Orissa

Rayagada

CC/87/2017

Sri Rama Krishna Panigrahi - Complainant(s)

Versus

SBI General Insurance Col Ltd., - Opp.Party(s)

Smt. Joshna Rani Panigrahi

27 Nov 2018

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,

                                      PO/DIST; RAYAGADA,   STATE:  ODISHA ,Pin No. 765001

C.C. Case  No.   87 / 2017.                             Date.      27      11   . 2018.

P R E S E N T .

Dr. Aswini  Kumar Mohapatra,                                                   President

Sri GadadharaSahu,                                                                        Member.

Smt.Padmalaya  Mishra,.                                                              Member

 

Sri Rama Krishna Panigrahi, S/O: Sri Panchanan Panigrahi, At:Main Road, po:Muniguda  Dist:    Rayagada, State:  Odisha.                                                …….Complainant

Vrs.

1.The  General  Manager,  SBI General Insurance  Company Ltd., Having its Registered office, At “Nataraj” 101, 201 & 301, Junction of Western Expresss High way & Andheri Kurla Road, Andheri (East), Mumbai- 400069.

2. The Branch Manager, SBI General  Insurance Company Ltd., Ist. floor, Sri Sai complex, Gandhi Nagar, Main Road, At/Po:Berhampur, Dist:Ganjam, Pin No. 760001.

3. The  Branch Manager,  State Bank of India, Muniguda Branch, Dist:Rayagada,State:Odisha.

.…..Opp.Parties

Counsel for the parties:                                 

For the complainant: - Smt. Jyostna  Rani Devi, Advocate, Rayagada.

For the O.Ps  1 & 2 :-. Sri  K.Ch.G.S.Kumandan, Advocate, Rayagada.

For the  O.P. No.3:- Self.

 

                                                JUDGEMENT.

The  curx of the case is that  the above named complainant alleging deficiency in service  against  afore mentioned O.Ps    for  non payment insurance  IDV a sum of Rs.4,77,000/- towards  theft of insured Bolero Pick up  bearing Regd. No.OD-18A-3767   for which  the complainant  sought for redressal of the grievances raised by the complainant.

Upon  Notice, the O.Ps No.1 & 2 put in their appearance and filed  written version through their learned counsel in which  they refuting allegation made against them.  The O.P No.1 & 2   taking one and another pleas in the written version   sought to dismiss the complaint as it is not maintainable  under the C.P. Act, 1986. The facts which are not specifically admitted may be treated  as denial of the O.P  No. 1  & 2. Hence the O.P No.  1 & 2  prays the forum to dismiss the case against  them  to meet the ends of justice.

The O.P. No.3  filed written version and submitted that unfortunately  the complainants Bolero pick up was  stolen.  He brought  to the notice of the bank and  the bank immediately  advised  him to lodge an FIR and assured  to  extended necessary help to him for his claim settlement. Since then the O.P.(bank) are also following with the local police  and the insurance company for early settlement of the claim. But to their knowledge, the  complaint has yet to receive the claim amount. Account is regular as on date. We have  never issued any notice demanding repayment of the loan  as the account is regular and standard.  The statement of the customer   that the O.P. (Bank)  have threat to initiate legal action is false  &  not true. The O.P. No.3  prays the forum to dismiss the case against  them  to meet the ends of justice.

Heard arguments from the learned counsel for the    O.P  No. 1  and from the complainant.    Perused the record, documents, written version  filed by the parties. 

This forum  examined the entire material on record  and given  a thoughtful consideration  to the  arguments  advanced  before us by  the  parties touching the points both on the facts  as well as on  law.

                                                                    FINDINGS.

On the basis of the pleadings of the parties, the sole question of determination is  Whether  the complainant is entitled  to insurance claim made by him ?

                On careful perusal of  all the  papers we  observed  that  there is no  dispute that the  complainant had  purchased a   BOLERO PICKUP  Vehicle bearing Regd. No. OD-18-A- 3767 on DT. 23.06.2014 by  borrowing  finance from the O.P. No.3 and got it insured with the O.P. No.1 & 2 which  was stolen    on Dt. 20.01.2016 by  unknown culprits  in night hours.  The policy  No. 0000000001859187-01 was effective from 23.6.2015 to  22.6.2016( copies of the policy issued in favour of the complainant by the O.P.  is in the file which is marked Annexure-I).

On perusal of the record this forum found  the BOLERO PICKUP  Vehicle bearing Regd. No. OD-18-A- 3767  was stolen    on Dt. 20.01.2016 by  unkown culprits  in night hours and the  complainant  was filed the case on Dt. 06.07.2017 before  the  forum,  but  till date the O.Ps  have not settled the above   claim even after completion of 3(three) years. Complainant consequently prayer  the forum to pass necessary order,  and not to   not allowing   further time to the O.Ps  and  according   on merit this forum should pass order.

On  perusal of the written version  filed  by the  O.P. No.1  & 2  it is revealed that  the  O.P. No.1  & 2  contended that  due to  non submission of the following  documents the  claim  of the complainant is not yet settled.

1. Vehicle service history.
2. Original or certified cop of court accepted final report.
3. Original or certified copy of untraced report.
4. Original intimation letter to RTO with acknowledgement.
5. Transffer forms 28 ( 4 copy) 29, 30 (3-3 copy) duly signed.
6. Non repossession  letter  letter from financer.
7. Foreclosure  report from  financier as on date.
8. Provide the NEFT/RTGS details of financier:

Bank  branch:

Beneficiary A/c. name:

Beneficiary A/c  No. :

RTGS code :

IFSC code:

9. Bank certificate  for  confirmation of bank details with Manager (Format attached).
10. Letter of  Subrogation (Notarized on Rs.100/- stamp.
11. Letter of Indemnity (Notarized on Rs.100/- stamp .
12. Discharge voucher(format attached).

During the course of hearing the  learned counsel for the  complainant  vehemently argued  that the complainant has filed  copies  the F.I.R and other police papers in G.R. case No.  30/2016, Original intimation letter to the R.T.O , The final form in G.R. No. 30/2016 is yet to be submitted by the police as such the same could not be filed. The documents such as the vehicle service history, Transfer  forms 28, 29 and 30 are irrelevant in this case.  The other documents are in their custody as such it is ridiculous to claim the complainant to submit those documents.

On the date of hearing the learned counsel for the O.P. submitted further written version and argued that  the O.Ps have also filed a petition on Dt. 15.9.2018 praying the  forum to direct the complainant  to produce the documents required for consideration of settlement and also the claim. The complainant  instead of arranging the documents needed by the O.Ps for settlement  of the claim and he also  very much aware of the requirement papers and documents but could not arranged and also made any efforts to got the same. The documents  and information needed is very much essential  for the proper adjudication of the claim and settlement. On 29.5.2017 he has been informed through the letter of SBI, G.I.Co.Ltd Corporate office & R.O., Mumbai and also from the day one the complainant has been informed the required information and papers.   It is  pertinent to state here that the documents which are required  by the company for settlement   and arrive the same have been asked as per the  IRDA and insurance provisions and  General Insurance Company regulations. The O.Ps have got  no malafide intention  and interest to delay  or evade the settlement and also enter in any litigation. The claim before the forum is  infructous and pre-matured and the complainant has got ample opportunity to approach the forum or proceed in any court of law and the O.Ps have not repudiated the claim  and requested to provide  the relevant and important documents for the adjudication of the claim.   The complainant has prayed for huge amounts on the differents which is not tenable and also beyond the purview of the provisions of C.P.Act, 1986   and IRDA.The O.Ps have  not caused any mental agony,  and liable  for payment   of any interest and also of income.  The complainant  hurriedly  and without exhausting   the other of the  Insurance Company and having   no  inclination to furnish the information.  On the other hand the complainant interested to claim the amounts which are not tenable. That the forum can  draw  adverse inferences and also presume that the complainant has got no genuine claim and suppressing some  facts.  The insurance policy is a contract and there are some obligations on the part of the policy holder. At last  the forum to dismiss the claim with a direction to furnish the  required  documents  and information  and on the repudiation of the claim he can approach the forum..

          On  query it is revealed  that   the required documents will neither  increase  nor decrease  the loss amount arrived  in the policy IDV value.  The  other documents  required by  the O.P.No.1 & 2   have  admittedly  sent to the   O.P.No.1 & 2  during pendency of this case.   So we feel that the documents  required  by the O.P. No.1 & 2  are  more formal in  nature than  compulsory or  binding  in  nature . So  at  present there is  no  impediment  on the part of the O.P.No.1  & 2  to pay the   IDV  insurance amount  as arrived  in the policy.

                For better appreciation  this forum relied citations which are mentioned here under:-

It is held as reported in SCC (1979) 4   page- 178  where in  the hon’ble  apex court observed that   “Resort to the plea of limitation by public authority to defeat just  claim of citizen depreciated- Though  permissible under law, such technical pleas should only be taken when claim is not well founded”.

Further it is held and   reported in   CPR- 2004(2) page No. 80  where  the Hon’ble   State Commission, West Bengal   allowed  similar  type of   case in  absence  documents as required by the O.P. No.1 & 2.

The Hon’ble  National Commission has held and reported  in  C.P.R. 2009(1)  page No. 44  where  in the Hon’ble National Commission, New Delhi observed  “when a company or any one obtains  an Insurance it is not part of commercial activity, but it  is obtaining in order to cover the risk to the commercial activity, hence, even companies  obtaining a insurance cover  will fall within the defination of ‘Consumer’.

            Further, it is held and reported in CTJ 2008 page 917  where in the Hon’ble Supreme Court observed  “That the insurance company after having accepted the value of a particular insured goods at time of insuring the goods cannot disown that very figure  on one pretext or other when they are called upon to pay the compensation. Taken it or leave it attitude in such a case is not only unwarranted being bad in law but ethically indefeasible would be liable to pay the compensation on  the insured amount on it had accepted  the premium for the entire amount covered under the policy”.

Further Para- 21 as per regulation 9(3) of the IRDA Protection of policy holders interest regulation 2002   the Insurance company was obliged to finalise the view  based on the report of the surveyor  or police  within a period of 30 days. Section 9(5) states that if the  insurer on the receipt of the survey or police report  finds that it is in complete in any respect, he shall require the surveyor under  intimation to the insured  to furnish an additional report on certain specific issue as may  be  required by the   insurer such a request may  be made within 15 days of receipt of the original survey or police report. Provided that the facility of calling for an additional report by the  insurer shall not be resorted more than once in the case of claim.  The other facts which is necessary is also dealt within Sub- section (4) and (5).

Further we would  like  to referred  the case law  in the instant case. It is held and reported in  CPC- 1991, page -540 the  Hon’ble  Hariyana State  Commission held that when ever there is any delay or dilatoriness in finalizing  the insurance claim, the same would be tentamount to a  deficiency  in service and thus comes squarely within the  purview of Consumer Forum.  Once it is held that default or negligence in the  settlement of an insurance claim is a deficiency  in service then an arbitrary  or mischievous  rejection  of an insurance claim  would patently  be a default  within its larger  meaning. On principle , it would   seem  some what manifest that the mere repudiation of the insurance claim cannot itself operate  as a  jurisdiction bar for redressel forums under the Act.  This is further  made it clear  it is held and reported  in CPR-1991(2), page No.18  the Hon’ble National Commission  clearly defines  the mere unilateral  rejection of an insured parties  claimed by the insurer does not  per  se  operate as jurisdictional bar to seek redressal before  the forums under the Act. It is on the strength of the  above decision  the instant case is admitted by this forum.

Coming to the merits of the case.  Perused the complaint petition  inter alia  documents filed by the parties  and this forum has   accepted the grievance of the complainant. It is the case of the complainant that the complainant in order to earn his  livelihood  had purchased  a Bolero availing  finance from the O.P. No.3. The said Bolero  had insured under Commercial Motor Goods carrying Certificate of Insurance -cum- policy schedule  sum insured Rs.4,77,000/- and the validity of the policy is in time(copies of the policy is in the file which is marked as Annexure-I).   When the policy is in force the above Bolero  was stolen    on Dt. 20.01.2016 by  unknown culprits  in night hours.. The matter was also intimated to the OP Insurance company and the OP sent its  Investigator Sri  P.K. Samantaray  on Dt.3.2.2016(copies of the check list made by the above Investigator is in the file which is marked as Annexure-2). The complainant had  informed to the police and filed F.I.R. bearing PS Case No.10 dt.21.01.16(Copies of the FIR is in the file which is marked as Annexure-3).  The complainant has submitted all the claim forms along with the police report and  the Investigator data sheet and the original policy bond to the O.Ps.  The OPs  also admitted that the Bolero was stolen by some unknown culprits on Dt. 20.1.2016  and the complainant registered FIR vide PS Case No.10 dt.21.01.16. After receipt of intimation the OPs have deputed an Investigator.

Further the complainant also filed bank statement which was issued by the O.P. No.3 where in the  O.P. No.3 charged interest @ Rs.12.70 per annum(copies of the  statement of account is in the file which is  marked as Annexure-4). The complainant has informed the R.T.O. , Rayagada towards  stolen of above vehicle(copies of the letter is in the file which is marked as Annexure-5).

During the course of  hearing the learned counsel for the complainant  submitted that inspite of rigorous search by the police, the aforementioned vehicle was not traced and the police have submitted final report in the said case which ends the investigation. The O.Ps have registered the complaint of the complainant as claim No. 233523.

 

This forum observed that in the present case  the insurance companies intends to take policy only   to collect the premium  from the  parties and not to pay back the same in time  at the event admitted/accepted  by the policy bond.

 

 

On  going  through  the  I.D.V. of the policy  No. . 0000000001859187-01   we are of the view that the  complainant is entitled to get Rs.4,77,000.00 who opted  to receive  compensation   on total  loss basis  as calculated  in the policy   by the O.Ps 1 & 2. 

In the present case the complainant has not sought any relief from the O.P. No.3.  So this forum need not  going  to the merit  of  the  case against the O.P. No.3.

In the above facts, circumstances  & on perusal of the record, the complaint petition,   documents, and referring on above Citations there  exists a strong “prima-facie” case in favor of the complainant.

On the strength of the aforesaid rulings of the Apex court  this forum  allow this case  in  part.

Hence  to  meet the  ends of justice, the following order is passed. 

The complainant is directed to cooperate   and furnish  all the required documents available with him as wanted    by  the O..Ps  for early  settlement  of his claim as the O.Ps are not repudiated the claim and ready to settle the claim  in favour of the complainant.                                           

                                                            ORDER.

In resultant   the complaint petition stands allowed  in  part  on  contest against  the O.P No. 1  & 2 .

The O.Ps 1 & 2   are  ordered to  reimburse the I.D.V.  amount a sum of Rs. 4,77,000/- with  interest  @  Rs. 13 % per annum  from the date of  theft of vehicle from   Dt. 21.1.2016  till realization  towards theft of Bolero Pick up  bearing Regd. No.OD-18A-3767 inter alia to pay Rs.2,000/- towards cost of litigation  to the complainant.

The O.P. No. 1  & 2   are  ordered to make compliance the aforesaid Order within  45 days from the  date of  receipt  of the  order  failing which  an interest  @ Rs.18%  would  accrue on the above  amount . from  the date of  default   till  realization.

The O.P. No.3 is  at  liberty  to recover the finance amount  from the complainant  if any , he can realize the same  as per law.

Dictated and corrected by me.       Pronounced on this       27^th.    .   Day of  November,   2018.

 Member.                                                            Member.                                      President