Tamil Nadu

South Chennai

CC/125/2015

P.Sathyanarayanan - Complainant(s)

Versus

The Reliance General Insurance Company Ltd - Opp.Party(s)

N.Jayakumar

10 Aug 2022

ORDER

Date of Complaint Filed : 20.03.2015

Date of Reservation      : 12.07.2022

Date of Order               : 10.08.2022

 

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.125 /2015

WEDNESDAY, THE 10^th DAY OF AUGUST 2022

P.Sathyanarayanan,

No 11/9, Venkatachalam Lane,

Middle Street,

Mylapore,

Chennai 600 004.                                                                                                                                                             ... Complainant                       

 

..Vs..

1.The Reliance General Insurance Company Ltd,

   Reliance House,

   6^th floor, No 6, Haddows Road,

   Nungambakkam,

   Chennai 600 006.

 

2.The Reliance General Insurance Company Ltd,

   Reliance Centre, No 19, Walchand Hirachand Marg,

   Ballard Estate,

   Mumbai 400 001.                                                                                                                                                     ...  Opposite Parties

 

******

Counsel for the Complainant            : M/s. N.Jayakumar

Counsel for the Opposte Parties        : M/s. Elveera Ravindran

 

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

 

 

ORDER

Pronounced by Member-I, Thiru. T.R.Sivakumhar, B.A., B.L.,

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 the insurance amount of Rs.2,50,000/- and to pay a sum of Rs.1,00,000/-towards compensation for the mental agony and the discomfort caused to the Complainant and to pay a sum of Rs.50,000/- towards the cost of this complaint.

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

The Complainant  had purchased TATA Indica car by availing loan from Indusind Bank. The Complainant submits that he had insured his vehicle with the office of Opposite Parties from the date of purchasing his vehicle. The Policy started in the Month of April, 2014 is still in force and the policy covers the Complainants' vehicle even today. The policy was taken for a period of one year and the policy number is 1212542338000308. The Complainant had insured his Tata Indica VZLS model car valued at Rs. 2,50,000/- under the above policy. He had paid the premium and the vehicle insurance covers the risk of accident as well as theft. His vehicle was stolen on 02.07.2014 at the mid night from the place where it is regularly parked. The Complainant  immediately given a police complaint on the early morning of 03.07.2014. The police people have instructed the Complainant to get a letter from the Indus Ind Bank stating that the vehicle is not seized by them for any payment default. He was regularly paying the instalment and immediately approached the Bank for issuance of non seizer letter. The concerned official of the bank was on leave and therefore the Complainant was able to get the letter only after 4 days i.e., the letter was issued only on 08.07.2014. The letter from the Indus Ind Bank the police officials have speeded their enquiry and the Complainant was always accompanied the police officials and the search was continued in a full-fledged manner for 2 to 3 days. The First Information Report (FIR) was lodged on 10.07.2014. The Complainant have requested for copy of the FIR, however the police people have taken almost a week to furnish a copy of FIR to the Complainant. The Complainant had forwarded the written letter as well as the document along with the FIR to the Indus Ind Bank, the Opposite Parties and the transport department. The Bank have received the letter along with the documents around 23.07.2014. In furtherance to the issuance of letter, the Complainant has visited the Opposite Parties again and again and finally on 06.08.2014 the vigilance person of the Opposite Parties had visited the Complainant's place and obtained signatures in the claim form as well as in a requisition letter. It is not out of place to mention here that even on the date of vigilance enquiry all the documents including FIR were available with Opposite Parties as well the Complainant. The Opposite Parties having obtained all the documents issued a letter dated 06.08.2014, wherein they have requested for certain documents, which were already available with them. The Complainant went in person to the Opposite Parties and informed the availability of the documents with the Opposite Parties office. The Opposite Parties had instructed the Complainant to contact them after 2 weeks to know about the claim amount. When the Complainant approached the Opposite Parties after 2 weeks, the Opposite Parties informed to the Complainant that the policy claim will be rejected on the sole ground of delay in intimation about the loss of vehicle. The conditions referred in the repudiation letter at the first instance is not specifying any time period for intimation. The condition also stipulates that the insured has to complaint the police and co-operate in securing the conviction of the offender. The Complainant immediately after the vehicle was stolen he had rushed to the police station and in fact the Complainant has went to police station day by day and only when the situation went beyond his control, the Complainant has immediately approached the Opposite Parties and intimidated the loss of vehicle. The Complainant has insured his vehicle having utmost good faith on the Opposite Parties believing that the Opposite Parties shall compensate the insured in case of any accident or loss of vehicle. This is the very purpose of taking the insurance and paying the premium amount. In such event rejecting the claim of the Complainant on flimsy reasons is against justice and fairness. The Complainant very well explained the struggles he suffered to trace the vehicle and in fact the complaint has expended a very huge amount in searching the vehicle through police people and put to serious mental agony. Having received the premium and knowing very well that the vehicle is lost by Complainant, the Opposite Parties sought not to have simply rejected the claim alleging some procedural non compliance. It is a well settled legal principle that "the delay never extinguishes the right. Therefore the so called delay is not a delay in the real sense. In fact the Complainant has immediately approached the Opposite Parties when he lost faith on the police people. In such event the Opposite Parties are adopting an unfair trade practice by alleging delay and seriously deficient in their service to honor the insurance claim of the Complainant. he had issued the legal notice dated 13.11.2014 to the first Opposite Party explaining the factual matrix of entire issue and claimed the amount. The first Opposite Party having received the legal notice has failed to even send a reply. Even after the expiry of more than two months the first Opposite Party was not bothered to respond the Complainant. Hence the complaint.

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

       The Complainant had purchased a TATA INDICA car by availing a loan from the Indusind Bank and that he had been insuring his vehicle with the Opposite Parties from date of purchase till date. In any event the Complainant has failed to mention the date of purchase of his vehicle. The Complainant is put to strict proof that the Opposite Parties had issued a policy bearing No 1212542338000308 for his vehicle. Further the Complainant is not a consumer as the vehicle is used for commercial purpose. The Opposite Parties deny the allegation that the Complainant’s  vehicle was stolen on 02.07.2014 at midnight from the place where it is regularly It is further denied that the Complainant immediately gave a police complaint on 02.07.2014 and that the police have instructed him to get a letter from the bank that the vehicle was not seized by them In any event the Complainant ought to have intimated the police authorities and the Opposite Parties immediately on the occurrence of the incident. The same was not complied with by the Complainant. The policy and the schedule shall be read together and any word or expression to which a specific meaning has been attached in any part of this policy or of the schedule shall bear the same meaning wherever it may appear Notice shall be given in writing to the company immediately upon the occurrence of any accident, loss or damage and in the event of any claim and thereafter the insured shall give all such information and assistance as the company shall require. Every letter, claim with summons and/or process or copy thereof shall be forwarded to the company immediately on receipt by the insured. Notice shall also be given in writing to the company immediately the insured shall have knowledge of any impending prosecution inquest or fatal injury in respect of any occurrence which may give rise to a claim under this policy. In case of theft or criminal act which may be the subject matter of a claim under this Policy the insured shall give immediate notice to the police and co operate with the company in securing the conviction of the offender. The terms, conditions and endorsement of its policy in so far as they relate to anything to be done and complied with by the insured and the truth of the statements and answers in the said proposal shall be condition precedent to any liability of the company to make payment under this policy. Hence it is clearly seen that the Complainant had violated the terms and conditions of the policy of insurance. Hence no claim is payable. The Opposite Parties deny according to the FIR which was given by one Adam, as late as 10.07.2014 there is not a whisper about any earlier complaint alleged to have been made by the Complainant. Instead the informant of the allegations made in the complaint and the Complainant is put to strict proof of the same that he had lodged a complaint with the police authorities on 03.07.2014, which is only an afterthought, since even the FIR had admitted that there was a delay in reporting the incident to the police authorities and in any even the complaint was only an afterthought and after an inordinate delay of more than 7 days. It is also admitted by the Complainant that he had not intimated the Opposite Parties about the alleged incident immediately as he was supposed to do. The Complainant had not come with clean hands before this Hon'ble Forum as alleged monthly EMI, while from the documents filed by him it is seen that he was not regular in payment. Further admitted by the Complainant that he did not intimate the Opposite Parties immediately but after an inordinate delay. The Opposite Parties were informed after a delay of more than 34 days. Hence it is submitted that the Opposite Parties was not put on notice immediately on the occurrence of the alleged incident, thus depriving the Opposite Parties of the opportunity to ascertain the genuineness of the alleged theft, hence violating the terms and conditions of the policy of insurance. As per the policy conditions the Complainant ought to have given notice in writing to the company immediately upon the occurrence of any accident, loss or damage in the event of any claim and thereafter the insured shall give all such information and assistance as the company shall require. as per the procedure had appointed their independent surveyor who had conducted the survey and on the basis of the documents submitted by the Complainant and on the application of mind to the facts and circumstances of the case, the Complainant was informed that the claim was repudiated. Thus the Complainant had committed breach of the conditions of the policy and also committed a breach of vital condition of the policy being the due observance of the terms and conditions of the policy in so far as they relate to anything to be done or complied with by the insured shall be a condition precedent to any liability of the company to make any payment under this policy. In view of the breach of the fundamental condition of the insurance relating to immediate notice has totally prejudiced the Opposite Parties right to verify and ascertain the loss and manner of occurrence thereof. The Opposite Parties had issued a letter dated 06.08.2014, without prejudice to their rights, clearly stating that the claim intimation was made only on 05.08.2014 after a delay of more than 34 days and called upon the Complainant to produce the mandatory documents. Thus the Opposite Parties had acted promptly and discharged their duties diligently. The Opposite Parties submit by their letter dated 18.09.2014, diligently informed the Complainant that his claim was repudiated owing to a breach of the policy conditions. Hence the complaint is to be dismissed.

4.     The Complainant submitted his Proof Affidavit and Written Arguments. On the side of Complainant, documents Ex.A-1 to Ex.A-9 were marked. The Opposite Parties submitted his Proof Affidavit and Written Arguments. On the side of Opposite Parties, documents Ex.B-1 to Ex.B-2 were marked.

Points for Consideration

1. Whether the Opposite Parties have committed deficiency of service?

2. Whether the Complainant is entitled for reliefs claimed in the Complaint?

3. Whether the Complainant is entitled for any other relief/s?

Point No.1:-

It is an undisputed fact that the Complainant had availed the service of the Opposite Party by availing Insurance Policy bearing No.1212542338000308 for his Tata Indica Car.

 The disputed fact is that whether the Complainant had intimated about his stolen car, immediately to the Opposite Parties, as per the terms and conditions of the Policy.

The contention of the Complainant is that his vehicle was stolen on 02.07.2014 and immediately he had lodged complaint on the early morning of 03.07.2014, but on perusal of Ex.A-2 in page No.4 it is clear that the vehicle of the Complainant was stolen on 02.07.2014 and the Complainant had lodged Complaint before Concerned Police Station only on 10.07.2014, which is clearly after 8 days from the date of vehicle was stolen and it is also clear from Ex.A-2 that the Complainant had delayed in lodging the Complaint, further it is clear from Ex.A-3 that the Complainant had lodged his claim form only on 05.08.2014 after 34 days from the date of vehicle was stolen.

The contention of the Opposite Parties that the terms and conditions was not strictly adhered by the Complainant, condition No.1 of Ex.B-2, the terms and conditions of the Policy, which is reproduced as follows:

      Condition No.1 of the Policy:  Notice shall be given in writing to the company immediately upon the occurrence of any accident, loss or damage and in the event of any claim and thereafter the insured shall give all such information and assistance as the company shall require. Every letter, claim with summons and/or process or copy thereof shall be forwarded to the company immediately on receipt by the insured. Notice shall also be given in writing to the company immediately the insured shall have knowledge of any impending prosecution inquest or fatal injury in respect of any occurrence which may give rise to a claim under this policy. In case of theft or criminal act which may be the subject matter of a claim under this Policy the insured shall give immediate notice to the police and co operate with the company in securing the conviction of the offender.

In support of his contentions, the Complainant had relied upon the Judgments of the Hon’ble Supreme Court in Civil Appeal No.653 of 2020 dated 24.01.2020 in Gurshinder Singh Vs- Shriram General Insurance Ltd & Another as well as Civil Appeal No.1069 of 2022 dated 11.02.2022 in Jaina Construction Company Vs-The Oriental Insurance Company Limited & Another, wherein the Complaints were lodged immediately after theft occurred, where as in the instant case, the Complaint itself was lodged with a delay of more than 7 days and the Claim form has been submitted after 34 days, i.e., on 05.08.2014, from the date of occurrence and hence the above Judgments relied by the Complainant will not apply to the instant case.

On the other hand, in support of their contentions, the Opposite Parties had relied upon the Judgement passed by the Hon’ble National Consumer Disputes Redressal Commission in Revision Petition No. 1362 of 2011 on 01.09.2011 in Rang Lal (Deceased) & 5 Others Vs- The Manager, United India Insurance Co Ltd & Another, wherein the delay in intimating the Insurance Company resulting the repudiation of claim was upheld, as well as reliance made on the Judgement passed by our Hon’ble Tamil Nadu State Consumer Disputes Redressal Commission in F.A.No.315 of 2013 on 16.02.2022 in The New India Assurance Co Ltd Vs- A.P.Tamilselvan (since Deceased) & 7 Others, wherein it was held that the delay in filing the complaint is a justifiable reason for rejecting the claim by the Opposite Party, which is also in violation of the terms and conditions of the Policy and the order of the District Consumer Disputes Redressal Forum, Villupuram, in allowing the complaint was set aside. Hence, both the judgments relied upon by the Opposite Parties squarely applies to the instant case.

Considering the facts and circumstances of the case and the Judgments relied upon by the Opposite Parties, we are of the Opinion that the delay in filing the complaint as well as the delay in informing the Opposite Parties, by the Complainant, resulted in repudiation of claim made by the Opposite Party as per the terms and conditions of the policy, which is legally sustainable. Hence, there is no deficiency of service on the part of the Opposite Parties. Accordingly Point No.1 is answered.

Point Nos.2 & 3:-

As discussed and decided Point No.1 against the Complainant, the Complainant is not entitled for the reliefs claimed in the complaint. And hence the Complainant is not entitled for any other relief/s. Accordingly, Point No.2 and 3 are answered.

In the result the Complaint is dismissed. No costs.

Dictated to Steno-Typist, transcribed and typed by her, corrected and pronounced by us in the Open Commission, on 10^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	April 2014	Copy of Insurance Policy
Ex.A2	02.07.2014	Copy of police complaint along with F.I.R and other documents
Ex.A3	Aug. 2014	Copy of client form
Ex.A4	06.08.2014	Letter issued by the Opposte Parties
Ex.A5	18.09.2014	Copy of repudiation letter
Ex.A6	13.11.2014	Copy of legal notice issued by the Complainant
Ex.A7	-	Copy of acknowledgement card
Ex.A8	30.01.2015	Copy of Rejoinder Notice
Ex.A9	-	Copy of acknowledgement cards

 

List of documents filed on the side of the Opposite Parties :-

 

Ex.B1	-	Copy of Policy
Ex.B2	-	Copy of terms and conditions of the policy

 

 

 

 

 

S. NANDAGOPALAN               T.R. SIVAKUMHAR                    B.JIJAA

         MEMBER II                       MEMBER I                         PRESIDENT