Delhi

North East

CC/9/2022

MOHD ARIF - Complainant(s)

Versus

ORIENTAL INSURANCE COMPANY LTD. - Opp.Party(s)

ALKA SHARMA

23 Apr 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION: NORTH-EAST

GOVT. OF NCT OF DELHI

D.C. OFFICE COMPLEX, BUNKAR VIHAR, NAND NAGRI, DELHI-93

Complaint Case No. 09/22

 

 

 

In the matter of:

 

		Sh. Mohd. Arif S/o Sh. Faizal Husain R/o 324, K Block Sunder Nagri, Delhi-110093		Complainant
		Versus
		Oriental Insurance Co. Ltd. Oriental House A 25/27, Asaf Ali Road, New Delhi-110002		Opposite Party
			DATE OF INSTITUTION:         JUDGMENT RESERVED ON:                           DATE OF ORDER:		31.01.22 20.02.24 23.04.24

 

CORAM:

Surinder Kumar Sharma, President

Anil Kumar Bamba, Member

ORDER

Anil Kumar Bamba, Member

The Complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against Opposite Party.

Case of the Complainant                                                                 

1. The case of the Complainant as revealed from the record is that Complainant purchased vehicle vide registration no. DL 6C Q 0473 and at the time of purchase the said vehicle got insured with Opposite Party vide policy no. 215700/31/2017/94664 from 17.11.16 to 16.11.17 and paid Rs. 19,036/- for premium. The Complainant renewed the said policy vide policy no. 215700/31/2018/192737 from 17.11.17 to 16.11.18 and paid Rs. 14,492/- as premium. It is stated that on 15-16 November the above said vehicle got stolen thereafter Complainant contacted customer care of Opposite Party. The Complainant lodged an FIR bearing no. 005253/2018 dated 16.11.18 at Police Station Bhajanpura and police officials did investigation regarding the theft but nothing could be traced out and on 09.04.18 final report was placed by concerned police officials before concerned court in said theft matter as “untraced”. Thereafter Complainant received letter from Laxman Das Arrora and associates appointed as investigator into theft claim of Complainant and Complainant submitted all available documents but despite that Opposite Party kept harassing the Complainant. On 06.03.20 Complainant received letter from Opposite Party wherein it was written that the claim of Complainant having ref. No. 510011/31/2018/030280 was repudiated and file has been closed as No Claim thereafter Complainant visited office of Opposite Party many times but all in vain.  The Complainant has prayed for compensation of Rs. 4,92,796/- along with 12 % interest along with Rs. 1,00,000/- for mental harassment. He has also prayed for litigation charges.

Case of the Opposite Party

2. The Opposite Party contested the case and filed written statement. The case of Opposite Party is that the contests of complaint are denied as the details of the FIR appear to be different from what the Complainant has stated. The amended application filed by the Complainant states that the owner of the vehicle in question is one Mr. Sanjay Bhati. However, the complaint is filed by Mr. Mohd. Arif who claims to be the owner of the said vehicle. This contradicts the very essential question of ownership of the vehicle as to who the true owner of the vehicle is. As per the records of the Opposite Party company, the policy is in the name of the Complainant, but the FIR registered by the Police states that Mr. Sanjay Bhati has reported the theft of his vehicle and not that of the Complainant. There is no reference mentioned in the FIR which bears the name of the Complainant till all. The Complainant has throughout the initiation of the matter changed their stories a number of times whether it is to the Opposite Party or to the investigator, etc. The Complainant has not stuck to a single story for once. The contents of the paras are totally denied on the basis that it appears to be untrue. It is therefore absolutely clear that at the relevant time of the theft of the vehicle, Mohd. Arif was not in possession of the said vehicle in question. Instead, the vehicle in question belonged to Mr. Sanjay Bhati S/o Rameshwar Dayal Bhati who reported the theft of his vehicle bearing Regn. No. DL 6C Q 0473 to the Police Station, Bhajanpura, North East, Delhi. On the basis of the said police complaint made by Mr. Sanjay Bhati, FIR No. 005253/2018 in respect of theft of the vehicle got registered.
3. The Opposite Party as per their due diligence and procedure sent a letter to the Complainant informing them about appointing an investigator in order to investigate into the theft claim of the Complainant pertaining to the said vehicle. For its process, the Complainant was required to submit all the documents available with him in order for the investigator to properly investigate the said matter. However, it is denied that the Complainant submitted all the available documents. It is also denied that the Complainant was harassed on one or other pretext in all of its entirely. The investigator or the Opposite Party were doing their job in investigating the said claim according to the proper procedures and guidelines and information such as documents and statements of the Complainant was to be required by the investigator. There was no harassment in any manner done to the Complainant as stated.
4. It is further submitted that vide letter dated 06.03.20 Opposite Party repudiated the claim as No Claim by stating that “Insurable interest does not exist under the policy.” “The insurer Mr. Arif and Sh. Sanjay Bhati has changed their statement again and again regarding possession of the vehicle. The statement of insured in the claim intimation letter and the statement given by him to the investigator completely differ from each other. Hence, there is misrepresentation/ non-disclosure on the part of the insured.”

Here, again the question of the ownership of the Complainant arises as the questioning was done to both the Complainant and Mr. Sanjay Bhati, and both were not sticking to their story for once, which is also one of the reasons the claim of the Complainant was repudiated by the Opposite Party. The Complainant right from the start of the investigation has not been totally and fully honest with the facts and circumstances of the case. The Complainant has concealed material facts and concocted false stories and statements regarding the stealing of the said vehicle. In view of the above, the Complainant does not have an insurable interest and therefore, the claim of the Complainant was inter alia repudiated.

5. The Complainant took the insurance policy after reading all the terms and conditions of the policy at that time and was fully aware of the same. The Opposite Party on every occasion assisted the Complainant in his claim. The Opposite Party never harassed the Complainant in any manner whatsoever and always tried to follow the procedure and perform their job diligently in order to investigate the claim as well as inform the Complainant at every update for any documents or reply.
6. The Opposite Party repudiated the claim and closed the file after fully investigating the case and claim of the Complainant. The contract of insurance is that of utmost good faith. This principle implies that the insured is required to be fully open and transparent and material facts have to be disclosed both before the policy is issued and after. There was no contractual liability on the part of the Opposite Party if the Complainant acts with a mala fide intention and conceals material facts and circumstances. The Complainant’s behaviour throughout this matter has been nothing but mischievous and wrongful as the Opposite Party is at no fault here in any manner.

Rejoinder to the written statement of Opposite Party

7. The Complainant filed rejoinder to the written statement of Opposite Party wherein the Complainant has denied the pleas raised by the Opposite Party and has reiterated the assertion made in the complaint.

Evidence of the Complainant

8. The Complainant in support of his complaint filed his affidavit wherein he has supported the averments made in the complaint.

Evidence of the Opposite Party

9. In order to prove its case, Opposite Party filed affidavit of Sh. Shishyapal Manager legal in Opposite Party wherein the averments made in the written statement of Opposite Party have been supported.

Arguments & Conclusion

10. We have heard the Ld. Counsels for the parties. We have also perused the file and the written arguments filed by the parties. The case of the Complainant is that he was having insurance policy with Opposite Party for his vehicle which was valid from 17.11.17 to 16.11.18 and said vehicle was stolen on the intervening night of 15-16 November 2018 for which he lodged an FIR with concerned Police Station on 16.11.18. After investigation by the concerned Police Station untraced report was filed with the concerned court which was duly accepted. The Complainant filed his claim with Opposite Party along with all required documents. The Opposite Party repudiated his claim vide letter dated 06.03.20 on the ground that “Insurable interest does not exist under the policy” “The insured Mr. Arif and Sh. Sanjay Bhati has changed their statement again and again regarding possession of the vehicle. The statement of insured in the claim intimation letter and the statement given by him to the investigator completely differ from each other. Hence there is misrepresentation/non-disclosure on the part of the insured.
11. On the other hand, the Opposite Party admitted that policy was valid at the time of theft of the said vehicle. The Opposite Party also did not contest the untraced report duly accepted by concerned court filed by the Complainant. The only ground of repudiation of the claim was FIR of the theft was not filed by the Complainant but by some other person hence Complainant was not in possession of the said vehicle in question and vehicle was belonged to Sh. Sanjay Bhati S/o Sh. Rameshwar Dayal Bhati who had reported the theft of the vehicle with concerned Police Station. Opposite Party repudiated the claim on the ground that “Insurable interest does not exist under the policy” but Opposite Party did not lead any evidence in this regard. On the other hand, Sh. Yash Bhati S/o Lt. Sh. Sanjay Bhati filed an affidavit stating that Complainant is the owner of the stolen vehicle and vehicle was borrowed by his Lt. father for personal use.
12. In our considered opinion, at the time of theft the policy was valid and untraced report was duly accepted by the concerned court. Hence, there is deficiency in service on behalf of Opposite Party for not sanctioning the legitimate claim of the Complainant. Therefore, the complaint is allowed.  The Opposite Party is directed to pay the IDV of vehicle in question of Rs. 4,92,796/- to the Complainant along with interest @ 9 % p.a. from the date of filing the complaint till recovery. The Opposite Party is further directed to pay Rs. 25,000/- to the Complainant on account of mental harassment and litigation expenses with interest @ 9 % p.a. from the date of this order till recovery.
13. Order announced on 23.04.24.

Copy of this order be given to the parties free of cost.

File be consigned to Record Room.

 

(Anil Kumar Bamba)          Member

(Surinder Kumar Sharma) President