BEFORE THE DISTRICT CONSUMER DISPUTES

REDRESSAL FORUM, JALANDHAR.

Complaint No.380 of 2014

Date of Instt. 29.10.2014

Date of Decision :16.04.2015

Mrs.Harbhajan Khaira wife of Surinder Khaira R/o VPO Khassan, Tehsil Bhulath, Kapurthala, Punjab-144601 through her lawful attorney Angrej Singh son of Kundan Singh R/o VPO Khassan, Tehsil Bhulath, District Kapurthala.

..........Complainant

Versus

1. Reliance General Insurance Company Limited, 570, Rectifier House, Naigaum Cross Road, Wadala (W) Mumbai-400031 (India) through its Manager/Authorized Person.

2. Branch Manager/Authorized Person, Reliance General Insurance Company Ltd, Ist Floor, Rattan Tower, New Namdev Chowk, Jalandhar (Punjab).

.........Opposite parties

Complaint Under the Consumer Protection Act.

Before: S. Jaspal Singh Bhatia (President)

Ms. Jyotsna Thatai (Member)

Sh.Parminder Sharma (Member)

Present: Sh.GL Gagneja Adv., counsel for complainant.

Sh.Vikas Gupta Adv., counsel for opposite parties.

Order

J.S Bhatia (President)

1. The complainant has filed the present complaint under the Consumer Protection Act against the opposite parties on the averments that the complainant is the owner of her car make Scorpio 2.6 DLX, having registration certificate No.PB09F-3365, year of manufacturing 2004, having chasis No.60075 and engine No.52974. The complainant had hired the service of the opposite parties at Jalandhar by getting full insurance of her above said vehicle vide policy No.2002782311009754 which was valid from 22.1.2009 to midnight of 21.1.2010. Unfortunately the above said vehicle of the complainant was stolen from outside of Shani Mandir, Near Gurudwara Darbar Sahib, Amritsar on 28.1.2009 and to this fact the complainant immediately got registered a criminal case vide FIR No.09 dated 28.1.2009 under section 379 of IPC with Police Station of Division E, Amritsar City and the matter was also reported to opposite party No.2 immediately and claim was lodged with the opposite parties vide claim No.2091090720. As per the instructions of the opposite parties the matter was also investigated by the authorized investigator of the opposite parties i.e Vigilant Detective Bureau, Batala. At the time of investigation by the said investigating officer all the relevant documents i.e copy of insurance policy, copy of FIR etc were also submitted by the complainant with him. Moreover in this regard a record of ownership of the vehicle in question was also confirmed and verified by the investigator from the office i.e the District Transport Officer, Kapurthala vide letter dated 30.4.2009. The complainant also submitted untraced certificate under section 173 Cr.P.C. issued by the concerned police with the opposite parties. The complainant approached the opposite party No.2 various times regarding the theft claim of her above said vehicle but the opposite party No.2 did not give any response to her and thus the complainant has suffered from mental harassment as well as monetary loss. Ultimately the complainant got service a legal notice dated 23.6.2010 upon the opposite parties through registered AD post as well as through UPC through her counsel Sh.GL Gagneja, Advocate, Jalandhar regarding the theft claim of the above said vehicle. The said legal notice was very much served upon the opposite parties but they have not paid any heed to the legal notice of the complainant and deliberately, intentionally did not release the theft claim of the complainant. Thereafter ultimately the complainant preferred a complaint before this Forum and the said complaint was registered vide complaint No.602 of 2010 as Mrs.Harbhajan Khaira Vs Reliance General Insurance Company Limited and another. The said complaint was accepted by this Forum vide order dated 12.9.2011 and the Forum directed the complainant to furnish order of Non-Traceable Report passed by Illaqa Magistrate to the opposite parties to get the theft claim from the opposite parties. The order regarding the above said Non-Traceable Report was passed by Sh.Jagdeep Sood, JMIC, Amritsar vide order dated 15.9.2012. After receiving the certified copy of the order regarding the above said Non-Traceable Report, the complainant in order to do the compliance of the order passed by this Forum submitted the certified copy of this order with the opposite party No.2 personally and requested to release the theft claim, but the opposite parties failed to release the theft claim of the complainant and failed to do the compliance of the order passed by this Forum. It is further alleged that finally opposite party repudiated the claim of the complainant vide letter dated 6.8.2014. On such like averments, the complainant has prayed for directing the opposite parties to pay her the claim amount of Rs.2,92,000/- alongwith interest. She has also claimed compensation and litigation expenses.

2. Upon notice opposite parties appeared and filed a written reply, inter-alia, pleading that there is no deficiency in service or negligence on the part of the answering opposite parties. Insurance is a contract between the insured and the insurer and the insured is bound to abide by the terms and conditions of the insurance policy in order to avail the benefits under the insurance contract. It is submitted that the complainant herself was negligent and failed to abide/has violated the terms and conditions of the insurance policy. It is submitted that the theft of the vehicle took place on 28.1.2009 and the intimation of theft was given to the answering opposite party after 90 days of the theft, which is a clear cut violation of condition no.1 of the insurance policy. It is submitted that on account of violation of the above said mandatory condition of the insurance policy claim of the complainant was refused by the answering opposite parties vide letter dated 6.8.2014 and the same was sent to the complainant on 8.8.2014. They denied other material averments of the complainant.

3. In support of her complaint, learned counsel for complainant has tendered into evidence affidavit Ex.CA alongwith copies of documents Ex.C1 to C21 and closed evidence

4. On the other hand, learned counsel for opposite parties has tendered affidavit Ex.OPA alongwith copies of documents Ex.OP1 and Ex.OP2 and closed evidence.

5 We have carefully gone through the record and also heard the learned counsels for the parties.

6. The facts involved in the present case are not much disputed. The insured vehicle of the complainant was stolen on 28.1.2009 and thereafter complainant lodged FIR No.9 dated 28.1.2009 Ex.C4 regarding theft. So FIR was lodged on the same day i.e on day of theft. The complainant lodged the claim with opposite parties and opposite parties appointed investigator i.e Vigilant Detective Bureau, who submitted its report Ex.C6. Ultimately, the opposite party insurance company repudiated the claim of the complainant vide letter dated 6.8.2014 Ex.C8 on the ground of delay in intimation. In the above said letter it is mentioned that claim was intimated on 28.4.2009 after the delay of 90 days whereas the alleged theft had taken place on 28.1.2009 and it is violation of policy condition No.1. Counsel for the opposite parties contended that complainant was required to intimate the insurance company immediately after theft and delay in intimation constitute violation of the condition No.1 of the policy and as such the opposite party insurance company has rightly repudiated the insurance claim of the complainant. In support of this contention, he has relied upon Gyarsi Devi & Ors Vs. United India Insurance Co.Ltd & Anr, 2012(1) CTL (NC), New India Assurance Company Ltd Vs. Trilochan Jane, 2012(4) CPJ (NC) 441, Praveen Dalal Vs Oriental Insurance Company & Ors, 2014(1) CPJ (NC) 546, Kuldeep Singh Vs. IFCO Tokia General Insurance Co.Ltd, 2012(2) CPJ (NC) 189.

7. We have carefully considered the above contentions advanced by learned counsel for opposite parties. The above cited authorities are on its own facts. Counsel for the complainant contended that complainant had informed the insurance company verbally regarding the theft on the same day. Now the question which fall for determination is whether delay in intimation to the insurance company by itself is valid ground to repudiate otherwise genuine claim of the insured? The Insurance Regulatory and Development Authority has issued a circular dated 20.9.2011 wherein it is mentioned 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 claim 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.

The insurers' decision to reject a claim shall be based on sound logic and valid grounds. It may be noted that such limitation clause does not work in isolation and is not absolute. One needs to see the merits and good spirit of the clause, without compromising on bad claims. Rejection of claims on purely technical grounds in a mechanical fashion will result in policy holders loosing confidence in the insurance industry, giving rise to excessive litigation".

8. In the present case, FIR was lodged by the complainant on the date of theft itself. Ex.C6 is report of the investigator i.e Vigilant Detective Bureau, appointed by opposite party insurance company and it has specifically reported that the Mahindra Scorpio under claim did really got stolen on 28.1.2009 from outside of Shani Mandir, Golden Temple, Amritsar as alleged. So even the above said detective agency has reported that vehicle was really stolen. In its report the said detective agency has also mentioned as under:-

"That the insured with her family is in USA, hence claim form, duly completed could not be had from her. The intimater Angrez Singh, close relative of the insured, has informed me telephonically that he is going to be appointed as special power of attorney in this claim and has further informed that he will submit the claim form duly completed and signed by him, shortly".

9. So in this case insured was in USA and as such it resulted in delay in written intimation to the opposite party insurance company. So in the above circumstances, when the FIR was lodged on the same day, the delay in intimation to the insurance company is not fatal and opposite party insurance company was not justified in repudiating the genuine claim of the complainant.

10. In view of above discussion, the present complaint is accepted and opposite party insurance company is directed to pay the insured declare value i.e Rs.2,92,000/- to the complainant alongwith 9% interest from the date of repudiation of her claim till the date of payment. It is clarified that interest amount is being granted by way of compensation. The complainant is also awarded Rs.3000/- on account of litigation expenses. Copies of the order be sent to the parties free of costs under rules. File be consigned to the record room.

Dated Parminder Sharma Jyotsna Thatai Jaspal Singh Bhatia

16.04.2015 Member Member President