Punjab

Faridkot

CC/15/163

Kamaljit Kaur - Complainant(s)

Versus

Tata Aig General Insurance Co. Ltd. - Opp.Party(s)

Ashok Kumar Monga

29 Jul 2016

ORDER

 DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FARIDKOT

 

Complaint No. :      163

Date of Institution:  20.11.2015

Date of Decision :   29.07.2016

 

Kamaljit Kaur w/o Harneet Singh r/o v. Ghuddu Wala, Tehsil and District Faridkot through her husband and General Attorney Harneet Singh s/o Sh Baljinder Singh s/o Jarnail Singh r/o v. Ghuddu Wala, Tehsil and District Faridkot.

 

...Complainant

Versus

1. Tata AIG General Insurance Co. Ltd, Rub Nagar, G T Road, Gulabi Bagh, Moga through its Incharge/Authorised Official.

2. Tata AIG General Insurance Co. Ltd Branch Office, Jallandhar through its Branch Manager...... (Ops)

    

Complaint under Section 12 of the

Consumer Protection Act, 1986.

 

Quorum: Sh. Ajit Aggarwal, President,

               Sh P Singla, Member.

 

Present: Sh Ashok Monga, Ld Counsel for complainant,

              Sh Neeraj Maheshwary, Ld Counsel for OPs.

 

(Ajit Aggarwal, President)

                                         Complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 against OPs seeking directions to OPs to make payment of insurance claim of Rs.6,00,000/-with interest and for further directing OPs to pay Rs 1,00,000/- as compensation for deficiency in service, harassment, inconvenience, mental agony and Rs.20,000/-as litigation expenses.

2                                    Briefly stated, the case of the complainant is that complainant got insured her vehicle Mohindera & Mohindera Bolero bearing Registration No. PB-04-R-7462 with OPs vide package policy no. WM 12670929 dt 19.02.2014 valid from 19.02.2014 to 18.02.2015 against all types of loss for Rs.6,00,000/-and paid premium of Rs27,485/-. On the intervening night of 11-12.12.2014 a close relative of complainant namely Suba Singh felt some pain in his kidneys and he was taken to Civil Hospital Sadiq at about 12.30 am in the insured vehicle of complainant. At about 4.30 am, when condition of Suba Singh became stable, they came out of hospital to reach home, but they found their car missing. Husband of complainant tried his best to find their car, but they failed as it was stolen by someone. They got registered FIR No. 82 to this effect on 12.12.2014 in Police Station, Sadiq and immediately informed about this theft to OPs. After 4-5 days, representatives of OPs came to complainant and also met said Suba Singh and they also visited the Police Station Sadiq to check and verify regarding lodging of FIR. They also recorded statements of complainant, her husband and said Suba Singh and also made enquiry about this fact from village and hospital. Thereafter, they assured complainant that claim would be paid shortly. Husband of complainant visited the office of OPs many times, but they did not make payment of claim. In last week of July, Op-2 told complainant that claim would be paid on submission of un-traceable report and then, complainant submitted un-traceable report dt 5.08.2015 with OPs, but despite submission of all requisite documents and completion of all formalities, OPs have not made payment of insurance claim. Complainant purchased the said vehicle by taking loan from bank and report regarding theft of said vehicle was also given to bank, but now, bank has filed recovery suit against complainant and guarantor Harneet Singh, which has aggravated the sufferings of complainant. Action of OPs in not making payment of genuine insurance claim of complainant, amounts to deficiency in service and trade mal practice on their part and it has caused harassment and mental agony to complainant for which he has prayed for directions to Ops to pay Rs.100,000/-as compensation and Rs.20,000/-for cost of litigation besides the main relief. Hence, the present complaint.

3                              The counsel for complainant was heard with regard to admission of the complaint and vide order dated 26.11.2015, complaint was admitted and notice was ordered to be issued to the opposite parties.

4                                    On receipt of the notice, the opposite party filed written statement taking preliminary objections that complaint filed by complainant is false and frivolous and it is filed only to injure the goodwill and  reputation of OPs. Present complaint involves complicated questions of law and facts requiring voluminous evidence, which is not possible in summary procedure under the act. Moreover, complainant has concealed the material facts and no cause of action arises against answering OPs and complainant has not complied with the terms and conditions of the insurance policy. It is further contended that complainant has not given any intimation regarding loss of said vehicle and therefore, complaint in hand is premature in nature and is liable to be dismissed. However, on merits, ld counsel for Ops has denied all the allegations levelled by complainant being wrong and incorrect and asserted that there is no deficiency in service on the part of OPs. It is admitted by Ops that said vehicle of complainant was insured with OPs for Rs.6,00,000/-, but it is totally denied that complainant ever informed them about the theft of said vehicle. It is further asserted that there is no document or evidence or document about the alleged story of parking of said vehicle of complainant. It is further averred that no claim was ever intimated by complainant to OPs and by not intimating the Ops, complainant has not only violated the terms and condition of insurance policy but have deprived them of their rights to investigate the voracity of claim and initiate steps towards recovery of vehicle. Conduct of complainant is not only gross negligence but also recklessness. It is further averred that there is no deficiency in service and all the other allegations alongwith allegation regarding relief sought too are refuted with a prayer to dismiss the complaint with costs.

5                                     Parties were given proper opportunities to prove their respective case. The complainant tendered in evidence his affidavit Ex.C-1, and documents Ex C-2 to C-7 and then, closed his evidence.

6                             In order to rebut the evidence of the complainant, the opposite party 1 tendered in evidence, affidavit of Mohd. Azhar Wasi as Ex OP-1 and then, closed the evidence.

7                    The ld Counsel for complainant argued that complainant got insured her vehicle Mohindera & Mohindera Bolero  with OPs vide package policy no. WM 12670929 dt 19.02.2014 valid from 19.02.2014 to 18.02.2015 against all types of risks for Rs.6,00,000/-and paid premium of Rs.27,485/-. On the intervening night of 11-12.12.2014 a close relative of complainant namely Suba Singh felt some pain in his kidneys and he was taken to Civil Hospital Sadiq at about 12.30 am in the vehicle of complainant. At about 4.30 am, when condition of Suba Singh became stable, they came out of hospital to reach home, but they found their car missing. Husband of complainant tried his best to find their car, but they failed as it was stolen by someone. They got registered FIR No. 82 to this effect on 12.12.2014 with Police Station, Sadiq and immediately informed about this theft to OPs. After 4-5 days, representatives of OPs came to complainant and also met said Suba Singh and they also visited the Police Station Sadiq and also recorded statements of complainant, her husband and said Suba Singh and also made enquiry about this fact from village and hospital. They assured complainant that claim would be paid shortly. Husband of complainant visited the office of OPs many times, but they did not make payment of claim. In last week of July, Op-2 told complainant that claim would be paid on submission of un-traceable report and then, complainant submitted un-traceable report dt 5.08.2015 with OPs, but despite submission of all requisite documents and completion of all formalities, OPs have not made payment of genuine insurance claim. It is contended that complainant purchased the said vehicle by taking loan from bank and information regarding theft of said vehicle was also given to bank, but now, bank has filed recovery suit against complainant and guarantor Harneet Singh, which has aggravated the sufferings of complainant. Action of OPs in not making payment of genuine insurance claim of complainant, amounts to deficiency in service. The complainant made many requests to Ops to make payment of insurance claim, but all in vain. All these acts of OPs amount to deficiency in service and trade mal practice on their part. He has prayed for direction to OPs to pay insurance claim of complainant alongwith interest and compensation.

8                               To controvert the arguments of ld counsel for complainant, ld counsel for OPs argued that complaint is false and frivolous and it is filed only to injure the goodwill and  reputation of OPs. It is further averred that complainant has not complied with the terms and conditions of the insurance policy as he has not given any intimation regarding alleged theft and therefore, complaint being premature in nature, is liable to be dismissed. However, it is admitted by that said vehicle of complainant was insured with OPs for Rs.6,00,000/-, but it is totally denied that complainant ever informed them about the theft of said vehicle. It is further asserted that there is no document or evidence about the alleged story of parking of said vehicle of complainant. It is further averred that no claim was ever intimated by complainant to OPs and by not intimating the Ops, complainant has not only violated the terms and condition of insurance policy but have also deprived them of their rights to investigate the veracity of claim and initiate steps towards recovery of vehicle. Conduct of complainant is not only gross negligence but also recklessness. It is further averred that there is no deficiency in service on the part of OPs and prayed for dismissal of complaint with costs.

9                                We have heard the learned counsel for the parties and have very carefully gone through the affidavits and documents on the file.

10                               The case of complainant is that insured vehicle of complainant was stolen during the validity of insurance and due intimation regarding theft was given to Ops and FIR to this effect was also got registered with Police, but despite submission of all requisite documents and completion of all formalities, Ops have not made payment of genuine claim of complainant. In reply, OPs asserted that complainant never informed them about the theft of vehicle and has violated the terms and conditions of insurance policy. Claim of complainant is premature in nature and thus, prayer for its dismissal is made. As per condition no. 1 of the Insurance Policy, the complainant had to give notice in writing to the Insurance Company immediately upon the occurrence of any accidental loss or damages in the event of claim, but in the presence case, the complainant never informed regarding the alleged incident to Ops

11                               The ld Counsel for complainant argued that they immediately informed regarding the theft of the vehicle to Police and Police lodged FIR. The copy of same is Ex C-4 and they immediately on the same day gave information to OPs vide letter Ex C-3. They submitted all the documents for processing of their claim to OPs. Even OPs appointed an Investigator in this case, who recorded the statements of complainant, her husband and other persons of the village and locality and also investigated the matter with Police and the place from where vehicle was stolen. Now, the Ops are intentionally denying this fact only to avoid the liability of indemnifying the complainant regarding his stolen vehicle. If the complainant immediately reported the matter with Police, then there is no reason for him  not to inform the OPs regarding the incident and to claim his genuine insurance claim. Now, the OPs are intentionally denying regarding it. He further argued that if in any case, it is presumed that the complainant did not inform regarding the incident to the Insurance Company on time and in that case also, the OPs can not deny payment of insurance claim to complainant. On this, he put reliance on citation 2016 (1) CLT 539 titled as Bajaj Allianz General Insurance Company Ltd Vs Abdul Sattar & anr wherein our Hon’ble National Commission has observed that in order to appreciate the contention of the petitioner, it would be useful to have a look on relevant condition no. 1 of the insurance policy, which is reproduced as under “1. Notice shall be given in writing to the company immediately upon the occurrence of any accidental loss or damage 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 /process or copy thereof shall be forwarded to the company immediately on receipt by the insured. Notice shall also be given in writing to the company immediately the insured shall have knowledge of any impending prosecution, inquest or fatal inquiry in respect of any occurrence which may give rise to a claim under this policy. In case of theft or criminal act which may be the subject of a claim under this policy the insured shall give immediate notice to the policy and co-operate with the company in securing the conviction of the offender”. On reading the above, it is clear that in the event of the theft of the vehicle, only requirement on the part of the insured was to intimate the policy immediately and co-operate in securing the conviction of the offender. He submitted that as per the observations of Hon’ble National Commission in case of theft, the only requirement on the part of complainant was to intimate the Police immediately and to co-operate with the Police in securing the conviction of the offender and complainant duly complied with this condition and immediately reported the matter with Police. Therefore, Insurance Company can not repudiate the claim of complainant.

12                         From the above discussion, we are of the considered opinion that complainant immediately on the same day reported the matter with Police and lodged FIR with Police and also intimated Ops vide letter Ex C-3 and the OPs can not deny the payment of insurance claim of vehicle of the complainant on the ground that there is violation of the terms and conditions of the Policy. Act of OPs in denying the payment of claim amounts to deficiency in service and trade mal practice on their part. We are  fully convinced with the arguments, evidence and case law produced by complainant. Hence, complaint in hand is hereby allowed. OPs are ordered to pay Rs.6,00,000/- (six lacs) the insured value of vehicle alongwith interest at the rate of 9% per anum from the date of filing the present complaint before this Forum i.e 20.11.2015 till final realization of entire amount. Opposite parties are further directed to pay Rs.15,000/- as compensation to complainant on account of                                                                  mental agony and harassment suffered by him besides Rs.3,000/-as litigation expenses. Compliance of this order be made within one month of receipt of the copy of the order, failing which complainant shall be entitled to proceed under Section 25 and 27 of the Consumer Protection Act. Copy of order be given to parties free of cost under rules. File be consigned to record room.

Announced in Open Forum

Dated : 29.07.2016                 

                                        Member                             President

                    (P Singla)                                (Ajit Aggarwal)