Punjab

Faridkot

CC/21/27

Daya Ram - Complainant(s)

Versus

United India Insurance Co. - Opp.Party(s)

Rahul Chaudhary

30 May 2022

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, FARIDKOT

Complaint No. :          27 of 2021

Date of Institution:     27.01.2021

Date of Decision :      30.05.2022

Daya Ram aged about 51 years son of Ram Kailash r/o Bhan Singh Colony, Faridkot, District Faridkot.   

...Complainant

Versus

1. United India Insurance Co. Ltd., Near IDBI Bank, Talwandi Road, Faridkot through its Manager.
2. United India Insurance Co. Ltd., G T Road, Shaheed Bhagat Singh Market, Moga, through its General Manager.

.......OPs

Complaint under Section 12 of the

Consumer Protection Act, 1986.

(Now, under Section 35 of the Consumer Protection Act, 2019)

 

Quorum:   Sh Kanwar Sandeep Singh, President,

                Smt Param Pal Kaur, Member,

                Sh Vishav Kant Garg, Member.

 

cc no.-27 of 2021

 

Present: Sh Rahul Chaudhary, Ld Counsel for complainant,

             Sh Ashok Monga, Ld Counsel for OPs,

 ORDER

(Kanwar Sandeep Singh, President)

                        Complainant Daya Ram (hereinafter referred to as complainant) has filed this complaint under section 12 of the C.P. Act 1986 (hereinafter referred as ‘Act’ before this Forum now Commission against United India Insurance Co. Ltd. And other (hereinafter referred as Opposite parties).

2                     Briefly stated, the case of the complainant is that his motor cycle make Hero Delux colour black bearing RC No.PB 04W-2745 registered with District Transport Office, Faridkot was duly insured with OPs vide Insurance Policy No.20128223119P107659711 valid for the period from 14.09.2019 to 13.09.2020 and during the subsistence of said policy on 11.03.2020, vehicle of complainant was stolen by some unknown persons from the parking area of More Super Market, Faridkot where son of complainant does his job. Complainant made large hue and cry to find his vehicle, but could not trace the same and then, he got recorded Rapat No.39 on 16.03.2020 at Police Station City, Faridkot regarding theft of his motorcycle, but

cc no.-27 of 2021

inadvertently, date of theft was written as 11.03.2019 instead of 11.03.2020 and correction regarding this was later on done vide rapat no.34 dated 18.09.2020. After lifting of curfew and lockdown, complainant duly informed OPs regarding theft of his motorcycle and submitted requisite record with OP-1 without any delay. Complainant made several requests to OPs to clear his insurance claim amount, but they kept putting him off on one pretext or the other and finally they repudiated the genuine claim of complainant vide letter dated 04.01.2021. All this amounts to deficiency in service and trade mal practice.

3                                    On this backdrop of facts, the complainant has prayed for directions to OPs to make payment of Rs.50,000/-on account of price of motorcycle and Rs.50,000/-as compensation for harassment and mental agony suffered by him besides Rs.11,000/-as cost of litigation.

4                                       Upon notice, OP-1 and 2 filed written statement taking preliminary objections that this Forum has no jurisdiction to hear and try the present matter and there is no deficiency in service on their part. It is averred that alleged incident occurred on 11.03.2020 but complainant reported the matter to Police on 16.03.2020 allowing the stolen vehicle being taken out of

cc no.-27 of 2021

reach diminishing the chances of recovery of the stolen vehicle. Intimation regarding theft was given to answering OP on 22.09.2020 preventing them to inspect the spot and to take firsthand knowledge of the incident. It is further averred that despite repeated reminders, complainant never supplied requisite documents mandatory for processing the claim. Matter was not investigated and after due inquiry and due application of mind, claim of complainant was closed as No Claim on the ground of providing late intimation and for non submission of requisite documents. Due intimation regarding this was also given to complainant vide letter dated 04.01.2021. It is further averred that complainant has not complied with the pre-condition for payment of claim which was mandatory for processing the claim. Moreover, it involves complex questions of law and facts requiring thorough enquiry, investigation and lengthy evidence that is not permissible in the summary procedure of Consumer Protection Act and matter is required to be referred to Civil Court. Further averred that complainant has concealed the material facts from this Commission and has filed this complaint on false, fake and frivolous grounds. On merits, OPs have denied all the allegations being wrong and incorrect and it is

 

cc no.-27 of 2021

reiterated that there is no deficiency in service on the part of answering OPs. Prayer for dismissal of complaint with costs is made.

5                                                        Parties were given proper opportunities to prove their respective case. Ld Counsel for complainant tendered in evidence affidavit of Daya Ram /complainant Ex C-1, affidavit of Krishan Kumar Ex C-2 and documents Ex C-3 to C-13 and then, closed the same on behalf of complainant.

6                                              In order to rebut the evidence of the complainant, the ld Counsel for OPs tendered in evidence affidavit of R. N Bansal Ex OP-1 and documents Ex OP-2 to Ex OP-8 and then, closed the evidence.

7                                              We have heard the learned counsel for the parties and have very carefully gone through the affidavits and documents placed on the record.

8                                               From the careful perusal of record and after going through evidence and documents produced on file by complainant as well as OPs, it is observed that case of complainant is that insured vehicle of

cc no.-27 of 2021

complainant was stolen by someone during the validity of insurance period and as per rules he gave due intimation regarding this incident to OPs as well as to Police, who registered Rapat No. 39 to this effect on 16.03.2020 Ex C-11, but OPs have not made a single penny on account of insurance claim. Action of OPs in not making payment of genuine insurance claim on account of theft of his vehicle, amounts to deficiency in service. In reply, OP-1 and 2 stressed mainly on the point that complainant did not give intimation to them regarding said theft in time. OP-1 and 2 alleged that said alleged theft occurred on 11.03.2020, but he gave information regarding this incident to them on 22.09.2020 after delay of long time. Moreover, complainant neither approached them in time nor submitted requisite documents to them. After due enquiry and on due application of mind, claim of complainant was closed as ‘no claim’ and he was duly informed regarding this vide letter dated 04.01.2021 and thus, nothing is payable to him as per instructions of IRDA. There is no deficiency in service on their part and prayed for dismissal of complaint with costs.

9                                              The main objection raised by OP-1 and 2 is that the alleged theft occurred on 11.03.2020, but he furnished information regarding this loss to them on 22.09.2020 after a delay of long time. It is

cc no.-27 of 2021

observed that when complainant reported the matter to Police immediately after the occurrence of theft to Police and after verification and investigation, Police also registered DDR to this effect on 16.03.2020, but inadvertently date of occurrence was wrongly mentioned by them as 11.03.2019, which was later on got corrected by complainant vide rapat no. 034 dated 18.09.2020, and after getting the corrected copy, he informed OPs. Moreover, reason for delay is also attributed to curfew and lockdown imposed by government on account of pandemic of covid. When complainant has informed the Police, then, then there is no reason for complainant to not to intimate the OPs. He might have informed OPs verbally in time and in writing on 22.09.2020. Ld counsel for complainant argued that complainant immediately informed regarding the incident of theft of his vehicle to Police and OPs. There is no reason for complainant to cause delay in giving information regarding theft of his vehicle and complainant is not guilty of any breach of terms and conditions of insurance policy in question and there is no fault on his part as he immediately reported the matter to Police and Police registered the DDR to this effect. Ex C-10 copy of DDR No.039 dated 16.03.2020, wherein date of incident is wrongly mentioned as 11.03.2019  proves the pleading of

cc no.-27 of 2021

complainant and Ex C-11 i.e rectified DDR No. 034 dated 18.09.2020 further proves the pleadings of complainant, in which date of incident of theft is correctly mentioned as 11.03.2020. It proves the contentions of complainant and there remains no doubt in it that complainant reported the matter regarding theft of his vehicle to Police immediately. From Ex C-12, it is clear that OPs repudiated the claim of complainant on account of ‘delay in intimation of claim’. Documents Ex C-8 and C-9 further prove the fact that his stolen vehicle was insured with OPs and declared insurance value of the vehicle was Rs.31,000/-. These documents justify the pleadings of complainant that his vehicle was duly insured with them vide policy in question for sum assured of Rs.31,000/-against all kinds of risks including theft. Ld counsel for complainant argued that only duty of complainant is to inform the Police regarding incident, but their act of not clearing the claim amounts is inappropriate.

10                                        It is admitted that vehicle of complainant was insured with Ops and it was stolen by someone and Police also recorded DDR regarding it. It is observed that complainant immediately gave information to Police as well as Ops and submitted all the documents for processing the claim to them and there is no question of delay on his part. Ops are now, intentionally

cc no.-27 of 2021

denying this fact only to avoid the liability of indemnifying the complainant regarding his stolen vehicle. Ground taken by OPs in not clearing the claim of complainant, has no legs to stand upon as he has duly reported the matter to Police as well as OPs and also furnished requisite documents to them for processing his claim, but OPs have intentionally repudiated the claim regarding theft of his vehicle. Therefore, Insurance Company cannot repudiate the claim of complainant. Reasons forwarded by Ops for not allowing the claim of complainant are not plausible and their action in denying payment of claim on baseless grounds is not appropriate and genuine, which amounts to deficiency in service on their part.

11                         Ld Counsel for complainant has placed reliance on judgment given by Hon'ble Supreme Court in the cc no. 323 of 2019 titled Gurshinder Singh Vs Shriram General Insurance Co. Ltd., & Anr (2020 (1) Apex Court Judgements (SC) 266 wherein it is held :- “Insurance Claim–Delay in intimating insurance company about occurrence of theft no ground to deny claim. Consumer Protection Act–Theft of vehicle–Delay in intimating to Insurance Company–Denial of Insurance claim–when insured lodged FIR immediately after theft of a vehicle occurred and when police after investigation have lodged

cc no.-27 of 2021

a final report after vehicle was not traced and when surveyor/investigator appointed by insurance company found claim of theft to be genuine, then mere delay in intimating insurance company about occurrence of theft cannot be a ground to deny claim – Held lodging of FIR on same day theft occurred – Therefore, denial of claim set aside.”

12                                        The observations of Hon'ble Apex Court in para No. 11 in the case Om Parkash Vs. Reliance General Insurance & Another IV(2017) CPJ 10 (SC) are as under :- It is a common knowledge that a person who lost his vehicle may not straightway go to the Insurance Company to claim compensation. At first, he will make efforts to trace the vehicle. It is true that the owner has to intimate the insurer immediately after the theft of the vehicle. However, this condition should not bar settlement of genuine claims particularly when the delay in intimation or submission of documents is due to unavoidable circumstances. The decision of the insurer to reject the claim has to be based on valid grounds. Rejection of the claims on purely technical grounds in a mechanical manner will result in loss of  confidence of policy-holders in the insurance industry. If the reason for delay in making a claim is satisfactorily explained, such a claim cannot be rejected on the ground of delay. It is also

cc no.-27 of 2021

necessary to state here that it would not be fair and reasonable to reject genuine claims which had already been verified and found to be correct by the investigator. The condition regarding delay shall not be a shelter to repudiate the insurance claims which have been otherwise proved to be genuine. It needs no emphasis that the Consumer Protection Act aims at providing better protection of the interest of consumers. It is beneficial legislation that deserves liberal construction. This laudable object should not be forgotten while considering the claims made under the 'Act'.”

13                                            Perusal of the investigation report Ex OP-5 reveals that even the investigator of OPs found the record pertaining to theft, in order and further found the claim as genuine and recommended for settlement. A perusal of aforesaid observations reveals that Insurance Companies are not justified to reject the claims on purely technical grounds in a mechanical manner and the condition regarding delay shall not be a shelter to repudiate the insurance claims which have been otherwise proved to be genuine. Therefore, the repudiation on the ground of delay is not justified as complainant intimated the loss to the police and OP. Thus, there is deficiency in service on the part of opposite party in repudiating the genuine claim of the complainant without any

cc no.-27 of 2021

reason. Hence, the complainant is entitled to the Insured's Declared Value (IDV) of the vehicle in question as per insurance policy, with interest.  

14                         From the above discussion and case law produced by the complainant, we are of considered opinion that complainant duly reported the matter with Police and got recorded DDR with Police and also intimated Ops. Ops cannot deny the payment of insurance claim of vehicle of complainant on the ground of delay in intimation. Act of Insurance Company in denying the payment of claim amounts to deficiency in service and trade mal practice on their part. We are fully convinced with the arguments, evidence and case law produced by complainant. Hence, complaint in hand is hereby partly allowed against Opposite Parties. OPs are directed to pay Rs.31,000/- i.e insured value of lost vehicle within 30 days from the date of transfer of Registration Certificate of the vehicle in question and other legally required documents for payment of claim by complainant in favour of OPs within 45 days from the date of receipt of these documents in their favour, failing which OPs shall be liable to pay interest at the rate of 9% per anum from the date of filing the complaint till final realization. OPs are further directed to pay Rs.10,000/- to complainant as consolidated compensation for harassment

cc no.-27 of 2021

suffered and litigation expenses incurred by him. Compliance of this order be made jointly and severally by OPs just as ordered above. Copy of order be given to parties free of cost under rules. File be consigned to record room.

Announced in Commission:

Dated: 30.05.2022

 

(Vishav Kant Garg)       (Param Pal Kaur) (Kanwar Sandeep Singh)

 Member                         Member                    President