Haryana

Karnal

CC/403/2021

Salim Khan - Complainant(s)

Versus

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

Sumar Aggarwal

25 Sep 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                        Complaint No. 403 of 2021

                                                        Date of instt.16.08.2021

                                                        Date of Decision: 25.09.2023

 

Salim Khan son of Shri Taju Din, resident of village Kutail, District Karnal.

 

                                                                        …….Complainant.

                                              Versus

 

1. Universal Sompo General Insurance Co. Ltd. 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. Rekha Chaudhary……Member

          

 Argued by: Shri Sumeer Aggarwal, counsel for complainant.

                    Shri Virender Sharma, counsel for the OPs.

 

                    (Jaswant Singh, President)

ORDER:  

                The complainant has filed the present complaint Under Section 35 of Consumer Protection Act, 2019, against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that complainant is owner of a vehicle no.HR-45-A-8575 and the said vehicle was insured with the OPs, vide policy no.USGI/POSWEB/0197350/00/000 and 2315/59418042/00/000 and on 25.01.2020, complainant had parked his abovesaid vehicle in front of shop no.250, 251, Anaj Mandi Taraori, District Karnal and went to Karnal for some work and when on 27.01.2020, complainant came back, he did not find his vehicle inspite of his best efforts and even after that complainant kept on searching his vehicle and ultimately, when the same was not found, then he got registered an FIR no.48 dated 31.01.2020 under section 379 IPC in Police Station Taraori, District Karnal. On the same day of theft, complainant informed the OPs and on receipt of intimation, OPs appointed a surveyor, who demanded so many documents alongwith untrace report from the complainant. Complainant submitted all the documents with the OPs except untrace report as the untrace report was not submitted by the police in the court and therefore, complainant was not able to submit the said report with the OPs and complainant had informed the OPs in this regard. However, after obtaining the untrace report dated 09.03.2021, when complainant contacted the OPs, then he came to know vide letter dated 26.02.2020 that OPs have repudiated the claim of the complainant on the false and frivolous ground i.e. delay in intimation to OPs, lodge the FIR after four days, the driver was not authorized to drive the vehicle and documents were not provided. Then complainant sent a legal notice dated 14.07.2021 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 this complaint.

2.             On notice, OPs appeared and filed its written version raising preliminary objections with regard to maintainability; cause of action; locus standi and concealment of true and material facts. On merits, it is pleaded that insurance of the vehicle bearing registration no.HR-45A-8575 with the OPs is concerned but complainant has never intimated the OPs regarding the alleged theft of vehicle. Moreover, the complainant has not lodged the claim regarding said vehicle with the OPs. It is further pleaded that complainant himself stated in his complaint that the vehicle had parked in front of shop no.250-251 Anaj Mandi, Taraori and went to Karnal for some work and when on 27.01.2020 he came back but he did not find his vehicle. Further, complainant has got registered an FIR no.48 on 31.01.2020 at Police Station Taraori, i.e. after a gap of four days from the date of alleged theft of vehicle. The complainant has even intimated the insurance company regarding theft of vehicle on 01.02.2020 i.e. after a long gap of five days from the date of alleged theft of vehicle and the driving licence submitted by the complainant is not authorized to drive the vehicle before theft and as per driving licence as provided by the insured the name is Saleem Ahmed however as per policy bank account and aadhar card bears the name is Salim Khan which is also suspicious. The complainant has provided one key of the vehicle and the road tax of the vehicle paid on 31.01.2020 after the theft. On investigation, it was found that the people working in Anaj Mandi, Taraori were not ready to provide eye witness or to give statement in respect of the alleged theft of vehicle. The complainant has also failed to provide RTO extract after theft, letter to RTO intimating about theft, NCRB report, copy of untrace report of the court. There is a delay in intimation, delay in FIR, reporting and driving license of the person who parked the vehicle before theft is not valid. Thus, the claim of the complainant has rightly been repudiated by the insurance company as per the policy of Motor Vehicle Act. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of repudiation letter dated 27.01.2020 Ex.C1, copy of insurance policy Ex.C2 and Ex.C3, copy of untrace report dated 09.03.2021 Ex.C4, copy of report u/s 173 Cr.P.C. Ex.C5, copy of legal notice Ex.C6, postal receipts Ex.C7 and Ex.C8 and closed the evidence on 04.04.2022 by suffering separate statement.

5.             On the other hand, learned counsel for the OPs has tendered into evidence affidavit of Ankita Bose Ex.OP1/A, copy of FIR Ex.OP1, cop of toll receipt Ex.OP2, copy of investigation report Ex.OP3, copy of affidavit of Salim Ex.OP4, copy of affidavit of Raj Kumar Ex.OP5, copy of statement of Raj Kumar Ex.OP6, copy of repudiation letter dated 26.02.2020 Ex.OP7 and closed the evidence on 19.04.2023 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 complainant got his vehicle insured with the OPs. On 27.01.2020, the vehicle of complainant was stolen and in this regard an FIR no.48 dated 31.01.2020, under section 379 of IPC was got registered with Police Station, Taraori, Karnal. The intimation was sent to the OPs. On 09.03.2021, the police submitted the untrace report. Complainant submitted all the documents alongwith the untrace report with the OPs and requested to settle the claim but OPs did not settle the claim and repudiated the same on the false and frivolous ground 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 the theft of the vehicle was occurred on 27.01.2020 and FIR no.48 dated 31.01.2020 was got lodged by the complainant after delay of four days and intimation was given to the OPs on 01.02.2020 i.e. after inordinate delay of five days. Upon receiving belated intimation of theft, OPs appointed a surveyor to investigate the alleged theft. But complainant neither submitted the required documents nor cooperate the investigator. Thus, the claim of the complainant was rightly 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, complainant got insured his vehicle with the OP. It is also admitted that the vehicle in question was stolen during the subsistence of the insurance policy. It is also admitted that the insured declared value of the vehicle in question is Rs.7,40,000/-.

 11.          The claim of the complainant has been denied by the OPs, vide letter Ex.C1/Ex.OP7 dated 26.02.2020 on the grounds, which are reproduced as under:-

“1.    You intimated us about the loss on 01.02.2020 after the delay of 5 days.

2. The FIR was lodged on 31.01.2020 after delay of 4 days. No receipt or documents was provided by you for reporting the loss to police on 27.01.2020.
3.  The driving license of the driver who parked the vehicle before theft is not authorized to drive said vehicle.
4. You did not provided documents vide letter dated 03.02.2020

1. Original RC/form 26
2. RTO Extract after theft
3. NCRB Report
4. Final Untrace Report accepted by CJM
5. Service history of vehicle
6. Form 28, 29, 30 (all triplicate copy)
7. Subrogtion and Indemnity Bond
8. One key out of both original key
9. Consent and Discharge voucher.

5. There is delay in intimation to insurance company and lodged of FIR which is violation of policy condition no.1.

In view of above points, we sincerely regret that we are unable to consider this claim”.

 12.          OPs had asked the complainant to complete the abovesaid formalities. The most of the queries alleged by the OPs are irrelevant and there is no legal hitch to decide the claim, when the complainant had already submitted the required documents for settlement of the claim. Hence, the demand of abovementioned documents is unnecessary and irrelevant and just to harass the complainant and denied the claim 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 litigation. Hence, in view of the above, we find no substance in this contention of the OPs.

13.           There is four days delay in lodging the FIR and five days delay of intimation regarding the theft of the vehicle in question by the complainant to the OPs. In the present complaint, vehicle in question was stolen on 27.01.2020 and complainant alleged that he had immediately intimated to the police and but police lodged the First Information Report (FIR) Ex.C5 on 31.01.2020. 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 have placed reliance upon 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.Further,Hon’ble Punjab and Haryana High Court in case titled as New India Assurance Company Ltd. Versus Smt. Usha Yadav & others 2008 (3) RCR (Civil) 111, has held as under:-

“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 that the ratio of the law laid down in aforesaid judgments, facts and circumstances of the present complaint, we are of the considered view that acts of the OP while repudiating the claim of the complainant 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.7,40,000/-. Hence the complainant is entitled for Rs.5,55,000/- i.e. 75% of the insured amount alongwith interest, compensation for mental pain and agony and litigation expenses etc.

18.           In view of the above discussion, we partly allow the present complaint and direct the OP to pay Rs.5,55,000/- (Rs.five lakh fifty five thousand only) to the complainant alongwith interest @ 9% per annum from the date of repudiation of the claim till its realization. We further direct the OP to pay Rs.20,000/- 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:25.09.2023     

                                                                  President,

                                                       District Consumer Disputes

                                                       Redressal Commission, Karnal.

 

(Vineet Kaushik)        (Dr. Rekha Chaudhary)

                     Member                        Member