Haryana

Bhiwani

CC/75/2022

Rohit Raheja Mobile - Complainant(s)

Versus

Tata Aig - Opp.Party(s)

Ravi Verma

21 May 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSASL COMMISSION, BHIWANI.

                                                                   Complaint Case No. : 75 of 2022

                                                                   Date of Institution    : 11.04.2022

                                                                   Date of decision:      : 21.05.2024

 

Rohit Raheja, son of Sh. Laxmi Narain, Near Luxmi Bikaner Misthan Bhandar, Hansi Gate, Bhiwani 127021.

                                                            ...Complainant. 

 

                                                    Versus.

1. Manager, Tata AIG General Insurance Co. Ltd., Unit Nos. 810-816, 8^th Floor, World Trade Tower, Plot NO.C001, Sector 16, Noida-201301, U.P.

 

2. Er. Ashish Bansal/Manager, T-three Insurance surveyor and Loss Assessor Private Limited, 78, Sukhdham Apartment, Sector-9, Rohini, Delhi-110085.

 

3. MD/GM, Tata AIG General Insurance Co. Ltd., Registered Office: Peninsula Business Park, Tower A, 15^th Floor, G.K. Marg, Lower Parel, Mumbai-400013, Maharashtra.

 

4. Manager, Tata AIG General Insurance Co. Ltd., all rights reserved.  Registered Office: Peninsula Business Park, Tower A, 15^th Floor, Ganpatrao Kadam Marg, Off Senapati Bapat Marg, Lower Parel, Mumbai-400013.

 

5. Insurance Ombudsman Office, SCO No.101-103, 2^nd Floor, Batra Building, Sector-17D, Chandigarh-160017.

 

                                                            ...Opposite parties.

 

COMPLAINT U/S 35 OF CONSUMER PROTECTION ACT, 2019.

Before: -       Mrs. Saroj Bala Bohra, Presiding Member.

                    Ms. Shashi Kiran Panwar, Member.

Present:        Sh. Anirudh, Advocate for complainant.

                    Sh. R.K. Verma, Advocate for OPs No.1 & 4.

                    OPs No.2 & 3 exparte vide order dated 22.08.2022.

                    OP No.5 given up vide statement dated 02.05.2022.

  

                                                  ORDER

 

SAROJ BALA BOHRA, PRESIDING MEMBER:

1.                 Brief facts of this case are that complainant got insured his shop and its stock viz. mobile phones, cash, mobile accessory etc. from OP insurance company.  It is alleged that in the morning of 06.09.2020, he came to know that there was a theft in his shop. Police was informed, FIR No.0268 of 2020 was registered but untraced report was submitted by the police.  Complainant has alleged that there was loss of Rs.12,72,292/-. Complainant has submitted that despite lodging claim the OP insurance company annexing all relevant document, the OP has not release the claimed amount. As per complainant, the matter was also reported to the Insurance Ombudsman but of no avail.  Hence, the present complaint has been preferred by complainant alleging deficiency in service resulting into monetary loss as well as mental and physical harassment. In the end, prayer has been made to direct the OPs to pay the claim amount of Rs.12,72,292/- to the complainant alongwith interest, further to pay Rs.2.00 lac as compensation for harassment besides litigation expenses. Any other relief to which this Commission deems fit has also been sought.

2.                 Upon notice, OPs No.1 & 4 appeared through counsel and filed written statement raising preliminary objections qua maintainability of complaint, locus standi, jurisdiction and suppression of material facts.  On merits, it is admitted that stock of shop of complainant was insured subject to certain terms and conditions for a period from 18.10.2019 to 17.10.2020 for an IDV of Rs.32,00,000/-. Out of which Rs.30.00 lac for stock and Rs.2.00 lac for fixture and furniture etc.  It is submitted that alleged theft occurred on 06.09.2020 but intimation was given to the OP on 08.09.2020.  However, surveyor was appointed who had sent letters/mails to insured to submit the required documents and to provide the proof of blockage of IMEI number of the stolen mobiles with respective service providers but complainant has not submitted required documents and queries to process the claim.  Hence, the claim of complainant was closed as no claim. OP denied the alleged loss of Rs.12,72,292/-. In the end, denied for any deficiency in service and prayed for dismissal of complaint with  costs.

3.                 Ld. counsel for complainant tendered in evidence, documents Annexure C-1 to Annexure C-8 and closed the evidence.

4.                 On the other side, Ld. Counsel for OPs No.1 & 4 tendered in evidence affidavit of Sh. Amit Chawla, DVP, Legal as Ex. RW1/A alongwith documents Ex. R-1  & Ex. R-2 and closed the evidence.

5.                 We have heard learned counsels for the contesting parties and perused the record carefully.

6.                 Admittedly, the claim of complainant was repudiated by OP insurance company for non-submission of requisite documents. It is also admitted that the IDV of the insured stocks was Rs.32,00,000/- and that theft occurred during the subsistence of the insurance policy.  

7.              Learned counsel for complainant has argued that the OP insurance company has arbitrarily and illegally rejected the claim of complainant whereas complainant is fully entitled to the loss occurred to him in the occurrence.

8.              On the other side, learned counsel for OP has argued that due to non-submission of necessary documents for processing of claim by complainant despite repeated reminder, claim of complainant was repudiated. The counsel has further argued that there is delay of two days in intimation to the OP insurance company about theft of the stocks in the shop.  As such, it is argued that the claim of complainant was rightly repudiated.

9.                 On perusing the evidence produced on record, we have observed that it is not a dispute that on the day of theft, the stock in the shop was under insurance cover given by OP.  It is further observed that during the course of investigation by police, the stock items could not traced out and police submitted untraced report which was accepted by the Court vide order dated 11.08.2021 (Annexure C-6.  It is worthwhile to mention here that the documents so required by OP before repudiation of the claim are annexed with this case file. Further, the OP never seek assistance of the Commission to get the requisite documents from complainant during course of the proceedings so this act & conduct of OP goes against it. The next plea of OP is that there was delay in intimation the OP insurance company as well as to the police.  In this regard, learned counsel for complainant has placed reliance on case law delivered by Hon’ble Supreme Court of India in Civil Appeal No.653 of 2020 titled Gurshinder Singh Vs. Shri Ram General Insurance Co. Ltd. &Anr. decided on 24.01.2020 wherein it has been observed that ‘Delay in intimating the insurance company about occurrence of theft no ground to deny claim.’  We have carefully gone through the surveyor’s report (Annexure R-1) and observed that it is not a complete piece of investigation but is on the basis of surmises and conjectures.  Thus we are not inclined to go with it.  It is worthwhile to mention here that the Hon’ble Supreme Court of India in Civil Appeal No.3253 of 2002 case titled New India Assurance Company Ltd. Vs. Pradeep Kumar  decided on 09.04.2009

10.               After hearing rival contentions of learned counsels for the contesting parties and going through the entire evidence produced on record including case laws, we have come to conclusion that as per FIR and details of loss (Annexure C-6) which corroborated with the final survey report (Annexure R-1) establish that complainant has suffered loss of Rs.12,72,292/- in the alleged theft of insured stock. As such, the complainant being owner of the insured stock is entitled to the said amount from OP insurance company. It is further observed that repudiation of the claim by OP insurance company was not reasonable and justified in the circumstances of the present case. This conduct of OPs must have caused mental and physical harassment to the complainant besides monetary loss. Hence, the complainant is also entitled to compensation for harassment. Accordingly the complaint is allowed and OPs No.1,3, & 4, jointly and severally,  are directed to comply with the following directions within 40 days from the communication of this order:-

(i)       To pay a sum of Rs.12,72,292/- (Rs. Twelve lac seventy two thousand two hundred ninety two) to the complainant alongwith simple interest @ 9% per annum from the date of institution of complaint till its realization subject to formalities, if any, in favour of OP insurance company by the complainant within 15 days from the date of communication of this order.

(ii)      Also to pay a sum of Rs.10,000/- (Rs. Ten thousand) on account of harassment  caused to the complainant at the hands of OPs.

(iii)     Also to pay a sum of Rs.11000/- (Rs. Eleven thousand five hundred) on account of litigation expenses.

                    In case of default, all the aforementioned awarded amounts shall attract simple interest @ 12% per annum for the period of default.  If this order is not complied with, then the complainant shall be entitled to the execution petition under section 71 of Consumer Protection Act, 2019 and in that eventuality, the opposite party may also be liable for prosecution under Section 72 of the said Act which envisages punishment of imprisonment, which may extend to three years or fine upto rupees one lac or with both.  Copies of this order be sent to the parties concerned, free of costs.  File be consigned to the record room after due compliance. 

Announced.

Dated:21.05.2024.