Het Ram, complainant (here-in-after referred to as 'complainant') has filed this complaint under Section 12 of the Consumer Protection Act, 1986 (here-in-after referred to as 'Act') against United India Insurance Co. Ltd., (here-in-after referred to as opposite party').
Briefly stated the case of the complainant is that he is owner of one motor cycle Hero Honda Splendor Plus, bearing Registration No. PB-03Y-7166. He has purchased this motorcycle from Kamal Enterprises, Bathinda vide Invoice No. 34982 dated 10-8-2011 for Rs 42,820/-. It was got insured with the opposite party vide policy No. 2004013116P 105080463 valid for the period from 12-7-2016 to 11-7-2017.
It is pleaded that Parvesh Babbar son of complainant is student of Giani Zail Singh Engineering College, Bathinda. He went to Ajit Road, Street No.13 Bathinda on 31-5-2017 for some domestic work and parked the motor cycle in front of Battlefield Computer Shop after locking the same. It was 11 AM. After spending 2 hrs in the shop, at 1 p.m. when he came out, he found that motor cycle was not standing there. He made enquiry from the adjoining shopkeepers and passer byes, but to no result. The original registration certificate of the vehicle was kept in the tool box. The motor cycle alongwith registration certificate was stolen by unidentified person. The son of the complainant immediately approached PS City for giving information about the whole incident. The police assured to find out the motor cycle but did not register FIR on the same day. The complainant lodged claim for theft of his motor cycle with the opposite party on 1-6-2017.
It is alleged that complainant and his son kept on approaching the concerned official of Police Station Kotwali, Bathinda, regularly and ultimately FIR No. 0121 dated 12-6-2017 was got registered at PS Kotwali Bathinda. The complainant submitted documents with the opposite party as demanded by them from time to time. On 30-10-2017 the complainant furnished the copy of FIR and photocopy of registration certificate because original RC was also stolen alongwith motor cycle. Thereafter, complainant was called to sign papers on 2-11-2017, as per requirement of the opposite party. The motor cycle was not found. The police, after due investigation, prepared the untraceable report under section 173 Cr.P.C dated 29-9-2017. The complainant submitted this report with the opposite party on 17-11-2017.
It is alleged that the officials of the opposite party did not inform in writing to the complainant regarding formalities required to be complied with but on every visit of the complainant, they used to put up new quarry for other documents such as DL, keys of the motor cycle, copy of Adhar card etc., Despite submitting all the documents, the claim of the complainant has not been processed though the complainant was regularly in touch with the opposite party.
It is also pleaded that complainant was called on 14-2-2018 to submit the duplicate copy of registration certificate of motor cycle. The same was submitted within one-week but the opposite party has again asked to submit the enquiry report from National Crime Records Bureau on 10-5-2018. The complainant obtained the same on 15-5-2018 and submitted with the office of opposite party. Even after completing all the formalities of opposite party as required by them, the complainant was called by the opposite party on 14-6-2018. He was asked to submit untraceable certificate signed by the Judge of the Court which is not possible under any provisions of law. The opposite party asked the complainant to submit the blank letter of subrogation for which he never agreed.
It is alleged that the opposite party is dilly dallying the payment of insured amount of Rs.18,500/-.
The complainant has pleaded that due to this act and conduct of the opposite party, he is suffering from harassment and mental tension. He also remained under depression due to callous attitude of opposite party. Now the opposite party vide letter dated 19-6-2018 had repudiated the claim of the complainant. This is totally illegal.
On this backdrop of facts, the complainant has prayed for directions to the opposite party to make payment of the vehicle as per terms and conditions of the policy and pay Rs. 10,000/- as compensation on account of mental tension and harassment and cost of litigation.
Upon notice, the opposite party appeared through counsel and contested the complaint by filing written reply. In written reply, the opposite party raised legal objections that intricate questions of law and facts are involved in the complaint which require voluminous documents. It is not possible in summary procedure under the 'Act'. That the complainant has concealed material facts and documents from this Forum. He has concealed the fact that the date of loss in this case has been intimated as 31-05-2017 and FIR with the police authorities was lodged on 12-06-2017. The intimation to the opposite party is dated 17-11-2017. There is delay of 12 days in giving intimation to the police authorities and delay of about 170 days in giving intimation to the opposite party. As per conditions of Motor Insurance Policy wordings, immediate notice to the company and to the police is required regarding alleged theft/criminal act. The complainant has violated the terms and conditions No.1 & 5 of the policy. Therefore, the claim was rightly repudiated vide letter dated 19-06-2018. That the complaint is not maintainable in the present form and lastly that this Forum has got no territorial jurisdiction to try and decide the complaint.
It is relevant to mention that opposite party has also quoted some case law to support these legal objections, the reference of which is not considered necessary at this stage for the sake of brevity.
On merits, ownership of the complainant over the vehicle and insurance by the opposite party is not denied but it is further mentioned that insurance is strictly as per terms and conditions of the policy.
In further version, the opposite party has reiterated its stand as taken in legal objections and detailed above. It is admitted that claim was repudiated vide letter dated 19-6-2018, but it is denied that letter is illegal, null and void. After controverting all other averments, the opposite party prayed for dismissal of complaint.
In support of his complaint, the complainant has tendered into evidence his affidavit dated 9-10-2018 (Ex. C-1), photocopy of Aadhaar Card (Ex. C-2), photocopy of bill (Ex. C-3), photocopy of policy (Ex. C-4), photocopy of R.C. (Ex. C-5), photocopy of FIR (Ex. C-6), photocopy of Untraceable report (Ex. C-7), photocopy of report (Ex. C-8), photocpy of e-mail (Ex. C-9), photocopy of letter (Ex. C-10) and closed the evidence.
In order to rebut this evidence, the opposite party has tendered into evidence affidavit dated 17-12-2018 of Baldev Singh (Ex. OP-1/1), affidavit dated 17-12-2018 of Pardaman Sharma (Ex. OP-1/2), photocopy of FIR (Ex.OP-1/3), photocopy of Investigation Report (Ex. OP-1/4), photocopy of letter (Ex. OP-1/5), photocpy of Insurance Policy (Ex. OP-1.6) and closed the evidence.
We have heard learned counsel for the parties and gone through the record.
The learned counsel for the complainant, after reiterating his version as detailed in the complaint, has submitted that material facts are not in dispute. It is not disputed the complainant being owner of the vehicle in question got it insured from the opposite party. The vehicle was stolen on 31-5-2017. The complainant lodged claim with the opposite party but the opposite party has repudiated the claim vide letter dated 19-6-2018 on the ground that there is violation of condition No. 1 i.e. there is delay in intimation and non-disclosure of material facts. The opposite party has not mentioned any material facts which are not disclosed by complainant. It shows that the opposite party has repudiated the claim illegally, arbitrarily and even without going into record/facts of the case. The other ground is regarding delay in intimation. Of course there is some delay in intimation to the opposite party but delay is duly explained. The opposite party has placed on record Investigation Report (Ex. OP-1/4). The Investigator has concluded that the theft of the vehicle in question has been confirmed and is genuine. The Investigator has also made Inquiry at the spot and has concluded that motorcycle was stolen on 31-5-2017 and not recovered till 12-12-2017. Therefore, no prejudice has been caused to the opposite party for delay in intimation to it. As such, repudiation of claim is not sustainable and is liable to be set aside. The complainant has also suffered mental tension for this act and conduct of the opposite party. Hence, the complainant is also entitled to compensation as prayed for.
In support of his submissions, learned counsel for the complainant has cited :
i) IV (2017) CPJ 10 (SC) case titled Om Parkash Vs. Reliance General Insurance & Anr.,
On the other hand, learned counsel for the opposite party has submitted that contract of insurance is like other ordinary contracts. The parties are bound by terms and conditions mentioned in the policy. The complainant himself has relied upon copy of Insurance Policy (Ex. C-4). As per condition No. 1, in case of accidental loss or damage, notice to the opposite party is to be given in writing immediately. Theft took place on 31-5-2017. The complainant was required to intimate the opposite party immediately thereafter. There is delay of 12 days in reporting the matter to the police. There is delay of 170 days in intimation to the opposite party. Of course, the Investigator has concluded that theft is genuine but this Forum can take judicial notice of the fact that opposite party lost the chance to get recovered the motorcycle only due to delay in intimation. Therefore, the complainant is not entitled to claim only for the reason that theft is found genuine. When the opposite party is deprived to take effective steps only due to delay in intimation, prejudice has been caused to the opposite party. There is breach of condition No. '1' of policy also.
To support these submissions, learned counsel for the opposite party has relied upon :-
i) 2014 (1) CPJ 29 case titled New India Assurance Co. Ltd., Vs. Ram Avtar
ii) 2016 (1) CLT 344 case titled Reliance General Insurance Co. Ltd., Vs. Jai Prakash Prop. M/s Aggarwal Construction Co.
iii) 2012 (4) CPJ 441 case titled New India Assurance Co. Ltd., Vs. Trilochan Jane
The learned counsel for the opposite party has further submitted that case law cited by learned counsel for the complainant are not applicable because in this case, there is no explanation for delay in intimation to the opposite party.
We have carefully gone through the record and have considered the rival contentions.
The admitted facts are that complainant, being owner got his motorcycle insured with the opposite party. Copy of the Insurance policy Ex. C-4 also proves this fact. IDV of the vehicle is Rs. 18,500/- and the covered period was 12-7-2016 to 11-7-2017. The vehicle was stolen on 31-5-2017, which is within covered period. The opposite party has repudiated the claim vide letter dated 19-6-2018 (Ex. C-10).
A Perusal of this letter reveals that the opposite party has denied the claim on the grounds of delay in intimation and non-disclosure of material facts. Of course opposite party has not revealed material facts which were concealed by complainant. Therefore, repudiation on this ground is not sustainable when the alleged material facts concealed by complainant are not disclosed by the opposite party in written version or in repudiation letter.
The other ground for repudiation is delay in intimation. As per complainant, theft took place on 31-5-2017. Of course, the complainant has pleaded that he lodged claim with the opposite party on 1-6-2017 but there is no documentary evidence to prove this fact. The opposite party has placed on record copy of Investigation Report (Ex. OP-1/4) which shows that intimation to the opposite party was given on 17-11-2017. Admittedly, there is some delay in reporting the matter to police also.
Now, it is to be seen that whether repudiation of claim in toto is justified.
In the case of Om Parkash Vs. Reliance General Insurance (Supra), Hon'ble Supreme Court has observed that :-
“It is true that the owner has to intimate the insurer immediately after the theft of the vehicle”.
But, it was further observed that :-
“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-holders in the insurance industry. If the reason for delay in making a claim is satisfactorily explained, such a claim cannot be rejected on the ground of delay.”
From the aforesaid observations, it is to be inferred that in case delay is properly explained the repudiation of claim is not sustainable. In the case in hand, the complainant has nowhere furnished any explanation regarding this delay. Therefore, it is to be accepted that there is no proper explanation for delay in intimation to the opposite party.
Hon'ble National Commission, in the case of United India Insurance Company Ltd., Vs. Aji Pal & Ors., I (2019) CPJ 452 (NC), after taking notice of observations of Hon'ble Supreme Court in the case of Om Parkash (Supra) has concluded that in such cases, the claim can be settled on non-standard basis. In this case also, theft occurred on 12-06-2009. Keeping in view these facts, Hon'ble National Commission observed that:-
“In view of the law laid down in the case of Amalendu Sahoo Vs. Oriental Insurance Co. Ltd., II (2010) CPJ 9 (SC), the matter can be decided on non-standard basis.
Therefore, keeping in the observations of the Hon'ble Apex Court in the case of Om Parkash (Supra) (relied upon by the complainant) and in the case Aji Pal & Ors., (supra) we considered it a case fit for settlement on non-standard basis. Hence, there is deficiency in service on the part of the opposite party in rejecting the claim of the complainant in toto. The complainant is held entitled to 75% of the IDV of the vehicle.
In view of what has been discussed above, this complaint is partly accepted with Rs. 5,000/- as cost. The opposite party is directed to pay to complainant Rs. 13,875/- being 75% of the IDV, with interest @9% p.a. from the date of repudiation of claim i.e. 19-06-2018 till realization. Complainant will execute letter of subrogation/documents and complete the other formalities, if any, required by law for release of claim
The compliance of this order be made within 45 days from the date of receipt of copy of this order.
The complaint could not be decided within the statutory period due to heavy pendency of cases.
Copy of order be sent to the parties concerned free of cost. File be
consigned to the record room.
Announced :
21-11-2019
(M.P.Singh Pahwa )
President
(Manisha)
Member
