Haryana

StateCommission

A/688/2015

UNITED INDIA INSURANCE CO. - Complainant(s)

Versus

RAJBIR - Opp.Party(s)

NITIN GUPTA

14 Jan 2016

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION, HARYANA,PANCHKULA

                                                 

First Appeal No.688 of 2015

Date of Institution:18/21.08.2015

Date of Decision: 14.01.2016

United Insurance Company ltd., Rohtak through its Divisional Manager.

Now represented through the duly authorized signatory of Regional office,SCO No.123-124, Sector 17-B, Chandigarh.

     …..Appellant

                                                Versus

 

Rajbir S/o Sh.Daya Nand Resident of village and Post Office Sundedrpur,Tehsil & District Rohtak.

         …..Respondent

 

CORAM:   Mr. R.K.Bishnoi, Judicial Member.
                   Mrs.Urvashi Agnihotri, Member.

 

Present:-    Mr.Nitin Gupta, Advocate for the appellant.

Mr.N.K.Malhotra, Advocate counsel for the  respondent.

 

                                      O R D E R

 

URVASHI AGNIHOTRI, MEMBER:

 

The United Insurance Company Ltd. – respondent/ OP is in appeal against the Order dated 15.07.2015 passed by District Consumer Disputes Redressal Forum (for short ‘District Forum’), Rohtak, whereby the complaint of Rajbir-complainant has been allowed and OP has been directed to pay to him declared value of the vehicle i.e. Rs.371000/- alongwith interest and litigation expenses.

 

2.      Briefly stated, the complainant was the owner of a Tractor bearing registration No.HR-12L-4378 which was fully insured with the OP for the period from 19.10.2008 to 18.10.2009 vide cover note No.454782. It is averred that on 17.05.2009, the complainant had gone to village Bohar with the tractor attached with a trolly and parked his vehicle opposite Dharamshala on the Bus Stand of village Bohar and when he came back, did not find the vehicle there. He informed the police on the same day and FIR No.225, dated 17.05.2009 was registered. Complainant also informed insurance company. Police submitted the untraced report on 14.12.2009. The complainant filed the claim with the OP and completed all the formalities. It is averred that despite his repeated requests, the claim was not settled by the OP.

3.      According to the OPs, the complainant did not file any application with the company regarding the theft of the tractor No.HR-12L-4378. The complainant had not filed any claim form with the company. The complaint of the complainant is pre-mature. It is submitted that according to the complainant, the tractor was parked unattended, without any supervision. Therefore, there was a violation of terms and conditions of the insurance policy and the company was not liable to pay any compensation.  Therefore, there was no deficiency in service or unfair trade practice on the part of the OPs.

4.      Rejecting the plea of the OP, the learned District Forum allowed the complaint vide order dated 15.07.2015.

5.      Against the impugned order, the OP has filed Appeal contending that the learned District Forum has allowed the complaint without any legal justification, as the complainant had not given immediate intimation of the alleged theft of insured tractor to the appellant. The complainant informed the insurance company about loss after three months i.e. on 31.08.2009, thereby violating the terms and conditions of the insurance policy.

6.      We have heard the learned counsel for the parties and have also gone through the record.

7.      In nutshell, the case of the complainant before the District Forum was simple i.e. theft had taken place of his tractor on 17.05.2009 which was duly insured with the OP. He lodged the FIR No.225 on same day. Police took their usual time for investigation. Thereupon, the company appointed their investigator/ surveyor, who submitted his report. Even thereafter when the OP did not settle the claim, the complainant served a legal notice on 13.03.2012 through his advocate.

8.      In reply, the OPs instead of specifically denying the above averments of the complainant simply made evasive denials. The vague statements were made to plead that FIR was not lodged on the same day, company was not informed nor any claim filed before it, nor any investigator was appointed by the company. Not even this, the OP has gone to the extent of denying even the untraceable report submitted by the Police and accepted by the court. The OP has even pleaded that the complaint before the learned District Forum was premature.  

9.      It is settled law that fact pleaded in the complaint and not specifically denied by the other party has to be taken as deemed to have been admitted.  Complainant in para No.2 of the complaint has specifically pleaded that on 17.05.2009 when the tractor was parked, it was stolen by some unknown person and that he informed the police of police station, Urban Estate, Rohtak on the same day i.e. 17.05.2009 besides that the complainant informed insurance company also. In reply to the corresponding para O.Ps. did not deny this fact.  Relevant portion of the para No.2 of the complaint and reply are reproduced below:-

Complaint Para 2         “Ultimately the complainant informed the police of police   station urban Estate, Rohtak on the same day i.e. 17.05.2009 regarding the theft of his aforementioned vehicle and the police of police station Urban Estate, Rohtak registered a case vide FIR No.225 dated 17.05.2009 under section 379 I.P.C. copy of the FIR is  attached herewith and the contents of the same may kindly be read as part of this complaint.  The complainant immediately informed the respondent company about the theft of his insured vehicle and the respondent company appointed as investigator surveyor and the said investigator verified the facts and gave his report to the respondent company.

Reply Para No.2 “That Para No.2 of the complaint is   not   non  therefore denied. According to the complainant the tractor was parked unattended, without the supervision of any person.  Therefore there is a violation of terms & conditions of the insurance policy and the company is not liable to pay any compensation.  It is wrong that FIR was registered on the same day.  It is also wrong that the complainant inform the company immediately and the company appointed a investigator who gave report to the company.  The whole para is wrong and denied.  As stated above the complainant did not inform the company and no investigator was appointed by the company”

10.    The O.Ps. did not deny the fact of intimation specifically. Besides OP has not led any evidence to prove that no information was given to them. Even otherwise Hon’ble National Commission in Revision Petition No.629 of 2015, New India Assurance Company Limited Vs. Gurmeet Kaur & others, decided on August 3^rd, 2015, cited as 2015 (3) CLT 476, held as under:-

“(i)Consumer Protection Act, 1986 Section 2 (1) (g)-Insurance  Claim-theft of vehicle- Delay in intimation to insurance company-the clause in the Insurance Policy require to give immediate intimation of accident, but did not require the insured to give immediately intimation of any loss of the vehicle to the insurance company-Held-that it applied only to the occurrence of an accident where a claim is to be lodged with the insurance company- the above referred clause does not require the insured to give immediate intimation to the insurance company in case of theft of the vehicle-  It is settled law that the terms of an insurance policy have to be strictly construed and the court can neither add to nor subtract anything from the terms and conditions contained in the policy- A theft being a deliberate dishonest act, cannot be said to be an accident-therefore, the complainant was not required, in this case, to give immediate intimation of the theft to the insurance company.”

(ii) Consumer Protection Act, 1986 1 (1) (g)-Insurance Claim- theft of vehicle-Delay in FIR-intimation given to police promptly, but FIR registered after 11 days by police-In FIR there is no reference of prompt intimation given by complainant-Held-the complainants cannot be held responsible for the time taken by the police in registering the FIR-He discharged his contractual obligation under the policy for informaing the concerned police station.”

11.    Even otherwise, in circular Ref:IRDA/HLTH/MISC/CIR/216/09/2011 dated September 20^th, 2011 issued by Insurance Regulatory Development Authority (for short ‘IRDA’), it is stated by IRDA that there may be a condition in the policy regarding delay in intimation but that does not mean that the insurer can take the shelter under that condition and repudiate the claim of the claimant, which is otherwise proved to be genuine.  The relevant art of the circular is as under:-

“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.”

12.    Firstly, we find that the denials made by the OP are wholly vague and not specific at all. They are even contrary to the documentary evidence available on the record. When the information was given by the complainant about the theft to the Police on the same day, there was no further requirement to inform the insurance company simultaneously. The mere fact that the information given to the Insurance Company was given late is no ground to repudiate the claim keeping in view the observation of Hon’ble Punjab & Haryana High Court expressed in National Insurance Company Limited, Gurgaon Versus Ravi Dutt Sharma and another (Civil Writ Petition No.9716 of 2011), decided on 30.05.2011. The learned District Forum has, therefore, rightly followed the aforesaid judgment while accepting the complaint of the complainant, as against the decisions of the Consumer Fora, which have only limited jurisdiction.

13.    Consequently, we do not find any merit in the appeal filed by the insurance company and dismiss the same with no order as to costs.      

14.    The statutory amount of Rs.25,000/- deposited at the time of filing of the present appeal be refunded to the appellant against proper receipt and due verification.

January 14th, 2016

Mrs.Urvashi Agnihotri, Member, Addl.Bench

R.K.Bishnoi, Judicial Member Addl.Bench

 

S.K.