of the duplicate certified copy of certificate of registration, which the appellant could not produce due to the circumstances beyond his control. In many cases, it is found that the insurance companies are refusing the claim on flimsy grounds and/or technical grounds. While settling the claims, the insurance company should not be too technical and ask for the documents, which the insured is not in a position to produce due to circumstances beyond his control.

In view of the aforementioned citations and in view of the given set of facts and circumstances, it would be just and appropriate if the complainant is directed to submit the requisite documents as per letter dated 27.06.2017 Ex. R4 with the opposite parties within 30 days and further the opposite parties shall consider and reimburse the claim of the complainant within 30 days from the date of receipt of documents from the complainant.

12.              As a result of above discussion, the complaint is partly allowed with an order that the complainant is directed to submit the requisite documents as per letter dated 27.06.2017 Ex. R4 with the opposite parties within 30 days from the date of receipt of copy of order and opposite parties are directed to consider and reimburse the claim of the complainant within 30 days from the date of receipt of documents from the complainant. However, there shall be no order as to costs. Copies of the order be supplied to the parties free of costs as per rules. File be indexed and consigned to record room.

13.              Due to huge pendency of cases, the complaint could not be decided within statutory period.

 

(Monika Bhagat)          (Jaswinder Singh)                      (Sanjeev Batra)                          Member                            Member                                       President         

 

Announced in Open Commission.

Dated:23.02.2023.

Gobind Ram.

 

 

Dharminder Pal Vs Oriental Insurance Co. Ltd.                      CC/19/387

Present:       Sh. Bhawandeep Kaura, Advocate for complainant.

                   Sh. Rajeev Abhi, Advocate for OPs.

 

                   Arguments heard. Vide separate detailed order of today, the complaint is partly allowed with an order that the complainant is directed to submit the requisite documents as per letter dated 27.06.2017 Ex. R4 with the opposite parties within 30 days from the date of receipt of copy of order and opposite parties are directed to consider and reimburse the claim of the complainant within 30 days from the date of receipt of documents from the complainant. However, there shall be no order as to costs. Copies of the order be supplied to the parties free of costs as per rules. File be indexed and consigned to record room.

 

(Monika Bhagat)          (Jaswinder Singh)                      (Sanjeev Batra)                       Member                     Member                                       President         

 

Announced in Open Commission.

Dated:23.02.2023.

Gobind Ram.