BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMRITSAR.
Consumer Complaint No.126 of 2015
Date of Institution: 3.3.2015
Date of Decision: 21.7.2016
Hardev Singh son of Gurcharan Singh resident of Village Khairabad, P.O. Central Jail, Amritsar
Complainant
Versus
United India Insurance Company Ltd., Branch Office, Batala Road, Amritsar through its General Manager
Opposite Party
Complaint under section 12 & 13 of the Consumer Protection Act, 1986 as amended upto date.
Present: For the Complainant: Sh.Sandeep Randhawa, Advocate
For the Opposite Party: Ms.Sneh Lata Kapoor, Advocate
Coram
Sh.S.S.Panesar, President
Ms.Kulwant Kaur Bajwa, Member
Mr.Anoop Sharma, Member
Order dictated by:
Sh.S.S. Panesar, President.
1. Sh.Hardev Singh has brought the instant complaint under section 12 & 13 of the Consumer Protection Act, 1986 on the allegations that complainant obtained house holders Insurance policy bearing No. A 696465 from the opposite party valid from 9.6.2013 to 8.6.2014 on payment of premium of Rs. 3606/-. As such the complainant hired the services of the opposite party for consideration and he is consumer of the opposite party and falls under the definition of consumer. During the period of 19.8.2013 to 21.8.20134 a theft was taken place at the house of the complainant and about 17/18 tola gold ornaments i.e. two gold rings, one gold karrah, one gold chain, one fan, one inverter, battery, two cylinder, one gas stove, electric motor etc were stolen by some unknown persons and regarding the same a report was lodged which was incorporated in the F IR No. 15/2013 under section 357/380 IPC of P.S. Kaboj which is pending investigation. The aforesaid articles were mentioned in the list and were duly insured with the opposite party. Copy of the insurance policy and list are enclosed. The complainant lodged the claim with the opposite party but the opposite party did not take any action on his claim for long period and thereafter he went to Abroad i.e. Denmark. Opposite party demanded some documents but as the complainant was not present , as such he could not produce those documents nor he received any letter from the opposite party. Thereafter the complainant came back to India in the month of February 2014 and enquired about his claim from the opposite party. Opposite party informed him that his case has been closed and directed the complainant to move the application for reopening the claim. On 27.5.2014 complainant moved an application for reopening his claim which was duly received by the opposite party. The complainant also submitted alongwith application all the necessary documents which were required to the opposite party including untraced report but till date the opposite party has not decided his claim and has not paid the claim amount to the complainant till date inspite of the repeated requests and demands made by the complainant. Due to the acts and deeds of the opposite party, complainant has suffered lot of harassment, mental pain, agony, tension and financial loss at their hands . As such the act on the part of the opposite party amounts to negligence, carelessness, deficiency in service and unfair trade practice. The complainant is entitled for compensation from the opposite party. The complainant has sought for following reliefs vide instant complaint :-
(i) Opposite party be directed to pay the claim amount of Rs. 5 lacs to the complainant immediately.
(ii) Compensation of Rs. 50000/- be also awarded to the complainant for the mental pain, agony and harassment suffered by the complainant alongwith litigation expenses to the tune of Rs. 11000/-.
Hence, this complaint.
2. Upon notice, opposite party appeared and filed written reply taking certain preliminary objections therein inter alia that the present complaint of the complainant is not legally maintainable ; that complainant has not come to the Forum with clean hands and has suppressed the true and material facts from this Forum, as such , he is not entitled to any relief as claimed for ; that complainant has got no cause of action to file the present complaint ; that complainant is guilty of his own act and conduct and is estopped from filing the present complaint ; that even otherwise, due to contravention of the terms and conditions of the policy and exclusions contained therein, the complainant is not entitled to any compensation ; that complaint is nothing but merely an abuse of the process of this Forum and is filed with malafide intentions and ulterior motives and no relief can be granted on the basis thereof ; that as per terms of the insurance policy, the complainant/insured has to inform the company immediately about any theft or loss if took place and to lodge the claim within the reasonable time and then to submit the documents as per terms and conditions of the policy, which the complainant has failed to do so. However, intimation in this regard was given late i.e. on 23.8.2013 and immediately surveyor Mr. J.S.Malhotra was appointed to make survey of the alleged burglary loss in the premises of the complainant and the surveyor made spot visit on 24.8.2013 itself. Thereafter he called the complainant telephonically time and again and even sent two registered letters dated 24.9.2013 and 22.10.2013 calling the complainant to submit certain requisite documents to process the claim and assess the loss, if any actually occurred to the complainant. But the complainant failed to submit any such documents and comply with the said letters. The complainant did not visit the company and did not cooperate with the surveyor as such the surveyor submitted his report vide letter dated 21.2.2014 and recommended to file the claim as “No claim”. Accordingly, claim file of the complainant was closed as “No claim” as inspite of all such requests and registered letters by surveyor, that from the facts of the present complaint, it is realized that the alleged theft occurred in between 19.8.2013 to 21.8.2013, which means that the complainant/insured failed to take reasonable steps and proper care of the articles during the said period, which he was bound to do so as per terms and conditions of the policy. Hence, in case of any contravention of any of the terms and conditions of the policy, the company is not liable to pay any compensation and the complaint is liable to be dismissed on this ground also . On merits facts narrated in the complaint have been specifically denied on the basis of pleas taken in the preliminary objections and a prayer for dismissal of the complaint with cost was made.
3. In his bid to prove the case Sh.S.S.Randhawa,Adv.counsel for the complainant tendered into evidence affidavit of the complainant Ex.C-1 alongwith documents Ex.C-2 to Ex.C-9 and closed the evidence on behalf of the complainant.
4. To rebut the aforesaid evidence Ms. Sneh Lata Kapoor,Adv.counsel for the opposite party tendered into evidence affidavit of Sh.Baldev Singh,Divisional Manager Ex.OP1, certified copy of Insurance policy alongwith terms and conditions Ex.OP2, letter dated 21.8.2013 Ex.OP3, copy of letter dated 24.9.2013 Ex.OP4, copy of letter dated 22.10.2013 Ex.OP5, copy of letter dated 21.2.2014 Ex.OP6.
5. We have heard the ld.counsel for the parties as well as written synopsis of arguments submitted on behalf of the complainant and have carefully gone through the evidence on record.
6. From the perusal of the evidence on record, it is proved that the complainant was insured with the opposite party as per insurance policy cover bearing No. A 696465 valid w.e.f 9.6.2013 to 8.6.2014 on payment of premium of Rs. 3606/-. Copy of the Insurance policy accounts for Ex.C-4. It is the case of the complainant that during the period of 19.8.2013 to 21.8.2013 a theft took place at the house of the complainant and about 17/18 tola gold ornaments i.e. two gold rings, one gold karrah, one gold chain, one fan, one inverter, battery, two cylinder, one gas stove, electric motor etc were stolen by some unknown persons .A report regarding the theft occurrence was lodged which was incorporated in the FIR No. 15/2013 under section 357/380 IPC of P.S. Kaboj , copy whereof is Ex.C-3 on record. The complainant thereafter lodged claim with the opposite party. It is the case of the complainant that the opposite party did not process the claim nor did it inform him regarding the progress made thereon.
7. However, on the other hand , it is the case of the opposite party that on receipt of the insurance claim, opposite party immediately appointed Sh.J.S.Malhotra,Surveyor to assess the loss and submit the report. But however, complainant did not assist the surveyor in assessing the loss. The surveyor also issued two registered letters which are Ex.OP4 and Ex.OP5 on record to the complainant to supply the documents necessary for finalization of the claim case. But the complainant neither responded to the letters nor did he visit the surveyor to assist him in that regard. As such the claim was filed as “No claim”. There is no default, deficiency in service on the part of the opposite party. It is the complainant, who is responsible for the reason on account of which the claim had to be filed as “No claim”.
8. From the appreciation of the evidence on record, it becomes evident that the claim of the complainant has been filed as “No claim” on account of the fact that the complainant did not supply the documents detailed in letter dated 24.9.2013, copy whereof is Ex.OP4 issued by the surveyor to the complainant, the details of which are as under:-
- Copy of FIR
- Claim form duly filled and signed in
- Estimate of loss
- Purchase bill of stolen items ,if any.
9. In our considered opinion, the complainant is liable to be directed to supply all these documents to the opposite party and for that purpose complainant is given a fortnight from the receipt of copy of order to comply with the directions and the opposite party shall decide the claim of the complainant within a further period of two months therefrom. Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Forum.The complaint stands disposed off accordingly. Copies of the order be furnished to the parties free of costs. File is ordered to be consigned to the record room.
Announced in Open Forum
Dated: 21.7.2016. /R/
