Tamil Nadu

South Chennai

CC/182/2017

Krishna Pradeep - Complainant(s)

Versus

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

J.Saravana Vel

17 Aug 2022

ORDER

Date of Complaint Filed : 12.04.2017

Date of Reservation      : 14.07.2022

Date of Order               : 17.08.2022

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,

CHENNAI (SOUTH), CHENNAI-3.

 

PRESENT:    TMT. B. JIJAA, M.L.,                                           : PRESIDENT

                       THIRU. T.R. SIVAKUMHAR, B.A., B.L.,           :  MEMBER  I 

                        THIRU. S. NANDAGOPALAN., B.Sc., MBA.,   : MEMBER II

 

CONSUMER COMPLAINT No.182 /2017

WEDNESDAY, THE 17^th DAY OF AUGUST 2022

Krishna Pradeep,

S/o. N. Damodaran,

No. 5, Sivagamipuram,

2^nd Street, Thiruvanmiyur,

Chennai-600041.                                                            ... Complainant             

 

..Vs..

1.New India Assurance Company Ltd,

   Regional Office-Claims Hub,

   Rep. by its General Manager,

   2-B, Unity Building Annexe,

   Mission Road, Bangalore-560 027.

 

2.UB Insurance Associates,

   (Apps-Daily Claims Division),

   Rep. by its General Manager,

   S 204 and 205 Suraj Plaza,

   196/8, 25th Cross 8th Main,

   Jayanagar 3rd Block,

   Bangalore-560011.

   Karnataka.

 

3.Fone City,

   Unit of Lakhiani Creations,

   Rep. by its Propertied,

   No. 11/1, M.G. Road,

   Adyar, Chennai-600020.                                            ...  Opposite Parties

 

******

Counsel for the Complainant                    : M/s. J. Saravana Vel

Counsel for the 1^st Opposite Party             : M/s. S. Radha Devi

Counsel for the 2^nd & 3^rd Opposite Parties  : Exparte

 

        On perusal of records and after having heard the oral arguments of the Counsel for Complainant and the Counsel for 1^st Opposite Party, we delivered the following:

ORDER

Pronounced by Member-II, Thiru. S. Nandagopalan., B.Sc., MBA.,

1.      The Complainant has filed this complaint as against the Opposite Party under section 12 of the Consumer Protection Act, 1986 and prays to pay Rs.1,00,000/- towards deficiency in service and to pay the insurance claim amount as per the policy along with cost.

2.     The averments of Complaint in brief are as follows:-

The Complainant purchased a mobile phone by a model name Samsung Galaxy S5 with IMEI No. 353295060506697 from the 3^rd opposite party on 23.06.2014 for a sum of Rs.40,000/- along with a Samsung Flip Case. On the Same day the 3^rd  opposite party compelled the Complainant to purchase an insurance policy of the 1st opposite party called "Daily Ultimate Protection" at the cost of Rs.2499/- which was processed by the 2nd opposite party. The 3^rd opposite party had issued receipts for purchase of both the mobile phone as well as the insurance policy. The Complainant submits that neither the 3^rd opposite party issued the insurance policy nor the 2nd opposite party furnished any information about the policy purchased by the Complainant from the 3^rd Opposite Party.

On 19.12.2014 the Complainant's mobile phone was stolen while he was travelling by MTC bus from Parrys corner to his residence in Adyar at about 7pm in the evening. The Complainant is a practising advocate at the Madras High Court. All efforts of the Complainant to trace the mobile was in vain. Hence on 20.12.2014 the Complainant gave a complaint to the Inspector of Police, Adyar Police Station with CSR No.349/2014 and as per the request of the Complainant, sim card was also blocked with the Vodafone service provider. After a search and investigation, Police treated the case as Non-traceable. Hence, The Inspector of Police (Crime), Adyar Police Station issued a non-traceable certificate dated 08.01.2015. The Complainant approached the 3rd opposite party for Insurance claim in return the 3rd opposite party informed the Complainant to make Online Claim since they are not responsible in any manner. So, the forms were downloaded from the internet by the complainant. On 09.01.2015, the complainant made a claim in Form IA and Form A by enclosing the necessary documents as required by the 1st opposite party. On the same day, the Complainant obtained a replacement sim card from the Vodafone Store at Adyar for the lost sim card. The 1^st Opposite Party issued a Claim Pre-Receipt Voucher in Form 5A.

After the claim there was no response from the 1st opposite party and hence issued a reminder dated 26.09.2015 seeking the status of the claim by claiming 53% of the purchase money as per the Insurance claim entitlement. The said reminder was sent via professional courier on 03.10.2015, but there was no response from the 1st opposite party. On 28.11.2015 the complainant received a letter from the 1st opposite party dated 06.06.2015 signed on 19.10.2015, stating that the claim is repudiated for the following reason: "As per registered Police Certification, Mobile was lost". The 1st opposite party further confirms that the claim falls under the exclusion category as per the terms and conditions of the policy. Hence, the claim is closed. On 04.03.2016 the Complainant sent a detailed notice, refuting the allegation of 1st opposite party and categorically stating that the insurance coverage was for theft / burglary as defined under Clause 4(b) of the terms and conditions issued by the Apps Daily Solution, which is the online portal of the 1^st opposite party herein and through which the insurance claim has been made. Since the Mobile was stolen and theft has been reported and the reason why the Police issued CSR followed by Non-traceable certificate after due investigation as the stolen mobile could not be detected. But the 1^st Opposite Party concludes that the mobile was lost as per the registered Police Certification is wrong on the face of the record. Moreover the repudiation of the Insurance claim based on a non-existent ground invented by the 1^st Opposite Party is totally arbitrary and amounts to gross deficiency in service. Hence the Complaint.

3. Written Version filed by the 1^st Opposite Party in brief is as follows:-

The 1^st Opposite Party submitted that the Complainant has not come to this Hon'ble forum with clean hands. All the allegations made by the Complainant were absolutely false and baseless allegations. The Complainant had filed this complaint after the lapse of 2 and half years and barred by limitation. The opposite Party admits that the complainant had purchased "Daily Ultimate Protection" at a cost of Rs.2499/- and it is an Application from Apps daily that comes with full security. The reliable anti-theft feature that lets you track your device once it's stolen or lost and helps us to take backup of contacts and messages for easy restoration. With the DND feature, you can block unwanted calls and SMS at ease. It comes equipped with SOS function and has an integrated antivirus. Real time GPS tracking is another highlight of the application. The Complainant had not filed the Insurance Policy terms and conditions before this Forum. Further the Complainant had to prove that there is a valid Insurance Policy for the said mobile at the time Mobile was lost.

The 1^st Opposite Party further states that they are the custodian of Public funds and they can use the funds only for genuine claims as per the terms and conditions of the policy. The Complainant stated in the complaint that his mobile was stolen while he was travelling by MTC bus from Parrys Corner to his residence at Adyar. Since the complainant used the said mobile in careless, irresponsible and hasty manner it is crystal clear that the mobile was lost only due to the gross negligence of the Complainant. On verification of records found in the claim form sent by the Complainant does not comply with the necessary requirements of terms and Conditions of Policy. Therefore the Complainant is not entitled to get an alleged claim hence it was repudiated for the correct reason of gross negligence on the part of the Complainant and there was no deficiency of service. Further the mobile was lost on 19.12.2014 and the complainant had intimated the loss to the 1st Opposite Party on 09.01.2015 i.e after 20 days of the theft of the said mobile. Under Policy exclusion clause if the mobile was lost due to mysterious disappearance, forgotten , misplaced , lost or if handset is left unattended at any point of time or any unexplained loss will not be liable to settle any claim. Hence, the claim was repudiated on 06.06.2015 but the Complainant had filed this complaint only in the year 2017 after two years. Therefore the Opposite Party pray to dismiss the Complaint.

4.      The Complainant submitted his Proof Affidavit and Written Arguments. On the side of the Complainant, documents Ex.A-1 to Ex.A-10  were marked. The 1^st Opposite Party submitted his Proof Affidavit and Written Arguments. On the side of the 1^st Opposite Party, Ex.B-1 alone was marked.   

5.     Inspite of sufficient notice served on Opposite Parties 2 and 3 , the Opposite parties 2 & 3 failed to appear before this commission and they have been called absent and set Ex-parte

Points for Consideration:-

 

1. Whether the Complaint is barred by limitation?

 

2. Whether there is any deficiency in service on the part of the Opposite    Parties?

 

3. Whether the Complainant is entitled for the reliefs sought for?

 

4.To what other relief the Complainant is entitled to?

 

Point No.1 : -

 

The Complainant had purchased Samsung Galaxy S5 mobile Phone on 23.06.2014 from the 3rd Opposite Party and had taken Insurance Policy for the said mobile on the same day. As the mobile was lost on 19.12.2014 he made a claim to the 1st Opposite Party on 09.01.2015 which was repudiated on 06.06.2015. This Complaint is filed on 12.04.2017 which is within 2 years from the date of repudiation. Hence the Complaint is well within limitation. 

Point No.2 : -

 

The Complainant purchased a mobile phone by a model name Samsung Galaxy S5 with IMEI No.353295060506697 along with Flip Case from the 3rd opposite party on 23.06.2014 for a sum of Rs.40,000/- as per Ex.A-1. On the same day the Complainant purchased the 1st opposite party Insurance Policy called "Daily Ultimate Protection" at the cost of Rs.2499/- from the 3rd Opposite Party as per Ex.A-2. The Complainant contended that neither the 3rd Opposite Party nor the 2nd opposite party furnished any information about the policy terms & conditions. On 19-12-2014 the Complainant mobile was stolen and he reported the same to the Adyar Police station and received the CSR No.349/2014 on 20.12.2014 in Ex.A-4. After a search and investigation, Police treated the case as Non-traceable. Hence, The Inspector of Police (Crime), Adyar Police Station issued a Non-Traceable Certificate dated 08.01.2015 in Ex.A-5. With all the necessary documents, Complainant claimed the Insurance with the 1st Opposite Party on 09.01.2015 as per Ex.A-6. Almost for more than 10 months there was no response from the 1st Opposite party for the claim made by the Complainant ,hence the Complainant sent a reminder letter dated 26.09.2015 seeking the status of the Claim as per Ex.A-8. Replying to the Complainants reminder, on 28.11.2015 Complainant received a letter dated 06.06.2015 from the 1st Opposite Party stating that the Claim has been repudiated for the following reasons "As per the Registered Police Certification, Mobile was Lost which falls under exclusion as per the terms and conditions of the policy claim" as found in Ex.A-7.

On Careful perusal of records it is seen that the Complainant mobile was stolen on 19.12.2014 who had insured his mobile with the 1st Opposite Party and hence submitted his claim with all relevant documents on 09.01.2015. However the 1st Opposite Party had repudiated the claim after a period of nearly 5 months on the ground that "As per the Registered Police Certification, Mobile was Lost" falls under the exclusions stipulated as per the terms and conditions of the policy, without providing the corresponding provisions of the Insurance Policy. A perusal of Ex.B-1 reveals that the reasoning given by the 1^st Opposite Party does not fall under any of the clauses under "Exclusion". The act of the Opposite Parties in repudiating the claim of the Complainant without proper reasoning and after a long delay amounts to deficiency in service on the part of the Opposite Parties. Accordingly, Point No.2 is answered.  

Point No.3 & 4 : -

 

As discussed and decided Point No. 1 and 2 in favour of the Complainant the Opposite Parties is directed to pay a sum of Rs.25,000/- towards deficiency of service and a sum of Rs.5000/- towards cost of the Complaint. Accordingly Point Nos 3 and 4 are answered.

In the result the complaint is allowed in part. The Opposite Parties 1 to 3 are jointly and severally directed to pay a sum of Rs.25,000/-(Rupees Twenty Five Thousand Only) towards deficiency of service and a sum of Rs.5,000/- (Rupees Five Thousand Only) towards cost of the complaint, within 8 weeks from the date of receipt of this order, failing which the above amounts shall carry interest at the rate of 6% p.a from the date of this order till the date of payment.

In the result the Complaint is allowed.

Dictated to Steno-Typist, transcribed and typed by her, corrected and pronounced by us in the Open Commission, on 17^th of August 2022. 

 

 

S. NANDAGOPALAN               T.R. SIVAKUMHAR                 B.JIJAA

         MEMBER II                       MEMBER I                        PRESIDENT

 

List of documents filed on the side of the Complainant:-

 

Ex.A1	23.06.2014	Purchase Bill os Samsung Galaxy Mobile
Ex.A2	23.06.2014	Purchase Bill of Insurance Policy. “ultimate Protection”
Ex.A3	20.12.2014	Complaint to the police
Ex.A4	20.12.2014	CSR issued by the police
Ex.A5	08.01.2015	Non- traceable certificate issued by the police
Ex.A6	09.01.2015	Complaint application to 1st Opposite Party through the 2nd Opposite Party with all enclosures. (Form A, Form IA and Form 5A)
Ex.A7	06.06.2015	1st Opposite Party letter repudiating the claim
Ex.A8	26.09.2015	Complainant letter to 2nd Opposite Party with courier receipt
Ex.A9	26.11.2015	1st Opposite Party postal cover
Ex.A10	04.03.2016	Complainant legal notice to 1st Opposite Party with postal receipt

 

List of documents filed on the side of the 1^st Opposite Party:-

 

Ex.B1

-

Copy of New India Assurance Company Limited

 

List of documents filed on the side of the 2^nd & 3^rd  Opposite Parties:-

 

NIL

 

 

 

S. NANDAGOPALAN               T.R. SIVAKUMHAR                    B.JIJAA

         MEMBER II                             MEMBER I                        PRESIDENT