West Bengal

Paschim Midnapore

CC/77/2016

Shane Newaze Khan - Complainant(s)

Versus

The New India Assurance Co.Ltd. - Opp.Party(s)

Swapan Bhattarcharya

17 Jan 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

PASCHIM MEDINIPUR.

                             

Bibekananda Pramanik, President

and 

Kapot Chattopadhyay, Member.

   

Complaint Case No.77/2016

 

                          Shane Newaze Khan, S/o Abu Musa Khan, Vill.  P.O. Digri, P.S. Garhbeta,

                          District - Paschim Medinipur. …………..………..……Complainant.

                                                                              Vs.

1)The New India Assurance Co. Ltd., Bommasandra Branch, KIADB COMPLEX, 1^st Floor, Hasur Main Road, Bangalore-526158,

2)U.B. Insurance Associates, (Apps – Daily Claims Division), S-204 and 205 Suraj Plaza, 196/8, 25^th Cross 8 Main Jayanagar, 3^rd Block, Bangalore-560011, Karnataka,

3)Mobile Plaza (Authorized agent U.S. Insurance Associate), P.O. Medinipur, District- West Medinipur, PIN 721101.....……….….Opp. Parties.

                                                    

                        For the Complainant: Mr.  Swapan Bhattacherjee, Advocate.

                         For the O.P.               : Mr. Mrinal Kanti Chowdhury, Advocate &

                                                             : Mr. Sirshendu Krishna Maity, Advocate.                     

 

 

Decided on: -17/01/2017

                               

ORDER

                          Bibekananda Pramanik, President – This is an application under section 12 of the C.P. Act, filed by the complainant Shane Newaze Khan against the New India Assurance Company Ltd. and the two others.

                         Fact of the case, in brief, is that on 28/10/2014,  the complainant purchased a mobile set of Samsung S 7582 – Galaxy S Duos 2, the details of which has been given in the schedule of the petition of complaint, from the O.P. no.3-Mobile Plaza at Keranitola,

Contd……………..P/2

 

 

( 2 )

 Medinipur at a sale price of Rs.8,500/-.  At the time of purchase of the said mobile set, the O.P. no.3 disclosed that O.P. no.1 has bought a policy of insurance over the said mobile set and being informed such, the complainant got his said mobile set insured with the O.P. no.1 under a insurance policy vide no.670302/46/13/24/00000008.  On 12/08/2015 at about 1.30 a.m., there was an occurrence of theft in the house of the complainant and the miscreants also took away his said mobile set including many other valuable articles from his house.  Complainant lodged a complaint regarding such occurrence of theft before I/C Chandrakona Police Beat House on basis of which Chandrakona P.S. Case no.388/2015 was started.  Thereafter the complainant submitted claim form before the O.P. no.1 through their T.P.A.-O.P. no.2 and he also submitted all documents but the O.P. no.1 did not take any action for settlement of the claim of the complainant.  Hence the complaint, praying for directing the O.Ps to pay a sum of Rs.8,500/- and order of compensation of Rs.20,000/-, litigation cost of Rs.10,000/- and for other reliefs.  O.P. nos. 1and 3 appeared in this case and by filing separate w/o, they have contested this case.  O.P. no.2 received notice of this case but he did not appear to contest this case for which the case was ordered to be heard ex-parte against O.P. no.2.

                     Denying and disputing the case of the complainant, it is the specific case of the opposite party no.1 as made out in the w/o that on submission of claim from by the complainant in respect of theft of his mobile set, process for settlement of claim was started and during such process, it was found that the complainant has violated the terms and conditions of the policy.  As per terms and conditions of mobile policy, the complainant is required to have blocked the SIM within 48 hours from the time of theft,  but the complainant applied to the customers service manager for blocking his SIM on 02/11/2015 i.e. after 20 days which clearly speaks  violation of terms and conditions of insurance policy.  According to the O.P. no.1, for such violation of terms and conditions of policy the claim was repudiated by the Insurance Company and for such repudiation of claim on the ground stated above  it cannot be said to be unjust and improper.  Such copy of repudiation letter has been annexed as ‘D’ with the written objection.  It is stated that as  the complainant has violated the mandatory terms and conditions of the policy, so the O.P.-Insurance Company has no deficiency in service in repudiating the claim of insurance.  O.P. no.1 therefore claims dismissal of the petition of complaint.

                     Denying and disputing the case of the complainant, it is the specific case of the O.P. no.3, as made out in his written objection, that the complainant purchased the mobile set from his shop and being questioned, one salesman of his shop  explained about  the procedure for insurance coverage of the mobile policy and after being fully satisfied

Contd……………..P/3

 

( 3 )

about such overage, the complainant got his mobile set insured with the O.P. no.1.  It is stated that once insurance coverage is done, the O.P. no.3 has got no liability as against the said mobile set.  If the O.P. nos.1 & 2 do not give effect to the policy and coverage, the O.P. no.3 cannot be held liable in any manner and therefore they have no deficiency in service and as such the claim of the complainant so far as the O.P. no.3 is concerned  is liable to be dismissed with cost.

                     To prove his case, the complainant has tendered his affidavit-in-chief in evidence and he was also examined on oath as PW-1. During his evidence, few documents were marked as exhibit 1 to 5 respectively.  On the other hand, neither the O.P. no.1 nor O.P. no.3 adduced any sort of evidence.  

 

                                                                 Points for decision

1)Is the case maintainable in it’s present form and prayer ?

2)Have the O.Ps deficiency in service in settling the claim of insurance, as alleged ?

3)Is there any unfair trade practice on the part of the O.P. no.1?

4)Is the complainant entitled to get the reliefs, as sought for ?    

                   

Decision with reasons

          For the sake of convenience and brevity, all the above points are taken up together for consideration.

           It is not denied and disputed that the complainant purchased the mobile set in question from the shop of O.P. no.3 and he got his said mobile set insured with the O.P. no.1.  Fact remains undisputed that after purchase of the said mobile set, an occurrence of theft took place in the house of the complainant on the night of 12/10/2015 and the miscreants took away many valuable articles including the said mobile set from the house of the complainant for which the complainant lodged a complaint before the local police station on basis of which Chandrakona P.S. case no.388/2015 was started.  It is also not denied and disputed that after such occurrence of theft, the complainant submitted claim form before the O.P. no.1 through the T.P.A. i.e. O.P. no.2.  In their written objection O.P. no.1 has stated that they processed the claim and during such process of claim, they found that although there was a condition in the policy that service provider is to be intimated in case of theft mobile SIM service is to be barred within 48 hours but the complainant applied to the customers service manager for blocking his SIM on 2/11/2015 i.e. after 20 days from the date of occurrence of theft.  As per terms and conditions of mobile policy, the complainant is

Contd……………..P/4

 

( 4 )

required to have blocked the SIM within 48 hours but the complainant has violated the said terms and conditions and as such the O.P. no.1 repudiated the claim of insurance.

           Now the question arises as to whether the said ground of repudiation is sustainable in law or not.  On this score, on behalf of the complainant it was submitted that in case of violation of any condition of the insurance, the company is to settle the claim on non-standard basis at 75% of the sum insured.  In support of such contention, Ld. Lawyer for the complainant has referred a decision of the Hon’ble N.C.D.R.C. reported in 2009 (1) CPR 26 NC.  We have gone through the said decision of the Hon’ble N.C.D.R.C. and found that it has been held that in case of violation of the terms and conditions of the policy, the claim is to be settled on non-standard basis at 75% as per the own Guidelines of the Insurance Company with interest.  So in view of the said decision of the Hon’ble N.C.D.R.C., we are of the view that the O.P.-Insurance Company should have settled the present claim of insurance of the complainant on non-standard basis at 75% of sum insured,  but the          O.P.-Insurance Company did not follow their own rules and straight way repudiated the claim of the complainant which not only amounts to deficiency in service but also an  unfair trade practice.  The petition of complaint is therefore deserves to be allowed against the O.P. no.1 and dismissed against O.P. no.2 & 3.

All the points are accordingly disposed of.  In the result, the complaint case no.77/2016 stands succeeds.  

                                                  Hence, it is,

                                                     Ordered,

                                       that the complaint case no.77/2016  is allowed on contest  against O.P. no.1 with cost and dismissed without cost against the O.P. nos.2 & 3.  O.P. no.1 is directed to settle the claim of insurance in question on non-standard basis at 75% of sum insured within 2 months from this date of order.  O.P. no.1 is further directed to pay a sum of Rs.1,000/- as compensation  and Rs.500/- as litigation cost to the complainant within 2 months from this date of order.

                               Let plain copy of this order be given to the parties free of cost.

            Dictated and Corrected by me

                       Sd/-B. Pramanik.                   Sd/- K.K.Chattopadhyay.                  Sd/-B. Pramanik. 

                           President                                      Member                                         President

                                                                                                                                 District Forum

                                                                                                                              Paschim Medinipur