Orissa

Baleshwar

CC/154/2015

Sri Gourahari Dash, aged 46 years - Complainant(s)

Versus

The Branch Manager, ICICI Lombard General Insurance Company Ltd., Balasore - Opp.Party(s)

Sri Bichitra Kumar Nanda & Others

31 May 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BALASORE
AT- COLLECTORATE CAMPUS, P.O, DIST- BALASORE-756001
 
Complaint Case No. CC/154/2015
 
1. Sri Gourahari Dash, aged 46 years
S/o. Sri Padmalochan Dash, At- Pandua, P.O- Darakholi, P.S- Oupada, Dist- Balasore.
Odisha
...........Complainant(s)
Versus
1. The Branch Manager, ICICI Lombard General Insurance Company Ltd., Balasore
Station Road, P.S- Town, P.O/Dist- Balasore.
Odisha
2. The Divisional Manager, ICICI Lombard General Insurance Company Ltd., Cuttack
Shree Kailash Plaza, 1st Floor, Link Road, Cuttack-753012.
Odisha
............Opp.Party(s)
 
BEFORE: 
 HON'BLE MR. SHANTANU KUMAR DASH PRESIDENT
 HON'BLE MR. SARAT CHANDRA PANDA MEMBER
 
For the Complainant:Sri Bichitra Kumar Nanda & Others, Advocate
For the Opp. Party: Sri A.K Panda, Advocate
 Sri A.K Panda, Advocate
Dated : 31 May 2017
Final Order / Judgement

                         The Complainant has filed this case alleging deficiency-in-service by the O.Ps, where O.P No.1 is the Branch Manager, ICICI Lombard General Insurance Company Ltd., Station Road, Balasore and O.P No.2 is the Divisional Manager, ICICI Lombard General Insurance Company Ltd., Shree Kailash Plaza, 1st Floor, Link Road, Cuttack. 

                     1. Succinctly put, the brief facts which are material to the case are that the Complainant, being the owner of Hero Honda Passion Pro Motorcycle bearing Regd. No.OR-01U-7709 was insured with the O.Ps for a period from 17.04.2014 to 16.04.2015. The Complainant has been to Soro fruit market to purchase fruits on 17.08.2014 at about 3 P.M, where the above said vehicle was stolen and his son was kidnapped. The Complainant could not trace out his vehicle despite of several and sincere attempts made by him. Thereafter, the Complainant lodged F.I.R before Soro Police Station on 23.08.2014, after collecting the relevant documents of the vehicle. A case was registered vide Soro P.S Case No.322, dt.23.08.2014 u/s. 363/379/34 corresponding to C.T No.776/2014. The claimant further lodged his claim before the O.Ps claiming damage of his stolen vehicle bearing claim No. MOTO4018243. The Complainant also submitted all necessary documents before the O.Ps in support of his claim. But the O.Ps repudiated the claim on 23.04.2015 on the ground “delay of lodging F.I.R”, even though the delay of lodging F.I.R was properly explained by the Complainant to the O.Ps. Prayer for payment of claim amount as per schedule with interest along with compensation and cost of litigation.

                     2. Written version filed by the O.Ps through their Advocate, where they have denied about maintainability as well as its cause of action. The O.Ps have further submitted that the Complainant intimated on 27.08.2014 to O.P No.1 that his motor cycle bearing Regd. No.OR-01U-7709 has been stolen on 17.08.2014 at about 3 P.M near fruit market, Soro. The O.P No.1 supplied with the claim form to the Complainant with a request to submit the same duly filled in along with copies of relevant documents for further course of action. But, the Complainant submitted the claim form duly filled in along with the copy of documents without copy of F.I.R and final form. And also the Complainant submitted certified copy of F.I.R in connection to P.S Case No.322, dt.23.08.2014 arising out of the alleged theft on 01.01.2015. On receipt of the same, the O.P No.1 submitted the claim form of the Complainant along with the copy of documents to the O.P No.2. On scrutiny of the documents, the O.P No.2 noticed that the above said vehicle alleged to have been theft on 17.08.2014 at about 3 P.M, but F.I.R is lodged after 6 days i.e. on 23.08.2014 at 10 A.M and intimation about loss of vehicle is given to O.P No.1 on 27.08.2014 i.e. after 10 days of alleged theft and there by the Complainant has violated the Condition No.1 of the Policy. Thereafter, the O.P No.2 had written a letter to the Complainant on 18.02.2015 narrating for violation of Condition No.1 of the Policy and reasons for delay in lodging F.I.R and intimation to O.P No.1 with a request to the Complainant to let them know the reasons within 7 days of receipt of this letter. But, the Complainant did not turn up there by the O.P No.2 repudiated the claim of the Complainant and intimated the same to him on 23.04.2015.  

                     3. In view of the above averments of both the Parties, the points for determinations of this case are as follows:-

(i) Whether this Consumer case is maintainable in eye of Law.

(ii) Whether there is a cause of action to file this case.

(iii) Whether the Complainant has reported the theft of the vehicle to the Police and the O.Ps i.e. the Insurer in time.

(iv) Whether there is any justification of repudiation of the claim of Complainant by the O.Ps in the ground of delay in lodging report to the Police and also to the O.Ps- Insurer.

(v) To what relief the Complainant is entitled for ? 

                    4. In view of the above disputes between the Parties, it has been argued on behalf of the Complainant though the Complainant is a bonafide Consumer having valid Policy Certificate, the O.Ps arbitrarily repudiated the claim by taking the plea of delay in lodging F.I.R in the Police Station and delay of intimation about theft of the vehicle to the O.Ps. The Complainant has specifically explained the cause of delay in lodging report to the Police and intimation about theft to the O.Ps both in F.I.R and in the complaint petition. In spite of above facts, in case of theft, delay is not a ground to reject the claim of the Complainant. In support to his arguments, the Ld. Advocate for Complainant relied upon five Authorities reported in 1998(II) OLR (SC)-93 in the case of Spring Meadows Hospital and another (Vrs.) Harjol Ahluwalia through K.S Adluwalia and another, where it has been held by the Hon’ble Supreme Court of India that as the act is a beneficiary liberal, construction is to be made. It is a case of negligence and deficiency on the part of Hospital Authority to a Patient. This Authority deals with the problem, which centres round the medical ethics on behalf of the Hospital Authority and liable to be dismissed against the Insurer. The Authority reported in 2011(4) CPR-502 (NC) in the case of Reliance General Insurance Co. Ltd. (Vrs.) Sri AVVN Ganesh, wherein it has been held by the Hon’ble National Commission, New Delhi that unlike in case of theft of movable insured Property, delay in intimation was not prejudicial to Insurance Company. In that case, death was due to dog bite and repudiation of the claim was in the ground of delay. The Authority reported in 2011(2) CPR-342 (NC) in the case of Niharika Maurya (Vrs.) Chief Manager, New India Assurance Co. and ors., wherein it has been held by the Hon’ble National Commission, New Delhi that breach of terms and conditions of Insurance Policy in case of theft of vehicle is immaterial. In that case, it was theft of a car and the Insurance Company repudiated the claim on the ground that the vehicle was used for commercial purpose in violation of the terms of the Policy and the claim was settled on non-standard basis. The Authority reported in 2010(1) CPR-219 in the case of Kamalabai Prakash Chavan (Vrs.) The Authorised Signatory, ICICI Lombard Insurance Co.  Ltd. and Anr., wherein it has been held by the Hon’ble State Commission, Maharashtra that the claim under Group Personal Accident Insurance Policy could not be repudiated only because it was delayed by 106 days. In that case, a farmer was died in a road accident. The Authority reported in 2008 (O) AIJEL-SC 41344 in the case of National Insurance Company Ltd. (Vrs.) Nitin Khandelwal, wherein it has been held by the Hon’ble Supreme Court of India that in the case of theft of vehicle, the breach of condition is not germane. Further it has been held that the Law seems to be well settled in case of theft of vehicle, nature of use of the vehicle cannot be looked into and the Insurance Company cannot repudiate the claim on that basis. In that case, theft was due to some unknown persons stopped the vehicle, tied the driver and dumped him on the way and snatched away the vehicle from the driver. In that case, Insurance Company repudiated the claim on the ground that the vehicle was insured for personal use, but it was used as a Taxi for carrying passengers. So basing on the Authority, it has been argued on behalf of the Advocate for the Complainant that the O.P-Insurance Company has no right to repudiate the claim of the Complainant and the Complainant is entitled for get relief as prayed for.

                    5. On the other hand, Advocate for O.Ps has argued that the allegation of theft is false and fabricated and there is much more delay in lodging report to both the Police and the Insurer. The incident was held on 17.08.2014 at 3 P.M at Soro market, but in F.I.R, it has been mentioned as at the fruit market near Uttareswar i.e. 1 K.M towards Soro. In the F.I.R, the Complainant has also mentioned that after theft, he went to his house from the place of theft and he was silent till 23.08.2014 by lodging reports, for which the Complainant has not given any scope to the Police to take up effective steps to trace out the vehicle, by which he allowed the culprit to fled away with the vehicle. Even also the Complainant did not intimate to the O.Ps to take steps to get the vehicle traced and to co-ordinate and co-operate the Police to trace the vehicle. As whether any theft has been taken place or not and as such the Complainant has not given any scope to the O.Ps-Insurer to protect their interest and violated the Condition No.1 of the Policy, for which O.Ps have rightly repudiated the claim. The Condition No.1 of the Policy is as follows:- “Notice shall be given in writing to the Company immediately upon the occurrence of any accidental or loss or damage and 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/or 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 injury in respect of any occurrence, which may give rise to a claim under this Policy. In case of theft or other criminal act which may be the subject of a claim under this Policy the insured shall give immediate notice to the Police and co-operate with the Company in securing the conviction of the Offender”. In support of the case, the Ld. Advocate for the O.Ps has relied upon the Authority reported in 2014(1) CPR-427 (NC) in the case of Ramesh Chandra, S/o. Shri Munshi Ram (Vrs.) ICICI Lombard General Insurance Co. Ltd., the Hon’ble National Commission, New Delhi held that where by failing to promptly inform the theft of the Truck to the Police as well as the Insurance Company, the Petitioner failed to take proper care to protect the interest of the respondent Insurance Company, as such, the respondent Insurance Company was justified in repudiating the claim. In that case, it was a theft of Insured vehicle, which was a Truck and delay in lodging report was for 11 days only. There is no specific date mentioned about report to the Insurance Company about the theft. In that Authority, it has been further held that delay obviously had prevented the Insurance Company as also the Police to start timely investigation with a view to locate and recover the Truck. The Advocate for O.Ps also relied upon the Authority reported in 2008 ACJ-2035 in the case of National Insurance Co. Ltd. (Vrs.) Nitin Khandelwal, which was also relied upon by the Advocate for the Complainant.

                    6. So, in the instant case, admittedly the delay in lodging F.I.R is 6 days before Police and delay in submission of report to the O.P No.1 is 10 days. Though Complainant has submitted that delay has been properly explained and the O.Ps have denied to it, but the fact remained that there was theft of vehicle and delay in lodging report to both the Police and the O.Ps- Insurance Company. The facts of the authorities on which the Advocate for Complainant has relied upon are not similar to the present case in hand. On the other hand, in present case, there was theft of vehicle and Condition No.1 of Policy regarding delay in lodging report to both the Police and the Insurance Company has been violated by the Complainant.                                 

                    7. So, now on careful consideration of all the materials available in the case record and on the basis of principle laid down by above authorities as discussed earlier, now this Forum come to the conclusion that the O.Ps have rightly repudiated the claim of the Complainant, for which the Complainant is not entitled for any relief as prayed for in this Forum and accordingly, this Consumer case is liable to be dismissed. Hence, Ordered:-        

                                                     O R D E R

                         The Consumer case is dismissed on contest against the O.Ps, but in the peculiar circumstances without cost.

 
 
[HON'BLE MR. SHANTANU KUMAR DASH]
PRESIDENT
 
[HON'BLE MR. SARAT CHANDRA PANDA]
MEMBER

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