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..................... | |