Before  the District Consumer Dispute Redressal Commission [Central], 5th Floor                                         ISBT Building, Kashmere Gate, Delhi

                               Complaint Case No.CC-131/17.07.2018

Mohd. Irfan son of Shri Sirajudddin

1376, Bazar Chitli Qabar, Gali Kallu Khawas,

Jama Masjid, Delhi-110006                                            ...Complainant

                                      Versus

OP1:  Royal Sundram General Insurance Co. Ltd.

through its Managing Director, A-14 Plot no.136,

Gurgaon, Haryana.

Also at : Royal Sundram General Insurance Co. Ltd.

through its Managing Director, Vishranth Melaram

Towers No.2/319, Rajiv Gandhi Salai (OMR)

Karapakkam, Chennai-600097

OP2:  M/s Rohit Auto Deals, through its

Authorized Signatory, 68 Chittragupta Road

Paharganj, New Delhi-110055                                         ...Opposite Party

                                                                   Order Reserved on:     26.12.2022

                                                                   Date of Order:            04.02.2023

Coram: Shri Inder Jeet Singh, President

              Shri Vyas Muni Rai,    Member

              Ms. Shahina, Member -Female

Inder Jeet Singh

                                             ORDER

1.1. (Gist of consumer dispute) :  The complainant had purchased an e-rickshaw through OP2. It was insured with opposite party no.1/Insurer. The IDV value of E-rickshaw was Rs.1,06,809/-. The E-rickshaw was stolen from service road of Vijay Ghat, Delhi, it was even not recovered by police after lodging of FIR.  The complainant lodged a theft claim with the Insurer but his claim was not considered and finalized despite furnishing the requisite documents. He claims this amount of Rs.1,07,000/-; damages of Rs.50,000/- for harassment & mental agony and litigation charges of Rs.11,000/- in the complaint under consideration. Whereas the complaint is opposed by the OP1 on the ground of breach of a condition of policy since there was  delay of 9 days in informing the insurer about alleged theft and also delay of 5 days to inform the police,  there were different cause of loss mentioned in the FIR  and in the claim form furnished to OP1 & requisite documents were not provided despite repeated letters. The complainant also failed to provide second ignition key of the vehicle to OP1.

          OP2 also opposed the complaint that OP2 was just introduced  the complainant to vendor [Sri Sai Som e-rickshaw Company] of e-rickshaw, as such there was no liability of OP2.  At the time of final hearing on this complaint, the complainant also made is clear that he does not make any monetary claim against OP2, which was accordingly recorded in the proceedings dated 26.12.2022.  

2.2:   The parties in their pleadings has furnished particulars of e-rickshaw and of policy, however, at some places last digit are mentioned or at some instance number is not completely/correctly mentioned, thus after reconciling the details with the documents, the same are being mentioned in this final order.

2.1 (Matrix of cases of the parties) :  The features of the case, as set-up  by the complainant (which is also not disputed by the OP1) is that the complainant had purchased battery operated e-rickshaw bearing registration no. DL6ER-0594 (Model Champion Poly Plast, Engine  no. 001070,  chassis no.  M5CHARMR I6002466; briefly e-rickshaw]. It was got insured from the OP1 for period w.e.f. 07.12.2016 to 06.12.2017 (vide policy no. VP0191552000100) against payment of premium.

          The other features of the complaint (which are disputed and denied by the OP1), are that the complaint used to ply the e-rickshaw on road.  On 15.04.2014 it was stolen from service road in front of Vijay Ghat between 12:30 hrs to 13:00 hrs. Then, the  complainant applied for insurance claim to OP1 on 24.4.2017 because of theft and in response to  clarifications/objections raised, he had also furnished requisite papers on 8.3.2018 and it was followed by many reminders dated 8.9.2017, 23.11.2017, 28.12.2017 13.2.2018 and 23.3.2018 but all went in vain. There is grossly deficiency of services by the OP.

2.2:    Since,  the OP1 had not finalized the claim intentionally and deliberately to evade the legal liability, the complainant sent legal notice dated 12.6.2018 by speed post to OPs, however, OP2 had given false reply.  That is why complaint was filed for cost of e-rickshaw of Rs.1,07,000/- along-with interest @ 18%pa apart from other claims.  The complaint is supplemented with documents, which also include copy of FIR no.011809/17, copy of un-trace report, his MLC  immediately after theft of e-rickshaw besides other records.

2.3:   The OP1 denies allegations of complaint  against it [some of them are already stated in the para 2.2 above]. There is breach of condition of policy since there was  delay of 9 days in informing the insurer about alleged theft, which ought to have been furnished in time without delay and for such breach of policy condition,  the claim does not sustain (reliance is placed on New India Assurance Co. Ltd Vs Trilochan Jane (FA no.321/2005 & Oriental Insurance Co. Vs Parvesh Chander Chadha CA no.6739/2010 dod 17.8.2010). The terms of policy is a contract between the parties and both the parties are bound by such terms and conditions of policy.  Moreover, there were different cause of loss mentioned in the FIR  &  in the claim  form lodged with the OP1. OP1 had also asked the complainant to provide information/clarifications by letters 25.4.2017, 8.9.2017, 23.11.2017,  28.2.2017 13.2.2018 & 23.3.2018 but requisite information were not provided. The complainant also failed to provide second ignition key of the vehicle. The OP1 had appointed Dynamic Investigator to investigate the loss, who had furnished his detailed report dated 18.07.2017.  Thus, claim deserves dismissal.

2.4:  OP2 also opposed the complaint that it was just introducer of complainant to vendor Sri Sai Som e-rickshaw Company, as such there was no liability of OP2. The complainant had also paid the sale amount to said vendor through UTR no.B00174000122 on 2.12.2016.

3:  At the juncture of evidence, the complainant filed his affidavit with support of documents, which were filed with the complaint.  On the other side Shri V Harishankar, Legal Executive, of OP1 and Shri Dheeraj Gupta, Investigator of OP1 filed their affidavits of evidence,  while relying upon the  insurance policy, letters and  surveyor's. Shri Rohit Chawla, authorized signatory of OP2 filed his affidavit of evidence for OP2.  

4.  Both the parties have also filed their respective written arguments.  They have supplemented with explanations to pleading & evidence of parties, apart from oral submissions. Their contentions will be dealt appropriately.

5.1 (Findings) : The rival contentions are considered keeping in view their case, evidence, nature of dispute apart from the precedent and case law presented. Since, the disputes are on specific points, thus they will be dealt point by point for sake of brevity and clarity.

 5.2: ( Regarding point of delayed information): Since there was objections by OP1 of delay in informing the police as well as the insurer, while referring the insurance policy and the complainant had also protested it by referring the record & precedent, thus it is appropriate to reproduce the clause/condition no.1 of policy (which is at page 14 of OP1's paper book under the heading "Conditions'), which reads-

 "Notice shall be given in writing to the company immediately upon the occurrence of any accidental 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 every letter, claim, writ, summons and/or process or copy thereof, shall be forwarded to the company immediately on receipt by insured. Notice shall be given in writing to the company immediately by the insured, who shall have knowledge and of  any impending prosecution, inquest or fatal inquiry in respect of  occurrence which may give rise to a claim under this policy. In case of theft or criminal act which may be subject of claim under this policy, the insured shall give immediate notice to the police and cooperate with the company in securing the conviction of the offender".

          According to OP1, for want of immediate information to OP1, it is breach of condition of policy. The OP1 was informed after 9 days from the date of alleged theft and police was informed after 5 days of incident. Thus, in terms of decision in Oriental Insurance Co. Ltd Vs. Parvesh Chandra Chadha case (supra), the claim is not made out.  On the other side, complainant explains that at the time of incident, he was administered intoxicant in cold drink, he became unconscious and he was taken to Aruna Asaf Ali Hospital, where he remained hospitalized till 18.4.2017, he gained consciousness only on 17.4.2017. His MLC was also prepared and he was discharged on 18.4.2017. Then he managed to report to police on 20.4.2017 & then informed to OP1 on 24.4.2017 after approaching to the OP2 and its advices. When there is sufficient explanations by the complainant, his claim cannot be rejected, the complainant relies upon ' Om Prakash Vs Reliance General Insurance Co.  [Civil Appeal no.15611/2017 arising out of SLP( C) no.742/2015] that "the decision of the insurer to reject the claim has to be based on valid grounds. Rejection of the claims on purely technical grounds in a mechanical manner will result in loss of confidence of policy holders in the insurance industry. If the reason for delay in making the claim is satisfactorily explained, such a claim cannot be rejected on the ground of delay".

5.2A:  In order to appreciate the rival contentions, it needs to refer the record.  The complainant has filed and proved his discharge summary vide MLC no.1008/17 dated 16.4.2017 (page 18 of paper book), which gives his relevant history of found drowsy on 16.4.2017 at Red Fort, Delhi apart from diagnosis & treatment given of gastric savage, he was discharged on 18.4.2017.   During inquiry by OP1, the complainant had also given explanation in writing (which at page no.25 of the paper book) that when he was under treatment as indoor patient in Aruna Asaf Ali Hospital, he came to know from doctors that he was got admitted in the hospital by the police. Moreover, after his discharge from the hospital, he was not fully recovered and was feeling weak, then later-on he, along-with family member, went to police station for register FIR.

          Under these circumstances, the OP1 refers condition no.1 of the insurance policy that there is delay in intimating the OP1 by complainant, but the complainant emphasizes the later part/last sentence of condition no.1, that he was hospitalized and police had brought him to hospital, how he could give immediate information to OP1. By reconciling these circumstances, it is apparent that complainant was hospitalized, he remained under treatment and as per discharge summary he himself was not in his own senses and he was in drowsy because of influence of some substance, for which  he was treated there.  When, he was drowsy condition and police had brought him to hospital, was he able to inform the OP1? The police was already in action by bringing him to hospital.   The police had given record of un-trace case of theft to the complainant. The OP1's surveyor/investigator had visited spot as well as police station to assess the circumstances, however, surveyor had not reported any fact, if inquired from Hospital in respect of treatment of complainant. Thus, situation comes within the later part of condition no.1 and complainant has satisfactorily explained the circumstances which prevented him from informing the OP1 immediately after incident, the ratio of precedent 'Om Parkash Vs Reliance General Insurance Co. (supra)  applies to the situation in hand. To that extent, the contentions are disposed off.

5.3:    (Regarding -point of different version in FIR and in claim form) :  The other issue raised by OP1 is in respect of contents of FIR that it was simply case of theft (page 16 of paper book), whereas in the claim form dated 15.05.2017 some other facts were mentioned that he picked two passengers and later he got unconscious  of (page 60 of paper book). Whereas according to complainant, he had explained everything in writing and there is nothing different version being projected by OP1 as there was theft of his vehicle. But later-on the OP1's own letter dated 13.2.018, suggests that delay of intimation was not at any issue and letter was just issued to put defence against claim of complainant.

5.3A: The answer to this point also lies in the documentary record, it needs reference to them, which includes surveyor's report, letters issued by the OP1 to the complainant, reply/compliances by complainant and FIR.

          It was an e-FIR reporting the theft of e-rickshaw, which was lodged by the complainant on 20.4.2017 after his discharge from the hospital.  He informed the OP1 after registration of FIR and OP1 had appointed its surveyor, who also furnished his report. The OP1 has also placed the record translated version complainant's letter dated 15.5.2017 (page 42 of paper book of OP1), which is of same date of claim form (page 60 of paper book of OP1).  The complainant had reported case of theft in FIR being e-FIR but narrated the episode in detail in his letter/statement dated 15.5.2017 that as to how two passenger hired his e-rickshaw, one lady passenger felt urgent need of water because of her dizziness in the way and then complainant had halted in the way, he was also offered & served cold drink, which made him unconscious at Rajghat and he found him in hospital when gained his consciousness..  So far claim form is concerned, its column no.2d seeks narration of case of accident/loss [but with instructions 'do not state police report attached or as per police report'], the complainant has replied that column in brief. In nu-shell, there are allegation of theft in the FIR, in the claim form as well as in the separate letter/statement dated 15.5.2017.  It has already been held in paragraph (5.2A) above that surveyor's report does not depict of inquiry to have been conducted from hospital or record of hospital or from police in respect of treatment of complainant vis a vis complaint has proved his discharge summary, thus preponderance of probabilities are in favour of complainant and circumstances do not suggest to be a case of different cause of loss.

          In addition, the complainant has placed on record, OP1's letter dated 8.9.2017 (8 point inquiry), letters dated 23.11.2017 & 28.12.2017 (which reduced to 3 point inquiry out of 8 points), then letter dated 13.2.2018 (further reduced to single query out of 8 points) and letter dated 23.3.2018 (again 2 point inquiry out of 8 point inquiry), despite the complainant had given letter dated 15.5.2017 in detail  apart from other responses furnished by him. This point also stand disposed off accordingly.

 5.4:     (Regarding-point of second ignition key) : This point has also been raised by the OP1 that complainant failed to handover second ignition key of the e-rickshaw to OP1, but the complainant has contrary stand.  Its answer is also in the record itself, which may be seen straight-way.  The translated version of letter dated 15.5.2017 (page 42 of OP1's paper book), which mentions that one key was stolen with e-rickshaw and other key in broken condition was handed over to surveyor (which surveyor confirms in his report under heading ignition keys of the vehicle at page 33 of the paper book). Since the vehicle was functional at the time of episode, it could be ignited with key only, thus it establishes that one key was stolen with the e-rickshaw. The other key was handed over to surveyor. This issue also disposed off.

5.5:   The circumstances established by complainant are of deficiency in services on the part of OP1. The complainant is entitled for amount of his valid claim proved. However, the surveyor  in his detailed report does not analyse and opine assessment of losses.

6.1: In view of above, the complainant is held entitled for amount of Rs. 1,06,809/- being IDV of e-rickshaw, along-with interest @ 6%pa (from the date of complaint till realisation of amount) against the OP1.

6.2 :  The other factors are also abundantly clear to what extent sufferings,  trauma and inconvenience had been faced by the complainant for seeking relief of his valid claim, which was with-held by OP1, thus the complainant deserves damages, which are quantified as Rs. 10,000/- in his favour and against the OP1, apart from costs of  Rs.5,000/-in favour of the complainant against the OP1.

6.3 : For want of case and claim against OP2, the complaint against OP2 is dismissed.

6.4: Hence, the complaint is allowed in favour of complainant and against the OP1, to pay a sum of Rs. 1,06,809/- along-with interest @ 6%pa from the date of complaint till realisation of amount apart from damages of Rs.10,000/- & costs of Rs. 5000/- within 30 days from the date of receipt of this order.           

7. Copy of this sent/provided forthwith to the parties free of cost as per Regulations.

8:  Announced on this 4th day of February, 2023 [माघ 15, साका 1944]