Delhi

East Delhi

CC/241/2022

MUKESH KUMAR - Complainant(s)

Versus

UNIVERSAL SOMPO G.I.C. - Opp.Party(s)

RAJENDRA VERMA

11 Jul 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION (EAST)

GOVT. OF NCT OF DELHI

CONVENIENT SHOPPING CENTRE, FIRST FLOOR,

SAINI ENCLAVE, DELHI – 110 092

 

C.C. No.241/2022

 

	MUKESH KUMAR S/O JAIPAL SINGH, R/O 14 No.17, SAKET BLOCK, MAIN ROAD MANDAWALI, DELHI - 110092	….Complainant
Versus
	UNIVERSAL SOMPO GENERAL INSURANCE COMPANY LTD. THROUGH ITS MANAGER, CORPORATE MOTOR CLAIMS, UNIVERSAL SOMPO GENERAL INSURANCE COMPANY LTD. REIABLE TECH PARK, CLOUD CITY CAMUS, AIRLOI OFFICE, UNIT No.601 AND 602, 6TH FLOOR, GUT NO.31, MOUJE ELTHAN THANE BELAPUR ROAD, AIROLI, NAVI MUMBAI, PIN CODE – 400708.	……OP

 

 

Date of Institution	:	13.05.2022
Judgment Reserved on	:	09.06.2023
Judgment Passed on	:	11.07.2023

 

                  

QUORUM:

 

Sh. S.S. Malhotra	(President)
Ms. Rashmi Bansal	(Member)
Sh. Ravi Kumar	(Member)

 

Order By: Ms. Rashmi Bansal (Member)

JUDGMENT

The present complaint filed by the Complainant against repudiation of his Insurance claim of the theft of his vehicle by OP without any reasonable cause, which caused him sufferings, mental agony and harassment and amounts to deficiency of service and unfair trade practice on the part of OP.  The Complainant prays for the insurance amount of his claim along with compensation and litigation cost with interest. 

1. Succinctly, the case of the complainant is that he is the owner of the vehicle i.e. New Ertiga Smart, Hybrid VDI, Maruti/Ertiga VDI, SHVs No.DL 3CCE 8699 duly insured by the OP for the period of 09.09.2019 to 08.09.2020 vide Policy bearing No.2311-60252807-00-000 for an amount of Rs.4,67,414 and paid a premium of Rs.17,919/-.  The complainant submits that on 19.08.2020 his vehicle was stolen and an FIR was registered with the Police and immediately handed over the copy of the said FIR to the local representative of OP who asked for certain related documents and assured the complainant to help. The said vehicle was on loan which  was cleared by  the complainant and also submitted a loan closure report to the above said representative of OP.  The complainant further submits that although the pandemic situation was there, the complainant has completed all the formalities for the clearance of his claim.  OP has deputed a Surveyor “Active Services” and he has also been provided by the required documents for verification/investigation. 
2. On 10.07.2021 a request letter was also sent to the Manager of the OP at his Mumbai based office to provide the claim of above stated vehicle but the same remained unanswered.  On 15.02.2022 the OP has denied/rejected the claim of the complainant stating the reason that there is inordinate delay of about 1 Months and 12 days in the intimation of the claim to Insurance Company which caused the Company a denial of the opportunity to arrange the surveyor and check the veracity of the claim made by the complainant.  The claim of the complainant was denied on the basis of condition No.1 of the Motor Policy which states as follows:

“Notice shall be given in writing to the company immediately upon the occurrence of any Theft/accidental loss or damage in the event of any claim and thereafter the insured shall given all such information and assistance as the company shall require.”

 

3. A request letter to reconsider the claim dated 15.03.2022, legal Notice dated 05.04.2022 and another request letter dated 26.04.2022 respectively to reconsider the denial of the claim was never responded by the OP.  Complainant submits that the OP remained deficient in its service by denying denial of his legitimate claim and he has suffered loss/injury due to deprivation, harassment, mental agony and professional loss for which he is entitled for the compensation along with the amount of claim of Rs.4,67,414/- with the interest from the date of registration of the case, compensation for harassment and mental agony and legal expenses.
4. Upon notice OP failed to appear and as such has been proceeded Ex-parte vide Order dated 06.09.2022. The Complainant has filed his Ex-parte evidence along with all the necessary documents.  Though the OP was running Ex-parte he was allowed to argue the matter on legal points. 
5. The Complainant has filed the following documents in support of his claim:  

• Policy for the period 09.09.2019 to 08.09.2020 as Ex. 1A. 
• Report of the FIR with code report as Ex. 2A. 
• Copy of appointment of Surveyor as Ex. 3A. 
• Copy of letter dated 10.07.2021 as Ex. 4A.
• Copy of repudiation letter dated 15.02.2022 as Ex. 5A. 
• Copy of letter dated 15.03.2022, legal Notice 05.04.2022 and request letter dated 26.04.2022 as Ex. 5A, B, C respectively. 

6. Both the parties are heard.
7.  OP has filed the judgment of Hon’ble NCDRC, First Appeal No.141 of 2009 in New India Assurance Co. Ltd. V/s Ram Avtar and another judgment of the Hon’ble NCDRC, Revision Petition  No.1068 of 2015 decided on 11.01.2016 in Gurnam Singh Vs. New India Assurance Co. Ltd. and Ors.
8. The Complainant in support of his case relied upon judgment of Hon’ble Supreme Court of India by  Mr justice N.V. Ramana, R. Subhash Reddy and B.R. Gavai, JJ) in Civil Appeal NO. 653 of 2020 decided on 24.01.2020 in Gurshinder Singh Vs. Shriram General Insurance Company Ltd and another. 
9. The Commission has perused the documents and judgements placed on record by both the parties.  
10. The issuance of the above sated policy, insurance, theft of the vehicle and the registration of the FIR on the same day of the theft  are not disputed. There is no delay in filing the FIR with the Police and the intimation of the said theft was also given to the representative of the OP which was not disputed. The only issue for consideration is “whether the insurance co. intimated about theft with a delay of 1 month 12 days and whether the same is sufficient cause to reject the claim of the complainant?”
11. Since, OP is proceeded ex-parte, therefore all the allegations of the complainant remain unrebutted and deemed to be accepted by the complainant. Even otherwise on the query put by this commission with respect to the intimation given to the representative of OP, the same is not denied by OP.
12. Hon'ble Supreme Court of India  in in Civil Appeal No.653 of 2020 (Arising Out of S.L.P.(C) No. 24370 of 2015) Gurshinder Singh vs Shriram General Insurance Co. Ltd. & Anr has said that delay in providing information to the Insurance Company is not fatal to the seeking of claim and held as follows:

“para 16 …. in the event, after the registration of an FIR, the police successfully recovering the vehicle and returning the same to the insured, there would be no occasion to lodge a claim for compensation on account of the policy. It is only when the police are not in a position to trace and recover the vehicle and the final report is lodged by the police after the vehicle is not traced, the insured would be in a position to lodge his claim for compensation. As observed by the bench of two learned Judges in the case of Om Prakash (Supra), after the vehicle is stolen, a person, who lost his vehicle, would immediately lodge an FIR and the immediate conduct that would be expected of such a person would be to assist the police in search of the vehicle. The registration of the FIR regarding the theft of the vehicle and the final report of the police after the vehicle is not traced would substantiate the claim of the claimant that the vehicle is stolen. Not only that, but the surveyors appointed by the insurance company are also required to enquire whether the claim of the claimant regarding the theft is genuine of not. If the surveyor appointed by the insurance company, upon inquiry, finds that the claim of theft is genuine then coupled with immediately registration of the FIR in our view, would be conclusive proof of the vehicle being stolen."

Further “para 20 ……….  when an insured had lodged the FIR immediately after the theft of a vehicle occurred and when the police after investigation have lodged a final report after the vehicle was not traced and when the surveyors/ investigators appointed by the insurance company have found the claim of the theft to be genuine, then mere delay in intimating the insurance company about the occurrence of the theft cannot be a ground to deny the claim of the insurance.” 

13. In view of the Hon’ble Supreme Court Order, this Commission is of the view that although there was some delay in lodging the claim with the OP but OP cannot reject the claim of the complainant in a mechanical manner and the repudiation of the claim filed on behalf of the complainant is arbitrary, unwarranted and unjustified on the part of the OP which act amounts to a deficiency in service on the part of the OP.  The judgments relied on by the OP are not applicable to the present case. We therefore held OP guilty of deficiency in service and direct as under:

• The OP is directed to pay the claim amount of Rs.4,67,414/-  towards IDV of the vehicle to the complainant along with interest @ 9% p.a. from the date of the filing the case i.e. 13.05.2022 till final payment. 
• The OP is also directed to pay an amount of Rs.25,000/- towards compensation and Rs.10,000/- towards litigation cost.            
• The above said order be complied within 30 days from the date of receiving the order failing which the entire amount accrued till 30^th day  shall carry an interest @ 12% p.a.              

14. Copy of the order be supplied / sent to the parties free of cost as per rules.

File be consigned to Record Room. 

Announced on 11.07.2023.