Repudiation of Insurance claim by the OP No. 1 has irked the policyholder, herein the complainant to lodge this complaint against the OP Nos. 1 & 2 for redressal u/s 12 of the C.P. Act, 1986.
The summation of the complaint goes that the complainant has submitted the complaint of theft of his insured motorcycle of Bajaj Discover make 125 CC bearing Registration No.WB-62C/6633. The theft was committed pm 6.10.2016 at Sibtoli, PO & PS: Balurghat, Dist. Dakshin Dinajpur between 9:00 pm and 9:30 pm when the complainant was on a visit to his relative house at the place. On the very day the complainant lodged a GDE bearing No.397 dt. 6.10.2016 with Balurghat police station. Accordingly, he submitted his claim to the OP No. 1 through the OP No. 2, which works as an agent of OP No. 1 on 24.10.2016. The OP No. 1 through some letters dt. 24.10.2016, 11.1.2016 and 15.2.2017 claim some necessary documents which the complainant through a letter dt. 17.2.2017 claimed to have submitted all to the OP No. 1 except FIR due to non-cooperation of local PS. But the OP No.1 has repudiated his claim through a letter dt. 22.2.2017 on the ground that the necessary documents have not been submitted to the OP No. 1.
The OP No. 1 in his written version states that though the complainant is a bona fide customer of the OP No. 1 but non-cooperation and non-submission of documents as per terms & conditions of the policy and also delay in submitting claim have obliged the OP office to repudiate the claim.
The OP No. 2 in their written version claimed to be a mis-joinder in the instant case as the OP No. 2 is banking organization and act as a mediator between the complainant and the OP No. 1 in the instant case. They have done only duty of transferring all the documents to the OP No. 1 as submitted by the complainant to them. But the OP No. 1 has repudiated the claim due to non-submission of required documents to them by the complainant. There is no deficiency in service on the part of OP No. 2.
On argument the complainant with documents has tried to prove that they have submitted all the documents including the copy of GDE with the Balurghat PS to the OP No. 1 through the OP No. 2. They have only failed to submit the FIR and FRT from the Balurghat PS on and before 22.2.2018 due to non-cooperation of the police administration. They have finally lodged an FIR on 4.4.2017 and FRT has also been received from the local PS on 17.10.2017. The Ld. Lawyer for the complainant argued that it was the duty of police administration to lodge the FIR on the basis of GDE, so it is not the fault of the complainant. On argument the Ld. Lawyer for the OP No. 1 with some documents including the report of investigator Mr. Abhijit Saha dt. 4.11.2016 has tried to prove that without proper documents no claim can be settled finally. FIR and FRT have been received by OP No.1 much latter than repudiation of claim. Moreover, the complainant has claimed that due to his illness he could not lodge FIR in due time. But it is found from the record that the complainant remained under the medical treatment in January 2017 but the accident occurred on 6.10.2016. So, it is negligence on the part of the complainant to lodge FIR in proper format with the local PS in proper time.
The OP No. 2 has not turned up during the course of argument, so his written version has been taken into consideration and as their averment.
Points for discussion:
- Is the complainant a consumer to the OP Nos.1 & 2?
- Is there any deficiency in service on the part of OP No.1?
DECISION WITH REASONS
Neither the OP No. 1 nor the OP No. 2 has declined to recognize the complainant as their bona fide customer. So, the complainant is a consumer in the instant case. The documents furnished by the complainant and the OP No. 1 reveal that theft has been committed on 6.10.2016 and the complainant had properly lodged the GDE and submitted his claim to the OP No. 1 through the OP No. 2 after 18 days. But it is not an exorbitant delay in submitting his claim. It is fact that the complainant has filed all the documents including GDE dt. 6.10.2016 to the OP No. 1 except FIR. It is the lapse of the local PS not to take up the GDE as an FIR and do the needful. Report of the investigator filed by the OP No. 1 also reveals that he has also got no cooperation from the Balurghat PS regarding GDE No.397 dt. 6.10.2016 as stated in the 2nd Para of conclusion with remarks and report at point-4. The OP No. 1 has also not taken initiative to obtain report from the local PS even after receiving the letter dt. 17.2.2017 wherein the complainant has expressed his inability to submit the FIR, but rather the OP No. 1 ventured to repudiate the claim. It is to be noted here that insurance is a contract between the parties on the basis of good faith. Moreover, the report of investigator appointed by the OP No. 1 in his report has admitted the fact of the theft. In this context we may take refuge to the important point observed by the Hon’ble National Commission in the Revision Petition No. 4446 of 2009 and decided on 14.1.2015 “claim cannot be repudiated where surveyor and investigator appointed by the insurance company did not raise any doubt about the manner of accident” [2015(1) CPR 621(NC)].
Hence, it is
O R D E R E D
that the OP No. is directed to pay the insured value of Rs.28,000/- and the litigation cost of Rs.2,000/- to the complainant within 30 days from the date of this order, failing which insured amount will bear interest @9% p.a. from 24.10.2016 on which date the complainant has submitted his claim to the OP No. 1. The OP No.2 is mis-joinder and is acquitted of charges.
The case be and the same succeeds on contest.
Let a plain copy of this order be furnished to the parties forthwith free of cost.
