ORDER

Complaint under  Sec.12 of the CPA 1986 as amended upto date

Ms. Nipur Chandna, Member

          Complainant is the SME PACKAGE Insurance policy holder of OP company vide policy no. 578221-01 for a period from 30.11.2013 – 29.11.2014.

It is alleged by the complainant that when he opened the factory premises on 10.3.2014, it was found that a burglary had been committed on 9.3.2014 i.e. on Sunday in the premises. It is further alleged by the complainant that while going through CCTV footage,  it was found that 2-3 persons had entered into the factory premises and had stolen the goods from the factory.

   It is further alleged by the complainant that an FIR was lodged against the aforesaid burglary on 10.3.2014 vide FIR No.121 and after thorough checking it was found that one of his workers namely Shambhu Sahni was involved in the same.

It is further alleged by the complainant that an Intimation about of the aforesaid burglary was given to OP company on its customer care no and the claim no.113224 was issued by the OP .

It is alleged by the complainant that OP had repudiated his genuine claim vide letter date 31.4.2014 on false and flimsy grounds.  Hence, this complaint.

Complainant has been contested by the OP .  OP has filed its W.S. Para No. 2 of the preliminary objection of the W.S. filed by the OP is relevant and is reproduced as under:-

Para No. 2

The complaint is liable to be dismissed in the absence of any cause of action having arisen in favour of the complainant and against the respondent.  The claim of complainant was rightly rejected vide letter dated 31.3.2014 already filed by the complainant wherein the relevant clauses of the policy were also highlighted due to which the claim was rejected. In fact, the complainant in Para 15 of the complaint has admitted that one of its own workman Sambhu Sahni was involved in the burglary.  The complaint itself is liable to be dismissed on this admission alone.  The insurance policy under Section B deals with Burglary insurance stating as to what all is covered therein. Under the said section there are clauses providing for exclusions wherein Clause 3 provides “Loss or damage where any inmate or member of the insured’s household or his own business staff or any other person lawfully in the premises is concerned in the actual theft of or damage to any of the articles or premises or where such loss or damage has been expedited or in any way assisted or brought about by any such person or persons.”

In the reported incident employee of insured, who had committed this crime had entered into factory without making any forcible entry into complainant’s premises by using duplicate key (Said fact has been recorded in FIR & Insured’s statement dated 19.3.2014) and thus benefit under Burglary policy is not triggered with policy coverage/condition reading as:-

“What is covered

The Company will indemnify the insured against : 1. Loss or damage to the property described in the Schedule by Burglary or Housebreaking (theft following upon an actual forcible and violent entry of or exit from the premises by the person or persons committing such theft) or Hole-up,”

Exclusion:-

“7. Theft or Burglary caused by use of the duplicate or original key, unless the key is obtained by force.”.

          Both the parties have filed their evidence by way of affidavits.

          We have heard arguments advanced at bar and have perused the record.

     The counsel for the OP had contended that the conditions of policy coverage are very clear and stipulate that policy will not be applicable if loss or damage is caused or in any way assisted by an inmate or member of business staff of the insured. He has contended that in the present case, insured’s own employee has been involved in the reported theft as is clear from the FIR lodged by the complainant.  He has contended that it is a case of infidelity of an employee, and hence the claim is not payable under Burglary policy.

         The counsel for the OP has also  taken us through the contents of the FIR, the bare perusal of which  makes it clear that breaking in into the insured premises had taken place with the lock being opened by the duplicate keys used by one of the worker name Shambhu Sahni.  He has further contended that  thus overage of Burglary policy is not triggered which stipulates forcible entry.  He has referred to Exclusion Clause No. 7 of the Policy which reads

      Exclusion 7

“Theft a Burglary caused by us of the duplicate an original key, unless the key is obtained by force”.

In view of the contention raised by the Ld. Counsel for the OP and the documents placed on record, we are of the considered opinion that the Insurance Company had rightly repudiated the claim of the complainant on the ground of use of duplicate key in causing entry to the Insured premises and also the involvement of an employee of the complainant in the incident in question as is evident for the statement of the complainant himself.

 We, therefore, see no merits in this complaint, the same is hereby dismissed.

            Copy of the order be made available to the parties as per rule.

 File be consigned to record room.

          Announced in open sitting of the Forum on.....................