Complaints filed on: 16-11-2022
Disposed on: 26-07-2023
BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, TUMAKURU
DATED THIS THE DAY 26th DAY OF JULY 2023
PRESENT
SMT.G.T.VIJAYALAKSHMI, B.Com., LLM., PRESIDENT
SRI.KUMARA.N, B.Sc. (Agri), LL.B., MBA., MEMBER
SMT.NIVEDITA RAVISH, B.A., L.L.B, LADY MEMBER
CC.No.174/2022
Smt. MANJULA W/o L.Raju,
Aged about 43 years, R/at
Kuruchara Colony, Sapthagiri
Extension, SIRA TOWN,
Sira Taluk, Tumakuru District.
……….Complainant
(By Sri. T.P.Mahesh, Advocate)
V/s
The Branch Manager,
The Claims Manager – Motor Insurance,
M/s ICICI Lombard General Insurance
Company Limited, No.27, S.J.R. Tower,
3rd and 4th Floor, Bannerghatta Main Road,
J.P.nagar, 3rd Phase, Bengaluru-560 078.
……….Opposite Party
(By Sri. H.K.Ramamurthy, Advocate)
:ORDER:
BY SMT.G.T.VIJAYALAKSHMI - PRESIDENT
The complainant alleging deficiency in service against the OP filed this complaint U/s 35 of the C.P. Act with a prayer to direct the OP to pay the claim amount with interest @ 18% PA from the date of issuance of notice till its realization and further prays to direct the OP to pay Rs.4,00,000/- due to deficiency in service, damages, mental shock and agony with 18% interest PA from the date of petition tot till realization.
2. The brief facts of the complaint are as under:-
The complainant is the RC owner of the vehicle Hero HF Deluxe BS4 bike bearing registration No.KA-06-HB-7069 and the same was insured with the OP vide policy No.3005/213114666/00/B00 and valid from 01.01.2021 to 31.12.2021 covering all kind of damages, like theft, fire, accident and etc., The complainant further submitted that on 29.11.2021 at about 6.00 PM, the husband of the complainant with intent to had tea, parked the bike and locked it in front of Jai Hind Hotel, beside HP Petrol Bunk on Hiriyur-Tumakuru Road at Sira Town and when he came back after had a tea, he noticed that the vehicle was not traced, thereafter he made his efforts to secure the said vehicle, but the same was not found, then he gave complaint to Sira police, but due to election, the staff were engaged in election duty, they failed to receive the complaint, but subsequently, the police have registered a case in crime No.41/2022 dated:06.03.2022 for the offence punishable U/s 379 of IPC. It is further submitted that complainant contacted the OP and one of the staff of OP informed the complainant to approach through toll free and as per the advice of toll free, the complainant sent all the details with claim application No.MOT12394991 to the OP. It is further submitted that the police have filed ‘C’ report before the Hon’ble Court on 10.08.2022 and therefore the complainant is entitled to get the policy amount regarding theft, but the OP instead of paying the claim amount, repudiated the claim through letter dated:11.07.2022 with flimsy reasons. Hence, the complainant issued legal notice to the OP to pay the entire claim with interest, but the OP did not comply the same.
3. After receipt of notice, the OP appeared through its counsel and filed the version contending that having received information from the complainant regarding theft of his vehicle bearing No.KA:06:HB:7069 on 24.06.2022 i.e. after lapse of 207 days from the date of theft which was occurred on 29th November 2021 and filed FIR on 6th March 2022 i.e. after lapse of 97 days from the date of theft, hence, the insured has violated the condition No.1 of the insurance policy terms and conditions. It is further submitted that as per condition No.1 of the policy, notice shall be given in writing to the company immediately upon the occurrence of any accidental theft or any damages. But the complainant did not do so. The OP further contended that after verifying the documents and crime records, they came to know that the complainant has clearly violated the policy terms and conditions for delay in intimation and therefore they have rightly repudiated the claim. Hence, there is no deficiency of service on the part of OP. On these among other grounds, it is prayed to dismiss the complaint.
4. The complainant has filed her affidavit evidence. The complainant marked the documents at Ex.C1 to C16. Miss.Ashwini, Legal Manager has filed her evidence by way of affidavit on behalf of OP. The OP marked the documents at Ex.R1 & R2.
5. We have heard the arguments from complainant’s counsel. In spite of sufficient time is granted, the OP did not address the arguments, hence arguments of OP is taken as NIL.
6. On perusal of pleadings and documents produced by the complainant, the points that would arise for our consideration are:
- Whether there is any deficiency in service on the part of OP?
- Whether complainant is entitled for reliefs sought for?
7. Our findings to the aforesaid points are as under:
Point No.1: Partly in the affirmative
Point No.2: As per the final order.
:REASONS:
8. On perusal of pleadings, evidence and documents, the admitted facts between the parties are:
The complainant is the RC owner of the vehicle Hero HF Deluxe BS4 bike bearing registration No.KA-06-HB-7069 and the same was insured with the OP vide policy No.3005/213114666/00/B00 and valid from 01.01.2021 to 31.12.2021.
On 29.11.2021 at about 6.00 PM, the husband of the complainant with intent to had tea, parked the bike and locked it in front of Jai Hind Hotel, beside HP Petrol Bunk on Hiriyur-Tumakuru Road at Sira Town and when he came back after had a tea, he noticed that the vehicle was not traced, thereafter he made his efforts to secure the said vehicle, but the same was not found, then he gave complaint to Sira police, but due to election, the staff were engaged in election duty, they failed to receive the complaint, but subsequently, the police have registered a case in crime No.41/2022 dated:06.03.2022 for the offence punishable U/s 379 of IPC and the police filed “C” report before the court on 10.08.2022.
9. Now the complainant allegation is that the OP is not settling the claim even police filed the “C” report and the valid policy in force.
10. Per-contra, the OP contended that the OP received information from the complainant regarding theft of his vehicle bearing No.KA:06:HB:7069 on 24.06.2022 i.e. after lapse of 207 days from the date of theft which was occurred on 29th November 2021 and filed FIR on 6th March 2022 i.e. after lapse of 97 days from the date of theft, thereby insured has violated the condition No.1 of the insurance policy terms and conditions. As per condition No.1 of the policy, notice shall be given in writing to the company immediately upon the occurrence of any accidental theft or any damages. But the complainant did not do so. The OP further contended that after verifying the documents and crime records, they came to know that the complainant has clearly violated the policy terms and conditions for delay in intimation and therefore they have rightly repudiated the claim.
11. Both the complainant and OP referred the repudiation letter dated:11.07.2022, but not submitted. As per Para-5 of the version, the OP repudiated the claim of the complainant and stated the reasons for repudiation as;
“Condition No.1 of the policy terms and follows “Notice shall be given in writing to the company immediately upon the occurrences of any accidental theft or any damages”.
But the complainant did not do so and there is delay in intimation.
12. No doubt, there is a delay in intimation and the complainant intimated to the police on 06.03.2022 i.e. after lapse of 97 days from the date of theft and 207 days delay in intimation to the insurance company. Therefore, the complainant clearly violated the condition No.1 of the policy.
13. The Hon’ble National Consumer Disputes Redressal Commission in the case between IFFCO TOKIO GENERAL INSURANCE COMPANY LIMITED VS. ANIL 2022(2) CPR 527, had applied the guidelines set-out by the Hon’ble NCDRC, New Delhi in the case between New India Assurance Co., Ltd., Vs. Narayana Prasad Appaprasad Pathak, wherein the Hon’ble NCDRC, New Delhi, has set out the guidelines regarding settling of all non standard claims as under:
Sl.No. | No.Description | Percentage of settlement |
(i) | Under declaration of licensed carrying capacity | Deduct 3 years difference in premium from the amount of claim or deduct 25% of claim amount, whichever is higher |
(ii) | Overloading of vehicles beyond licensed carrying capacity | Pay claims not exceeding 75% of admissible claim. |
(iii) | Any other breach of warranty/condition of policy including limitation as to use | Pay up-to 75% of admissible claim. |
Considering the above guidelines, it is just and proper to direct the OP to settle the claim of the complainant on non standard basis for the violation of condition No.1 of the policy. The ID value of the vehicle as on the date of theft was Rs.48,615-00. Hence, the OP is directed to pay 70% of the ID value i.e. 34,030-00 together with interest @ 8% PA from the date of complaint to till realization. For the act of OP, the complainant compelled to approach this Commission. Hence, OP is liable to pay litigation cost of Rs.10,000-00. Accordingly, we pass the following:-
:ORDER:
The complaint filed by the complainant is allowed in part.
The OP is directed to pay Rs.34,030-00 along with interest @ 8% PA from the date of complaint to till realization to the complainant.
The OP is also directed to pay Rs.10,000/- towards litigation expenses to the complainant.
The OP is further directed to comply the above order within 45 days from the date of receipt/knowledge of the order.
Supply free copy of this order to both parties
