Haryana

Karnal

CC/561/2019

Virender Sharma - Complainant(s)

Versus

SBI General Insurance Company Limited - Opp.Party(s)

Surjeet Chauhan

01 Dec 2021

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL  COMMISSION, KARNAL.

 

                                                        Complaint No. 561 of 2019

                                                        Date of instt. 30.08.2019

                                                        Date of Decision: 01.12.2021.

 

Virender Sharma son of Shri Ram Pushotam Sharma, resident of House no.1556, Shivaji Colony, Hansi Road, Karnal.

 

                                                 …….Complainant.

                                      Versus

 

SBI General Insurance Company Limited, Old Mughal Canal, Karnal through its Branch Manager.

 

                                                                      …..Opposite Party.

 

Complaint Under section 12 of the Consumer Protection Act, 1986 as amended Under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.       

      Sh. Vineet Kaushik…….Member

 

 Argued by: Shri Surjeet Chauhan, counsel for complainant.

Shri Naveen Khetarpal, counsel for OP.

 

                    (Jaswant Singh President)

ORDER:

 

                The complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 as after amendment Under Section 35 of Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that complainant got insured his Honda City car bearing registration no.HR-41G-4615 with the OP. Unfortunately, the said vehicle was theft by someone and in this regard an FIR bearing no.0165 dated 09.02.2019 was got registered by the complainant at Police Station, Karnal. After the theft of the vehicle, complainant immediately informed the OP. Thereafter, OP demanded some documents i.e. Registration Certificate, Insurance Policy, driving licence of the complainant, First Information Report, cancelled cheque, Form no.28,29,30, KYC, statement etc. and accordingly the complainant had submitted all the relevant documents with the OP and the surveyor also. Thereafter, complainant visited the office of OP several times and requested for settlement of the claim but OP did not pay any heed to the request of complainant and lingered the matter on one pretext or the other. Then complainant sent a legal notice dated 31.07.2019 to the OP for settlement of the claim but it also did not yield any result and lastly OP has sent no claim (claim closure) letter to the complainant. Due to this act and conduct of OP complainant suffered great mental pain and agony, harassment as well as financial loss. Hence, this complaint.

2.             On notice, OP appeared and filed written version raising preliminary objections with regard to jurisdiction; estoppal; cause of action; deficiency in service and concealment of true and material facts. On merits, it is pleaded that on receiving the intimation from insured/owner of the vehicle in question, OP appointed an investigator to investigate the matter and the investigator vide letter dated 20.03.2019 requested the insured on behalf of OP to provide 7 following documents:-

1. Copy of previous year insurance policy.

2. Same day receiving intimation letter from police station.

3. Final untraced report issued from Court.

4. User statement about the incidence alongwith his passport photo and DL & UID Card.

5.  All Original Key of the Insured Vehicle.

6.  Second hand purchased records (Sale/Purchase records)

7.  Last Service bill of the insured vehicle.

 

But complainant has not complied the same in totally. Thereafter, 1^st reminder dated 25.03.2019 and final reminder dated 28.03.2019 was sent to insured for providing requisite documents as well as information but complainant did not provide the same, perforce investigator submitted his report dated 30.03.2019. OP also sent letters dated 17.04.2019, 02.05.2019, 16.05.2019, 06.06.2019, 19.06.2019 and letter dated 29.06.2019 to insured to provide requisite documents and information but complainant neither replied the said letter nor provided requisition documents. Thereafter, OP close the claim of complainant, vide Closure Letter dated 02.08.2019, which was also sent to complainant. Claim of the complainant has been closed by OP as complainant has failed to provide requisition documents for processing the claim and verify the facts.

3.             Further, it is pleaded that there is delay in lodging of one month and eight days in intimation to company, hence, the delay in intimation to company has prejudiced possibility of recovery of the vehicle. This constitute serious breach of terms and conditions of the insurance policy, which states that notice shall be given in writing to the company immediately upon occurrence of any loss and in the event of any claim and thereafter insured shall give all such information and assistance as the company shall require. Failure of the complainant to intimate the company immediately is valid reason for repudiation of the claim of the complainant by the company, thus the claim of the complainant is not maintainable, as per terms of the policy, as OP has been deprived of its valuable right to get the investigation immediately. There is no deficiency in service on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

4.             Parties then led their respective evidence.

5.             Complainant tendered into evidence his affidavit Ex.C1, legal notice Ex.C2, registered post slip Ex.C3 to Ex.C5, copy of Aadhar card of complainant Ex.C6, driving licence of complainant Ex.C7, driving licence of Vijay Sharma Ex.C8, PAN card of complainant Ex.C9, copy of R.C. Ex.C10, postal receipt Ex.C11, postal receipt of legal notice Ex.C12, insurance policy Ex.C13, copy of FIR Ex.C14, copy of court order dated 11.1.2021 Ex.C15, copy of police reply dated 11.1.2021 Ex.C16, R.C. cancellation (black list) Ex.C17, document regarding transfer of ownership of vehicle Ex.C18, form no.29,30,26 (three set) Ex.C19 and closed the evidence on 03.03.2021 by suffering separate statement.

6.             On the other hand, OP tendered into evidence affidavit of Balauadra Khatua Ex.RW1/A, affidavit of Jitendra Dhabhai Deputy Manager Ex.RW2/A, letter dated 20.03.2019 sent by Investigator to insured Ex.R1, letter to insured dated 25.03.2019 Ex.R2, letter dated 28.03.2019 Ex.R3, investigation report Ex.R4, letters to insured dated 17.04.2019, 02.05.2019, 16.05.2019, 06.06.2019, 19.06.2019 and  29.06.2019 Ex.R5 to Ex.R10, claim form Ex.R11, terms and conditions of the insurance policy Ex.R12 and closed the evidence on 28.10.2021 by suffering separate statement.

6.             We have heard the learned counsel for the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for the complainant, while reiterating the contents of the complaint, has vehemently argued that during subsistence of insurance policy, the vehicle of the complainant has been stolen by some unknown person. Information regarding theft of the vehicle was given to OP. OP appointed an investigator for investigation of the matter. The investigator demanded relevant documents from complainant, complainant submitted all the required documents with the OP. Thereafter, complainant requested the OP for releasing of his genuine claim regarding the vehicle in question but OP did not pay any heed to the request of complainant. Hence, prayed for allowing the complaint with compensation and litigation expenses etc.

8.             Per contra, learned counsel for the OP, while reiterating the contents of the written version, has vehemently argued that on receiving the intimation regarding the alleged accident, OP appointed an investigator for investigation of the matter.  After the investigation, the investigator of the OP issued so many letters to complainant vide which they demanded certain documents but complainant did not cooperate with the OP and failed to submit the documents as demanded by the OP. Hence, the claim of the complainant had been closed due to non-compliance of documents. He further argued that there is delay in intimation to the OP regarding the theft of the vehicle in question.  Hence, prayed for dismissal of complaint with costs.

9.             Admittedly, the vehicle in question was stolen during the subsistence of insurance policy. Intimation was given to the OP and matter was got investigated by the OP. The claim of the complainant has been closed by the OP, vide letter Ex.R11 dated 02.08.2019 due to non-submission of the documents as required by the OP.

10.           The OP has taken a plea that there is delay in intimation regarding theft of the vehicle in question by the complainant. In the present case vehicle in question was stolen on 08.02.2019 and complainant gave the intimation to the police on the next day and lodged the FIR on the very next day i.e.09.02.2019 . Hence, there is no delay on the part of the complainant for lodging the FIR. The plea taken by the OP that there is delay in intimation regarding theft of the vehicle in question by the complainant has no force. In this regard we have placed reliance upon the case titled as Om Parkash Versus Reliance General Insurance and anr. in Civil Appeal no.15611 of 2017 decided on 4.10.2017 whereby Hon’ble Supreme Court of India held in para no.11 of the said judgment, that it is a common knowledge that a person who has lost his vehicle may not straightway go to the Insurance Company to claim compensation. At first, he will make efforts to trace the vehicle. It is true that the owner has to intimate the insurer immediately after the theft of the vehicle. However, this condition should not bar settlement of genuine claims particularly when the delay in intimation or submission of documents is due to unavoidable circumstances. 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 holder in the insurance industry. If the reason for delay in making a claim is satisfactory explained, such a claim cannot be rejected on the ground of delay. We also placed reliance upon the judgment in case titled as Gurshinder Singh Versus Shri Ram General Insurance Co. in Civil Appeal no.653 of 2020 decided on 24.01.2020 wherein Hon’ble Supreme Court in para no.20 of the said judgment has held that when an insured has lodged the FIR immediately after the theft of a vehicle occurred and when the police after investigation have lodged a final report after the vehicle was not traced and when the surveyors/investigators appointed by the insurance company have found the claim of the theft to be genuine, then mere delay in intimating the insurance company about the occurrence of the theft cannot be a ground to deny the claim of the insured.  

11.           The main plea taken by the OP is that, the complainant had not submitted the requisite documents with the OP as demanded vide letters dated 20.03.2019 Ex.R1, 25.03.2019 Ex.R2 and 28.03.2019 Ex.R3 written by the investigator to insured, vide which investigator demanded copy of previous year insurance policy; Same day receiving intimation letter from police station; Final untraced report issued from Court; User statement about the incidence alongwith his passport photo and DL & UID Card; All Original Key of the Insured Vehicle; Second hand purchased records (Sale/Purchase records) and Last Service bill of the insured vehicle. Thereafter, OP wrote many letters of different dates i.e. 17.04.2019, 02.05.2019, 16.05.2019, 06.06.2019, 19.06.2019 and 29.06.2019  to the complainant requesting him to provide original RC, letter to the concerned Police Station about original papers (if lost) of the vehicle in FIR/FR and provide us the copy of the same alongwith acknowledgement slip, all original keys, second hand purchase bill, previous insurance policy, required clarification on delay in claim intimation to the insurance company, last user statement with ID proof, transfer form 26, 29, 30 (3-3) copies, 28 (4 copies) with signed by insured, name printed cancel cheque or passbook copy to process claim via NEFT, bank certificate for confirmation of bank details with Signature attestation from Bank Branch Manager, CKYC Form duly filled and signed by insured, letter of subrogation, letter of indemnity and discharge voucher. Abovesaid letters have been sent by the OP through registered AD, which has been proved from the postal receipt affixed on the said letters. Despite repeated requests, complainant did not co-operate the OPs. As per the above letters complainant failed to submit the documents as required by the OP. As per the version of the complainant he supplied all the required documents to the OPs but in this regard complainant has not placed on record any document/receipt vide which he submitted the documents with the OP. Complainant is an Advocate by profession. Since when complainant submitted the documents with the OP then why he had not receive the receipt from the OP.  So, the complainant has failed to rebut the abovesaid letters by leading any cogent and convincing evidence. Hence, it appears that complainant has failed to fulfill the formalities mentioned in the abovesaid letters .The claim of the complainant has not been repudiated by the OP and the same has been closed by the OP on the abovesaid ground. Hence, we are of the considered view that, at the stage, the complaint of complainant is pre-mature and OP is not deficient in closing the claim of the complainant.

12.            In view of the above discussion, the present complaint is disposed of with the direction to the complainant to fulfill the formalities as mentioned in the letters Ex.R1 to Ex.R10, and after completion of all the formalities, OP is hereby directed to settle the claim of the complainant, within 30 days from completion of the formalities. No order as to costs. This order shall be complied with accordingly. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:01.12.2021 

                                                                       

                                                                President,

                                                    District Consumer Disputes

                                                    Redressal Commission, Karnal.

 

 

 (Vineet Kaushik)      

     Member