State Consumer Disputes Redressal Commission
Oriental Insurance Co. Ltd. vs Dr. Madhu Barua, on 18 December, 2008
IN THE STATE COMMISSION: DELHI (Constituted under section 9 clause (b) of the Consumer Protection Act, 1986) Date of Decision: 18.12.2008 Appeal NO. FA-1091/06 (Arising out of Order dated 28.9.2006 passed by the District Forum (North), Tis Hazari, New Delhi, in complaint No. 152/06) Oriental Insurance Co. Ltd. Oriental House, A-25/27, Asaf Ali Road, New Delhi Senior Manager, The Oriental Insurance Co. Ltd. C.B.O. 8, Code 271601 1576, First Floor, Church Road, Kashmeri Gate, Delhi -110006 Through The Oriental Insurance Co. Ltd. Emca House, First Flooor, 23/23B, Ansari Road, Daryaganj, New Delhi .. Appellant Through Sh. S.M. Tripathi, Advocate Versus Dr. Madhu Barua, D/o Late Sh. R.J.K. Barua, B-1757/9, Shastri Nagar, Delhi .. Respondent CORAM: Mr. Justice J.D. Kapoor President Ms. Rumnita Mittal Member
1. Whether reporters of local newspapers be allowed to see the judgment?
2. To be referred to the Reporter or not?
Justice J.D. Kapoor (Oral) 1 The appellant has been vide impugned order passed by the District Forum directed to pay Rs. 6,70,000/- as insurance claim and Rs. 25,000/- as compensation for mental agony and harassment along with Rs. 5000/- as cost of litigation. Feeling aggrieved the appellant has preferred this appeal.
2. Admittedly the appellant repudiated the claim as no claim on the premise that the property jewellary alleged to have been stolen from the premises which was not insured and moreover in the police report the insured did not state that jewellary belonged to her as the jewellary was stolen form her parents house. Further that the respondent was operating bank lockers without information to the surveyor and did not give opportunity to the surveyor to inspect the locker and moreover no due notice was given in advance as to the shifting of the residence.
3. The version of the respondent leading to the impugned order in brief was that she has been getting her house, various household goods including electrical gadgets, jewellary and other related items including building ) of A class construction), insured against fire and allied perils, burglary , house breaking , all risks, breakdown of domestic appliances, TV set/ Video, Baggage and Public Liability, with the appellant since 1995 and has been regularly paying the due premium every year to the appellant. The policy was lastly issued by Appellant No. 2 on 14.11.2002 and the coverage for all risks in the said policy was to the tune of Rs 12,43,850/- . The respondent stated that she previously used to live at Faridabad (Haryana) but afte the demise of her mother who had expired at their Shastri Nagar residence on 31.8.2003, she kept her entire jewellery at her parents house at Shastri Nagar in safe custody. On 26.9.2003 , on the night between 25th ad 26th at about 2.30 AM, 4 dacoits forcibly entered the house of the father of the respondent at Shatri Nsagar and decamped with the entire jewellery and cash etc. lying in that house. The incident was reported to the Police Station Rohilla at 5.20 AM on th same day and FIR 332/2003 under section 394/34 of the IPC was recorded.
The respondent stated that a detailed information about the dacoity and the stolen ornaments was given to the appellant on 29.9.2003. On 6.10.2003 the respondent also informed the appellant that she had inadvertently missed two golden chains and a Mangal Sutra to be mentioned in the list of stolen ornaments. The police submitted untraced report u/s 173 Cr. P.C. On 14.3.2004 appellant appointed one Sh. G.B. Mathur & Co. Investigators to survey into the claim of the respondent . The said surveyor had been dilly dallying and postponing the inquiry on one pretext or the other. The respondent also submitted untraced report with the appellant . The surveyor raised various objections in its letter dated 21.5.2004. Appellant repudiated the claim vide its letter dated 28.7.2004. Respondent sent various letters to the appellants after repudiation but all in vain. The complainant sent a legal notice on 6.4.2005 and the reply was sent by the appellant on 26.11.2005 that the policy does not envisage that the jewellary items would be kept in the house at Faridabad.
Consequently the respondent filed the instant complaint seeking Rs. 6,70,000/- value of the jewellary along with interest, cost and compensation.
4. As observed above, the appellant took the plea that there was no proof of ownership of property alleged to have been taken away by dacoits. Respondent does not have interest in the property said to have been lost in the occurrence. The indemnification was not available in this case as the property was stored / lying on the premises other than the premises in which it is stored. Appellant further stated the responded cooked up a story to obtain an unlawful gain and there was no evidence that the respondent kept that entire jewellery at her parents house at Shatri Nagar in safe custody. The intimation of the incident was given only on 1.10.2003 and intimation regarding additional items was given on 8.10.2002 and not on 6.10.2003. Appellant denied the surveyor acted with malafide intentions or was dilly dallying in the enquiry. The surveyor had first gone with the respondent to inspect the bank lockers on 21.10.2003 but it could not be done as public dealing time was over and inspection could also be done on 4.12.2003. The respondent without informing the surveyor operated the bank locker No. 393 on 15.11.2003 and locker No. 834 on 28.11.2003 and did not give the opportunity to the surveyor to inspect the lockers. It was also stated that in case of shifting of residence, due notice was to be given to the appellants in advance which was not given. the surveyor of the appellant suggested that the claim of the respondent be treated as No Claim
5. Apart from the above, the learned counsel for the appellant has also raised doubts in the version of the respondent . For instance no person would carry such a huge oranemnts including as many as 6 pendants and further initially she gave loss to the tune of Rs. 4.50 to 5 lacs with the police and thereafter they filed claims of Rs. 6.52 lacs with the insurance company and the District Forum awarded over and above Rs. 6.70 lacs.
6. We have perused the insurance policy closely . In the insurance policy only address of the insured is as that of Faridabad and section wise premium details has also been provided showing all risks covered to the tune of Rs. 15,43,850/-, building of A class construction for 12 lacs and house breaking and burglary for Rs. 7,25,307 etc . Even if we accept that burglary did not take place at Faridabad, but burglary and house breaking was not confined to Faridabad house only.
7. Person may carry the jewellary in some other eventuality and if the theft takes place in some other place does not mean insurance policy does not cover the risk of burglary and house breaking . What is covered is burglary , housebreaking and in the instant case even if we apply this to the house of respondent still risks are covered which includes jewellary and other kind of risks as mentioned in the policy. Respondent has been obtaining this policy since 1995 and at no given point of time had ever filed such a claim. The circumstances under which she had kept this jewellary at parents house are such that inspire confidence and stands scrutiny on the element of prudence .
8. It was the jewellary that was insured and the claim was preferred only in respect of loss of jewellary and the damage to the building from where the jewellary was stolen . Had it been a case of house of her parents having suffered damages , respondent was not entitled for any claim in this regard. The case is altogether on different footing and therefore was not dealt with in correct and right perspective.
9. As regards role of the investigators and surveyors, the insurance companies cannot initiate parallel inquiry as police is the only authority to investigate into such criminal offences.
Insurance companies thus have no option but to accept the report of the police. As regards the surveyors role with the regard to assessment of loss, we have always impressed upon the insurance companies to get the actual loss assessed but they cannot file no claim report as in the eventuality of ground of rejection if found untenable the insured is entitled to claim the amount of insurance .
10. In the instant case, no such procedure was adopted by the surveyor. However, in view of the actual claim filed by the respondent in the complaint to the tune of Rs. 6.52 lacs , we allow the appeal to this extent that appellant shall pay Rs.
6.52 lacs instead of 6.70 lacs and maintain rest of the order.
11. FDR/Bank Guarantee, if any, furnished by the appellant be returned forthwith after completion of due formalities.
12. A copy of this order as per statutory requirements, be forwarded to the parties free of charge and also to the concerned District Forum and thereafter the file be consigned to the record room.
Announced on 18th December, 2008.
(Justice J.D. Kapoor) President (Rumnita Mittal) Member rk