DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II
Udyog Sadan, C-22 & 23, Qutub Institutional Area
(Behind Qutub Hotel), New Delhi-110016.
Case No.147/2012
Mrs. Nargis Harbans Kaur Senior Citizen
W/o Late Brig. Gurdip Singh 90 Years
R/o S-55, Greater Kailash-II,
New Delhi-110048 ….Complainant
Versus
The New India Assurance Company Ltd.
through its Branch Manager
Branch office: 311502, 2nd Floor,
Mother House, 22 Yusuf Sarai,
Commercial Complex, Gulmohar Enclave,
New Delhi-110049 ……Opposite Party
Date of Institution : 11.04.12 Date of Order : 04.07.16
Coram:
Sh. N.K. Goel, President
Ms. Naina Bakshi, Member
Sh. S. S. Fonia, Member
O R D E R
S.S. Fonia, Member
Briefly stated, the case of the Complainant is that she had obtained a policy No.311502/48/10/32/00000120 towards insurance of her household items which was valid from 30.06.10 to midnight of 29.06.11 (copy annexure C/1). She states that in the first week of February, 2011 while she was away to Kolkata some miscreants/thieves broke open the window in the rear side on ground of her house at S-55, G.K.-II, New Delhi and decamped with her household goods at the intervening night of 7/8 February, 2011. She returned from Kolkata on 18.02.11 at 5 p.m. and soon on her return, when she came to know about the said theft she is reported to have been shocked and fell ill. However, on feeling little better on 20.02.11 she approached the police but police did not pay any heed to her request and did not lodge any FIR. She thereafter sought legal advice and was advised that she should report the matter in writing. Accordingly, she reported the crime to local police Chitranjan Park vide her letter dated 25.02.11 and an FIR No.48 dated 02.03.2011 U/s 380 IPC was lodged by the police in this regard (copy annexure C/2). However, the Complainant points out that the report was already lodged by Mr. Daljit Singh, who is the son-in-law of the Complainant and resides on the first floor of the said property. Thereafter, the Complainant lodged a claim alongwith list of stolen items which was received by the OP on 28.03.11 as is stated to be cleared from the letter dated 28.03.11 sent by investigator of the OP. She further states that the investigator of the OP requested her on the same day to submit documents to enable them to submit their report to the OP (copy annexure C/3). The Complainant vide letter dated 19.04.11 submitted all the requisite documents to the said investigator and requested for early settlement of her claim (copy Annexure C/-4). This was followed by her letters dated 21.04.11 & 02.05.11 in which the original documents were sent to investigators (Copy Annexure C/5 Collectively). The Complainant was shocked to receive a letter dated 29.08.11 from the OP whereby the OP has inter-alia informed her that the claim of the insured/Complainant is not tenable as per policy terms and conditions. In other words, OP rejected the claim of the Complainant on totally false and frivolous grounds. Consequently, the Complainant not only suffered financially but also mentally. The Complainant issued a legal notice dated 28.01.12 to the OP calling upon them to pay Rs.5 lacss for deficient services as also reimbursement of the amount claimed by her for the loss suffered by her in the aforesaid theft case alongwith interest @ 24% per annum w.e.f. March, 2011 till the actual date of payment. The OP vide letter dated 12.03.12 repeated that the claim of the Complainant had been rightfully repudiated (Copies of the legal notice and reply of the OP are marked as Annexure C/7 & C/8 respectively). Aggrieved by the response of the OP and pleading deficiency in service on the part of the OP the Complainant has invoked the jurisdiction of this Forum praying for the following reliefs vide her complaint dated 11.04.12:-
- Direct the OP to disburse the amount claimed by the Complainant for the theft took place in her residence.
- Direct the OP to pay a sum of Rs.5 lacs to the Complainant for causing mental torture and agony to the Complainant and her family members alongwith interest @ 18% p.a. from March 2011 till the date of actual payment.
- Direct the OP to pay the cost of the proceedings.
OP has filed its written statement reiterating the stand taken by it in reply to her legal notice and has specifically relied upon condition 5 of the contract of the insurance under heading “Claims Procedure” which stipulates that “the insured shall upon the occurrence of any event giving rise or likely to give to the claim under this policy:
- in the even of theft, lodge forthwith a complaint with the Police and take all practicable steps to apprehend the guilty person or persons and to recover the property lost;
- give immediate notice thereof to the Company and shall within 14 days thereafter furnish to the Company at his own expenses detailed particulars of the amount of the loss/damage together with such explanations and evidence to substantiate the claim as the Company may reasonable require.”
The OP has further stated that though the intimation of the loss in the present case was given to them only on 10.03.11 by the Complainant but the claim formalities were not completed by the Complainant till 30.04.11 inspite of the letters sent by Surveyor which is clear violation of the insurance contract. It is stated as under:-
“ 2. That a claim intimation was given to the respondents vide her letter dated 25.02.2011 which was received by respondents office only on 10.03.2011 wherein it was informed that there was a theft at the insured premises and the estimated loss is being ascertained when the respondents office immediately deputed an investigator D. L. Aggarwal & Company for the investigation and Survey of the loss caused by alleged theft as per Statutory requirements of Section 64 UM of Insurance Act, 1986.
3. That the deputed investigator visited the insured premises on 11.03.2011, inspected the premises and requested the complainant verbally and vide his letter dated 28.03.2011 to provide various relevant documents which are required for assessment of loss.
4. That the complainant failed to provide the required documents and also failed to contact the deputed surveyor as she again went out of station resulting delay in completion of claim formalities.
5. That as per information provided to the surveyors and confirmed by him is his Survey Report, the complainant failed to show any damaged window to the IO as such the concerned IO did not arrange any photographs of the damaged window. Even the FIR made by the complainant is silent about the damaged window and she failed to produce any witness/evidence etc. in this regard.
6. That the deputed surveyor visited Police Station for verification of FIR met Shri Shiv Shanker Singh, HC/IO of the case when it was informed by the IO that the complainant failed to show any damaged window to the IO that the complainant failed to show any damaged window to the IO as such the concerned IO did not arrange any photographs of the damaged window.
7. That the deputed surveyor took one photographs of the premises and it was found by the surveyors that only two items were covered in the insurance policy i.e. 4 Bangles amounting to Rs.60,000/- and 1 Chain amounting to Rs.42,000/- and all other items claimed are not covered. The surveyor has clearly opined that the loss as such is not payable as the insured failed to produce any witness to theft.
8. That the complainant claimed for the loss of silverware whereas no Silverware was found insured in the policy, hence no liability was accepted by the surveyor.
9. That accordingly respondents sent a Regd. AD letter dated 29.08.2011 to the complainant informing her about the repudiation of her claim.”
Accordingly citing other reasons inter-alia the OP has prayed for dismissal of the complaint with cost.
Complainant has filed rejoinder to the written statement of the OP and reiterated her claim mainly by asserting that since she was away to Kolkata she could lodge the complaint with police on 20.02.11 and since the local police did not register the case she lodged a written complaint on 25.02.11 and an FIR No.48 dated 02.03.11 was lodged by the local police. She further states in her rejoinder that her son-in-law who is residing on the first floor of the said property had already lodged the complaint with the OP alognwith list of stolen items which was received by the OP on 28.03.11.
Complainant has filed her own affidavit in evidence. On the other hand affidavit of Sh. Surinder Kumar Batoha, Sr. Divisional Manager has been filed in evidence on behalf of the OP.
Written arguments have been filed on behalf of the parties.
We have heard the arguments on behalf of the parties and have also gone through the file very carefully.
We straightaway come to the question, whether the relief is admissible to the Complainant as prayed for?
Admittedly, the Complainant had taken a household insurance policy from the OP for the period 30.06.10 to midnight of 29.06.11. She was away to Kolkata during the first week of February, 2011 and it is alleged that some miscreants/thieves broke open window in the rear side on ground floor of her house at S-55, G.K.-II, New Delhi and decamped with her household goods at the intervening night of 7/8 February, 2011. Admittedly the son-in-law of the Complainant was staying on the first floor of the said property but the matter is said to have been reported to the police only on 20.02.11. However, as per the credible evidence available with this Forum the FIR No.48 dated 02.03.11 U/s 380 IPC was lodged by the police based on the written complaint of the Complainant dated 25.02.11. Another most important aspect of the complaint is that the intimation to the OP was given on 28.03.11 as evident from Annexure C/3 i.e. much after the alleged theft on 07-08.02.11. With advent of the communication and presence of the son-in-law on the first floor the same house, it cannot be disbelieved that the matter could have been reported to the police as well as OP immediately on occurrence of the theft by the son-in-law of the Complainant in consultation with his mother-in-law over telephone from Kolkata. The delay in giving intimation to the OP from 07-08.02.11 to 23.03.11 in the facts and circumstances of the case is quite abnormal and is clear violation of the condition 5 of the insurance police. This factum has not been specifically denied by the Complainant in her rejoinder. The delay in intimation to the insurance company in violation of condition of the policy has been squarely covered by the national commission in the matter of Kuldeep Singh Vs. IFCO Tokio General Insurance Co. Ltd. II (2013) CPJ 189 (NC), decided on 18.01.13 and also delay in lodging in FIR has been squarely covered in the matter of Satish V/s United India Insurance Cl. Ltd. II (2013) CPJ 481 (NC) decided on 16.04.13. In both the judgments, the abnormal delay in giving intimation to the Insurance Company and police have been held to be fatal and considered serious violation of the condition of the insurance policy.
Secondly, the Complainant has not given the details of the stolen articles in the complaint or in her affidavit. In FIR Gold bangles (one pendent) and gold neck chain have been described to be stolen property. Vide letter dated 28.03.2011 (Copy Ann. C3 and R 3) the OP had inter-alia asked the Complainant to provide “proof of stolen items.” Vide letter dated 19.04.11 (copy Ann. C4) the Complainant inter-alia informed the OP as follows:-
“proof of stolen items were pictures taken by you and your Company as stated in the FIR lodged with the Chitranjan Police Station.”
In this regard the report of the Investigator becomes relevant. Copy of the same is Ann. R-5. We have very carefully perused the report. Relevant portion of the report reads as under:-
“Details of the stolen items covered under the policy:-
The following stolen jewellery and other items are covered and insured under the policy as per details given hereunder:-
Item Weight Sum Assured
4 Bangles Not mentioned Rs.60,000.00
1 plain chain 32 gms. Rs.42,000.00
Double Bed Sheet 4 Pairs
Visit to the police station:
We visited C.R. Park Police Station, New Delhi and discussed the matter with Mr. Shiv Shanker Singh, H.C. – Investigating office in this case who told us that on receipt of complaint letter of Mrs. Nargis Harbans Kaur, he visited at S-55, Greater Kailash II, New Delhi on 02-3-2011, but he was not shown any damaged window etc by the insured and as such he did not arrange any photographs.
Policy No.311502/48/10/32/00000120:
It stands issued in favour of the insured Mrs. Nargis Harbans Kaur covering Household goods and jewellery at premises- S-5, under Section 2 & 3 of the policy for Rs.2,15,000/- and Rs.2,22,00/- respectively.
On perusal of the above, it is clear that the facts mentioned in the complaint letter and the statement recorded of the insured is silent about the window where the mishap is alleged to have taken place, and she failed to produce any witness in this regard. The said claim stands reported in the insurer’s office after a lapse of more than one month.
Keeping in view the above facts into consideration, we feel that the claim of the insured is not tenable as per terms and condition of the policy and as such it is recommended that the same may be repudiated.”
Without delving further into the matter we do not see merit in the case and accordingly we dismiss the complaint with no order as to costs.
Let a copy of this order be sent to the parties as per regulation 21 of the Consumer Protection Regulations. Thereafter file be consigned to record room.
(S. S. Fonia) (Naina Bakshi) (N. K. Goel)
Member Member President
Announced on 04.07.16.
