CONSUMER DISPUTES REDRESSAL FORUM – X
GOVERNMENT OF N.C.T. OF DELHI
Udyog Sadan, C – 22 & 23, Institutional Area
(Behind Qutub Hotel)
New Delhi – 110 016
Case No.58/2013
SH. RAMDEV SHARMA
S/O SH. KARTIK SHARMA
R/O 140, O BLOCK, SOURABH VIHAR,
BADARPUR, NEW DELHI
…………. COMPLAINANT
Vs.
M/S RELIANCE GENERAL INSURANCE CO. PVT. LTD.,
(CLAIMS MANAGER)
PLOT NO.60, OKHLA INDUSTRIAL AREA, PHASE-III,
NEW DELHI-110020
…………..RESPONDENT
Date of Order:11.07.2017
O R D E R
A.S. Yadav - President
It is an admitted fact that the motorcycle of complainant was duly insured with OP for the period from 24.06.09 to 23.06.10 for an IDV of Rs.33,155/-.
It is not in dispute that the motorcycle was stolen on 07.12.09 and on that very day FIR was lodged with the police. It is not in dispute that finally untrace report was filed.
The claim of complainant was repudiated on the ground that complainant has given intimation regarding the theft after 43 days to OP hence condition No.1 of the policy has been violated.
We have gone through the case file and perused the records carefully.
The only point for consideration is whether the OP is justified in repudiating the claim of the complainant. Condition no.1 of the policy is reproduced as under:-
“Notice shall be given in writing to the company immediately upon the occurrence of any accident or 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”.
Complainant has highlight the aforesaid policy and has submitted that “in case of theft or criminal act which may be the subject of claim under this Policy the insured shall give immediate notice to the police and co-operate with the Company in securing the conviction of the offender”.
It is significant to note that in case of theft, the matter is to be brought to the notice of police immediately. In this case the matter was reported to the police immediately on the day of theft and FIR was lodged on the same very day. OP was not justified in repudiating the claim only because there was delay of 43 days.
It is useful to refer to judgment of Hon’ble Supreme Court in case of National Insurance Co. Ltd. Vs Nitin Khandelwal Vs Nitin Khandelwal IV(2008) CPJ(SC) - in that case the vehicle was stopped by certain persons, the driver was tied and gunned on the way and the vehicle was snatched. The contention of the insurance company is that the vehicle was used for commercial purpose and passengers had hired the vehicle on the way i.e. some passenger snatched the vehicle from the driver. In that case the Hon’ble State Commission settled the claim on non-standard basis and directed to pay 75% of the insured amount. The order was upheld by the Hon’ble National Commission. The appeal preferred by the insurance company was dismissed. Para-13 and para-16 of the judgment is reproduced as under:-
“13. In the case in hand, the vehicle has been snatched or stolen. In the case of theft of vehicle breach of condition is not germane. The appellant Insurance Company is liable to indemnify the owner of the vehicle when the insurer has obtained comprehensive policy for the loss caused to the insurer. The respondent submitted that even assuming that there was a breach of condition of the insurance policy the appellant Insurance Company ought to have settled the claim on non-standard basis. The insurance Company cannot repudiate the claim in toto in case of loss of vehicle due to theft.
16. The State Commission has allowed only 75% of the respondent on non-standard basis. We are not deciding whether the State Commission was justified in allowing the claim of the respondent on non-standard basis because the respondent has not filed any appeal against the said order. The said order of the State Commission was upheld by the National Commission.”
In view of law laid down by the Hon’ble Supreme Court, it was not appropriate to repudiate the claim in case of theft of vehicle on the ground of breach of condition of insurance policy.
Ld. Counsel for complaint has referred to case of Shriram General Insurance Co. Ltd. Vs Manoj – III(2015) CPJ 99 (Har.) – in that case, Hon’ble Court in para 6 held as under:-
“6. The contention raised on behalf of the appellant-opposite party is not acceptable. The evidence available on the record establishes that it is a genuine claim of the respondent-complaint. F.I.R.No.327 dated August 31st, 2011 was recorded and intimation was also given o the Insurance Company. Thus, it is amply proved that the vehicle was stolen and could not be traced. It was a genuine claim of the complainant in view of law laid down by this Commission in Shriram General Insurance Company Limited V. Rajesh Kumar, 2014(2) CLT390, wherein reference of the circular dated September 20th, 2011 issued by Insurance Regulatory and Development Authority (IRDA) has been given. It has been specifically mentioned 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 claim, which is otherwise proved to be genuine. The operative part of the circular reads 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.”
It is evident from the guidelines issued by IRDA that the claim should not be repudiated on ground of breach of condition of policy simply because there was delay in intimation.
Similar view was taken in case of Oriental Insurance Co. Ltd. Vs Mukesh Mali – III (2015) CPJ 104 (Raj.).
Repudiation of the claim was not justified. It is a clear cut case of deficiency in service on the part of OP.
OP is directed to pay IDV of the vehicle i.e. Rs.33,155/- to complainant alongwith interest @ 9% p.a. from the date of filing of claim till realization. OP is further directed to pay Rs.5,000/- towards compensation and Rs.5,000/- towards litigation expenses.
Let the order be complied with within one month of the receipt thereof. The complaint stands disposed of accordingly.
Copy of order be sent to the parties, free of cost, and thereafter file be consigned to record room.
(D.R. TAMTA) (RITU GARODIA) (A.S. YADAV)
MEMBER MEMBER PRESIDENT
