Haryana

Panchkula

CC/133/2018

SURINDER PAL BHOJ. - Complainant(s)

Versus

THE MANAGER,THE SHRIRAM GENERAL INSURANCE CO.LTD. - Opp.Party(s)

ASHOK SHARMA

03 Oct 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,  PANCHKULA

                                                       

Consumer Complaint No	:	133 of 2018
Date of Institution	:	01.08.2018
Date of Decision	:	03.10.2019

 

Surinder Pal Bhoj aged 52 years son of Sh.Prem Chand resident of House No.1127, Sector-26, Panchkula District Panchkula.

 

                                                                           ….Complainant

 

Versus

1.     The Manager, The Shriram General Insurance Co. Ltd. SCO No.178, Sector-38-C, Chandigarh.

2.     The Branch Manager, The Shriram General Insurance Co. Ltd. E-8, EPIP, RIICO, Industrial Area, Sitapura, Jaipur-302022 Rajasthan

 

….Opposite Parties

 

COMPLAINT UNDER SEC. 12 OF THE CONSUMER PROTECTION ACT, 1986.

 

Before:              Sh. Satpal, President.

Dr. Pawan Kumar Saini, Member.

Dr. Sushma Garg, Member.

 

For the Parties:   Complainant  in person.

                        Mr. Inderjeet Singh, Advocate for the OPs.

 

ORDER

(Satpal, President)

1.     The brief facts of the present complaint are that the complainant is the registered owner of Aviator No.HR-03-N-1138 and the same was insured with the OPs vide policy no.105009/31/17/002487 and the same was valid from 15.07.2016 to 14.07.2017. On dated 27.06.2017 the vehicle of the complainant was stolen from Sector-25, Panchkula and to his effect a FIR No.196 dated 16.07.2017 under Section 379 IPC was registered with P.S. Chandimandir District Panchkula. On the same day i.e. on 27.06.2017 the son of the complainant namely Surinder Pal Bhoj had expired, therefore, the complainant and his family remained busy in performing the last rites of the deceased son as the complainant went to his native village and return back to Panchkula after performing the last rites and bhog ceremony of his son and due to this reason the complainant could not inform the company in time. Thereafter, the complainant requested the OPs Company to release the claim amount on account of theft of the motor cycle and the complainant continuously making the correspondence with the company of the OPs to release the claim amount. The complainant has deposited the necessary documents as demanded by the OPs but the OPs had refused to pass the claim amount on ground of late information as “no claim” vide their letter Memo No.SGIC/CLM/17-18 dated 27.03.2018. The complainant had many times requested the OPs for the release of the claim amount but the OPs did not pay any heed to the request of the complainant. The complainant has also served a legal notice dated 17.05.2018 upon the OPs. Due to the act and conduct of OPs, the complainant has suffered a great deal of financial loss and mental agony, harassment. Hence the present complaint.

2.             Upon notice OPs No.1 & 2, appeared through counsel and filed written statement raising preliminary objections qua complaint is not maintainable; no cause of action has arisen in favour of the complainant; the present complaint is time barred and the complainant has not come with clean hands. On merits, OPs No.1 & 2 stated that there is delay of 19 days in reporting the matter to the police authorities and delay of 72 days in reporting the matter to the company. It is submitted that as per the terms of the insurance policy, in case of any loss, the immediate information is required to be given to the policy authorities and insurance company. In the present case alleged theft has taken place on 27.06.2017 but the information to the police was given on 16.07.2017 and information to the insurance company was given on 07.09.2017 accordingly there is breach of the policy terms on the part of the complainant.  Further, there is another breach on the part of the complainant as despite the several reminders/ communications, the complainant is unable to submit  the original  keys(all with clip no.) of the insured vehicle and  accordingly this non-submission  gives raise  to the fact that complainant/insured  has not taken  reasonable care  in safeguarding  the vehicle and left the key  of the insured  vehicle  within  the  vehicle which facilitated  the claim theft.  So, there is no deficiency in service on the part of OP and prayed for dismissal of the present complaint.

3.             To prove his case, the complainant has tendered affidavit as Annexure C/A along with documents Annexure C-1 to C-14 in evidence and closed the evidence by making a separate statement. On the other hand, the ld. counsel for the OPs No.1 & 2 tendered affidavit Annexure R/A along with document Annexure R-1 to R-9 and closed the evidence.

4.             We have heard the complainant, ld. counsels for OPs No.1 & 2 and gone through the arguments filed by learned counsel for the Ops, record carefully and minutely.

5.             The complainant has sought release of amount i.e. Insured Declared Value (IDV) of the vehicle, namely, Aviator no. HR-03-N-1138 which was, admittedly, stolen on 27.06.2017 during the subsistence of the insurance policy which was valid from 15.07.2016 to 14.07.2017. The OP has closed the claim case as “no claim” vide letter dated 27.03.2018 (Annexure C-7) mainly on three grounds as mentioned below:-

a) That there is delay of 19 days on the part of the complainant while lodging   the FIR pertaining to the stolen vehicle.

b) That there is delay of 72 days in reporting to the matter to the OP/insurance company.

c) That the complainant has failed to provide the original keys of the insured vehicle thereby committing the breach of the terms and conditions of the insurance policy.

A & B- The grounds mentioned at serial No. a and b above being related to the delayed intimation to the police and insurance company about the theft of the insured vehicle are being taken together for discussion.

6.             The learned counsel for the OP asserted that it was mandatory as per condition No.1 of Insurance policy upon the insured to give a notice in writing immediately upon the occurrence of any incident causing   loss or damage so as to enable the OP Insurance Company as well as   the police to enquire and investigate the occurrence of theft to nab the real culprit. The learned counsel asserted that there is delay of 19 days  and 72 days in reporting the matter to the police and insurance company respectively and thus the complainant has violated the expressed terms and conditions of the insurance policy. The learned counsel contended that delay on the part of the complainant is fatal and is sufficient to disentitle him to the claim in question. In support of his contentions, reliance has been placed upon the case law laid down by Hon’ble National Commission while deciding the revision petition NO. 1155 of 2017 vide its order dated 05.07.2017 titled as Manoj Kumar Sharma Vs. Iffco Tokio General Insurance Co.  Ltd. reported in 2017(3) CPR 125. The learned counsel also placed reliance upon case law laid down by Hon’ble State Commission Punjab while deciding the first appeal No. 1673 of 2010 vide its order dated 19.08.2013 titled as Malkiat Singh Versus Iffco Tokio General Insurance Co. Ltd. Concluding the arguments the learned counsel stated that the complaint deserves dismissal out rightly on the ground of delayed intimation to the police as well as OP Insurance Company and hence the same be dismissed accordingly.

7.             On the other hand the complainant, appearing in person, while admitting the delay on his part, in informing the police as well as insurance company submitted that he was prevented from lodging the FIR as well as sending the intimation to the insurance company immediately and promptly on account of sudden and untimely death of his young son.  The complainant stated that he came to know about the death of his young son from the police official (PCR) on telephone and thereafter he along with his family went to his native village for the cremation of the dead body of his son. It is further stated that he was engaged for another 15 days in connection with subsequent events pertaining to the funeral rites/rituals including the “Kirya”.   It is further stated that due to the untimely death of his young son, he and his wife Surinder Kaur were in the grip of acute grief and sorrow leading to the mental depression and unstable mental condition, which further compelled to take the treatment from Dr.Rajeev Trehan, MD Psychiatry, Consultant Neuro Psychiatrist Panchkula, Civil hospital, Panchkula. In this regard, the complainant invited our attention towards the treatment record pertaining to the mental ailments of the complainant and his wife which is available on record as Mark 5.

8.             After hearing the complaint and as well as the learned counsel for OP and perusing the record available on file, we find that the basic question to be decided by us is whether the delay in question was fatal disentitling the complainant to the claim of IDV.  No doubt as per terms and condition of the policy the insured is duty bound to inform the insurance company as well as the police promptly without any delay so as to enable them to enquire/investigate the matter and to nab the culprit/accused person involved.  The promptness and immediate action on the part of the insured about providing intimation in the theft cases is  insisted upon by the insurance company with an objective to prevent the possibility of  falling the stolen vehicle in the hands of scrap dealers.  However, in the present case, the complaint was prevented from sending the intimation to the police as well as company on account of sudden demise of his young son. It may be mentioned here that a person who is caught in the grip of acute grief and sorrow on account of untimely demise of his young son is least expected to visit the police station or insurance company for providing the intimation with regard to the stolen vehicle and then to perform the rituals related to death.   We completely agree with the contention of the complainant that he was prevented on account of a justifiable and valid reason to provide the immediate intimation to the police as well as company due to sudden demise of his son. We are also satisfied that the complainant was engaged in the performance of death related rituals till he informed the police by lodging the formal FIR on 16.07.2017. At this juncture it would be relevant to mention that admittedly the complainant came to know about the death of his son on the basis of information as provided by police and as per untraceable report, which is available on record as Annexure C-14, the complainant was taken to the hospital etc. by PCR-18 and thus it is evident that the incident was in the notice of the police even on the day of occurrence i.e. 27.06.2017 though the formal FIR was lodged by the complainant on 16.07.2017  The treatment taken by the complainant and his wife from Dr. Rajeev Trehan, MD Psychiatry, Consultant Neuro Psychiatrist Panchkula, Civil hospital, Panchkula which is available on record as Mark 5 clearly establish that complainant and his wife were in the stage of mental depression and stress. Moreover, the genuineness of the claim has not been doubted by the OP/ insurance company. At this stage, it would relevant to mention here that the Insurance Regulatory and Development Authority vide   circular dated 20.09.2017 has asked all the insurance companies that the condition with the regard to delay should not prevent settlement of   genuine claims, particularly when there is delay in intimation or in submission of documents due to unavoidable circumstances. The aforesaid circular contains the direction also which is as under:-

The insurers’ decision to reject a claim shall be based on sound logic and valid grounds. It may be noted that such limitation clause does not work in isolation and is not absolute. One needs to see the merits and good spirit of clause, without compromising on bad claims. Rejection  of claims on purely  technical  grounds  in mechanical  fashion  will result in policyholders  losing  confidence in the insurance  industry  giving  rise to excessive litigation.

9.             Furthermore, with regard to delayed intimation, the Hon’ble Apex Court in the case titled as  Om Parkash Vs. Reliance General Insurance Company in Civil Appeal No.15611 of 2017 decided on 06.10.2017, wherein the delay occurred in a theft  case,  held as follows:-

“It is common knowledge that a person who lost his vehicle may not straight way go to the insurance company to claim compensation. As, first, he will make efforts to trace the vehicle. It is true that the owner has to intimate to the insurer immediately after the theft of the vehicle. However, this condition should not bar settlement of genuine claim particularly when the delay in intimation or submission of document is due to unavoidable circumstances. The decision of the insurer to reject the claim has to be  based on valid grounds. Result in loss of confidence policy holders in the insurance industry. If the reason of delay in making the claim is satisfactorily explain, 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  the claims which had already  been verified  and found  to be correct by the investigator. The condition regarding the delay shall not be shelter to repudiate the insurance claim which have been otherwise  proved  to be genuine”.

10.            In view of above discussion,  we have no hesitation  to conclude  that there has been lapse and deficiency  on the part of the OPs  while  declining  the genuine  claim of the complainant  on the basis of flimsy  and frivolous grounds.

11.            As a sequel to above discussion, we partly allow the complaint with the following directions:-

1.     That  the  OPs shall make the payment of Rs.28,000/- i.e IDV of the vehicle alongwith  interest @9% p.a. from the date of filing  of present complaint  till its realization  subject  to submission of following  papers/ documents  by the complainant  with OPs:-

1. Letter of subrogation (on non-Judicial stamp paper of Rs.100/- duly notarized.
2. Letter of indemnity.
3. Form No.29 & 30 of M.V.Act duly signed by the owner.
4. Form No.35 duly signed from the financier if the vehicle  was financed.
5. Discharge voucher, consent letter and cancel cheque  duly signed by the owner/complainant if not already given to OP.

 

2.    The OP shall make the payment of above said amount of Rs.28,000/- alongwith interest as directed  above within  a period of 30 days from the receipt of papers/documents  from the complainant failing which the OPs shall pay the interest @ of 12%  on the awarded sum of Rs.28,000/-.

3. Further, the OPs are directed to pay Rs.20,000/- as compensation on account of mental agony and harassment.  

 4. Apart from above, the OPs shall pay an amount of Rs. 5,500/- to the complainant for litigation charges.  

12.    It is made clear that OPs shall extend maximum co-operation to the complainant while getting the above mentioned formalities completed. Order be complied within one month from the date of preparation of copy of this order. Copies of this order be supplied to the parties concerned free of costs. File be consigned to the record room after due compliance.

Announced:03.10.2019

 

Dr.Sushma Garg          Dr. Pawan Kumar Saini         Satpal          

        Member                           Member                               President

 

Note: Each and every page of this order has been duly signed by me.

 

                                         Satpal  

                                           President