State Consumer Disputes Redressal Commission
The National Insurance Co Ltd vs Anirudh Lalasaheb Patil on 15 January, 2020
1 FA/58/2019
Date of filing :08.01.2010
Date of order :15.01.2020
MAHARASHTRA STATE CONSUMER DISPUTE
REDRESSAL COMMISSION,MUMBAI, BENCH AT
AURANGABAD.
FIRST APPEAL NO. : 58 OF 2019
IN COMPLAINT CASE NO.: 102 OF 2017
DISTRICT CONSUMER FORUM : LATUR.
The National Insurance Company Ltd,.
Through its Manager, Gurudwara road, Latur.
Through its Divisional Office, Hazari Chembers,
Padampura, Railway Station road, Aurangabad. APPELLANT
VERSUS
Anirudh Lalasaheb Patil,
R/o Sindala (J), Tq. Ausa at present
Parwati Apartment, Datta Mandir,
Latur. RESPONDENT
CORAM : Smt.S.T.Barne, Hon`ble Presiding Judicial
Member.
Mr.K.M.Lawande, Hon'ble Member.
Present : Adv.S.V.Kulkarni for appellant,
Adv. N.J.Patil for respondent.
JUDGMENT
Per Smt.S.T.Barne, Hon'ble Presiding Judicial Member.
1. The National Insurance Company Ltd,. has preferred this appeal against the judgment and order in CC No. 102/2017 decided 2 FA/58/2019 by District Consumer Forum, Latur on 26.11.2018, The respondent Anirudh Lalasaheb Patil is the complainant and the appellant National Insurance Company Ltd,. is the opponent in the original complaint. Hence, parties are hereinafter referred as per their status in the original complaint.
2. It is the case of complainant before the District Consumer Forum that he is the owner of truck No.MH-24-F-9019. He has insured it with the opponent insurance company for the period of 29.10.2009 to 28.10.2010. It's then I.D. value was Rs.7 Lakhs. He has paid the premium of Rs. 19,618/- towards the insurance policy to the compnay. Said truck was stolen away in the night of 4.10.2010. Police have inquired into the matter and submitted A-summary on 13.10.2012. The complainant has submitted his claim proposal to opponent insurance company. However, the opponent insurance company repudiated his claim on 14.3.2013 for non compliance of documents. Thereupon, the complainant approached to District Consumer Forum. The District Consumer Forum decided said complaint with directions to complainant to submit the claim again to the insurance company and that the insurance company shall decide the claim within 30 days.
3. It is further alleged by the complainant that on 7.9.2016 as per the directions of District Consumer Forum he has again submitted his claim. However, the opponent failed to dispose off his claim. Thereupon, the complainant filed execution petition No.71/2016. In the said proceeding the opponent insurance company informed that on the date of theft the truck was kept in front of the house of 3 FA/58/2019 driver. On that date there was no fitness validity certificate. Hence, his claim is repudiated. The complainant came to know about the said letter given by opponent in the execution proceeding on 9.2.2017. Therefore, he has preferred the complaint NO. 102/2017 with the allegation that the opponent caused deficiency in service in repudiating his claim. He has claimed Rs. 7 Lakhs along with interest @ 12% towards insured amount from the date of theft till realization of amount. The complainant has also claimed Rs. 50,000/- towards mental agony and Rs. 20,000/- towards cost of proceeding.
4. The opponent insurance company filed its reply to the complaint before the District Consumer Forum. Its copy is at page No. 33. It is not denied by the opponent that the vehicle in question was insured with opponent for the period of 20.10.2009 to 28.10.2010. The ID value of the truck is shown as Rs. 7 Lakhs in the insurance policy. It is also denied that vehicle was stolen away on 4.10.2010 and the police have submitted A-summary on 13.10.2012. It is admitted to some extent that the complainant has submitted earlier claim and it has been rejected for want of compliance of documents. It is admitted that the complainant has filed consumer complaint No. 66/2015 and execution in respect of the same and it is still pending. It is admitted that as per the directions of the District Consumer Forum in complaint No. 66/2015 the opponent insurance company received the claim of the complainant. The opponent has decided the same and again repudiated it. It is the contention of opponent that the claim is rightly rejected by the opponent as there is breach of policy condition. There is also no cause of action. The 4 FA/58/2019 police had investigated FIR. There were two different FIR lodged at different places in respect of theft. Therefore, the complaint is based on false facts and grounds. Hence the opponent prayed for dismissal of complaint.
5. On the basis of rival submissions of the parties the District Consumer Forum pleased to allow the complaint with directions to opponent to pay the amount if insurance Rs. 7 Lakhs along with interest @ 7 % p.a. from the date of theft i.e. 4.10.2010 within 30 days from the date of order of District Consumer Forum, failing which further directions are given to recover the amount with further interest @ 9 % p.a. till realisation of entire amount. In addition to that, the District Consumer Forum has awarded Rs. 15,000/- towards mental agony and Rs. 15,000/- towards the costs. Being aggrieved by said order National Insurance Company has preferred this appeal on the following grounds.
That, there is no deficiency in service on the part of insurance company. The District Consumer Forum wrongly awarded the compensation against the terms and conditions of the policy. The complainant has not submitted documents of vehicle for 5 years. There is breach of policy condition on the part of owner. The District Consumer Forum has wrongly interpreted the facts.
6. In view of the respective submissions of the parties & the judgment of District Consumer Forum, following points arise for our determination.
5 FA/58/2019
Sr.No. Points. Findings.
1. Whether, the opponent has committed Yes.
Deficiency in service towards the
complainant?
2. Whether, there requires interference Yes.
in the Judgment and order of District
Consumer Forum?
3. What order ? As per final order.
REASONS.
7. Points No.1&2 :- Heard learned Adv. for complainant as well as opponent. It is submitted on behalf of opponent that the present according to complainant the theft occurred on 4.10.2010. The vehicle was parked in front of the house of driver and it has been stolen away. He took search and then lodged report on 10.10.2010. According to complainant FIR was lodged. However, police have submitted A-summary. He has submitted the claim to opponent. According to opponent there was no intimation along with documents, the opponent issued several letters to the complainant and ultimately the claim was closed on 14.3.2013. The complainant earlier filed complaint No.66/2015 before the District Consumer Forum. The District Consumer Forum gave directions to resubmit the documents and to decide the claim within one month by opponent. However, there was no fitness certificate and permit and relevant documents. Hence, claim is rejected by opponent. The complaint filed by the complainant is beyond the limitation and there is breach of policy conditions. Hence, the complaint itself is not tenable.
6 FA/58/2019
8. On the other hand the learned Adv. for complainant argued that after the theft, the claim was submitted to opponent. However, it is not decided for longer period. Therefore, the complainant approached to District Consumer Forum with complaint No.66/2015. The District Consumer Forum gave directions to resubmit the claim along with documents with directions to opponent to decide the same within one month. However, opponent has not decided the claim as per the directions of District Consumer Forum. It is the defence of the opponent that there was no fitness certificate and therefore, there is breach of policy conditions. In fact, the claim can not be repudiated for want of fitness certificate in case of theft.
9. On perusal of record it clearly reveals that the complainant is claiming himself as a owner of the vehicle truck No. MH-24-F-9019. It was insured with opponent for the period of 29.10.2009 to 28.10.2009. The policy to that effect is produced on record at page No. 56 of compilation. It reveals that the complainant has submitted intimation about theft of his vehicle to opponent on 14.10.2020, the FIR was lodged with police. Said intimation is at page No.58. The copy of FIR is dt.10.10.2010 at page No. 59. The RTO particulars of the vehicle is at page No. 68, fitness certificate for the period of 30.07.2009 to 29.07.2020 is at page No. 69, permit up to 30.12.2020 is at page No. 70,71, A-summary is at page No. 72 to 76, letter closing the claim of complainant issued by opponent dated 14.2.2013 is at page No. 77, the repudiation letter of subsequent claim dated 19.12.2016 is at page No. 84. From aforesaid documents it clearly reveals that, there are documents regarding ownership of vehicle with the complainant. The vehicle is with the complainant. It was 7 FA/58/2019 insured at the relevant time with opponent when the theft occurred on 4.10.2010. There is immediate intimation after taking search of the vehicle which is dated 10.10.2010 on the basis of which FIR is registered and it reveals that A-summary is filed by police after investigation on 13.10.2012. Admittedly, the intimation of the theft is given to opponent insurance company and RTO on 14.10.2010. According to complainant the opponent has not decided his claim till he approached to the District Consumer Forum. While the opponent is claiming that several intimation were given for submission of required documents. However, no compliance is made and therefore, ultimately it is intimated to the complainant on 14.2.2013 that there is no claim and closed the file.
10. It further reveals that thereafter, the complainant approached to District Consumer Forum and filed complaint for alleged deficiency in service bearing CC No.66/2015 wherein the defence of the opponent was that the complainant has not submitted all required documents. Hence, the file was closed. Therefore, the District Consumer Forum gave directions to the complainant to submit requisite documents to the opponent and opponent was directed to decide claim within 30 days. The aforesaid facts are not disputed.
11. It further reveals that the opponent insurance company pleased to repudiate the claim by letter dated 19.12.2016 and gave intimation to that effect to the complainant that at the time of theft the vehicle was parked in front of driver's residence. It means it was plying on road, fitness certificate of the vehicle was not valid on the date of theft. For the said reason the claim is repudiated. The 8 FA/58/2019 second complaint is filed by the complainant before the District Consumer Forum bearing CC No. 102/2017 on 15.06.2017 with the allegation that the opponent has not decided the claim as per the directions of the District Consumer Forum. It is also submitted that the opponent intimated him by letter dated 19.12.2016 that his claim is rejected on the ground of want of fitness certificate.
12. Thus, in short the repudiation of claim is for want of fitness certificate. The learned Adv. for opponent mostly relied upon the policy and its terms and conditions that vehicle can not ply on road without fitness certificate and permit and on the date of theft vehicle was stopped in front of house of driver. It means vehicle was plying and therefore, there is breach of policy condition and the complainant is not entitled for insurance amount or compensation from opponent for alleged deficiency in service.
13. On the other hand the learned Adv. for complainant has submitted that the claim is in respect of theft. Merely because the Vehicle was standing in front of house of driver. It can not be inferred that it was plying. Secondly in respect of theft the claim can not be denied for want of fitness certificate. Though admittedly the period of fitness certificate was up to July 2010. However, there was permit renewed up to 2012. He placed reliance upon the following cases.
(i) The Hon'ble Himachal Pradesh State Commission -
National Insurance Company Vs. Suresh Kumar, 2017(2) CPJ, 122 : 2017(3) .
(ii) The Hon'ble Supreme Court -- National Insurance Co. Ltd vs Nitin Khandelwal - IV(2008) CPJ. 1 (SC).
9 FA/58/2019
(iii) The Hon'ble State Consumer Disputes Redressal Commission U.P., Lucknow.--Revision Petition No. 2340/2013 --The New India Assurance Company Ltd., Vs. Surendra Kumar.
(iv) The Hon'ble State Commission - Tejsingh Vs. National Insurance Company- Revision Petition No. 622/2013.
14. Wherein the Hon'ble National Commission as well as Apex Court held that in case of theft the claim can not be rejected for want of fitness certificate.
15. It reveals from the judgment of District Consumer Forum that the District Consumer Forum has also rightly concluded that the opponent insurance company has wrongly repudiated the claim on the ground of want of fitness certificate. So far as entitlement of insurance amount by the complainant is concerned, his claim is rightly concluded by the District Consumer Forum. However, while awarding the compensation towards mental agony and cost, the District Consumer Forum ignored that initially the claim was pending for want of submission of documents by complainant to opponent insurance company. Thereafter in the year 2015 on closing the claim by the opponent the complainant approached to District Consumer Forum and the District Consumer Forum was required to give directions to the complainant to submit all the documents with fresh claim proposal. Thereafter, the claim has been repudiated by opponent insurance company for want of fitness certificate and some other documents. Therefore, the second complaint filed with the allegations that opponent failed to consider the claim as per directions of the District Consumer Forum. When in fact, the 10 FA/58/2019 opponent repudiated the claim for want of fitness certificate. Therefore, in the circumstances at the most the District Consumer Forum ought to have awarded interest from the date of second complaint.
16. Apart from this the compensation awarded towards the mental agony is concerned, it reveals that for the second time the complainant has made compliance of documents. Since 2010-2013 the required documents are not produced before insurance company. Hence, claim came to be closed and on second time in deciding the claim it is found that there was no fitness certificate and the claim is repudiated by holding that the vehicle was plying without fitness certificate and therefore, claim is rejected. It was for the complainant to submit the claim with required documents. So far as happening of theft of the vehicle is concern the opponent is not responsible. Hence, it is not desirable to grant amount of Rs. 15,000/- towards mental agony. Same is the case with cost of the proceeding merely because complainant required to file consumer complaint twice, it is not proper to award heavy cost, if initially he himself not taken case of filing document. Hence, at the most the District Consumer Forum ought to have awarded Rs. 5,000/- towards cost against the present complaint. With this we are of the opinion that interference is required in the judgment to modify rate of interest awarded and quantum of compensation towards mental agony. We therefore, answer the points accordingly and pass following order.
ORDER
1. The appeal is partly allowed.
11 FA/58/2019
2. The judgment and order of District Consumer Forum as to clause No. 2 to 4 is hereby set aside & modified and it be read as follows.
(i) The opponent insurance company shall
pay amount of Rs. 7 Lakhs towards the
insurance amount along with interest
@6 % p.a. from the date of CC No.
102/2017 i.e. from 15.6.2017 till
realization of the amount.
(ii) The opponent insurance company shall
pay amount of Rs. 5,000/- towards the
cost of proceeding.
Mr.K.M.Lawande Smt.S.T.Barne,
Member Presiding Judicial Member
UNK