Repudiation of Insurance claim for a stolen vehicle by the OP has irked the policyholder, herein the petitioner i.e. complainant to lodge this complaint for redressal u/s 12 of the C.P. Act, 1986.
The complaint in brief goes that the complainant had a commercial vehicle (Truck) No.WB73-D/0552, which was stolen on in between 30.9.2015 to 1.10.2015 at about 7:00 pm – 6:00 am from Gangarampur P.S. area. The said stolen vehicle has package policy with the OP vide No.150704/31/15/6300001754 and it was valid for the period from 4.7.2015 to 3.7.2016. The vehicle was stolen in the absence of the driver Swapan Roy, who kept the vehicle on road side near Bhowmick Garage under Gangarampur P.S. in the evening and left for home 1½ km far from Bhowmick Garage. On the next morning i.e. 1.10.2015 he did not find the vehicle in the place and raised hue and cry and informed the owner of the vehicle. The matter of theft as the complaint was lodged with Gangarampur in the morning on 1.10.2015, but the officer on duty at the P.S. though kept it but asked to enquire into the fact and then it would be recorded as a G.D.E. On 4.10.2015 the officer on duty at the P.S. gave a receipt of a letter dt. 4.10.2015 though the complaint was lodged on 1.10.2015. The complainant in her averment as stated that she brought it to the knowledge of the OP about theft on 1.10.2015 verbally and on receipt of the copy of G.D.E. from the PS dt. 4.10.2015. She in writing brought to the knowledge of the OP on 5.10.2015 with all necessary documents including the copy of G.D.E. bearing No. 336/15 dt. 4.10.2015 u/s 379 IPC. But the OP has sent a letter of repudiation on ground of violation of policy condition 1 & 5 of the said policy. The complainant has prayed for her claim amount of Rs.4 lakh, Rs.10,000/- as compensation and Rs.5,000/- as litigation cost.
The OP in his written version that repudiation was made for negligence of taking care of the vehicle properly as the driver kept the vehicle on National Highway and left the vehicle for whole night. It is against the law and terms & conditions of the insurance. The petitioner’s statement that the matter of theft was informed the Gangarampur P.S. on 1.10.2015 is false as the G.D.E. entry made by the P.S. has shown in the complaint as G.D.E. No.336/15 dt. 4.10.2015. This is the clear violation of the terms & conditions of the policy condition of Sl. No.4 (a) of the policy. So, the repudiation is not illegal and there is no deficiency in service on the part of the OP. The OP has prayed for rejection of the instant case.
On argument the Ld. Lawyer appearing for the complainant has filed a carbon copy of the complaint to the P.S. dt. 1.10.2015 though the G.D.E. recorded by the concerned P.S. shows 4.10.2015. The certified copy of the G.D.E. filed by the complainant shows that the G.D.E. was made on 4.10.2015 and it was written by some Priyojit Chakraborty, Adv., though the carbon copy and certified copy differ in some respects. He also argued that the vehicle was left on the roadside near the reputed garage where there are so many vehicles remained parked.
Ld. Lawyer for the complainant with documents stated to this Forum that the complainant has insurance of her other vehicles with the same OP and also filed a report of the Surveyor engaged by the OP “During our visit to PS and local people it was confirmed that the theft was genuine”.
Ld. Lawyer for the OP has filed the copy of insurance policy and brought to the notice to this Forum to Sl. No.4(a) of the terms & conditions of the policy. He has also submitted the ruling of the Hon’ble National Commission in the case between New India Assurance Co. v. Trilochan Jane, judgment dt. 9.12.2009 wherein there are so many explanations of word “immediately”. Ld. Lawyer for the OP argued that the complainant has violated the condition No. 1 & 4(a). He filed a record submitted by the complainant to the Income Tax Department wherein she stated that “I informed the matter verbally to PS on 1.10.2015.” But, after investigation of PS the theft has been recorded in case vide G.D.E. No.336/2015 dt. 4.10.2015. So, it is not correct that the complainant had submitted her written complaint to the PS on 1.10.2015, but the PS has recorded it as G.D.E. 4.10.2015. So, the ground on which the repudiation of claim has been made is legal and justified.
Points for decision:
- Is the complainant a consumer to the OP company?
- Is repudiation made by the OP justified and legal?
- Is there any deficiency in service on the part of OP?
DECISION WITH REASONS
From the above discussion it is confirmed that the complainant is a bona fide policyholder to the OP company so, she is a consumer u/s 2(d) of the CP Act, 1986.
It is revealed from the above discussion that the theft actually occurred between 7:00 pm on 30.9.2015 and 6:00 am on 1.10.2015. The record of the carbon copy of the G.D.E. proves that the complaint was lodged with Gangarampur PS on 1.10.2015 by the driver of the vehicle though the G.D.E. No.336/2015 shows that it was recorded on 4.10.2015. There is discrepancy between certified copy of G.D.E. and carbon copy of the G.D.E.. It has been noted that in the carbon copy there is no name of Lawyer but in the certified copy of G.D.E. one Mr. Priyojit Chakraborty, Adv. Buniadpur has been mentioned. So, it is crystal clear that immediate notice in writing to the Hon’ble PS has been made. The complainant has stated that he has brought the matter of theft to the notice of the OP verbally on 1.10.2015 and informed in writing on 5.10.2015 after receiving the copy of G.D.E. No.336/2015 dt. 4.10.2015 from the concerned police station. The complainant has brought the matter to the notice to the OP in writing on 5.10.2015 i.e. 4 days later of the theft but she had brought it to the notice to the OP verbally on 1.10.2015. Honouring the ruling of the Hon’ble National Commission dt. 9.12.2009, we may take resort to important point raised by the National Commission in the case of Universal Sampo General Insurance Company v Ruplal Dangi {2017(2) CPR 210 (NC)}. “Insurance Companies could not reject otherwise genuine claims on technical grounds of delay in intimation of theft, if delay is properly explained”. In the instant case the documents filed by the complainant – Surveyor’s report dt. 8.12.2015 which shows that the theft was genuine. In the circumstances, repudiation of claim by the OP is a deficiency in service on the part of OP.
Hence, it is
O R D E R E D
that the OP is instructed to make a payment of claim value of Rs.4 lakh within 30 days from the date of this order. The complainant is eligible to get the compensation amount of Rs.8,000/- for his harassment and mental agony and Rs.2,000/- for litigation cost. The insured total claimed amount, compensation amount and litigation cost are to be paid by the OP within 30 days from the date of judgment, failing which the claimed amount and the compensation amount will bear interest @ 9% p.a. till the full realization of the amount.
The complainant is directed to deposit Rs.4,000/- to the State Consumer Welfare Fund, by way of bank draft or account payee cheque on P.N.B. Balurghat Branch immediately after receipt of the compensation amount from the OP.
The case be and the same succeeds on contest.
Let a plain copy of this order be furnished to the parties forthwith free of cost.
