Order by:

Smt.Priti Malhotra, President

1.       The complainant has filed the instant complaint under section 35 of the Consumer Protection Act, 2019 stating that the complainant has been availing the services from the Opposite Parties from the last about 5 years. The complainant insured his vehicle/Motorcycle bearing no.PB-29AC-1098, vide policy no.2012043119P101070092. Unfortunately the said motorcycle alongwith driving license, insurance and registration certificate got stolen on 30.09.2022 at about 1.00 am in the midnight. In this regard FIR u/s 379 got registered with P.S. City South vide FIR No.211 dated 02.10.2022 and intimation about the said incident was also given to agent of Opposite Party namely Navin Mittal. Thereafter the complainant sent various emails to Opposite Parties on different dates and also visited personally in the office of Opposite Parties, but all in vain. Complainant also served a legal notice dated 27.03.2023 upon the Opposite Parties, but to no effect. Hence, this complaint. Vide instant complaint, the complainant has sought the following reliefs:-

a)       Opposite Parties may be directed to make the payment of Rs.1,25,000/- in toto i.e. Rs.75,000/- alongwith interest @ 18% per annum till the date of payment.

b)      To pay an amount of Rs.30,000/- as compensation on account of mental tension and harassment.

c)       To pay an amount of Rs.20,000/- as litigation expenses.

d)      And any other relief which this Commission may deem fit and proper be granted to the complainant in the interest of justice and equity.

2.       Opposite Parties No.1 & 4 appeared through counsel and contested the complaint by filing written reply taking preliminary objections therein inter alia that the complaint is not maintainable; the complainant has got no locus-standi; no deficiency in service has been attributed to the Opposite Party and from the allegations in the complaint no deficiency in service is made out; the complaint is barred by the terms and conditions of the insurance policy; the complaint is absolutely false and frivolous. Averred that claim was reported to answering Opposite Parties on 26.11.2022 regarding theft of Hero Splendor Plus Spoke BS IV Motorcycle No.PB-29AC-1098 on 30.09.2022 at about 1 AM in midnight from opposite Chintpurni Dharamshala, Geeta Bhawan Chowk, Moga, but the complainant informed/reported the theft to answering Opposite Parties on 26.11.2022 and to police on 22.11.2022. Whereas complainant had to inform immediately to answering Opposite Parties regarding the theft. The answering Opposite Parties vide their letter no.1477 dated 04.01.2022 asked the complainant to explain the reason for late intimation. Then again vide letter no.1511 dated 24.01.2023 which was wrongly mentioned as acknowledged as 16.01.2022 instead of 16.01.2023 asked for explanation the reason for delay in intimation to insurance company and also to supply copy of FIR lodged by him. Lastly vide letter no.1526 dated 06.03.2023 asked for explanation the reason for delay in intimation to insurance company and also to supply copy of FIR lodged by complainant, failing which, it shall be presumed that you are not interested in the claim. Hence vide letter no.255 dated 27.03.2023 complainant’s file was closed as ‘no claim’ due to non submission of requisite documents. On merits, all other allegations made by complainant are denied and a prayer for dismissal of the complaint is made.

3.       Opposite Party No.5 appeared through counsel and filed written reply taking preliminary objections, therein inter alia that the present complaint is not maintainable; no cause of action arose to the complainant against answering Opposite Party as complainant never informed the answering Opposite Party regarding the alleged accident; the present complaint is filed by the complainant just to harass the answering Opposite Party and to grab huge amount by hook and crook; the complainant concealed various material facts from this Commission just to take the favourable verdict. On merits, all other allegations made in the complaint are denied and a prayer for dismissal of the complaint is made.

4.       In order to prove his case, the complainant has placed on record his affidavit Ex.C1 alongwith copies of documents Ex.C2 to Ex.C8.

5.       On the other hand, Opposite Parties No.1 to 4 have placed on record affidavit of Sh.Inderjit Ghosh, Divisional Manager, United India Insurance Co. Ltd. as Ex.OP1 to 4/1 alongwith copies of documents Ex.OP1 to 4/2 to Ex.OP1 to 4/10. Whereas, Opposite Party No.5 has placed on record his affidavit as Ex.OP5/1.

6.         We have heard the ld. counsel for both the parties and also gone through the record.

7.       It is not disputed that the complainant is owner of Motorcycle bearing no.PB-29AC-1098, which was insured with Opposite Parties, vide policy no.2012043119P101070092. It is also not disputed that the said motorcycle got stolen on 30.09.2022 at about 1.00 am in midnight and FIR no.211 dated 02.10.2022 u/s 379 IPC got registered with P.S. City South and intimation regarding the said incident was also given to Opposite Parties. The dispute arises between the parties, when Opposite Parties No1 to 4 closed the claim of the complainant as ‘No Claim’, vide letter dated 27.03.2023 on the ground that there was delay of intimation and delay in lodging FIR. The said letter has been challenged by the complainant through this complaint.

8.       Now, we have to decide whether declaring the claim of the complainant as ‘No Claim’ is genuine or not?

9.       The perusal of the record reveals that vide letter dated 04.01.2023, the Opposite Parties have raised the objection that vehicle was stolen on 30.09.2022 and the complainant intimated to them on 26.11.2022 and vide said letter the insurance company asked the complainant to explain the reason of late intimation and enable them to proceed further. Thereafter, the complainant vide letter dated 16.01.2023 (wrongly mentioned as 16.01.2022 as per version of Opposite Parties) (Ex.OP1 to 4/6) explained the reason for late intimation to Opposite Parties and late lodging of FIR, but despite that Opposite Parties issued letters on different dates raising the same query. Perusal of the record further reveals that the complainant timely filed a complaint with P.S. City Moga, vide case no.211 dated 02.10.2022 (which is proved on record, vide document attached with Ex.C3). From the above discussion, we are of the considered view that the declining the claim of the complainant as ‘No Claim’ by Opposite Parties is illegal and in-genuine. The repudiation of the claim by the Opposite Parties is also not genuine as per IRDA circular issued to the Insurance Companies stating that the genuine claims shall not be rejected on hyper technical grounds i.e. delay etc. which for the sake of convenience is reproduced as under:-

“INSURANCE REGULATORY AND DEVELOPMENT   AUTHORITY

Ref. IRDA/HLTH/MISC/CIR/216/09/2011 Dated:20.09.2011 CIRCULAR

To All life insurers and non-life insurers.

Re: Delay in claim intimation/documents submission with respect to

 i.         All life insurance contracts and 

ii.       All Non-life individual and group insurance contracts.

The Authority has been receiving several complaints that claims are being rejected on the ground of delayed submission of intimation and documents.

The current contractual obligation imposing the condition that the claims shall be intimated to the insurer with prescribed documents within a specified number of days is necessary for insurers for effecting various post claim activities like investigation, loss assessment, provisioning, claim settlement etc.  However, this condition should not prevent settlement of genuine claims, particularly when there is delay in intimation or in submission of documents due to unavoidable circumstances.  

 The insurer’s decision to reject a claim shall be based on sound logic and valid grounds.  It may be noted that such limitation clause does not work in isolation and is not absolute.  One needs to see the merits and good spirit of the clause, without compromising on bad claims.  Rejection of claims on purely technical grounds in a mechanical fashion will result in policyholders losing confidence in the insurance industry, giving rise to excessive litigation.

10.     From the above discussion, it is evident that Opposite Parties illegally and wrongly denied the claim of the complainant.   

11.     Now came to the amount to be awarded. Perusal of policy document Ex.C4 reveals that year of manufacturing of the vehicle in question is 2019 and the alleged accident took place in the fourth year from the date of its manufacture, so IDV of the vehicle comes to Rs.31,524/- as per the Policy Schedule placed on record by both the parties. Hence we allow the same.

12.     Sequel to the above discussion, the present complaint is allowed in part and Opposite Parties are directed to pay Rs.31,524/- (Rupees Thirty One Thousand Five Hundred Twenty Four only) as IDV of the vehicle in question to complainant, subject to furnishing the letter of subrogation, power of attorney, indemnity bond and other required documents for transfer of Registration certificate  of the vehicle in question, NOC from the financiers of the vehicle in question if any, by the complainant in favour of the Opposite Party-Insurance Company. Opposite Parties are further directed to pay compository cost of Rs.7000/-(Rupees Seven Thousand only) to be paid to the complainant on account of compensation and litigation expenses. The pending application(s), if any also stands disposed of. The compliance of this order be made by the Opposite Parties within 30 days from the date of receipt of copy of this order, failing which, the Opposite Parties are burdened with additional cost of Rs.10,000/-(Rupees Fifteen Thousand only) to be paid to the complainant for non compliance of the order. Copies of the order be furnished to the parties free of costs. File is ordered to be consigned to the record room.

Announced on Open Commission