State Consumer Disputes Redressal Commission
Dharam Kumar Agrawal vs Bajaj Allianz General Insurance ... on 23 November, 2011
CHHATTISGARH STATE
CONSUMER DISPUTES REDRESSAL COMMISSION,
PANDRI, RAIPUR (C.G.)
(A/11/ 2679)
Appeal No.398/2011
Instituted on :18/07/2011
Dharam Kumar Agrawal,
S/o Late Shri Ambika Prasad,
Address : Lodhipara Chowk, Kampa,
Tehsil & District - Raipur (C.G.) ... Appellant
Vs.
1. Bajaj Allianz General Insurance Company Ltd.
Address : G.E. Plaza, Airport Road,
Yerawada, Pune (Maharashtra)
2. Road Safety Club Private Limited.,
2A, Prakasham Road, T. Nagar,
Chennai 600017
3. Bajaj Allianz General Insurance Company Ltd.
Branch Office - Shivmohan Bhawan,
Jeevan Beema Marg, Pandri,
Raipur (C.G.) .... Respondents
PRESENT :
HON'BLE JUSTICE SHRI S.C. VYAS, PRESIDENT
HON'BLE SHRI V.K. PATIL, MEMBER
COUNSEL FOR THE PARTIES :
Shri C.S. Pandey, for appellant.
Shri Sanjay Nayak, for respondent Nos.1 & 3.
Shri Rajesh Pandey, for respondent No.2.
ORDER (ORAL)
DATED : 23/11/2011 PER :- HON'BLE JUSTICE SHRI S.C. VYAS, PRESIDENT This appeal is directed by the complainant of Complaint Case No.65/2008 against the order dated 21.06.2011 of District Consumer Disputes Redressal Forum, Raipur (C.G.) (hereinafter called "District // 2 // Forum" for short), whereby the complaint alleging deficiency in service against the Insurance Company and claiming compensation of Rs.2,00,000/-, on account of damages to the insured Printing Press, has been dismissed on the ground that Insurance Company, was intimated very late after five months and it was material violation of the terms of the insurance policy.
2. Briefly stated, the facts of the case are that the complainant is owner of a Printing Press and the said Printing Press, was insured by the respondent Nos.1 & 3/Insurance Company under a Shopkeeper's Package Insurance Policy, for a period between 30.04.2007 to 29.04.2008. In an incident of fire on 10.05.2007, the machineries of the Printing Press were damaged very badly and complainant was required to suffer loss of around Rs.4,00,000/-. He immediately informed the Insurance Company regarding the incident and later on information was also given by him in writing. Then a claim was preferred before the Insurance Company, which was repudiated by the Insurance Company, on the ground that intimation regarding incident was given five months late and so the Insurance Company was having no occasion to get the loss assessed by some licenced Valuer or Loss Assessor. It was material violation of terms of the insurance policy, so the Insurance Company, is not liable to pay any amount to the complainant/appellant. In the written version of the complaint filed // 3 // before the District Forum, the Insurance Company took the same defence.
3. Learned District Forum, agreed with the defence taken by the Insurance Company and dismissed the complaint by the impugned order.
4. We have heard arguments advanced by all parties and perused record of the District Forum.
5. As per complainant/appellant, the incident of fire happened on 10.05.2007. The assertion of the complainant/appellant, is that he gave information to the Insurance Company at about 12.00 noon by his mobile phone. Mr. Meenakshi Patel, Manager of respondent No.2 at that time received the intimation. This fact has been denied by the Insurance Company and Shri Pankaj Kumar, Senior Legal Executive of the Insurance Company, in his affidavit has stated that immediate information regarding incident was not given by the complainant and information was given only after five months from the date of incident. Another person, Shri M. Ramani, Manager of respondent No.2 has also stated the same facts in his affidavit. He stated that for the first time on 29.09.2007, claim was preferred by the complainant/appellant. Thus, there is merely oral assertion of the complainant/appellant to the effect that intimation was given by him on telephone to the // 4 // Insurance Company. There is no written document or no written confirmation of giving any such information on telephone. The claim of the complainant/appellant has been denied by the Insurance Company, so his self serving statement in this regard appears after thought and cannot be said to be conclusive proof of giving information regarding incident. As per record of the Insurance Company, the claim was preferred by the complainant/appellant in the month of September, 2007 around five months after incident.
6. The next contention of learned counsel for the complainant/appellant, is that there was no term in the insurance policy to the effect that the incident of fire, was to be reported to the Insurance Company immediately after incident. Before District Forum, copy of Certificate - Shopkeeper's Package Insurance, Annexure C-1, was filed by the complainant/appellant. In that copy, it has been mentioned clearly that Conditions apply as per overleaf details, but the conditions which were printed on the overleaf of this certificate, were not brought on record by the complainant/appellant and photocopy of those conditions were not filed. The Insurance Company filed photocopy of the same certificate containing such conditions as Annexure D-1. Learned counsel for the Insurance Company submitted that as per condition No.2.3.1.1, it was duty of the insured to have intimated the Insurance Company immediately in // 5 // any event within 24 hours of the happening of any insured event giving rise to or likely to give rise to any claim under this Policy and to give written notice to the Company. He submitted that this condition, has been grossly violated by the insured and intimation regarding incident was given after five months.
7. Learned counsel for the complainant/appellant in this regard argued that this condition No.2.3.1.1. is applicable only in case of cover 2 and cover 2 was regarding burglary and robbery, whereas the incident of fire come under cover 1, which was applicable for fire, lightning, explosion/implosion, aircraft damage etc. It has been submitted that this condition is not applicable in the incident of fire.
8. It is difficult to digest the arguments of learned counsel for the appellant, because this condition might be printed under the head 'Special Conditions Applicable to Cover 2' but the condition is that "immediately and in any event within 24 hours of the happening of any insured event giving rise to or likely to give rise to any claim under this Policy give written notice to the Company to the address shown in the Schedule, and in the case of the notification of an event likely to give rise to a claim, the insured shall specify in writing the grounds for holding such belief."
// 6 //
9. Thus, from the wordings of condition no.2.3.1.1, it is clear that it is not only applicable for the incident of burglary and robbery, but is applicable for any other incident, which is insured and which is likely to give rise to any claim under any policy issued by the Insurance Company. The incident of fire was also an insured peril and was under the policy and was likely to give rise to any claim, so under this condition, which might have been printed under the head 'Special Conditions Applicable to Cover 2', the insured was having a duty to inform in writing the Insurance Company within the time specified regarding the event happened, as he was going to move a claim regarding that incident in future.
10. The detailed terms & conditions of the Shopkeeper's Package Policy have also been filed before us at appellate stage by the Insurance Company and as per General Conditions - 3.1, it has been specified by the Insurance Company that the insured shall immediately and in any event within 14 days give written notice of the same to the address shown in the Schedule for this purpose, and in case of notification of an event likely to give rise to a claim to specify the grounds for such belief. This condition has been printed under the head "Duties and Obligations after Occurrence of an Insured Event". Thus, if an insured event happened, then it was duty of the // 7 // insured/complainant to notify it to the Insurance Company immediately or within a period of 14 days.
11. Hon'ble National Commission in case of New India Assurance Company Limited Vs. Trilochan Jane, in First Appeal No.321 of 2005, decided on 09.12.2009 has taken into consideration in detail the meaning of the word "immediately" and ultimately concluded that the period of 9 days even during which the incident was not reported to the Insurance Company, was fatal to the complainant and so the Insurance Company can not be faulted, if claim of the complainant has been repudiated by it.
12. In the facts of the present case, the delay is of five months, which can never be pardoned, particularly when the Insurance Company has been deprived of getting the matter investigated by some qualified Surveyor & Loss Assessor and to assess the loss.
13. In view of aforesaid, we do not find any error in the order recorded by the District Forum. The appeal has got no substance and is hereby dismissed. No order as to the cost of this appeal.
(Justice S.C.Vyas) (V.K. Patil)
President Member
/11/2011 /11/2011