STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

U.T., CHANDIGARH

Jagdish Mohan Bansal s/o Sh.Jaswant Rai r/o H.No.256, Sector 16, Panchkula.

                                                                  ….   Appellant

                                         Versus 

The New India Assurance Company Ltd., through its Divisional Manager, Divisional Office, SCO No.36-37, Ground Floor, Sector 17-A, Chandigarh.

….Respondent

Appeal under Section 15 of the Consumer Protection Act, 1986.

QUORUM:   JUSTICE SHAM SUNDER, PRESIDENT.

                   MRS. NEENA SANDHU, MEMBER.

Argued by:  Sh.S.S.Chadha,  Advocate for the appellant

              Sh. R.K.Bashamboo, Advocate for the respondent.

Per Justice Sham Sunder , President

1.             This appeal is directed against  the order dated 29.4.2011, rendered by the District Consumer Disputes Redressal Forum-I, U.T. Chandigarh (hereinafter to be referred as the District Forum only), vide which the complaint of the complainant was dismissed. 

2.             The facts, in brief, are that the  complainant (now appellant), took household insurance policy, vide cover note No.480833 dated 18.07.2008, covering the risk from 23.07.08 to 22.07.09, for a sum of Rs.10 lacs approximately, after paying the premium of Rs.1432/-,  from the opposite party(now respondent).  On 13.11.2008, at about 7.00 p.m., the main front door, which was locked from outside, was found to be locked from inside, and the light of the house was on. The complainant, alongwith his neighbours, went inside the room, and found that the almirahs were broken and goods were taken away. The matter was reported to Police Station, Sector 14, Panchkula. On the basis of report made by the complainant,  FIR No.39 dated 13.11.2008, was  recorded.  The intimation, with regard to the theft, was also given to the opposite party on 14.11.2008. The complainant also submitted the claim for Rs.2.16 lacs, to the opposite party.  It was stated that the complainant completed all the formalities, as required by the Opposite Party, vide its letter dated 5.1.2009. Thereafter, he received letter dated 14.02.09, alongwith a questionnaire from M/s Surya Surveyors Pvt. Ltd., through Sh.Jaswant Singh asking him to submit   various documents. The complainant  replied to the questionnaire vide letter dated 27.02.2009. The complainant also submitted the untraced report dated 13.03.2009.  He again received a  letter dated 14.07.2009, from the surveyor, to furnish the details of the insured items,  which were supplied by him,  vide letter dated 20.07.09.   In the said letter, it was specifically stated that there was some mistake, while calculating the value of the stolen jewellery.  Thereafter, the complainant wrote letters dated 13.07.09 and 05.1.10, to the opposite party to settle the claim, but it failed to settle the same and, on the other hand, treated the same as closed.  It was further stated that the  aforesaid acts of the Opposite Party, amounted to deficiency, in rendering service, and indulgence into unfair trade practice.  When the grievance of the complainant, was not redressed, left with no alternative, a complaint under Section 12 of the Consumer Protection Act, 1986(hereinafter to be called as the Act only) was filed.  

3.             The opposite party, in its reply, stated that  loss of jewellery and valuables, was not  covered, under the terms and conditions of the  insurance policy. It was further stated that, under these circumstances, the claim of the complainant was rightly closed vide letter dated 30.03.09, as he  failed to supply a copy of the FIR and claim form, despite reminders. It was further stated that the complainant took household insurance policy, which was valid from 23.07.08 to 22.07.09. It was further stated that the policy was taken only for covering risks, under sections1-B, 2, 4, 5, 6, 8 and 10A, mentioned therein (policy). It was further stated that the risk regarding the loss of jewellery and valuables, was not covered under the policy.   It was further stated that the loss of jewellery was covered under Section III of the policy, but the complainant had not taken the policy for the same and  even no premium was paid by him, for this purpose. It was  denied that  theft took place on 13.11.2008.  It was denied that the opposite party was deficient, in rendering service. The remaining averments, were denied, being wrong. 

4.             The Parties led evidence, in support of their case.

5.             After hearing the Counsel for the parties  and, on going through the evidence, and record of the case, the District Forum dismissed the complaint, on the ground, that loss of jewellery, silver bowls, coins, and other valuables, was not covered under the terms and conditions of the Insurance Policy.

6.             Feeling aggrieved, the instant appeal, has been filed by the appellant/complainant.

7.             We have heard the Counsel for the parties, and, have gone through the evidence and record of the case, carefully.

8.             The Counsel for the appellant, submitted that, in the cover note Annexure C-1, of the policy, the risks, which were covered under the same, were mentioned.  He further submitted that a separate list Annexure C-12, containing, interalia,  all the household goods, as also the jewellery, silver bowls, coins, and other valuables, for which the policy was taken, was furnished to the Insurance Company, by the complainant. He further submitted that, when theft was committed, in his house, the appellant/complainant, got registered an FIR on 13.11.2008. The theft could not be traced   He further submitted that claim Annexure C-3, was also lodged by the complainant with the Opposite Party,  alongwith the list of articles and the cash, which were stolen. He further submitted that Annexure C-5, letter dated 14.02.2009, alongwith the questionnaire, was received from the Surveyor, and, he, answered that questionnaire, vide Annexure C-6 dated 27.02.2009. He further submitted that, even the untraced report Annexure C-7, was submitted to the Insurance Company, but it illegally treated his claim, as closed, vide Annexure R-5 dated 30.03.2009, though the Surveyor continued demanding the information/documents upto 14.07.2009 vide letter Annexure C-8. He further submitted that the District Forum, did not appreciate the evidence, in its proper perspective, as a result whereof, it fell into a grave error,  in dismissing the complaint. He further submitted that the order of the District Forum, being illegal, and invalid, is liable to be set aside.

9.             On the other hand, the Counsel for the respondent/Opposite Party, submitted that the complainant, did not cooperate with the Surveyor, as he did not supply, all the relevant documents. He further submitted that even, the loss of jewellery, silver bowls, coins, and other valuables, was not covered, under the terms and conditions of the policy, nor any premium, was paid, with respect to the same, by the complainant. He further submitted that, under these circumstances, the claim of the complainant was rightly treated, as closed, as he was not entitled to any indemnification, under the terms and conditions of the policy. He further submitted that the order of the District Forum, being legal and valid, is liable to be upheld.

10.           After giving our thoughtful consideration, to the rival contentions, advanced by the Counsel for the parties, and the evidence, on record, we are of the considered opinion, that the appeal is liable to be accepted, for the reasons, to be recorded hereinafter. Admittedly, the complainant, obtained the Insurance Policy, the cover-note whereof is Annexure C-1, against fire and allied perils, theft larceny, domestic breakdown, T.V. set one all risk, plate glass, baggage insurance and public liability, for which he paid a premium of Rs.1432/-. The item-wise sum insured details, are given, in a document at page 14/51 of the District Forum File, attached with the cover note R1/C1.   According to the details mentioned at page 51, household goods, under Section 1-B;  household goods under Section 2; Plate Glass under  Section 4; Electrical Items under Section 5; TV Set under  Section 6; and Baggage under Section 8 of the policy were got insured, for different amounts and the premium was paid. It is also proved, from the evidence,  on record, that when the theft took place, on the same day, the complainant lodged FIR, copy whereof is Annexure C-2, wherein, it was stated by him, that the gold jewellery, silver bowls, coins etc./jewellery, as also cash amounting to Rs.25,000/-, were stolen. He further stated in this FIR, that complete details of the goods stolen, shall be given, after checking the same. Thereafter, he submitted his claim Annexure C-3, alongwith which list of the articles, which were stolen, with price thereof, was submitted to the Insurance Company. In para no. 6 of the written reply, it was admitted by the Opposite Party, that the claim was lodged by the complainant. In para no. 8 of the complaint, it was stated by the complainant,  that the untraced report was also submitted to the Insurance Company. In para no. 8, of the written reply, it was stated by the Opposite Party, that it was a matter of record. It means, that the fact of submission of the untraced report, was not denied by the Opposite Party. Untraced report Annexure C-7, contains the report, which was made by the complainant, with regard to theft, on the basis whereof, the FIR was registered. Therefore, it could not be said that copy of the  FIR, was  not supplied to the Opposite Party, by the complainant. Even the questionnaire, which was sent by the Surveyor to the complainant, was answered by him. It is, therefore, held that that,  whatever record, was required by the Opposite Party, for the purpose of settlement of the claim, on account of the loss of goods, aforesaid,  and available with the complainant, was supplied to it, from time to time. Under these circumstances, the case of the Opposite Party, that all the relevant papers, required were not supplied, could not be said to be correct. The closure of the claim of the complainant, regarding indemnification, on account of non-supply of the copies of  documents, therefore, being, in the facts and circumstances of the case, could be said to be illegal and invalid. The Opposite Party, was, thus, deficient, in rendering service.

11.           The next question, that arises, for consideration, is, as to whether, the complainant, also got insured jewellery, silver bowls, coins, wears, other valuables etc. etc., at the time of taking the Insurance Policy C-1/R-1. C-12, is the list, bearing the stamp of the Insurance Company, which means that the same was supplied to the Insurance Company, at the time of taking the policy,  by the complainant. The case of the complainant, fell within the purview of Section II of the terms and conditions of the policy R/1-A, which relates to burglary and housebreaking including larceny or theft (excluding money and valuables). As stated above, Annexure R-1/C-1, insurance cover, was also taken against burglary and housebreaking including larceny or theft. According to this Section, the Company would indemnify the Insured, in respect of loss or damage to the contents, whilst contained in the Insured premises, by Burglary, housebreaking, including larceny and theft. The special exceptions under Section II of the terms and conditions of the policy Annexure R/1-A, read as under:-

       “The Company shall not be liable in respect of:

                        i.   loss or damage by Burglary and/or Housebreaking or theft where any employee of the insured or member of the Insured`s family is concerned as principal or accessory

                       ii.   loss of or damage to livestock, motor vehicles and pedal cycles.

                     iii.   loss or damage to money, securities for money, stamps, bullion, deeds, bonds, bills of exchange, promissory notes, stock and share certificates, business books, manuscripts, documents of any kind, unset precious stones and jewelry and valuables, unless specifically declared”.

12.           The perusal of special exception (iii) of Section II of the terms and conditions of the policy, clearly goes to show, that Insurance Company was not liable for loss or damage to money, securities for money, stamps, bullion, deeds, bonds, bills of exchange, promissory notes, stock and share certificates, business books, manuscripts, documents of any kind, unset precious stones and jewelry and valuables, unless specifically declared. Had the complainant,  not declared vide list Annexure C-12, the articles in respect whereof, the insurance was taken by him, against various risks or perils, the matter would have been different. In Annexure C-12, the list, which was supplied to the Opposite Party, by the complainant, at the time of taking the insurance policy, jewellery, silver bowls, coins, wears, other valuables, wrist watches etc., are mentioned. The complainant took insurance of three wrist watches, Titan (02) and Citizen (01) in the sum of Rs.3000/-; sliver bowls, glasses, coins and wears in the sum of Rs.10,000/-; gold bangles 08 in number weighing 80 gms, in the sum of Rs.48,000/-; two gold bracelets 40 gms, in the sum of Rs.24,000/-; one gold chain 10 gms, in the sum of Rs.6,000/-; two gold rings weighing 10 gms in the sum of Rs.6,000/-; one gents gold ring weighing 10 gms in the sum of Rs.6000/-; two gold sets (30 gms and 50 gms) in the sum of Rs.18,000/- and Rs.30000, respectively, alongwith other articles. When theft is committed, in the house of a person, he immediately reports the matter, to the Police, and mentions therein, the articles, found to be missing on cursory look. It is only after due inspection of all the articles, that he can come to the conclusion, as to what else was stolen, or what was left out. In the list at page 19 of the District Forum file, which was attached with the claim form, Annexure C-3, at page 18 of the District Forum file, the complainant claimed the loss of one gold chain 10 gms, two gold rings 10 gms, two gold sets (30gm and 50 gms), four bangles, five silver glasses, two silver bowls, 10 silver coins, two wrist watches (Titan) alongwith cash of Rs.25,000/-,  and, thus, he sought indemnification, in the sum of Rs.2,16,000/-. It may be stated here, that in Annexure C-12, there was no mention, with regard to cash and, hence, claim of the complainant, in that regard, is untenable. In Annexure C-12, the price of 8 bangles was mentioned as Rs.48,000/-, whereas, according to the complainant, as per the list at page 19 referred to above, four bangles of 40 gms were stolen. It means that the price of those bangles was Rs.24,000/-. The complainant claimed Rs.12,000/- in respect of loss of one gold chain of 10 gms, whereas, the value of one gold chain mentioned in Annexure C-12, is Rs.6,000/-. The complainant further claimed the loss of two gold rings weighing 10 gms valued at Rs.12,000/-,  whereas, as per Annexure C-12, the value of two gold rings was mentioned as Rs.6,000/-. The complainant claimed a sum of Rs.96,000/- in respect of two gold sets( 30gms and 50 gms), in the list which is at page 19, whereas the value of the two gold sets(30 gms and 50 gms), was mentioned in the list annexure C-12 as Rs.48,000/-. The complainant claimed the amount of Rs.20,000/-, in respect of five silver glasses, two silver bowls and 10 silver coins, whereas, in the list Annexure C-12, the value of silver bowls, coins and  wears was mentioned as Rs.10,000/-. The complainant, in the list at page 19 claimed Rs.3000/-, on account of loss of two wrist watches(Titan), whereas, in Annexure C-12 list, he mentioned the value of two Titan watches, as Rs.2000/-. The District Forum, did not properly go through Section II of the terms and conditions of the policy R/1-A and special exceptions, mentioned thereunder,  and, therefore, fell into a grave error, in holding that jewellery, silver bowls, coins, wears, other valuables etc., were not covered under the same. The complainant, in our considered opinion, is  entitled to indemnification of Rs.96,000/- ( Rs.6000/- on account of loss of one gold chain; Rs.6000/- on account of loss of two gold rings; Rs.48,000/- on account of loss of two gold sets (30 gms and 50 gms); Rs.24,000/- on account of loss of four gold bangles; Rs.10,000/- on account of loss of five silver glasses, two silver bowls and ten silver coins; Rs.2000/- on account of loss of two Titan watches).  The Opposite Parties, thus, illegally repudiated the claim of the complainant, to the tune of Rs.96,000/-. The findings of the District Forum, that loss of the jewellery, silver bowls, coins, wears and other valuables, was not covered, under the policy, being perverse are reversed.

13.           The next question, that arises for consideration, is, as to whether, the complainant is entitled to interest, if so, at what rate and from which date. The rightful claim of the complainant was illegally denied to him on frivolous grounds by the Opposite Party. Had the amount of Rs.96,000/- been paid to the complainant, after about 4 months, from the date of lodging the claim, he would have deposited the same in some bank, or invested it in some business, thereby earning handsome returns on the same. He, thus, suffered financial loss. The complainant is, thus,  entitled to interest @10% p.a. from 01.04.2009, i.e. after the expiry of about 4 months from 14.11.2008, when the claim Annexure C-3 was lodged by him with the Opposite Party.

14.           It was the duty of the Opposite Party, to properly, process the claim of the complainant, and settle the same, especially, as held above, when all the necessary and requisite documents, for doing so, had been submitted by the complainant, to it. The Opposite party, on one pretext or the other, on frivolous grounds, kept on postponing the matter, and, ultimately, the claim was treated, as closed, on the ground, that the complainant had not supplied a copy of the FIR and the claim. As held above, the untraced report was supplied by the complainant, wherein, the report lodged by the complainant, on the basis whereof,  the FIR was registered, was mentioned. Even according the complainant C-2, copy of the FIR was supplied to the Opposite Party. It may be stated here, that at the most, the claim of the complainant, should have been settled, by the Opposite Party,  within 4 months,  from the date of lodging the same, but it, did not do so. Under these circumstances, the complainant had to suffer a tremendous physical harassment and mental agony, for which he,  is entitled to be compensated. Compensation in the sum of Rs.40,000/- if awarded, in our considered opinion, shall be just and fair.

15.                  No other point, was urged, by the Counsel for the parties.

16.           For the reasons recorded above, the appeal is accepted, with costs. The impugned order is set aside. The complaint is accepted, in the following manner:-

                      i)     The respondent/Opposite Party, is directed to pay Rs.96,000/- by way of indemnification, on account of the loss of articles, referred to above, in theft, to the complainant.

                    ii)     The respondent/Opposite Party, shall pay interest @10% p.a. on the amount of Rs.96,000/- from 01.04.2009, till realization.

                   iii)     The respondent/Opposite Party, is directed to  pay compensation, in the sum of Rs.40,000/-, for physical harassment, and mental agony, caused to the complainant.

                    iv)     The respondent/Opposite Party, shall also pay Rs.7,000/-, as litigation costs, to the complainant.

                     v)     The aforesaid payable amounts, mentioned in directions (i) and (ii) above,  shall be paid to the appellant/complainant, within 30 days, from the date of receipt of a certified copy of this order, failing which the respondent/Opposite Party shall pay penal interest @12% pa., instead of 10% p.a., on the same, till realization.

                    vi)     The amount mentioned in direction no. (iii) above, shall be paid within thirty days from the date of receipt of a copy of the order, failing which the respondent/opposite party shall pay penal interest @12% p.a., on this amount, from the date of order till realization,

17.           Certified Copies of this order be sent to the parties, free of charge.

18.           The file be consigned to Record Room, after completion

Pronounced.

January 17, 2012

Sd/-

[JUSTICE SHAM SUNDER]

PRESIDENT

Sd/-

[NEENA SANDHU]

MEMBER

Rg