Haryana

Karnal

CC/667/2021

Gurmukh Singh - Complainant(s)

Versus

Universal Sompo General Insurance Company Limited - Opp.Party(s)

Sudhakar Mittal

01 Apr 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                        Complaint No. 667 of 2021

                                                        Date of instt.30.11.2021

                                                        Date of Decision:01.04.2024

 

Gurmukh Singh son of Shri Raj Singh aged 42 years, resident of near Minarva Public School, Dera Jind Road, Village Bandarala, Tehsil Assandh, District Karnal.

                                               …….Complainant.

                                              Versus

 

Universal Sompo General Insurance Company Limited, having one of its office at 3^rd Floor, SCF-55, Main Market, Sector-6, Karnal, through its Manager/authorized signatory.

 

                                                                      …..Opposite party

 

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.

              Sh.Vineet Kaushik…….Member

      Dr. Suman Singh………Member

          

 Argued by: Shri Sudhakar Mittal, counsel for complainant.

                    Shri Mohit Goyal, counsel for the OP

 

                    (Jaswant Singh President)

 

ORDER:

 

                The complainant has filed the present complaint Under Section 35 of Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that complainant is registered owner of vehicle bearing registration No.HR55J-5481. The vehicle was comprehensively insured by the OP having IDV of Rs.11,50,000/-. On 24.08.2019 at about 07:30 PM, the complainant well locked and parked his vehicle near to his residence. At about 08:30 PM, the complainant did not find his vehicle at the place, he searched his vehicle but could not find the same. The complainant reported the matter to police on 25.08.2019 and police got registered a FIR No.608 dated 26.08.2019, under Section 379 of IPC. The complainant also intimated the theft to the OP and by doing so also lodged its claim by submitting all the relevant documents, as desired and OP assured the complainant that after due procedure, the claim would be settled within short span of time. The OP further demanded untraceable report of the police duly accepted from the concerned court. The complainant submitted untraceable report to the OP and thereafter visited the office of OP for settlement of his claim and to release the payment but to the utter surprise and dismay, the complainant came to know that his claim has already been closed by the OP vide letter dated 26.11.2019 without any reason. In this way there is deficiency in service and unfair trade practice on the part of the OP. Hence this complaint.

2.             On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability, suppression of true and material facts; cause of action, etc. On merits, it is pleaded that the theft of the vehicle occurred on 24.08.2019, and the FIR was recorded on next day i.e. on 25.08.2019.  After receiving the information about the alleged theft, immediately OP deputed its approved surveyor and investigators to investigate the matter and OP had sent letter dated 19.10.2019, 01.11.2019 and 15.11.2019  asking some important documents in order to process the claim but there was no reply from complainant side and lastly the OP closed the claim of the complainant and conveyed him vide letter dated 26.11.2019. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Complainant has tendered into evidence his affidavit Ex.CW1/A, copy of FIR Ex.C1, copy of statement made in the concerned court Ex.C2, copy of untraced report Ex.C3, copy of insurance cover Ex.C4, copy of Aadhar Card Ex.C5 and closed the evidence on 28.07.2022.

5.             On the other hand, learned counsel for the OP has tendered into evidence affidavit of Prashant V Shukla as Ex.OPW1/A, copy of letter dated 19.10.2019 Ex.OP1, copy of letter dated 01.11.2019 Ex.OP2, copy of letter dated 15.11.2019 Ex.OP3, copy of letter dated 26.11.2019 Ex.OP4 and closed the evidence on 20.07.2023 by suffering separate statement.

6.             We have heard the learned counsel for the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that complainant got insured his vehicle with the OP. On the 24.08.2019, the vehicle in question was stolen. Complainant intimated the police on the very next day. In this regard an FIR no.608 dated 25.08.2019 under section 379 IPC has been registered in Police Station City, Assandh. Intimation in this regard was sent to the OP and complainant also lodged the claim alongwith all the required documents to settle the claim but despite repeated requests, the OP did not settle the claim of the complainant and lastly closed the same on the ground of non-submission of documents whereas no such letter/reminders as alleged by the OP has not sent to the complainant and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OP, while reiterating the contents of written version, has vehemently argued that complainant has not supplied required documents despite various repeated requests and reminders. In the absence of requisite documents the OP were unable to decide the claim and due to non-submission of documents. He further argued that there is delay of one day in giving the intimation to the police, thus, the complainant has violated the terms and conditions of insurance policy, and as such, he is not liable to any claim and lastly prayed for dismissal of the complaint.

9.             Admittedly, the vehicle in question was stolen during the subsistence of the insurance policy. It is also admitted that the IDV of the vehicle is Rs. 11,50,000/- (Rs. Eleven lacs fifty thousand only).

10.           The claim of the complainant has been closed by the OP, vide letter Ex.OP4 dated 26.11.2019, on the following ground:-

“We have perused the pertinent claim documents submitted by you along with the investigation report of the independent investigator appointed for the loss and found that :

You have not provided documents to the letter dated 15.11.2019, 01.11.2019 and 19.10.2019.

In view of the above points, we sincerely regret that we are unable to consider this claim.”  

 

11.           The claim of the complainant has been closed by the OP on the abovementioned ground.

12.           The OP has alleged that the complainant has not provided the documents as sought through letter dated 19.10.2019 Ex.OP1, letter dated 01.11.2019 Ex.OP2 and letter dated 15.11.2019 Ex.OP3. On the other hand, the complainant has denied the receipt of the said letters. The OP has not placed on record any postal receipts and receiving of the complainant whereby it can be proved that the letters Ex.OP1 to Ex.OP3 were received by the complainant. It means that the said letters have never been received by the complainant.  Moreover, during the course of arguments, the complainant has placed on file documents sought by the OP and also placed on file receiving of the official/ officer of the OP whereby demanded documents had been supplied to the OP on 04.09.2021 and 03.03.2021. From the said receiving, it has been clearly proved that the complainant has already provided the requisite documents to the OP. Thus, there is no legal hitch to decide the claim as the complainant had already submitted the required documents for settlement of the claim. It is unbelievable an insured whose personal interest is involved for such huge amount why he will not supplied the documents to the insurance company for getting his claim amount and will indulge himself in unwanted litigation. Hence, in view of the above, we found no substance in this contention of the OP.

13.           The OP further alleged that there is one day delay in intimation regarding the theft of the vehicle to the police. In the present case vehicle in question was stolen on 24.08.2019 and complainant intimated to the police on 25.08.2019 and in this regard the First Information Report (FIR) No.608 dated 26.08.2019 was registered in Police Station, Assandh, Karnal. Generally, the owner/Driver of the vehicle first tries to search the vehicle at his own level, but when he fails to trace out the same, the matter is reported to the police. It is also a matter of common knowledge that the police does not register the FIR immediately after getting information of theft of any vehicle, either the complainant is asked to trace out the vehicle at his own level or efforts are made by the police for searching the vehicle, but when the vehicle is not traced out, then only the FIR is registered. Therefore, it cannot be said that there was any unreasonable delay on the part of the complainant in lodging the FIR. In this regard we have placed reliance upon the case titled as Om Parkash Versus Reliance General Insurance and anr. in Civil Appeal no.15611 of 2017 decided on 4.10.2017 whereby Hon’ble Supreme Court of India held in para no.11 of the said judgment, that it is a common knowledge that a person who has 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 holder in the insurance industry. If the reason for delay in making a claim is satisfactory explained, such a claim cannot be rejected on the ground of delay. We also placed reliance upon the judgment in case titled as Gurshinder Singh Versus Shri Ram General Insurance Co. in Civil Appeal no.653 of 2020 decided on 24.01.2020 wherein Hon’ble Supreme Court in para no.20 of the said judgment has held that when an insured has 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 insured. The similar view was taken by Hon’ble Supreme Court of India in case titled as Dharamnder Versus United India Insurance Co. Ltd. and others in civil Appeal no.5705 of 2021 date of decision 13.09.2021 and Jatin Construction Company Versus Oriental Insurance Company Limited and Anr. in Civil Apeal no.1069 of 2022 date of decision 11.02.2022.

14.  

“It seems that the Insurance Companies are only interested in earning the premiums which are rather too stiff now a days, but are not keen and are found to be evasive to discharge their liability. In large number of cases, the Insurance companies make the effected people to fight for getting their genuine claims. The Insurance Companies in such cases rely upon clauses of the agreements, which a person is generally made to sign on dotted lines at the time of obtaining policy. This is, thus pressed into service to either repudiate the claim or to reject the same. The Insurance Companies normally build their case on such clauses of the policy, but would adopt methods which would not be governed by the strict conditions contained in the policy”.   

15.           Keeping in view that the ratio of the law laid down in aforesaid judgments, facts and circumstances of the present complaint, we are of the considered view that acts of the OP while closing the claim of the complainant amounts to deficiency in service and unfair trade practice, which is otherwise proved genuine one. 

16.           As per cover note of the insurance policy Ex.C4, the Insured Declared Value (IDV) of the vehicle in question is Rs.11,50,000/-. Thus, the complainant is entitled for the IDV, alongwith interest, compensation and litigation expenses etc.

17.           In view of the above discussion, we allow the present complaint and direct the OP to pay Rs.11,50,000/- (Rs. Eleven lacs fifty thousand only) alongwith interest @ 9% per annum from the date of closing of the claim i.e. 26.11.2019 till its realization. We further direct the OP to pay Rs.25,000/- to the complainant on account of mental agony and harassment suffered by him and Rs.11,000/- for the litigation expense. Complainant is also directed to complete the formalities with regard to transfer/ cancellation of registration certificate of vehicle in question. This order shall be complied within 45 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

 

Announced

Dated:01.04.2024

                                                                       

                                                                  President,

                                                     District Consumer Disputes

                                                     Redressal Commission, Karnal.

 

(Vineet Kaushik)                (Dr. Suman Singh)

                           Member                                  Member