- The complainant has filed this case against the O.P for not settling the claim arbitrarily and illegally repudiating the claim of petitioner. As such there is gross negligency and deficiency in services rendered by the O.P. as well as its unfair trade practices.
- The complainant’s case in brief is that the complainant is a registered owner of Mahindra Bolero bearing registration no.JH04H2033. The said vehicle was insured with O.P. that is Oriental Insurance Company Limited under Private Car package Policy under Policy No. 332401/31/2016/2649 valid and effective from 10.11.12 to 09.11.2016 and the entire risk and liabilities including the liability arises from theft of vehicle is fully covered under the said policy. It is further submitted that the said Bolero vehicle bearing registration no. JH04H2033 was stolen away by unknown miscreant in the night of 10.11-4-16 while the same was parking near the house of Lalan Jee Maharaj the brother of the complainant who was using and occupying the said vehicle being brother of the complainant owner and the same could not be traced out on search.
- Thereafter F.I.R was lodged in Dumka Town Police Station regarding theft of the Bolero vehicle no. JH04H2022, case no. 84/16 dt. 11.04.16 and the same was received by O.P on 11.04.16 being Motor Theft Claim no. 332401/31/2017/000006. It is further submitted that after due inspection the police found the theft true and submitted the final form as true but no clue and the final form has been accepted by the Learned Chief Judicial Magistrate, Dumka. Thereafter, the complainant submitted the certified copy of F.I.R and final form before the O.P which was received by O.P on 19.07.16. The complainant submitted entire documents relating to the said vehicle and also other required documents by the O.P and the O.P received the same on 01.08.16. In spite of that O.P failed to settle the claim in time and with an intension to cause unnecessary delay in settling the claim written a frivolous letter dt. 26.12.16 to the complainant and the complainant on his turn replied the said letter vide his letter dt. 10.01.17 and the O.P cold not settle the claim and the complainant intimated vide his letter dt. 01.08.16. Thereafter the O.P vide its letter dt. 16.04.17 sent a pre – repudiated letter to the claimant and the complainant sent its reply to the O.P vide letter dt. 23.05.17. In spite of that O.P failed to settle the claim.
- The insured amount of the vehicle is Rs 5,23,000 and the O.P Insurance Company has withhold the claim amount and utilized the same in its use depriving the complainant from getting usufruct of the same and the complainant has suffered immense loss and damages and entitled to get interest @ 18% p.a on the claim amount from the date of theft till its payment. It is further submitted by complainant that the Policy no. 332401/31/2016/2949 was filled up by the agent of the O.P. There is no suppression of material fact on the side of the complainant. It is submitted that the material facts of the vehicle is the description of the particulars of the vehicle insured and there is no suppression of any material facts in respect of the description of vehicle insured. The letter dt. 16.05.17 was handed over to the insured on 16.05.2017 after a lapse of 18-19 months from the date of issue of policy and after 12-13 months from the date of loss.
- After the O.P through its agent influenced the insured to get the vehicle insured with the O.P and allowed no claim bonus knowing its full well that there was no O.D claim with the previous Insurance Company after being satisfied the O.P has allowed No Claim Bonus reasons best known to him and its agent. The complainant claim following amount –
- Principal amount of loss due to theft of vehicle Rs 5,43,000/-
- Compensation amount of Rs 1,00,000/-
- Cost of Litigation Rs 10,000/-
Total Rs 653,200 was claimed by the complainant with interest @ 18% on the said amount.
- The cause of action arose in the night of 10.11-4-16 when the vehicle was stolen away and it also arose subsequent dates including 23.05.2017 on which date demand for settlement of the claim was made3 with assertion that if not settled within 7 days the complainant will take shelter of the court. The complainant claimed following reliefs :-
- The O.P may be directed to remove the defect by settling the claim and making payment of insured amount of Rs 5,43,200 to the complainant.
- The O.P may further be directed to make payment of compensation amount of Rs 1,00,000 to the complainant.
- The O.P may be directed to make the payment of interest amount @18% p.a on the awarded amount from the date of theft till its payment.
- Cost of Litigation of Rs 10,000 may also be awarded.
- Any other relief or reliefs for which the complainant is entitled may also be awarded.
- The O.P Oriental Insurance Company Limited appeared and filed his so cause on 15.02.18. He has submitted in the so cause that the case of the complainant is wholly misconceived, illegal and untenable in law. It is further submitted that there is no deficiency in services or latches whatsoever on the part of this opposite party nor the company has refused to settle the claim illegally and arbitrarily causing any damage to the complainant as alleged by the complainant in his petition. There is no valid cause of action of this case. It is further submitted that complainant has concealed the true facts of the case. In Para 8 of his so cause he has admitted this fact that the complainant’s vehicle Mahindra Bolero bearing registration no. JH04A2033 was insured with this O.P that is Oriental Insurance Company Limited for the period 10.11.15 to 09.11.16 and the sum insured was Rs 5,43,200.
- It is further submitted that before purchasing the insurance policy the proposal form duly filled in and signed by the complainant and said proposal form the complainant has given the information on back page in S1.6(ii) that he is entitled to get No Claim Bonus and has made the declaration that the information given in the proposal form is true to his full knowledge and belief and further has declared that if this declaration is found false all the benefit to be given under this policy would be forfeited. It is also admitted fact by the O.P that the information regarding theft of the insured Bolero vehicle was reported to this O.P by the complainant’s letter dt. 11.04.16 along with the ‘Claim for damage’ to the insured vehicle in the Motor Claim form on 11.04.16. And after receiving the claim form duly completed by the insured on 11.04.16, this O.P got the matter investigated through their own agency and vide O.Ps letter dt. 26.02.16 made certain queries regarding measures taken by the insured for safety and protection and further stated that in the same process the made query about the NCB (No Claim Bonus) from Royal Sundaram Alliance Insurance Co. Ltd. vide its policy no. VPC0662507000100.
- This O.P wrote the letter on 10.11.15 to the above insurance company where previously this vehicle in question was insured in order to know if previously on this vehicle the insured had earned any NCB (No Claim Bonus). It is pertinent to mention here that this vehicle in question was previously insured for the periods 01.11.14 to 02.11.15 with the Royal Sundaram Insurance Co. Ltd. vide Policy no. VPC0662507000100. The above mentioned Royal Sundaram Insurance Company replied via e-mail dt. Dec 30,2016 at 10:30 AM – “ Nil ncb due to odd claim.” (Nil claim bonus due to own damage claim). From the above replied email of the previous insurer that is Royal Sundaram Insurance Co. Ltd. it is crystal clear that the complainant made a false NCB declaration in his proposal during insurance and the claim 20% No Claim Bonus and also availed the benefit in the policy on account of the past claim experience in his previous policy, which is breach of utmost good faith and violation of policy terms and conditions.
- And considering above facts the complainant was given the pre repudiation letter dt. 10.04.17 mentioning the above facts mentioned in Para 12 of the letter and this O.P was given by this O.P one more chance to substantiate his claim before taking final decision on the basis of the above grounds and the complainant submitted his reply to his pre repudiation letter vide his letter dt. 23.05.17 in which instead of substantiating his claim through satisfactory reply based on truth, complainant made several false and also incriminating allegations. The complainant has falsely alleged that he signed the proposal form in good faith and bonafide benefit at the instance and direction of the O.P’s agent and the complainanat has falsely alleged that the O.P through his agent influenced the complainant insured to get the vehicle insured with O.Ps Company. And the O.P allowed “NOC No claim bonus” knowing it fully well that there was vehicle claim with previous insurance company Royal Sundaram and the O.P after being satisfied allowed No Claim Bonus. As such both the allegations are highly incriminating and based on blatant lie and total falsehood which this O.P vehemently and emphatically denies and protests against this baseless false allegations and prayed that in view of the facts and circumstances stated in his so cause the complainant is entitled and deserves for any cost and reliefs and the complainant case may be dismissed with cost in favour of the opposite parties.
- The main points in the determination of this case is that whether the complainant is entitled for any relief or reliefs as claimed !
Findings
The complainant in support of his case filed certain documents which are as follows :-
Exhibit 1 – is the certificate of registration vehicle no. JH04H2033
Exhibit 2 – is the photocopy of Insurance – Cum – Policy _ Schedule of vehicle no. JH04H2033
Exhibit 3 – is the photocopy of F.I.R of Dumka Town P.S Case No. 86/16 which was registered as GR case no. 430/16
Exhibit 4 – is the photocopy of written information given by K.K maharaj to Branch Manager Oriental Insurance Company, Dumka dt. 11.04.16
Exhibit 5 – is the Motor claim form claim no. 332401/31/2017/6
Exhibit 6 – is the final form of Dumka petition P.S case no. 84/2016 filed in GR case 430/16
Exhibit 7 – is the photocopy of certified copy of Order Sheet of CGM, Dumka of GR case no. 430/16
Exhibit 8 – is the photocopy of letter dt. 11.07.16 written by complainant Kaushal Kishore Maharaj to Branch Manager Oriental Insurance Company
Exhibit 9 – is the list of documents whichwas given to Oriental Insurance Company on 01.08.16 by the complainant.
Exhibit 10 – is the letter of Oriental Insurance Company dt. 26.12.16 address to Kaushal Kishore Maharaj, informant.
Exhibit 11 – is the photocopy of letter of K.K. Maharaj dt. 10.01.17
Exhibit 12 – is the photocopy of letter address to the S.P Dumka dt. 01.08.16
Exhibit 13 – is the letter dt. 16.04.17 of Oriental Insurance Company in relation to Pre – Repudiation letter
Exhibit 14 – is the reply of the complainant of the letter of the Oriental insurance Company dt. 16.04.17
Apart from that the complainant himself filed the affidavit as a witness as PW1 as Kaushal Kishore Maharaj. Apart from that the complainant has not filed any other documents or evidences in support of his case.
- The opposite party in support of his defence has filed some documents or evidences in support of his case.
Exhibit A – Motor Insurance – Cum – Policy – Schedule of JH04H2033 for the period from 10.11.15 to 09.11.16
Exhibit B – is the Insurance proposal form dt. 10.11.15
Exhibit C – is the letter written by Oriental Insurance Company to Branch Manager, Royal Sundaram Insurance Alliance Co. Ltd. dt. 10.11.15 regarding percentage of No Claim Bonus earned if any
Exhibit D – is the certificate of Insurance – Cum – Policy – Schedule issued by Royal Sundaram for the period 01.11.14 to 02.11.15
Exhibit E – is the photocopy of email regarding request of NCB confirmation of your policy written by Oriental Insurance Company to Royal Sundaram Co. Ltd.
Exhibit F – is the photocopy of the letter dt. 16.04.17 regarding Pre – Repudiation letter of Oriental Insurance Company
Exhibit G – is the letter of Oriental Insurance Company dt. 18.10.17 given to Kaushal Kishore Maharaj, complainant
Apart from that the O.Ps has not filed any other evidences documentary or oral in support of his case.
- From carefully scrutinizing and analyzing the evidences it is of both the parties the complaint petition and so cause the following are admitted facts :-
- The vehicle registered as JH04H2033 Dumka of which the complainant is registered owner has taken Insurance Policy to the O.P for the period 10.11.15 to 09.11.16 by Policy No. 332401/31/2016/2949 for the entire liabilities including theft also.
- It is also admitted fact that the said vehicle was stolen away on 10.11 - 4 - 16 in the night which is also established by Exhibit 3, F.I.R – Exhibit 6, Final form and Exhibit 7 - The Order Sheet of the CGM.
- It is also admitted fact of the said vehicle was previously insured by another Insurance Company namely Royal Sundaram Alliance Insurance Co. Ltd. which was also disclosed by the complainant himself in his proposal form for Insurance as it is apparent from Exhibit B.
- It is also admitted fact by both the parties that theft claim was registered as claim no. 332401/31/2017/6 which is corroborated by Exhibit 5. From perusal of Exhibit 9 it also appears that on 01.08.16 this complainant has already handed over all the relevant and required documents to the office of Oriental insurance Co. Ltd.
- The Oriental insurance Co. Ltd. that is O.P has rejected the claim of the complainant merely on the ground that the complainant concealed the fact regarding no claim bonus which is mentioned in Exhibit B which is proposal form for the Insurance of the vehicle in which both the complainant has disclosed this fact that previously this vehicle was insured with Royal Insurance Alliance Co. Ltd. vide insurance no. VVPC0662507000100 and he claim the no bonus for 20%. From carefully going through Exhibit B which is proposal form for obtaining Motor Insurance and the insurer has right to accept the proposal of the complainant or rejected but after receiving the insured amount he accepted proposals form of the complainant and insured the vehicle of the complainant for the period from 10.11.15 to 09.11.16 and accordingly he issued the Motor Insurance – Certificate - Cum – policy – Schedule which is Exhibit A corresponding to Exhibit 2.
- It is also evident from the record that receiving proposals form on 10.11.15 the Oriental Insurance Company for the confirmation of No Claim Bonus written letter dt. 10.11.15 that is on the same day to the Branch Manager Royal Sundaram Insurance Co. Ltd. and thereafter he kept mum and when the vehicle was stolen away on the night of 10.11-4-16 then the O.Ps made several correspondence to the complainant regarding theft and other things and started to withhold the claim of the complainant this or that way.
- And finally on 16.04.17 he gave the Pre – Repudiation letter to the complainant and repudiated the claim of the complainant saying that he has made a false NCB declaration in his proposals form and claim 20% No Claim Bonus on account of that and he sent his letter on the email which is Exhibit A sent to the O.P by Royal Sundaram Insurance Co. Ltd. from carefully going to the Exhibit A.
- It is apparent that this email is dt. 30.12.16 and the complaint was lodged by the complainant on 11.04.16 and complainant handed over all the required and bonafide and necessary documents to the complainant on 01.08.16. In spite of giving payment the claim the O.P intentionally withheld the claim of the complainant and after sometime he repudiated the claim of the complainant.
- From the perusal of Exhibit 2 which is Insurance – Certificate – Cum – Policy –Schedule it appears that the complainant has paid Rs 14072 as a premium to the O.P in which No Claim bonus was obtained Rs 1815.80 only. The O.P has taken the plea that in Exhibit B which is the proposal form in which it is specifically mentioned that if regarding the declaration of NCB evidences found false and incorrect then the Insurance Company has right to forfeit all the benefits. Merely on this ground for features or repudiation of the claim since not justified as Exhibit 3. Exhibit B is the proposal form and it is not mandatory or necessary to accept the proposals of the complainant to insure his vehicle. The Insurance Company has full liberty to accept or reject the proposals of the complainant regarding Insurance of his vehicle to his company but insurance company whose business is to insure the vehicle anyhow practically there are several Insurance Co. there are competition between them to insure the vehicle. The business of the Insurance Co. is very competitive and as such to gain the monetary benefit this Insurance Co. in spite of query regarding NCB to the previous Insurance Co. accepted the proposals of the informant and issued the certificate of Insurance Co. to the complainant.
- And ones the Insurance Co. accepted the proposals and issued the certificate regarding the Insurance of the vehicle he is bound by terms and conditions of the Insurance Policy then what conditions written in the proposals form has no material facts. At this stage when the claimant claims for the theft of his vehicle. And repudiation the claim by the Insurance Co. is totally illegal, arbitrary and unjustified.
- From the above discussion we come to the conclusion that O.P has illegally and arbitrarily repudiated the claim of the complainant. We therefore,
Ordered
That the opposite party, The Oriental Insurance Company Limited represented through its Branch Manager, Dumka Branch, Court Compound, Dumka, P.O.- Dumka, P.S.- Dumka Town, Dist.- Dumka is hereby directed to pay the complainant Principal amount loss of due to theft of the vehicle Rs 543,200 and also directed to pay compensation of Rs 1,00,000 and O.P is also directed to make payment of interest amount @12% per annum on the awarded amount from the date of theft till its payment and also directed to pay the complainant the cost of litigation of Rs 10,000.
Thus, this case is decided in favour of complainant on contest. This case is disposed off accordingly.
Office is directed to supply the copy of this order to both the parties free of cost.