DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, NUH

Consumer Complaint No. 08 of 2017

                    Date of Institution:      19.05.2017

                    Date of Decision   : 30.08.2019

Suban Khan son of Shri Mamraj, R/o Raipuri Tehsil Sohna District Gurgaon 

                             .. Complainant.

                    Versus

Tata AIG General Insurance Company Ltd., 2nd Floor, SCO-6, SCO Complex, Near Payal Cinema, Sector-14, Gurgaon District Gurgaon through its Branch Manager. 

                                        ..Respondent.

COMPLAINT UNDER SECTION 12 OF CONSUMER PROTECTION ACT

BEFORE:        Rajbir Singh Dahiya        :    PRESIDENT

             Urmil Beniwal            :    MEMBER

PRESENT:    Mr. M.S. Khan, Adv. for complainant.

    Sh. S.K. Verma, counsel for the respondent. 

ORDER:

RAJBIR SINGH DAHIYA, PRESIDENT:

1.         Brief facts of the complaint are that the complainant is registered owner of truck bearing Registration No. HR-55A-1303 insured by the respondent for the period of one year i.e. 20.03.2014 to 19.03.2015. That on 26.02.2015 at about 7:00 PM., the driver Mohd. Tarif was going to Biwan from Rajpuri for loading the truck. At about 9:00/9:15 P.M.. when the driver reached near village Kankarkhedi, the driver parked the truck after loading the same, he went to village Kankarkheri for getting the payment from Hakam S/o Abdul Rehman and the driver ate food in the house of Hakam and rested there for two hours. At about 10:30 P.M. the driver came at the spot and he did not find the truck. After that the driver informed the complainant and the complainant and driver searched the truck here and there but the vehicle was not found and the driver moved an application on the same day to the local police station and FIR No. 46 dated 13.03.2015 u/s 379 of IPC was lodged in P.S. Nagina on the same day regarding this incident. The original document were also stolen with the vehicle. That complainant also informed to the insurance company on same day and the complainant lodged claim with the insurance company regarding theft of vehicle. The complainant also fulfilled all the requirement and also supplied relevant document for getting the claim on account of theft of his vehicle. The officials of the insurance company gave only oral assurance to release the claim in favour of the complainant shortly. Tat investigator of the respondent company also visited at the spot. After this complainant was rest assured by the investigator of the insurance company to get his O.D claim released at the earliest.

2.         That thereafter, the complainant many times requested to the respondent to release the claim but the respondent kept on evading the matter on the false pretext and a week ago orally refused to release the claim without assigning any reason for which they have no right to do so. Hence, this complaint and the complainant prayed to direct the respondent to pay Rs. 14,00,000/- (IDV value) alongwith lost and interest @ 18% per annum from the date of theft till realization.

3.        After registration and admission of the complaint, notice was issued to the respondent, the respondent appeared and filed written statement taking the preliminary objections that the complainant has neither any legal right nor any cause of action to file and maintain the present complaint. The complainant is hopelessly time barred. That the complainant himself has not complied with the specific agreed terms and conditions of the insurance policy consequently, his claim was repudiated and he was duly informed vide letter dated 19.05.2016. Therefore, the complainant has no cause of action to file the present complaint. That the theft took place on 26.02.2015 and the police informed and FIR was lodged only on 13.03.2015 after a delay of 15 days, the insurance company was also informed on 17.03.2015 after a delay of 19 days and the condition no. 1 and 8 of the insurance contract was clearly violated.

4.         That without prejudice after receiving the intimation on 17.03.2015 an independent investigator M/s Vikas Kumar and Associates were appointed for investigation of the case by the respondent. He contacted the insured and requested him to supply the requisite documents including the original keys of the vehicle and arrange meeting with the driver Mohd. Tarif to verify the alleged theft incident and the alleged place of theft. But, in spite of assurance and promise, no meeting was arranged till the last. The complainant himself even could identify the alleged place of alleged theft. The said investigator besides personal visits and telephonic conversations on different occasions also wrote three registered letters dated 20.5.2015, 06.07.2015 and 21.12.2015 to the complainant/insured, seeking clarification about the delay in reporting the matter to the police and the company and regarding the other material aspects of the case as is clear from the contents of the said letters and the report of the said investigator. The complainant, even did not submit the complete requisite documents nor submits the original keys of the vehicle. Ultimately, the said investigator submitted his detail report dated 10.03.2016. As per the case of the complainant it is quite clear from the contents of FIR, the vehicle was left un-attended, un-guarded, without any proper safeguard, in open, on a road, even without lock, on a road in night hours at 9:00 PM, during winter season, for more than two hours. From all these facts, it is crystal clear that the complainant had not properly safeguarded the vehicle as he was required to do under the terms and conditions of the subject insurance policy. Thus, the complainant/insured had also violated the Claim Form Declaration and policy condition No. 5 of the Insurance Policy. In the end he prayed that the complaint of the complainant my kindly be dismissed with costs.

5.        Complainant closed the evidence after tendering the affidavit Ex. CW1/A and documents Ex. C1 to Ex. C14. 

6.        Learned counsel for the respondents closed the evidence after tendering the two affidavits Ex. RW1/1 & Ex. RW2/1 & documents Annexure-1 to Annexure-10.

7.        Arguments heard and file perused. 

8.         After going through the evidence of both the parties, their arguments and citations, the opposite party has taken mainly following objections-

        Delay in  lodging FIR and 

        Delay in intimation to the opposite party.

        It is established on the court file that driver of the vehicle Mohd. Tarif immediately informed the complainant about theft and both driver and complainant after trying their best to trace the vehicle nearby places of occurrence on the intervening night of 26.02.2015/27.02.2015 approached the nearest police station and informed the local police about the incident. Thereafter, when the local police did not register the case the driver approached the Senior Police Officers, Mewat and also given a application to SP Mewat for registration of FIR which is placed on the file Ex. C-5 FIR no. 46 dated 13.03.2015 u/s 379 of IPC lodged in P.S. Nagina. Untrace report of the same is Ex. C3 dated 28.09.2015. So, it is evidently clear that there is no negligence or carelessness on the part of the complainant in informing the local police. The complainant was running after the local police officials for registration of his case which consumed 15-16 days. So, it cannot be said that there was any delay on the part of the complainant in lodging the FIR and information to the opposite party.

        After going through the citations produced by both the parties, we have concluded that the citation of Hon’ble Supreme Court and Hon’ble Punjab & Haryana High Court have to be looked into the main citation on behalf of opposite party cited in Oriental Insurance Co. Ltd. Vs. Parvesh Chander Chadha, Civil Appeal No. 6739/2010 decided on 17.8.2010, wherein the stand of the insurance company of rejecting the claim of insured was upheld due to the reason of informing the insurance company after about 4 months. This authority would have been sufficient to dismiss the claim of the complainant in the present complaint, had there been no circular issued by “Insurance Regulatory and Development Authority” (IRDA for short) to all insurance companies including the opposite party dated 20.09.2011 after the present authority of Hon’ble Supreme Court. We reproduce below the relevant part of the circular which is binding on the opposite party insurance company as well, reads as under:-     

        “The Authority has been receiving several complaints that claims are being rejected on the ground of delayed submission of intimation and documents.

        The current contractual obligation imposing the condition that the claims shall be intimated to the insurer with the prescribed documents within a specified number of days is necessary for insurers for effecting various post claim activities like investigation, loss assessment, provisioning,. Claim settlement etc. However, this condition should not prevent settlement of genuine claims, particularly when there is delay in intimation or in submission of documents due to unavoidable circumstances.

        The insurers’ decision to reject a claim shall be based on sound logic and valid grounds. It may be noted that such limitation clause does not work in isolation and is not absolute. One needs to see the merits and good spirit of the clause, without compromising on bad claims. Rejection of claims on purely technical grounds in a mechanical fashion will result in policyholders losing confidence in the insurance industry, giving rise to excessive litigation.

        Therefore, it is advised that all insurers need to develop a sound mechanism of their own to handle such claims with utmost care and caution. It is also advised that the insurers must not repudiate such claims unless and until the reasons of delay are specifically ascertained recorded and the insurers should satisfy themselves that the delayed claims would have otherwise been rejected even if reported in time.

        The insurers are advised to incorporate additional wordings in the policy documents, suitably enunciating insurers’ stand to condone delay on merit for delayed claims where the delay is proved to be for reasons beyond the control of the insured.”

        And it clear the confusion regarding objection of the opposite party of delayed intimation.

9.        Though, no concrete proof of delayed intimation has been placed on record by O.P. to disprove the sworn statement of the complainant regarding intimation of theft immediately. However, even for the sake of arguments we persure that there is delay in intimation by 15-16 days, this objection cannot come to the rescue of opposite party, in view of the judgment of Hon’ble Punjab & Haryana High Court in CWP No. 21383 of 2016 decided on 09.12.2016 wherein above stated circular of IRDA of 20.09.2011 is incorporated, so, judgment of Hon’ble Supreme Court in Oriental Insurance Co. Ltd. Vs. Parvesh Chander Chadha, Civil Appeal No. 6739/2010 decided on 17.8.2010, is no help after issuance of circular by IRDA on 20.09.2011. This judgment of Hon’ble Apex Court has also been discussed in this judgment of Hon’ble High Court.

10.        In view of the above discussion, the complaint is accepted and the opposite party is directed to pay Rs. 14,00,000/- (IDV Value of the vehicle) alongwith interest @ 9% per annum w.e.f. 19.05.2017 till its realization and pay Rs. 5000/- harassment and litigation expenses within 30 days after receipt of this order. Copy of this order be given to the parties free of costs and file be consigned to the records.    

Announced on: 30.08.2019            (Rajbir SINGH Dahiya)

                            President

District Consumer Disputes Redressal Forum, Nuh.

(Urmil Beniwal)

                             Member

District Consumer Disputes Redressal Forum, Nuh