Delhi

Central Delhi

CC/375/2014

VIJAY KUMAR MALHOTRA - Complainant(s)

Versus

UNITED INDIA INSURANCE CO. LTD - Opp.Party(s)

27 May 2015

ORDER

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Complaint Case No. CC/375/2014
 
1. VIJAY KUMAR MALHOTRA
2/89 SUNDER VIHAR N D 87
...........Complainant(s)
Versus
1. UNITED INDIA INSURANCE CO. LTD
9/54 D.B.G. ROAD KAROL BAGH N D 5
............Opp.Party(s)
 
BEFORE: 
 HON'BLE MR. RAKESH KAPOOR PRESIDENT
 HON'BLE MR. VIKRAM KUMAR DABAS MEMBER
 HON'BLE MRS. NIPUR CHANDNA MEMBER
 
For the Complainant:
For the Opp. Party:
ORDER

ORDER
Per SH. RAKESH KAPOOR, PRESIDENT

The complainant is having a House Holder Insurance Policy in respect
of premises and House no. 2 /89 Sunder Vihar, New Delhi and the
valuable contents therein issued by the OP which was valid for the
period 17.5.2013 to 16.5.2014.  It is alleged by the complainant that
on 26.7.2013 , he and his family had left for U.K. and in their
absence a burglaryhad been committed  in the house on 27.7.2013.
The matter was immediately reported to the policeby one AnantSingh,an



 employee of he complainant and an FIR bearing no. 199 / 2013 was
registered in this regard.    The complainant and his family was
constrained to return  to Delhi and immediately after reaching back
had informed the OP about the incident vide letter dated 28.7.2013.
The OP had appointed a surveyor who had physically inspectedthe spot.
The surveyor had also recorded the statement of the complainant and
had collected the list of missing articles from him.   It is allehged
by the complainant that the surveyors had desired  to operate bank
lockers in the presence of their reprersenatives and the same was
confimed on 22.6.2013. The surveyor had also asked for some other
documents which were supplied to them.   There was a typographical
error in the copy of the FIR and the complainant had filed an
application with the S. H.O for rectification of the mistake.  The
complainant had also filed a revised claim form as per the direction
of the surveyors after the operation of the bank lockers  in the
presence  of the representatives of the OP.   The complainant had also
submitted a no trace report to the surveyors.   Since , the OP had
failed to settle the claim in almost a period of one year, the
complainant was constrained to serve the OP  with a legal notice dated
19.8.2014.  But to no result. The OP repudiated the claim vide letter
dated 13.10.2014.    on flimsy and illgocial grounds.   The
complainant has alleged  that the repudiation of the claim was illegal
and uncalled-for.   Hence, the complaint.
The OP has contested the complaint and has filed a written statement.
It has taken preliminary objections that the complaint is false ,
frivolous and is replete with baseless assumptions.  It has claimed
that the complaint is liable to be dismissed with exemplary cost.
Preliminary objection no. 5 to 12  give the defence of the OP
justifying the repudiation  of the claim. These paras are reproduced
as under:-

5. That the complainant is holding a House holders Insurance Policy
vide policy No. 040401/48/13/32/ 00000349 for the period of 17/05/2013
to 16/05/2014.
6. That the alleged theft was occurred in a very flimsy manner. As per
averments made by the complainant as he had to go to foreign country
for a long tour, he left the premises on 26.07.2013. He had given a
key to his employee for accessing outer area of bed room including one
more key to given to his sister for accessing main bed room. It is
submitted that as per statement of the Anand Singh who has lodged FIR,
on the date of occurrence, he left the premises at 3:30 p.m in order
to proceed to the AIIMS Hospital after handling over the key of
premises to the neighbour one Sh. Sanjay Kapoor. It is further
submitted that there were three persons who were holding the key of
premises.
7. That as per averments, the complainant has three lockers, Locker
No. 215, 216 and 625 in Maharastra Bank. but before going to foreign
for a long time, complainant has not put his cash and gold jewellery
in these lockers. It is a clear case of negligence on the part of
insured. It is submitted that the complainant is seeking the claim
from the answering respondent for the negligence committed by him.
8. That the employee of the complainant Shri Ananci Singh has lodged FIR U/S
454/380 IPC at P.S Milanwali Nagar. The statement given by’ him is
also contradictory. At the time of registration of FIR, he told the
Police Authorities that he left the house of the insured at 3:30 pm
and after visiting various places at Karol Bagh, AIIMS etc. He came
back to the insured residence at 4 pm which is not possible by any
manner. on 02/08/2013, he improved upon his earlier statement that he
left the residence of the complainant at 7:30 AM on 27/07/2013 and
came back at 4:10 PM and this is a material discrepancy and a
circumstances against the insured. The Employee of insured is a single
witness after the theft, but the complainant has taken him very
casually. He has filed an application dated 18.09.2013 with concerned
SHO for correction in FIR. It is submitted that corrected FIR was not
obtained from SHO and nor provided till date to the answering
respondent and material fact of the FIR registered prima-facie will be
taken into consideration in evidence as per law.
9. As stated, the complainant had three Bank Lockers, locker no. 625, 215 and
216. The Insured was informed by the surveyor about not to operate the
lockers without informing to the surveyor. The lockers were need to be
verified which was necessary to confirm that claimed item were not
lying there. After the insured’s confirmation, the surveyor visited to
the Bank for verification of the locker no. 625 and surveyor found
that no intact jewellery similar to be claimed was found there. It is
submitted that the surveyor found in investigation that said lockers
was already operated by insured after the date of loss, though before
appointment of surveyor, on 30.07.2013. The confirmation of dates of
operatIon of lockers have been noted down from I i bank’s record by
the surveyor during his visit there. The Confirmation of dates of
operation of locker is annexed as ANNEXURE- B.
10. That after verification of locker no. 625, the surveyor requested
the insured for allowing him for similar verification of the remaining
two lockers (i.e locker no. 215 and 216 before these were operated)
but insured refused to allowthe verification of the same. The surveyor
again requested for verification but insured did not allow him. The
surveyor has sent many quest letters for verification of lockers vide
letter dated 7.11.2013, 17.02.2014, 14.03,2014 and 21.05.2014, but the
insured replied that answering respondent has no locus to approach
upon the details of my other assets. It is submitted that complainant
has not allowed to verify remaining lockers with his malafide
intention. It clearly appears from the conduct of the complainant that
claimed items are in the custody the claimant and safe in his other
lockers which could not be verified. The complainant was also asked
for the list of jewellery kept in these lockers but insured refused to
provide the same. The Letter sent by the surveyor to insured.is
annexed as ANNEXURE-C.
11. That it is transpired that the complainant acted in a manner
prejudicial to the interests of the company by having recourse to the
court of law for obtaining untraced report whilst the investigation
was in progress and thus prevented the police from conducting the
further investigation.
12. That the Complainant has provided list of lost items but has not
provided bills, brochures, etc. He assured to provide the confirmation
of wealth tax returns, but till date no documents is been provided, it
is submitted that the surveyor, without admitting the liability, has
assessed the loss to the cune of Rs. 4,75,813/-. But keeping in view
the facts and circumstances peculiar to the case, the claim has been
repudiated by the answering respofldent. It is stipulated under the
terms and conditions of the policy that the insured should act as If
Is unInsured and a duty Is bestowed upon him to exercise due diligence
and reasonable care on the subject matter of  policy. The Repudiation
letter of the claim is annexed as ANNEXURE-D.


The OP has contested the complaint on merits and has reiterated that
the claim has been righlty repudiated .  It has claimed that there are
no merits in this complaint and the same is liable to be dismissed.
It has prayed accordingly.
We have heard arguments advanced at the bar and have perused the record.
The complainant has filed his own affidavit dated 10.3.201 wherein he
has corroborated the contents of the complaint and has maintained that
the claim lodged by him has been repudiated on flimsy grounds.    On
behalf of the OP no evidence has been filed  to prove its defence
despite opportunites granted to it.
The question for consideration before us is as to whether  the op
insurane company was justified in repudiating the claim lodged by the
complainant .
It has been noticed  that there has been a tendency on the part of the
insurer to repudiate  the claims lodged by the insured on one pretext
or the other.   Courts on a number of occasion have impressed upon the
officers of the insurance companies , dealing with the pssage of
claims to act in a manner which advances the purpose  for which the
insurance contract is entered into.    The present one is an example
where  a claim has been repudiated on flimsy grounds.
It is the admitted case of the parties that a burglary had taken place
in the house of the complainant on 27.7.2013 when the complainant and
his family was away to U.K.  It is also admitted that the matter was
immediately reported to the police  by One Anant Singh and an FIR was
registered bearing no. 199 /2013 at PS Miawali Nagar , Paschim VIhar,
New Delhi. It is not denied that the complainant had informed the OP
vide letter dated 28.7.2013about the burglary and had also furnished
the details of the FIR.   It is also not disputed that a surveyor had
been appointed who had submitted  a report and had assessed the loss
at Rs. 475813/-.  A surveyor is a netural person and his report cannot
 be rejected unless there are  very sound and cogent grounds . In the
present case, the insurance company has rejected the report of the
surveyor and has repudiated the claim on the following grounds.
33.( a). that you did not conform to the duty of assured clause which
means that at all times the insured should act as if he is uninsured
and a duty is bestowed upon him to exercise due diligence and
reasonable care on the subject matter of the policy but in the present
case the you have acted in a very casual and indifferent manner by
handing over the keys of the flat to your emØ4oyees and also parted
with the keys of the place where the alleged theft of valuables took
place and more particularly when you were absent from the residence
for long int,erval and considering the facts and circumstances, you
were prima facie negligent in protecting your property with due
diligence and care.
(b). that you had also acted in a manner prejudicial to the interests
of the company by having recourse to the court of law for obtaining
untraced report whilst the investigation was in progress and thus
prevnted the police from conducting the further investigation.
(c ). That the FIR being the basic and primary document in such type
of cases suffered from a serious infirmity due to contradiction in the
statements of Shri Anand Singh who was the first person to notice the
theft and thus being an important and material witness was not able to
explain the contradictions regarding the time in FIR and in his
subsequent statements to police and instead you took the initiative to
explain the discrepancy in the most routine and casual manner.
(d). That despite the request of the surveyor, you had not got the
locker No.215 and 216 inspected as requested by the surveyor, whereas
you were under an obligation to cooperate with the surveyor and
provide the legitimate and required documents necessary for the
payment of the claim. Further, you failed to provide bills/cash memos
pertaining to the articles lost to the surveyor.

We have considered the aforesaid grounds, a perusal of which shows
that  rather than considering the claim lodged by the complainant in
the right perspective, an effort was directed at finding out ways and
menas to rejct the claim.It has been alleged by the insurance company
that there was an absence of reasonable care on the part of the
complainant who had left the keys with an employee.
The complainant in his evidence has  explained that  he had kept a
watchman for 24 hours  who was holding keys of the common open area so
that he may have an access to the toilet ,bathroom and kitchen etc.
The valuables   were kept in the lockers and  under lock and key which
were left with the sister of the complainant. A report was immediately
lodged about the incident and it was confirmed that it was a case of
burglary committed after breaking open the locks and doors.   It,
therefore, did not lay in the mouth of the insurance company   to say
that the complainant had acted in a casual and indifferent manner and
that there was a want of due diligence and reasonable care on his
part.   Under the ground (b) and (c) , the insurance company has
claimed that the complainant had interefered in the investigation and
had obtained an untraced report when the matter was still being
investigated .   The averment appears misplaced. The investigation of
the case was being conducted by the police and the complainant could
not have interefered in the same.   It has to be rememberered that
after an FIR is lodged and after the police files a report under
section 173  CRPC on completion of the investigation, the Court
accepts the report or rejects the same.   There is no occasion for
seeking an untraced report before the closure of the investigation by
the police.   As regards the contradiction in the statement of Anant
Singh who had lodged the FIR of burglary, the contradiction was
explained to the police by the witness in his subsequent statement
recorded by the police  U/s 161 CrPC.  As regards the operation of
locker numbers 215 and 216, the complainant has explained that the
surveyors had made inquiries from the bank  regarding the past
operation of the lockers and, therefore, were satisfied with the
explanation furnished by the complainant.    The OP has failed to
place on record the surveyor report or any evidence whatsoever in its
defence. As already stated, the surveyor had assessed the loss to the
tune of Rs 4,78,513/-. Keeping in view  the facts and circumstances of
the case, we are of the considered  opinion that the OP insurance
company ought not to have repudiatedthe claim on the ground s
mentioned in the repudiation letter.   We hold that there was no case
of want of reasonable care on the part of the complainant to safeguard
the insured property.    The insured had cooperated with the OP in the
assessment  of the claim . We, therefore, hold that the OP as
deficient in rendering service to the complainant .  Accodingly, we
direct the OP as under:-
1. Pay to the complainant a sum of Rs. 475813/- along with interest @
10% p.a. from the date of submission of the claim till payment.
2. Pay to the complainant a sum of Rs. 50,000/- as compensation for
the pain and agony suffered by him.
3. Pay to the complainant a sum of Rs. 10,000/- as cost of litigation.
The OPs shall pay this amount within a period of 30 days from the date
of this order failing which they shall be liable to pay interest on
the entire awarded amount @ 10% per annum.  IF the OPs fail to comply
with this order, the complainant may approach this Forum for execution
of the order under Section 25/27 of the Consumer Protection Act.
Copy of the order be made available to the parties as per rule.  File
be consigned to record room.
Announced in open sitting of the Forum on.....................

 
 
[HON'BLE MR. RAKESH KAPOOR]
PRESIDENT
 
[HON'BLE MR. VIKRAM KUMAR DABAS]
MEMBER
 
[HON'BLE MRS. NIPUR CHANDNA]
MEMBER

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