State Consumer Disputes Redressal Commission
Reliance Gen.Insurance Co. vs Pushkar on 23 January, 2018
Daily Order STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA First Appeal No : 484 of 2017 Date of Institution: 20.04.2017 Date of Decision : 23.01.2018 Reliance General Insurance Company Limited, Regional Office, SCO No.212-214, Sector 34-A, through its authorised signatory, Shri Amit Chawla, Manager Legal, Regional Office, SCO 145-146, 2nd Floor, Sector 9-C, Madhya Marg, Chandigarh. Appellant-Opposite Party Versus Pushkar s/o Sh. Chander Man, Resident of Village Sandwa, Tehsil Tosham, District Bhiwani. Respondent-Complainant CORAM: Hon'ble Mr. Justice Nawab Singh, President. Mr. Balbir Singh, Judicial Member.
Argued by: Shri Satpal Dhamija, Advocate for appellant. Shri Ajay Vijarania, Advocate for respondent. O R D E R BALBIR SINGH, JUDICIAL MEMBER
This appeal has been preferred against the order dated February 17th, 2017 passed by District Consumer Disputes Redressal Forum, Hisar (for short 'the District Forum').
2. Pushkar - complainant (respondent herein) registered owner of Scorpio car vehicle bearing registration No.HR-61-7686 got his vehicle insured with Reliance General Insurance Company Limited (for short 'the Insurance Company')-Opposite Party/appellant mentioning total Insured Declared Value (IDV) as Rs.6,78,536/- regarding the period from January 08th, 2009 up to January 07th, 2010. On June 25th, 2009 when the above mentioned car vehicle was being driven by Ram Parsad alias Lalu on Bhatol Road, near Village Sorkhi, District Hisar, the same was stolen/robbed by some unknown persons. Intimation regarding theft of the car vehicle was given to the Insurance Company as well as Police of Police Station, City Hisar. First Information Report (FIR) No.694 (Annexure C-2) was lodged in Police Station City, Hisar on June 26th, 2009. The Insurance Company appointed Royal Associates, Investigating and Detective Agencies. The needed documents including copy of FIR and copy of report under Section 173 Cr.P.C. etc. were handed over to the investigating agency by the complainant. The complainant also submitted his reply explaining delay of 29 days in submitting information to the Insurance Company. The Insurance Company did not accept the insurance claim submitted by the complainant without any reason. In the beginning, the complainant filed an application before the Chairman Permanent Lok Adalat, Public Utility Services, Hisar seeking relief from the Insurance Company but that petition was dismissed as withdrawn vide order dated February 07th, 2014 (Annexure C-8). It is alleged by the complainant that he had to face un-necessary harassment and mental agony due to faults of the Insurance Company - opposite party.
3. The complainant filed complaint under Section 12 of the Consumer Protection Act, 1986 before the District Forum with a prayer to direct the opposite party - Insurance Company to pay an amount of Rs.6,78,536/- being IDV of the car vehicle with interest at the rate of 18% per annum from the date of theft and to pay an amount of Rs.50,000/- on account of un-necessary harassment and mental agony.
4. The opposite party - Insurance Company in its written version has taken plea that the insurance claim of the complainant is not covered within the terms and conditions of the insurance policy; it is not a case of deficiency in service and that the District Forum, Hisar has no jurisdiction to decide this complaint. The insurance claim submitted by the complainant was repudiated validly vide letter dated March 12th, 2010. As per version of the complainant, theft of the car vehicle was committed on June 25th, 2009 but FIR No.694 was lodged in Police Station City Hisar on June 26th, 2009. Information was given to the Insurance Company on July 24th, 2009 after more than a period of 29 days from the date of theft in violation of the terms and conditions of the insurance policy. In this way, the Insurance Company has been deprived of its right to investigate the matter immediately after theft was committed and to make efforts to recover the stolen vehicle. As the complainant has violated the terms and conditions of the insurance policy, the complainant is not entitled to receive the insurance claim. The decision of the Insurance Company to repudiate the insurance claim of the complainant is valid and justified and prayed that the complaint filed by the complainant be dismissed.
5. Parties adduced evidence in support of their respective claims before the District Forum.
6. After hearing arguments, vide impugned order dated February 17th, 2017 complaint filed by the complainant was allowed directing the opposite party - Insurance Company to pay an amount of Rs.6,78,536/- to the complainant with interest at the rate of 9% per annum from the date of filing of the complaint; to pay an amount of Rs.5,000/- on account of un-necessary harassment, mental agony and an amount of Rs.1,000/- as litigation expenses.
7. Aggrieved with the impugned order dated February 17th, 2017 passed by the learned District Forum, the appellant/opposite party/Insurance Company has filed the present First Appeal No.484 of 2017 with a prayer to set aside the impugned order and to dismiss the complaint filed by the complainant.
8. We have heard learned counsel for the parties and perused the case file.
9. During the course of arguments there was no controversy of any type that the complainant Pushkar being registered owner of Scorpio car vehicle bearing registration No.HR-61-7686 got the above mentioned car vehicle insured with the opposite party/Insurance Company regarding the period from January 08th, 2009 to January 07th, 2010 mentioning total Insured Declared Value (IDV) of the vehicle as Rs.6,78,536/- vide insurance policy Annexure C-1. Admittedly, on June 25th, 2009 the above mentioned car vehicle was stolen near Village Sorkhi on Bhatol Road, District Hisar when the above said car vehicle was being driven by Ram Parsad alias Lalu as per instructions of the complainant. It is also not in dispute that intimation was given to the Police of Police Station City Hisar and FIR No.694 (Annexure C-2) was lodged on June 26th, 2009 under Sections 328,379,392,395 of the Indian Penal Code and 25/54/59 of the Arms Act. Intimation was given to the Insurance Company on July 24th, 2009 after 29 days of the occurrence.
10. Insurance claim of the complainant was repudiated by the Insurance Company on the ground that when the Scorpio car vehicle was stolen/robbed, the vehicle was being used at that time on hire and reward and that the complainant violated the terms and conditions of the insurance policy as information was not given to the Insurance Company soon after the car vehicle was stolen because the information was given after 29 days on July 24th, 2009. Regarding violation of the terms and conditions, the Insurance Company had written letters dated October 05th, 2009, November 18th, 2009, December 04th, 2009 and March 12th, 2010 (Annexure R-3 to R-6) but the complainant did not submit his reply and did not explain his position regarding the information sought by the Insurance Company. Learned District Forum has given findings that on the plea of delay in submitting information to the Insurance Company regarding theft of the car vehicle, the insurance claim of the complainant should not have been repudiated as the information was given to the Police by the complainant soon after the incident took place and FIR No.694 (Annexure C-2) was lodged on next day June 26th, 2009 in Police Station City, Hisar. Learned District Forum gave findings in favour of the complainant on this point of controversy following a decision of the Hon'ble Punjab and Haryana High Court while deciding Civil Writ Petition No.9716 of 2011 decided on May 30th, 2011 titled as " National Insurance Company Limited Gurgaon vs. Ravi Dutt Sharma and another" and another decision of State Consumer Disputes Redressal Commission, Punjab, Chandigarh in case Shriram General Insurance Company Limited and another versus Gurshinder Singh and another, 2013(3) CPC 593.
11. In case law referred above National Insurance Company Limited Gurgaon vs. Ravi Dutt Sharma and another (Supra), it was held that theft of car which was duly insured and report lodged with the Police promptly, delay in informing the Insurance Company cannot be a ground to repudiate the claim of the claimant. Cited case law above under similar circumstances fully supports the version of the complainant.
12. As per facts of case law referred above Shriram General Insurance Company Limited and another versus Gurshinder Singh and another (Supra), the vehicle was stolen on October 28th, 2010 and claim with the Insurance Company was submitted on December 15th, 2010. The claim filed by the complainant was repudiated by the Insurance Company on the ground that there was delay of 52 days in giving intimation to the Insurance Company. Complaint being filed before the District Forum was allowed and the order passed by the learned District Forum was upheld by the Hon'ble Punjab State Commission.
13. Apart from it another decision of the Hon'ble Punjab and Haryana High Court, Chandigarh in case law Bharti Axa General Insurance Company Limited vs. Ms. Monu Yadav and another, 2014(4) PLR 861, also supports the version of the complainant. As per facts of that case, the delay in lodging claim with the Insurance Company was of 54 days. The findings in that case were given in favour of the claimant on the basis of the guidelines issued by IRDA. The Insurance Companies were advised that they must not repudiate such claims on the ground of delay especially when the Police have been promptly informed in this regard.
14. In our view, the delay in giving information to the Insurance Company is not enough to give right to the Insurance Company to repudiate the genuine claim of the insured if the delay is properly explained. Generally the insurance policy documents are found with lengthy contents. Although legally and technically, it is duty of the insured to put his/her signature on the insurance policy documents after going through the contents but this fact also cannot be completely overlooked that the contents of the insurance policy are not read over and explained to the insured before obtaining his/her signature. The complainant, being illiterate villager, is also not supposed to know the technicalities of law so minutely. Resultantly, findings of the learned District Forum regarding delay in giving intimation to the Insurance Company stand affirmed and it is held that the complainant has not violated Condition No.1 of the Insurance Policy and claim of the complainant cannot be repudiated on this ground.
15. The other ground taken by the Insurance Company is regarding use of the vehicle on hire and reward. First Information Report No.694 dated June 26th, 2009 (Annexure C-2) was lodged on the statement of Ram Parsad alias Lalu, who was driving the Scorpio car vehicle before it was stolen. Ram Parsad @ Lalu-driver of the car vehicle mentioned in his statement before the Police that he used to drive the Scorpio car vehicle bearing no.HR-61-7686 as a taxi. The car was booked as a taxi by some unknown persons. He was taken to a place near Village Sorkhi on Bhatol Road, District Hisar where he was given four injections and he became unconscious. Thereafter, the car vehicle was stolen. In this way from the statement of the driver Ram Parsad @ Lalu before the Police itself, it is clear that the Scorpio car vehicle was being used for hire and reward as the vehicle was booked by some unknown persons as a taxi. As per terms and conditions of the insurance policy Annexure C-1, the vehicle was got insured for personal use and the complainant violated the terms and conditions of the insurance policy by using the insured car vehicle for hire and reward. This controversy was not discussed by the learned District Forum in its order dated February 17th, 2017. Anyhow only act of violation of terms and conditions of the insurance policy is that the insured vehicle was got insured for personal use but the vehicle was being used for hire and reward by the complainant. During the course of arguments, learned counsel for the complainant argued that merely due to the reason that the vehicle was used for hire and reward, the insurance claim of the complainant should not be denied. In case this Commission feels that the complainant should not be awarded total Insured Declared Value of the vehicle, in that eventuality at least the complainant should be awarded 75% of the total insured declared value of the vehicle. In support of this contention, learned counsel for the complainant placed his reliance upon a decision of the Hon'ble Supreme Court in case law cited as National Insurance Company Limited versus Nitin Khandelwal, IV (2008) CPJ 1 (SC), wherein the Hon'ble Supreme Court held as under:-
"12. In the case in hand, the vehicle has been snatched or stolen. In the case of theft of vehicle breach of condition is not germane. The appellant Insurance Company is liable to indemnify the owner of the vehicle when the insurer has obtained comprehensive policy for the loss caused to the insurer. The respondent submitted that even assuming that there was a breach of condition of the insurance policy, the appellant Insurance Company ought to have settled the claim on non-standard basis. The Insurance Company cannot repudiate the claim in toto in case of loss of vehicle due to theft."
16. In Amalendu Sahoo Versus Oriental Insurance Company Limited, 2010 CTJ 485 (Supreme Court), Hon'ble Apex Court held that the insurance company cannot repudiate the insurance claim in toto and the insurer is liable to pay 75% of the admissible claim. The above being the legal position, the Insurance Company is liable to indemnify the complainant on non-standard basis, that is, to the extent of 75% of the IDV.
17. As per discussion above in detail as the only act of violation of the terms and conditions of the insurance policy is that the insured vehicle was used for hire and reward, keeping in mind the nature of violation and following the decision of the Hon'ble Supreme Court in case laws referred above, we feel it will be justified to award the complainant 75% of the total insured declared value of the insured vehicle instead of affirming findings of the learned District Forum to award total insured declared value of the vehicle Rs.6,78,536/-. Findings of the learned District Forum while awarding an amount of Rs.5,000/- to the complainant as compensation on account of un-necessary harassment and mental agony, and Rs.1,000/- as litigation expenses stand affirmed.
18. Resultantly, with this modification, the appeal filed by the Insurance Company is partly allowed. The Insurance Company-Opposite Party is directed to pay to the complainant 75% of the total insured declared value of the vehicle which comes to Rs.5,08,902/- with interest at the rate of 9% per annum from the date of filing of the complaint till its realisation; to pay an amount of Rs.5,000/- as compensation on account of un-necessary harassment, mental agony and an amount of Rs.1,000/- as litigation expenses.
19. The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the complainant against proper receipt and identification in accordance with rules, after expiry of period of appeal/revision, if any.
Announced:
23.01.2018 (Balbir Singh) Judicial Member (Nawab Singh) President CL