State Consumer Disputes Redressal Commission
Anil Chander Sarin vs New India Assurance Co. Ltd on 24 May, 2007
IN THE STATE COMMISSION : DELHI IN THE STATE COMMISSION : DELHI (Constituted under Section 9 clause (b) of the Consumer Protection Act, 1986) Date of Decision: 24.05.2007 Complaint Case No.251/1998 Dr. Anil Chander Sarin Complainant. A-2/97, janak Puri, New Delhi. Versus New India Assurance Co. Ltd. Opposite Party. 1/704, G.T. Road, Shahdara, Delhi CORAM: 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. Through this complaint the complainant has claimed compensation of Rs.17,59,041/- from the OP on account of its failure in not settling the claim of the complainant.
2. Facts of the case in brief are that the complainant and his wife Dr. by profession subscribed for householder insurance package policy being issued by the OP. Necessary premium was paid. The total value of the sum ensured around was Rs.6,00,000/. On 24.07.1992, when the complainant and his wife returned home, from the clinic at about 9.30.p.m. they found that some one had entered in their house un-authorisedly and a burglary had been committed. FIR was lodged at Police Station, Janak Puri, New Delhi. The complainant also lodged his claim with OP Company. However, in spite of repeated visit to the OP (Insurance Company) and several requests the claim was not settled hence the present complaint was filed. Actual loss suffered by the complainant was about Rx.5,77,476/- and the remaining amount has been claimed as compensation for mental, agony, harassment and cost of litigation etc.
3. While denying allegations of deficiency in service on its part. The OP New India Assurance Company resisted the complaint firstly on the ground that the claim is barred by limitation and further that the old records of the company including the complainants claim folder were destroyed long ago in accordance with the rules/guidelines of the company and lastly that the insured was not co-operating with the surveyors, hence the claim was ultimately rejected. According to the OP the repudiation of claim was duly communicated to the complainant.
4. In support of his claim, the complainant has produced the following documents:
I. Annexure A, is the copy of FIR bearing No.462/1992 PS Janak Puri, New Delh under section 457/380 IPC.
II.
Annexure B, is the Copy of the supplementary list filed by the complainant to the police.
III.
Annexure C, copy of the untraced report made by the police IV.
Annexure D, Copy of the Insurance Policy.
V. Annexure E, Copy of the letter dated 23.11.1992 sent by the respondent to the complainant informing him that they are investigating the matter.
VI.
Annexure F, copy of the letter dated 30.09.1994 sent by the investigator informing the complainant about the progress of the investigation.
VII.
Annexure G, copy of three letters dated 27.10.1994 sent by the complainant to the respondent.
VIII.
Annexure H, copy of the letter dated 23.01.1995 sent by the respondent to the complainant informing the complainant that the respondent is taking up the matter with the higher authority for the necessary approval.
IX.
Annexure I, copy of the letter dated 08.05.1995 sent by the respondent to the complainant informing him about the progress of the claim.
X. Annexure-J, copy of the letter dated 12.05.1995 informing the complainant that the respondent has involved one more investigator.
5. So far as the contention of the counsel for the respondent that the complaint is barred by limitation is concerned it is without substance as the cause of action was of subsisting nature and continuing till the settlement of the claim one way or the other. Aforesaid series of letters sent by the complainant and the communication received by the complainant from the respondent bears testimony that the respondent did not send any communication as to its final decision in respect of the claim of the complainant, till the filing of the complaint.
6. Perusal of the communications sent by the respondent company shows that the respondent was all the time harping upon the investigational aspect of the matter as to whether any burglary had taken place or not and did not dwell upon the loss nor did it attempt to assess the loss suffered by the complainant. Once the report with the police was lodged, the investigation into the offence of burglary fell with the domain of the police and not with the investigator of the company.
7. Criminal Procedure Code empowers only police to investigate into the criminal offences, Insurance companies can appoint surveyor or investigator to look into the genuineness of the claim and the actual loss suffered by the complainant. If they are allowed to start parallel investigation alongwith the police and the results are contradictory to each other, it is the report of the police which will supersede the report of the investigator appointed by the insurance company.
8. In our view the inordinately long time taken by the insurance company to take final decision on the claim preferred by the insured either by rejecting it or by allowing it partly or fully itself amounts to deficiency in service as no insured or consumer can be kept in suspended animation as to the fate of his claim. If insured satisfies the company by filing requisite documents as to the amount of claim preferred by him, insurance company is free to take any view but it cannot keep the decision in abeyance without intimating the insured as to the final adjudication of his claim.
9. Again the failure of the company not to assess the loss or the damage on their own and not to inform the consumer about the loss assessed by them is also deficiency in service which means any fault, imperfection, shortcoming or inadequacy in the quality, nature and manner of performance which is required to be maintained by or under any law for the time being in force or has been undertake to be performed by a person in pursuance of a contract or otherwise in relation to any service.
10. It is prerogative of the insurance company to come to any conclusion by scrutinising the documents and material supplied by the insured. But it is not the prerogative of the insurance company to shy away from the matter by not taking decision within the reasonable period. Such an approach and attitude of insurance company causes immense mental agony and harassment and suffering by the insured who has obtained the policy by paying heavy premium and when his turn to reap the benefits of the policy comes he is put to suffer such an agony that he runs from pillar to post sending letters after letters and filing documents after documents and if the company sits over those communications and documents for long and does not give decision, the adverse inference has to be drawn and the claim preferred by the insured has to be taken as correct and liable to be indemnified.
11. In view of the aforesaid reasons, we allow the complaint with the direction to the respondent to pay the claim amount of actual loss of Rs.5,77,476/- preferred by the complainant and award Rs.25,000/- as compensation as to the mental agony and harassment suffered by the complainant and the injustice done to him besides Rs.10,000/- as cost of litigation.
12. The payment shall be made within one month from the date of receipt of this Order.
13. A copy of this order as per the statutory requirements be forwarded to the parties free of charge and thereafter the file be consigned to Record Room.
14. Copy of the order be sent to all the District Fora.
Announced on 24th day of May 2007.
(Justice J.D.Kapoor) President (Rumnita Mittal) Member Tri