BEFORE THE PRESIDENT, DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SAMBALPUR

C.C NO-22/2015

Present-Sri Dipak Kumar Mahapatra, President, Smt. Smita Tripathy, Member (W).

Raghunandan Mittal,aged about 44 years,

S/O- Late Srinibas Mittal,

R/O-Goshala,P.O-Kalamati,P.S-Burla,Dist- Sambalpur,

At present at C/O- Radhey Beriwel, At-Badabazar,

P.O/P.S-Khetrajpur,Dist-Sambalpur.                                                           …..Complainant

Vrs.

1. The Divisional Manager,

National Insurance Co Ltd, Sambalpur.

2. The Insurance Ombudsman,

Office of the Insurance Ombudsman,

Plot N-62,Forest Park,Bhubaneswar,Pin-750009.

3. National Insurance Co Ltd, A Govt. of India Undertake,

Head Office 3- Middle Street,

Kolkata, Pni-700071.

4. Odissey Motors Pvt. Ltd, Sambalpur,

P.S-Ainthapali, At/P.O/Dist-Sambalpur.

5. SBI,SME Branch,

Sambad Bhawan,Sakhipara, Sambalpur.……O.Ps

Counsels:-

1. For the Complainant:-          Sri A.K. Dash, Advocate & Associates.
2. For the O.P-1& 3       :-          Sri B.K. Purohit, Advocate & Associates.
3. For the O.P-2,4 &5    :-          None

DATE OF HEARING : 15.03.2021, DATE OF ORDER : 12.04.2021

SRI DIPAK KUMAR MAHAPATRA,PRESIDENT:-Brief facts of the case is that the Complainant is the registered owner of a Maruti Suzuki Wagon R Car bearing Regd No- OD-15 A 4699 bearing Chassis No- Ma3EWDEIS00587949 and engine No- KIOBN7264523 purchased on dtd24.07.2013.  The said car was insured by National Insurance Company vide Policy No- 351010/31/13/6133455503 valid from dtd. 24.07.2013 to 23.07.2014.  The Complainant has appointed a driver named Amit Kumar Sahu on dtd.24.04.2014 belong to Suguda,P.S-Deogarh, Dist-Deogarh but presently residing with the Complainant in a separate room in the house of the Complainant in Badabazaar.  On dtd. 30.04.2014 the driver took the Car for washing at about 7.00am and did not returned home till 10.00am the Complainant made contact on his mobile phone but the mobile phone of the driver was found switched off.  On the same day the Complainant at about 11.00 am rushed to Khetrajpur P.S and narrated the matter verbally and the police sent VHF message to different bordering police stations at about 11.45 AM. After waiting for 9 days when the police could not find the vehicle on dtd. 10.05.2014 the police lodged   a FIR to the effect vide FIR no- 0097 dtd. 10.05.2014. The Complainant informed the theft to the Insurance Company on dtd.  10.05.2014 and also he informed this matter to the Financier on the same day in writing. The Complainant filed an Insurance claim in prescribed form on dtd.21.05.2014. On dtd. 21.06.2014 the investigator of the Company Sri A.K Sinha & associate asked for some documents to the Complainant along with the driving licence of the driver but the Complainant was unable to submit the DL. But on dtd. 02.02.2015 the Insurance Company denied to pay the claim and repudiated the same. The Complainant alleged that in spite of having a valid insurance policy the Company did not settle the claim which is a deficiency in service. During this time the case G.R No-1058/2014 at SDJM, Sambalpur the accused person were arrested and the case is already was disposed off but the police could not trace the Car. The Complainant claims that due to the negligence of the Insurance Company he is suffering from loss and lost all hopes on the Company and decided to seek relief from this Commission.

As per the O.P -1 & 3, a Private Car package Policy of Insurance was issued to the Complainant vide no-351010/31/13/6133455503 valid from dtd. 24.07.2013 to 23.07.2014. As per the policy condition – Notice shall be given in writing to the Company immediately upon the occurrence of any accidental 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. The Insured shall take all reasonable steps to safeguard the vehicle insured from loss or damage and to maintain it in  efficient conditions  and the company  shall have at all times free and full access to examine the vehicle insured or any part thereof or any driver of the employee insured.  The IDV of the vehicle was Rs. 4,22,192/- and the premium was Rs.14,156/- per annum.   During the currency of the policy on dtd. 15.05.2014 at about 5.45 pm the Insured intimated the insurance company about the theft of the car. The Insurance Company verified that the FIR was lodged on dtd. 10.05.2014  at 2.15 pm and the date of occurrence was mentioned as  dtd. 30.04.2014 at about 7 am and the Claim form was submitted by the Insured on dtd. 21.05.2014. A surveyor was engaged who submitted the report on dtd. 30.06.2014 and a report was sought from the Complainant regarding the delay of intimation of the theft to the Insurance Company. Thereafter the Insurance Company on dtd. 02.02.2015 repudiated the claim of the Complainant on the ground of the violation of  the policy condition no-1 &4 that there was a delay of 15 days in reporting the Insurance Company about the theft. As per the Insurance Company the Insured has not informed the Insurance Company as well as Police immediately after the occurrences. The Insurance company has placed reliance on the decision of “ New India Assurance Co. Vrs. Trilochan Jane” to support his stand. Again he contends that the Insured is not eligible to get any claim as it is illegal , baseless and false for which the petition is not maintainable.

POINTS OF DETERMINATION:-

1. Whether the Complainant is comes under the purview of Consumer Protection Act-2019?
2. Whether the O.Ps has committed any Deficiency in Service to the Complainant?

From the above discussion and materials available on records we inferred that the Complainant comes under the purview of Consumers as he has got the Maruti Car Insured with the O.P-2 in payment of premium as consideration.  The Complainant has got the Car insured with the National Insurance Company vide Policy No- 351010/31/13/6133455503 valid from dtd. 24.07.2013 to 23.07.2014. The Car was stolen on dtd. 30.04.2014, however the FIR was lodged on dtd. 0.05.2014 and informed to the Insurance Company on dtd. 15.04.2014. It was rejected on the ground  intimation was given belatedly  after 15 days.  It is common knowledge that a person who lost his vehicle may not straightaway go to the Insurance Company to claim compensation. At first, he will make efforts to trace the vehicle. It is true that the owner has to intimate the insurer immediately after the theft of the vehicle. However, this condition should not bar settlement of genuine claims particularly when the delay in intimation or submission of documents is due to unavoidable circumstances. The decision of the insurer to reject the claim has to be based on valid grounds. Rejection of the claims on purely technical grounds in a mechanical manner will result in loss of confidence of policy-holders in the insurance industry. If the reason for delay in making a claim is satisfactorily explained, such a claim cannot be rejected on the ground of delay. It is also necessary to state here that it would not be fair and reasonable to reject genuine claims which had already been verified and found to be correct by the Investigator. The condition regarding the delay shall not be a shelter to repudiate the insurance claims which have been otherwise proved to be genuine. It needs no emphasis that the Consumer Protection Act aims at providing better protection of the interest of consumers. In the instant case, the Complainant has given cogent reasons for the delay of 15 days in informing the respondent about the incident. This matter has been well settled in the case of Om Prakash vs Reliance General Insurance on 4^th  October, 2017 Supreme Court. Again reliance is placed on the decision of Supreme Court of India in the matter of Gurshinder Singh vs Sriram General Insurance Co. Ltd. on 24 January, 2020. The O.P-4 & 5 has no role in this case and they are discharged from every liability. Hence we order as under :-

ORDER

The Complaint petition is allowed. The O.P No.- 1 & 3 are jointly and severally  directed to pay a sum of Rs. 4,22,192/- to the Complainant which  is the Insured Declared Value (IDV) of the Maruti Car as per the Policy copy to be expired on dtd.23.07.2014 with interest @ 5% per annum from the date of filing of the claim petition till the date of payment. Further the O.P No.- 1 & 3 are jointly and severally  directed to pay a sum of Rs.5,000/-to the Complainant as Cost of litigation. All the payment, as above, shall be made within a period of 8 weeks from today.

Order pronounced in the open Court today i.e, on 12^th day of April 2021 under my hand and seal of this Commission.

Office is directed to supply copies of the Order to the parties free of costs receiving acknowledgement of the delivery thereof.

I agree,                                                                                            

-Sd/-                                                                                                   -sd/-

MEMBER(W)                                                                                                PRESIDENT  

                                                            Dictated and Corrected

                                                                             by me.

                                                                           -Sd/-

   PRESIDENT.