DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,

BATHINDA

C.C. No. 212 of 20-08-2018

Decided on : 17-12-2021

Baljinder Singh aged about 50 years S/o Sh. Gurdev Singh R/o # 399, Vidhata Patti, Village Selbrah, Teh Phul, District Bathinda 151 104.

........Complainant

Versus

New India Assurance Co. Ltd., Branch Office, Mall Godam Road, Rampura Phul, District Bathinda 151 103 through its Branch Manager

.......Opposite party

Complaint under Section 12 of the Consumer Protection Act, 1986

QUORUM

Kanwar Sandeep Singh, President

Sh. Shivdev Singh, Member.

Present

For the complainant : Sh. Naresh Garg, Advocate

For opposite parties : Sh. Ishwinder Pal Singh Advocate.

ORDER

Kanwar Sandeep Singh, President

1. The complainant Baljinder Singh (here-in-after referred to as complainant) has filed this complaint U/s 12 of Consumer Protection Act, 1986 (Now C.P. Act, 2019, here-in after referred to as 'Act') before this Forum (Now Commission) against New India Assurance Co. Ltd., (here-in-after referred to as opposite party).

2. Briefly stated the case of the complainant is that he is registered owner of the vehicle bearing registration No. PB-03-T-8059. The said vehicle is comprehensively insured vide Insurance Certificate No. 36060431150100001137 w.e.f. 30.06.2015 to 29.06.2016 (Package Policy) with the opposite party for the IDV of Rs.11,00,000/-.

3. It is alleged that in the intervening night of 12/13.06.2016 the said vehicle No. PB-03-T-8059 was parked at Village Aklia Jalal, but in the morning, it was not there. The vehicle was stolen by unknown and unidentified person(s). The complainant tried his best to trace the said vehicle, but all in vain. The complainant duly informed the Police and opposite party and lastly the complainant recorded his statement with the Police and the FIR No.83 Dated 14.06.2016 was registered at PS Dayalpura in this regard.

4. It is further alleged that intimation regarding theft was given to the opposite party. The opposite party firstly appointed Er. K.S. Chandhok who verified the theft of the vehicle and he also took the signatures of the complainant on some blank Forms and discharge voucher etc. with the understanding that this is total loss. The documents were duly submitted with the opposite party through its investigator along with all the necessary papers i.e. copy of Insurance Certificate (Policy not issued till date), copy of FIR, copy of fitness, copy of Tax Receipts, copy of certificate of Exemption of Permit, original Non-Traceable certificate, original NCRB report etc. Thereafter the opposite party demanded the file closure report from JMIC, although the same is not necessary. However, the complainant under compulsion and under financial crunch provided the opposite party file closure report from JMIC. The opposite party appointed Er. Dinesh Kumar Goyal who assessed the value of the vehicle as per make & model of the vehicle. On the day of loss, the value of the vehicle was about 11,00,000/- and the said surveyor recommended the Total Loss as per IDV Value.

5. It is alleged that on 21.06.2018, the complainant wrote registered letter to the opposite party regarding payment of less amount and the complainant received that payment under protest as the opposite party paid sub standard claim and took the signatures on consent, Affidavit on Full and Final discharge and other bonds and subrogation etc. before releasing the said amount with the threat and compulsion that the sub standard amount will not be released if the complainant will not sign the said papers. The complainant signed the above said documents as he was under financial crunch as the opposite party was sitting on the claim of the complainant for the last more than two years.

6. It is also alleged that now the complainant received the less amount of Rs. 2,76,500/- (Rs.11,00,000/- (-) Rs.8,23,500/-). The said amount is lying with the opposite party for the last 2 years and the opposite party did not release the interest as per IRDA Guidelines Regulation 2002.

7. It is further alleged that on 09.10.2017 after 1 year 4 months the opposite party firstly approved the full claim of the complainant and then arbitrarily reduced the same from Rs.10,98,500/- to Rs.8,23,500/-. The opposite party reduced the claim from Rs.10,98,500/- to Rs.8,23,500/- on the ground of late intimation. The opposite party illegally and on flimsy ground rejected the Legal claim of Rs.2,76,500/-of the complainant by using such type of clause Late Intimation. Due to Non- payment of the balance claim i.e. Rs.2,76,500/- by the opposite party, complainant has suffered mental agony and pains for which he claims compensation to the tune of Rs.1,00,000/-.

8. On this backdrop of facts, the complainant has prayed for direction to the opposite party to pay balance claim amount of Rs. 2,76,500/- alongwith interest and interest on Rs. 8,23,500/-(amount already paid), alongwith damages to the extent of Rs. 1,00,000/- in addition to Rs. 50,000/- as litigation expenses.

9. Upon notice, opposite party appeared through counsel and contested the claim of the complainant by filing written reply raising legal objections that the complainant has concealed material facts and documents from this Commission as well as from the opposite party.

10. It is pleaded that the complainant has concealed the fact that the date of loss in this case has been intimated as 12/13-06-2016 whereas the FIR has been lodged with the police on 14-06-2016, hence, there is delay of 2 days in giving intimation to the police authorities. Further there is delay in intimation to the opposite party by 44/45 days as the claim was intimated on 28-07-2016 to the opposite party. Hence, there is delay in FIR and intimation to the opposite party, which has prejudiced possibilities of recovery of the vehicle. The complainant has violated the terms and conditions of the policy. Further the opposite party has already settled the claim at Rs. 8,23,500/- of the complainant on Sub Standard basis with the consent of complainant and the amount has already been paid to the complainant which has also been admitted by the complainant. The complainant also submitted duly attested affidavit whereby he has specifically stated that he is ready to receive the payment of Rs, 8,23,500/- i.e. 75% of the IDV. He has further stated that he is giving the said consent with his own free will without any pressure from any side.

11. The further legal objections are that the complainant has no locus standi or cause of action to file the present complaint and that the complaint is not maintainable in the present form.

12. On merits, the opposite party denied that the opposite party took any signatures of complainant on any blank forms or discharge vouchers etc., with any understanding that this is total loss. However, it is admitted that the complainant submitted the documents with the opposite party through investigation etc., The date of loss in this case has been intimated as 12/13-06-2016 whereas the FIR has been lodged with the police on 14-06-2016, hence, there is delay of 2 days in giving intimation to the police authorities. Further there is delay in intimation to the opposite party by 44/45 days as the claim was intimated on 28-07-2016 to the opposite party. Hence, there is delay in FIR and intimation to the opposite party, which has prejudiced possibilities of recovery of the vehicle. The complainant has violated the terms and conditions of the policy. Further the opposite party has already settled the claim at Rs. 8,23,500/- of the complainant on Sub Standard basis with the consent of complainant and the amount has already been paid to the complainant. After denying all other averments of the complainant, the opposite party prayed for dismissal of complaint.

13. In support of his claim, the complainant, has tendered into evidence his affidavit dated 17-08-2018 (Ex.C-1) photo copy of RC of vehicle (Ex.C-2), photo copy of insurance certificate (Ex.C-3), photo copy of FIR No. 83 dated 14-06-2016 (Ex.C-4) photo copy of NCRB report (Ex.C-5) photo copy of file close report from JMIC (Ex.C-6), photo copy of Eng. Dinesh Kumar report dated 29-11-2017 (Ex.C-7), photo copy of letter along with postal receipt dated 21-06-2018 (Ex.C-8) photo copy of circular of IRDA (Ex.C-9), photocopy of letter of approval containing pages 1 to 5 ( Ex.C-10) and photocopy of IRDA circular (Ex.C-11) and closed evidence.

14. In order to rebut the evidence of the complainant, opposite party tendered into evidence photo coy of affidavit of Baljinder Singh dated 06-04-2018 (Ex.OP-1/1), photocopy of letters (Ex.OP-1/2 to Ex.OP1/4) photocopy of insurance policy (Ex.OP-1/5) photo copy of terms and conditions of policy (Ex.OP1/6), and affidavit of Ashish Pal DM, dated 12-10-2018 (Ex.OP-1/7), photocopy of letter of indemnity (Ex.OP-1/8) photocopy of letter of undertaking (Ex.OP-1/9), photocopy of letter of subrogation ( Ex.OP-1/10) and closed evidence.

15. We have heard learned counsel for the parties and gone through the record.

16. There is no dispute regarding Insurance of vehicle No. PB-03-T-8059 of complainant, Theft of vehicle and payment of 75% claim amount i.e 8,23,500/- to complainant.

17. The allegation of the complainant is that the opposite parties have not settled his claim as per terms and conditions of policy and to his entire satisfaction.

18. The plea of the opposite party is that the reason behind payment of claim i.e. 75% amount of the IDV on sub standard basis is that the theft took place in the intervening night of 12/13-6-2016, the complainant got registered the FIR on 14-6-2016 i.e. after 2 days regarding theft of vehicle and intimated this loss to the opposite party on 28-7-2016 i.e. after 44/45 days. The opposite party has also pleaded that complainant has received the above said claim amount with his free will and submitted all the required documents including affidavit whereas version of the complainant is that he was under financial crunch, so he received the claim in question under protest.

19. Head Office of the opposite party has also issued letter dated 24-2-2012 to all Regional Offices

    “Motor/HO/Cir.No./2012/08

    24-02-2012

     

    To All Regional Offices

     

    Re: Delay by insured in giving intimation to insurer in case of Theft of the vehicle insured.

     

    Motor department is receiving queries from many Regional offices regarding IRDA circular IRDA/HLTH/MISC/CIR/216/09/2011 dated 20-09-2011 dealing with delay in claim intimation / documents submission with respect to non life insurance contracts. ROs seeking HO advice as to how to deal with Motor OD claim (particularly theft claims) where there is delay in claim intimation/ documents submission on the part of the insured. HO after perusing above IRDA circular and some of the NCDRC judgments on the issue wishes to advise the ROs as follows :

     

    1) No claim shall be repudiated just because there is a delay

    2) If there is delay of more than 24 hours in giving intimation to us by insured, an explanation in writing from the insured must be taken and recorded.

    3) If the delay is proved to be material to avoiding / minimizing the loss the claim shat be repudiated. However circumstances (4) and (5) below shall be considered.

    4) If the insured was negligent about informing the loss immediately and if a timely investigation could have given positive results, then the claim depending on the nature and material impact of such negligence, can be repudiated or paid as Non Standard upto 75%.

    5) If insured has acted as if uninsured and delay was totally beyond his control claim may be settled on Standard Basis.

    6) As mentioned in IRDA circular IRDA/HLTH/MISC /CIR/216/09/2011 dated 20-09-2011, there should be no compromise on bad claims.

    7) AIl the offices must ensure that Investigator is appointed within 24 hours of receipt of intimation. Wherever delay in intimation has been recorded, the investigator can asked to look into the reported circumstances of the delay.

     

    We are forwarding the same to you for your perusal and guidance and circulation to all operating offices under your control.”

20. This Commission is of the view that complainant should have given information to police immediately, so that timely investigation could have given positive result. Therefore, keeping in view the above said guidelines issued by IRDA, the complainant was entitled to 75% of the claim amount as there was delay in registration of FIR and in intimation to opposite party.

21. As per IRDA Guidelines Regulation 2002 (9) (6) (Insurance Regulatory and Development Authority Notification, the 16^th October, 2002, Insurance Regulatory and Development Authority (Protection of Policy holder's Interest) Regulations 2002 ) (6) – Upon acceptance of an offer of settlement as stated in sub-regulation(5) by the insured, the payment of the amount due shall be made within 7 days from the date of acceptance of offer by the insured. In the cases of delay in the payment, the insurer shall be liable to interest at the rate which is 2% above the bank rate prevalent at the beginning of the financial year in which the claim is reviewed by it.

22. It is admitted fact that consent for settlement was given by complainant to opposite party on 6-4-2018 (Ex. OP-1/1). So, as per IRDA Guidelines Regulation 2002 (9) (6) (Insurance Regulatory and Development Authority Notification, 16^th October, 2002 (Ex. C-8), complainant is entitled to interest if payment is not made within 7 days upon acceptance of an offer of settlement, but in this case payment is made on 26-6-2018. Thus, there is deficiency in service on the part of the opposite party in not paying interest on the claim amount.

23. Resultantly, this complaint is partly allowed against the opposite party. The opposite party is directed to pay interest on the settled and paid claim amount of Rs. 8,23,500/- of the vehicle in question, @9% p.a. with effect from 13-4-2018 (consent 6-4-18 (Ex. OP-1/1) till 26-6-2018 (date of payment).

24. The compliance of this order be made by the opposite party within 45 days from the date of receipt of copy of this order.

25. The complaint could not be decided within the statutory period due to heavy pendency of cases.

26. Copy of order be sent to the parties concerned free of cost and file be consigned to the record.

    Announced :

    17-12-2021

    (Kanwar Sandeep Singh)

    President

     

     

    (Shivdev Singh)

    Member