Haryana

Karnal

CC/274/2021

Mukesh Kumar - Complainant(s)

Versus

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

Sumer Aggarwal

22 Apr 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No. 274 of 2021

                                                        Date of instt.09.06.2021

                                                        Date of Decision:22.04.2024

 

Mukesh Kumar son of Shri Goverdhan Dass, resident of house no.A-123, Parshavnath City, Sector-35, Karnal.

                                                                        …….Complainant.

                                              Versus

 

1. Universal Sompo General Insurance Company, Block-B, Ground floor, plot no.52, sector-44, Gurgaon through its Managing Director.
2. Universal Sompo General Insurance Co. Ltd. SCO no.9, opposite bus stand, 1^st floor, above Central Bank of India, Panchkula-134009.

                                                                …..Opposite Parties.

 

Complaint under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.      

      Sh. Vineet Kaushik…….Member

      Dr.  Suman Singh…..Member

 

 Argued by: Sh. Sumer Aggarwal, counsel for the complainant.

                    Shri Anuj Gupta, counsel for the OPs.

 

                     (Jaswant Singh, President)

ORDER:   

                

                The complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that complainant is owner of a vehicle bearing Registration no.HR-45-A-5275 and the said vehicle was insured with the OPs, vide policy no.USGI/POSWEB/0196258/00/000, valid from 14.02.2019 to 13.02.2020. On 15.06.2019, complainant  parked his vehicle in front of shop no.348, Anaj Mandi Karnal and in the morning of 16.06.2019, complainant did not find his vehicle inspite of his best efforts and the complainant kept on searching for his vehicle and ultimately, when the same was not found, then he got registered an FIR no.544 dated 25.06.2019 under section 379 IPC in Police Station City, Karnal. The intimation in this regard was also sent to the OPs. OPs demanded several documents from the complainant including untrace report and ultimately, OPs repudiated the claim of the complainant, vide letter dated 14.08.2019 on the ground of non-submission of the documents including untrace report whereas the complainant has submitted all the required documents except untrace report. It is further alleged that the said untrace report was provided to the complainant when the same was submitted by the police in the court of Harish Goyal, Learned ACJM, Karnal on 24.11.2020 and therefore, it was not possible for the complainant to produce the same with the OPs, however, the OPs inspite of being informed by the complainant in this regard that submitting the untrace report was beyond the control of the complainant but OPs intentionally repudiated the claim of the complainant. Then complainant sent a legal notice dated 01.04.2021 to the OPs but it also did not yield any result. In this way           there is deficiency in service and unfair trade practice on the part of the OPs. Hence complainant filed the present complaint.

2.             On notice, OPs appeared and filed its written version raising preliminary objections with regard to maintainability; cause of action; locus standi; jurisdiction and concealment of true and material facts. On merits, it is pleaded that the OPs, vide letter dated 14.08.2019 considered the documents submitted by the complainant and investigation report of the independent investigator and found that the alleged date of loss to the complainant was intimated to the OP as 17.06.2019, but in the FIR the date of alleged loss is shown as 15/16.06.2019 night. The intimation about the alleged loss was given to the OPs on 19.06.2019 i.e. after delay of three days (whereas it should be intimated immediately) and the FIR was lodged by the complainant on 25.06.2019 i.e. after delay of 9 days, totally in violation of the condition no.1 of the policy, which clearly proves that the FIR is after thought. It is further pleaded that the complainant did not provide one key of the alleged vehicle to the OPs out of the two keys. The person who parked the vehicle in question at the place of alleged theft (occurrence) was/is not authorized to drive the same. The complainant also did not provide RTO Extract after alleged theft, letter of intimation to the RTO regarding alleged theft, NCRB report, final form, untrace report accepted by the learned CJM, Service records, forms 28,29,30 and the loan statement (which were/are necessary for the consideration of the alleged claim of the complainant). Hence, the complainant is not entitled to any claim. There is no deficiency in service and unfair trade practice on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complainant.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of the complainant Ex.CW1/A, copy of insurance policy Ex.C1, copy of receiving of key Ex.C2, copy of FIR Ex.C3, copy of untrace report Ex.C4, copy of acceptance of untrace report Ex.C5, copy of repudiation letter dated 14.08.2019 Ex.C6, legal notice Ex.C7, postal receipts Ex.C8 and Ex.C9, acknowledgement Ex.C10 and closed the evidence on 16.03.2023 by suffering separate statement.

5.             On the other hand, learned counsel for the OPs has tendered into evidence, affidavit of Ankita Bose Ex.OPW1/A, copy of claim form Ex.OP1, copy of repudiation letter dated 14.08.2019 Ex.OP2 and closed the evidence on 18.08.2023 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 during the subsistence of insurance policy, the vehicle of the complainant was stolen. Information regarding theft was given to police as well as to the OPs. The OPs demanded certain documents from the complainant including untrace report. Complainant submitted all the documents with the OPs except untrace report. Complainant requested the OPs for releasing of his genuine claim but OPs did not pay any heed to the request of complainant and repudiated the claim of complainant on 14.08.2019 on the false and frivolous ground. He further argued that Police submitted the final report before the concerned court on 24.11.2020 and after accepting the same, complainant had submitted the certified copy of untrace report to the OPs but same was not considered by the OPs and thus there is no delay on the part of the complainant and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OPs, while reiterating the contents of written version, has vehemently argued that OPs demanded certain documents from the complainant but complainant did not submit the same. There is delay of four days to intimate the OPs and nine days delay for lodging the FIR. The claim of complainant has rightly been repudiated by the OPs and lastly prayed for dismissal of the complaint.

9.               We have duly considered the rival contentions of the parties. 

10.           Admittedly, the vehicle in question was stolen during the subsistence of insurance policy. It is also admitted that the insured declared value (IDV) of the vehicle in question is Rs.10,00,000/-.

11.           The claim of the complainant has been repudiated by the OPs, vide repudiation letter Ex.C6/Ex.OP2 dated 14.08.2019 on the grounds, which are reproduced as under:-

   “1. The loss date intimation to OPs is 17.06.2019 whereas as per FIR date of loss is 15.06.2019-16.06.2019 night.

2. The intimation about the loss was sent to OPs on 19.06.2019 after the delay of 3 days.

3. The FIR was lodged on 25.06.2019 after delay of 9 days.
4. Complainant did not provide one key of pair of two keys.
5. The driving license of the driver who parked the vehicle before theft is not authorized to drive said vehicle.
6. Complainant did  not provide the documents; RTO extract after theft, letter to RTIO intimating about theft, NCRB Report, final form, untrace report accepted by CJM, service records form 28,29,30 two copies each and loan statement.
7. There is delay in intimation to insurance company and lodging of FIR which is a violation of policy condition no.1.”

 

12.                   The claim of the complainant has been repudiated by the OPs on the aforesaid grounds. Complainant has placed on file receipt of key Ex.C2 issued by the OPs. At the time of theft the vehicle in question was parked in the grain market, Karnal and was not plying. Hence, question for demanding the driving licence of driver does not arise at all. The vehicle of the complainant was stolen on 15.06.2019 and the police had submitted the final report before the court on 24.11.2020, which was accepted by the concerned court. Hence, the submission of the untrace report was beyond the control of the complainant. Moreover, it is also unbelievable an insured whose personal interest is involved for such huge amount why he will not supply the documents to the insurance company for getting his claim amount and will indulge himself in unwanted litigations. Hence, in view of the above, we found no substance in the contentions of OPs.

13.           There is nine days delay in lodging the FIR and four days delay of intimation regarding the theft of the vehicle in question. Vehicle in question was stolen on 15.06.2019 and complainant alleged that he has immediately intimated to police but police lodged the First Information Report (FIR) Ex.C3 on 25.06.2019. 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 place reliance on 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.           Furthermore, if for the sake of gravity, if it is presumed that complainant has violated the terms and conditions of the insurance policy, in that eventuality, the claim of the complainant cannot be repudiated in toto.  In this regard, we  rely upon the case laws cited in Revision Petition no.1870 of 2015(NC) decided on 14.08.2018 titled as New India Assurance Co. Ltd. Versus Thirath Singh Brar and authority of our own Hon’ble State Commission in First Appeal no.717 of 2016 decided on 6.4.2017 titled as United India Insurance Company Limited and others Versus Anshul Bansal.  In both judgments it was held that in case of any breach of warranty/condition of the policy the insurer is liable to pay 75% of admissible claim on non-standard basis.

15.  

“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”.   

16.           Keeping in view the ratio of the law laid down in aforesaid judgments, facts and circumstances of the present complaint, the act of the OPs while repudiating the claim of the complainant in toto amounts to deficiency in service and unfair trade practice, which is otherwise proved as genuine one.  Hence, complainant is entitled to get 75% only of the admissible claim on non-standard basis.

17.           As per insurance policy Ex.C1, the insured declared value of the vehicle in question is Rs.10,00,000/-. Hence the complainant is entitled for Rs.7,50,000/- i.e. 75% of the insured amount alongwith interest, compensation for mental pain and agony and litigation expenses etc.

19.           In view of the above discussion, we partly allow the present complaint and direct the OPs to pay Rs.7,50,000/- (Rs. seven lakhs fifty thousand only) to the complainant alongwith interest @ 9% per annum from the date of filing the complaint i.e. 09.06.2021 till its realization. We further direct the OPs 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 expenses. This order shall be complied within 45 days from the receipt of copy of this order. However, the complainant is also directed to complete all the formalities with regard to transfer/cancel of the RC of the vehicle in question. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced
Dated:22.04.2024 

  President,       

District Consumer Disputes

Redressal Commission, Karnal.

 

                  (Vineet Kaushik)              (Dr. Suman Singh)   

                       Member                             Member