Haryana

Fatehabad

CC/253/2019

Rajesh - Complainant(s)

Versus

Royal Sundram Alliance Insurance - Opp.Party(s)

Kaushal Mehta

18 Aug 2023

ORDER

BEFORE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, FATHEBAAD.

 

                                                        Complaint No.  253 of 2021

                                                        Date of instt:     08.07.2019

                                                        Date of decision:18.08.2023

 

Rajesh son of Ramesh Kumar resident of village Pillimandori District Fatehabad now at Bhattu Kalan, Tehsil & District Fatehabad.

 

                                                                           ...Complainant.

Versus

Royal Sundram Alliance Insurance Company Limited through its Divisional office-Rider House Plot No.136, Sector 44, Gurgaon (Haryana)-122002 through its Branch Manager.

 

                                                                        …Opposite party.

Complaint under section 35 of

 

BEFORE:                  SH.RAJBIR SINGH, PRESIDENT.    

                                SMT.HARISHA MEHTA, MEMBER                

                                      DR.K.R.NIRANIA, MEMBER

 

Present: -     Sh. Kaushal Mehta, counsel for complainant.

                   Sh.U.K.Gera, counsel for Opposite party.

 

Order

SH.RAJBIR SINGH, PRESIDENT

 

                   The facts of the present complaint are that the complainant being the registered owner of vehicle Tractor New Holland 3630 bearing registration No.HR-22N-9357 got it insured with Op vide insurance policy No.VOC054878000100 for the period 07.12.2017 to 06.12.2018; that the sum  assured was to the tune of Rs.7,65,700/-; that on 17.05.2018 said vehicle was stolen by an unknown person when it was lying in stationary condition; that regarding this police also registered a case FIR No.0117 dated 18.05.2018 under Section 379 IPC in Police Station, Bhattu Kalan; that the complainant intimated the OP/insurance company and further submitted all the requisite documents for the settlement of the claim including the untraced report but the Op illegally, wrongly and in arbitrarily manner rejected the claim on dated 07.11.2018. The act and conduct of the Ops clearly amounts to deficiency in service on their part. In evidence, the complainant has tendered his affidavit Annexure C1 and affidavit of Raju son of Ramesh Kumar as Annexure C2 alongwith documents Annexure C3 to Annexure C8.

2.                Upon notice, OP appeared and filed its reply wherein it has been sub mitted that the complainant had left the vehicle unattended with the key in the vehicle thereby giving access to the vehicle and resulting in the same being stolen; that the complainant himself has violated the policy condition No.5 which provided that the insured shall at all times take due and reasonable care to protect and safeguard the insured vehicle but the complainant did not do so, therefore, his claim was rightly repudiated by the replying Op on 07.11.2018, therefore, there is no deficiency in service on the part of insurance company. Other pleas made in the compliant have been contorverted and prayer for dismissal of the complaint has been made.  In evidence, the Op has tendered affidavit of Sh.Pushkin Bhatt as Ex.RW1/A besides documents Annexure RW1/A to Annexure RW1/7.

3.                We have heard learned counsels for the parties and carefully gone through the case file.

4.                          Learned counsel for the complainant has argued that the theft of the vehicle had taken place during the subsistence of the policy in question and the insurance company is liable to indemnify the loss suffered by him because he has paid premium for getting the vehicle in question insured but the insurance company has not settled the claim despite the fact that the  all the formalities have already been completed by the complainant.

5.                          Per contra, it has been argued by learned counsel for the Op that the complainant himself has violated the condition No.5 of the policy by leaving the vehicle unattended with key, therefore, the present compliant is liable to dismissed.

6.                          The facts regarding ownership of vehicle, purchasing of  insurance policy by the complainant from the Op, theft of insured vehicle during the subsistence of the policy, lodging of claim with the insurance company, lodging of FIR, submission of untraced report duly accepted by the Court as well as other documents  to the OP are need not to be discussed because the Op has stressed hard only on one point that the complainant has left the vehicle unattended with key thereby giving access to the vehicle and resulting the same being stolen, therefore, the claim with regard to theft of said vehicle is not permissible as there is clear cut violation of Condition No.5 of the terms and conditions of the policy. In support of his arguments learned counsel for the Op has drawn the attention of this Commission towards the investigation report Annexure RW1/3 besides statement of complainant recorded during the course of investigation by the investigator.

7.                          After going through the material available on the case file as well as hearing the contentions on behalf of both sides one thing is very much clear that the insurance company is mainly relying upon the Condition No.5 of the terms and conditions of policy but it is strange that no terms and conditions have been placed on the case file by the insurance company and even there is nothing on the case file to show that the same have ever been supplied to the complainant/insured at the time of issuance of policy and especially the exclusion clauses were informed to the complainant at the time of obtaining the policy in question. It is a settled principle of law that unless the insured is duly informed about the exclusion clause same cannot be applicable. On this point reliance can be taken place from case law titled as New India Assurance Company Limited & Ors. Versus Paresh Mohan Lal Parmar decided on 04.02.2020 by Hon’ble Apex Court  in   Civil Appeal No.10398 of 2011.  Though learned counsel for the OP has placed on record photo copy of keys (Annexure R1/7) to justify the repudiation but in our view this photograph is not helpful to the case of the Op rather it supports the case of the complainant because in this very document two keys are visible and further it appears that the insurance company in this way or that way wants to avoid the genuine claim of the complainant by taking the advantage of the statement made by the complainant bonafidely during the course of investigation by the investigator.  The insurance company is not supposed to earn profit/premium from the customer as it is its prime duty to indemnify the claim for the loss if causes during the subsistence of the policy. 

8.                          It is not disputed that the vehicle was stolen by an unknown person during the subsistence of the policy as is evident through photo copy of FIR No.0117 dated 18.05.2018 (Annexure C3). It is also not disputed that the vehicle was not traceable and after conducting the throw investigation the police authorities have filed the untraced report duly accepted by the learned JMIC, Fatehabad (Annexure C8).  In the present case, one more thing which this Commission has noticed that the insurance company is trying to keep the investigation report of the investigator parallel to the investigation done by the police authorities and by using the report of the investigator as a weapon has repudiated the genuine claim of the complainant. In the case in hand, the vehicle has been stolen and regarding this FIR has also been registered and the untraced report has also been accepted by the court.  In the case of theft of vehicle, breach of condition is not germane. The 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.

9.                          It is also relevant to mention here that Section 19 of the General Insurance Business Nationalization Act, 1972 states that it shall be the duty of every Insurance Company to carry on general insurance business so as to develop it to the best advantage of the community. The denial of claim which is other than proved to be a genuine means that it is mere an excuse to escape liability and is not bona fide intention of the insurance company. Fairness and non-arbitrariness are considered as two immutable pillars supporting the equity principle, an unshakable threshold of State and public behavior. What brought insurance into being was popular concern for future uncertainty. Man wanted to protect their hard earned property from uncertainty and this simple requirement was given a shape with the innovation and improvement of insurance policy. The only principle was to make good the loss. In our country, the insurance sector was nationalized with an objective to reach the corners of this country with insurance network, mobilize a huge resources and lend our shoulders in the nation building and in similar way the Insurance Companies also should not shirk their liabilities in case of genuine claims, like the present one, made under the insurance policies. Moreover the insurers’ decision to reject a claim shall be based on sound logic and valid grounds. It may be noted that 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 losing confidence in the insurance industry, giving rise to excessive litigation.

10.              Keeping in view the above discussion as well as the law laid down in New India Assurance Company Limited & Ors. Versus Paresh Mohan Lal Parmar (supra) we have no hitch to allow the present complaint. Accordingly, the present complaint is hereby allowed with costs and Op is directed to pay Rs.7,65,700/- (being IDV mentioned in Annexure C4) alongwith interest @ 6 % from the date of filing of the complaint till its realization.  The Op is further directed to pay a sum of Rs.11,000/- on account of litigation charge, mental harassment & agony alongwith cost of litigation. The order be complied with a period of 45 days, failing which the awarded amount would carry interest @ 9 % per annum from the date of filing the claim till its realization.   Copies of the order be sent to the parties concerned, free of costs, as per rules.

11.                        In default of compliance of this order, proceedings against respondents shall be initiated under Section 72 of Consumer Protection Act, 2019 as non-compliance of court order shall be punishable with imprisonment for a term which shall not be less than one month, but which may extend to three years, or with fine, which shall not be less than twenty five thousand rupees, but which may extend to one lakh rupees, or with both. A copy of this order be sent to the parties free of cost. This order be also uploaded forthwith on website of this Commission, as per rules, for perusal of parties herein. File be consigned to the record room after due compliance.     

Announced in open Commission

Dated: 18.08.2023

       

 

                                                                                                        

          (K.S.Nirania)                       (Harisha Mehta)                (Rajbir Singh)                              Member                               Member                                           President