State Consumer Disputes Redressal Commission
1. Branch Manager, United India ... vs Smt. Sandhya Bhagat Wife Of Shri Parmod ... on 18 October, 2012
STATE CONSUMER DISPUTES REDRESSAL COMMISSION, HARYANA, PANCHKULA First Appeal No.754 of 2010 Date of Institution: 24.05.2010 Date of Decision: 18.10.2012 1. Branch Manager, United India Insurance Company Limited, Branch Office Delhi Road, Sonepat. 2. Divisional Manager, United India Insurance Company Limited, Divisional office, LIC Building, G.T. Road, Panipat. Through its Manager (Legal), United India Insurance Company Limited, Regional Office, SCO No.123-124, Sector 17-B, Chandigarh. Appellants (Ops) Versus Smt. Sandhya Bhagat wife of Shri Parmod Kumar Bhagat, resident of Bhagatpura, Sonepat (Haryana). Respondent (Complainant) BEFORE: Honble Mr. Justice R.S. Madan, President. Mr. B.M. Bedi, Judicial Member. For the Parties: Shri Rajneesh Malhotra, Advocate for appellants. Shri Rohit Goswami, Advocate for respondent. O R D E R
Justice R.S. Madan, President:
Undisputed facts of the present case are that Parmod Kumar Bhagat-husband of the respondent-complainant had obtained a Householder Insurance Policy from the appellant-opposite party No.1 w.e.f. 4.7.2007 to 3.7.2008. On 06.11.2007 the family members of the complainant had gone to attend the birthday function hosted by their children in Gurgaon. The complainant was carrying jewellery items namely four babgles of gold weighing about 50 grams, one gold chain weighing about 40 gms, one diamond pendant set (necklace set) worth Rs.one lac and one diamond ear ring worth Rs.60,000/-
total amounting to Rs.2,95,000/- approximately in her purse which were stolen at the time when the complainant was busy in shopping alongwith her husband. Matter was reported to the police of Police Station Karol Bagh District Central Delhi upon which the police registered NCR No.1842/2007 dated 6.1.2007 at 21:40 hrs with General Diary No.598 under Section 155 Cr.P.C. Intimation was given to the opposite parties. Complainant submitted claim with the opposite parties but the same was repudiated on the ground that the the insurance policy was taken in the name of Parmod Kumar Bhagat and therefore the complainant was not entitled for any insurable benefits; that no F.I.R. was lodged with the police and the police had not conducted any investigation after lodging the DDR and the report under Section 173 Cr.P.C. was prepared. Challenging the repudiation of her claim, the complainant filed complaint before the District Consumer Forum.
The opposite parties contested the complaint before the District Forum while justifying the repudiation of complainants claim on the ground stated in the preceding para of this order and prayed for dismissal of the complaint.
On appraisal of the pleadings of the parties and the evidence adduced on the record, District Consumer Forum accepted complaint with the following observations:-
5. After giving thoughtful consideration to each and every aspect of this complaint, reply points argued by the parties and perusing the documents very carefully, we are of the considered view that by repudiating the claim of complainant, the respondents company, in our considered view, have committed negligence and deficiency in service. Hence, the complainant is entitled for the relief. Now-a-days, the parties of gold items are on higher side than at the time of its purchase, hence, the complainant is entitled for the claim amount as per the present rates of gold in market but as the complainant had purchased the diamond pendant set worth Rs.89,716/- and diamond tops (ear ring) worth Rs.32,800/- as per the invoice placed on file, hence, in the case of claim amount for diamond Pendant set and diamond tops (ear rings), the complainant is entitled for Rs.89,716/- and Rs.32,800/- respectively only.
Accordingly, we direct the respondents to make the payment of claim of 82.400 gm gold as per present market rate i.e. (51.900 gm gold for four bangles + 30.500 gms for golden chain) as per invoice placed on record and Rs.1,22,516/- on account of cost of diamond pendant set and diamond tops along with interest @ 9% p.a. from the date of filing the present complaint till realization of final payment besides a compensation of Rs.20,000/- on account of mental agony, harassment and litigation expenses to the complainant. The order be complied within one month from the date of this order. Accordingly, the present complaint stands disposed of.
Aggrieved against the order of the District Consumer Forum, the opposite parties have come up in appeal.
Arguments heard. File perused.
On behalf of the appellants it is contended that since the Insurance Policy was taken by Parmod Kumar Bhagat, therefore, the complaint filed by complainant was not maintainable.
The above contention raised on behalf of the appellants is not tenable in view of the terms and conditions of the Insurance Policy which reflect that the family members of the insured were also covered under the policy. In this reference may be made to the relevant portion of HOUSEHOLDERS INSURANCE POLICY under the heading SECTION III-ALL RISKS (JEWELLERY AND VALUABLES), reproduced as under:-
The Company will indemnify the Insured or any member of her/his family in respect of loss of or damage to jewellery and/or valuables caused by Accident or Misfortune whilst anywhere in India. Provided that the liability of the Company in respect of any one item in any one period of Insurance will not exceed the Sum Insured set against such item in the Schedule hereto and not exceeding in the aggregate the total Sum Insured hereby. Provided further that where damage to any item can be repaired, the Company will pay expenses necessarily incurred to restore the damaged item to its former state of serviceability, but not exceeding the Sum Insured in respect of such item.
Thus, in view of the condition of the Insurance Policy, the appellants-opposite parties are liable to indemnify the loss suffered by the complainant, being the wife of insured Parmod Kumar Bhagat.
Learned counsel for the appellants has further argued that the theft of the jewerlly was not proved by the complainant because in this case neither any FIR was recorded by the police nor the investigation was conducted on the basis of DDR. But this plea of the appellants is not acceptable in view of settled law by Honble Delhi State Consumer Disputes Redressal Commission, New Delhi cited as RIDHI GUPTA versus NATIONAL INSURANCE CO. LTD., III(2008) CPJ 459, wherein it has been observed that:-
13. In our view FIR is not a requirement for adjudicating the insurance claim.
Whenever vehicle or any cash or goods are stolen insured takes some time to search for the vehicle and the goods and does not lodge the report immediately. It is the discretion of the Police Officer to convert the complaint of the insured into the FIR or not. Information to the Police in any form including the DD report is sufficient requirement and the Insurance Company only is concerned whether the theft has taken place or not. Once the report is lodged with the police may be in any form, the Insurance Company is barred from appointing any Investigator to investigate into the fact whether the theft has taken place or not. It may appoint Surveyor for the purpose of assessing the loss. If the police finds that a person has lodged a false report he can be prosecuted for the offence punishable under Section 182 of the IPC but in any way the Insurance Company cannot indulge in such exercise and enter into such an arena that does not belong to it.
Similar view has been taken by the State Commission, Delhi in Appeal No.A08/181, decided on 23.04.2008 titled as United India Insurance Co. Ltd. versus Mr. Subhash Chander Khanna and Complaint Case No.C-52/2006, decided on 5th January, 2009 titled as Rinku Sharma versus New India Assurance Co. Ltd. This case is fully covered by the aforementioned judgments relied upon by the learned counsel for the respondent-complainant.
The other contention raised on behalf of the appellants is that the District Consumer Forum has wrongly awarded the insurable benefits to the complainant as per the market rate of the jewellery at the time of deciding the complaint whereas as per the Insurance Policy, the complainant can only be compensated with respect to the insured value of the stolen jewellery.
We find force in the contention raised on behalf of the appellants. Though the complainant has claimed the value of the stolen items as per the existing market value of the stolen jewellery at the time of filing complainant but this plea is not acceptable for the reason that in case the price of the jewellery would have gone down in that event whether the appellants-opposite parties were under an obligation to pay the insurable benefits to the complainant taking into account the falling price of the gold? The answer to this question is in negative. The complainant can claim only the insured amount of the stolen jewellery for which premium was received by the Insurance Company, the details of which as per the Insurance Policy is given herein below:-
BANGLES 6 NOS 60 GR Rs.54000/- KANGAN/KARA 2 NOS 30 GR Rs.27000/- NECKLACE 24GM 21600/- CHAINS 2 40 GM Rs.36000/- EAR RINGS 4 SET 30 GM Rs.27000 TWO SET 60 GMS Rs.54000/- TWO DIAMOND PANDENTS 80000/- NACKLACE(D) THREE Rs.250000/- W.E.SPRIT TWO 6000/- CLOCK FIVE Rs.500/-
This fact finds support from the terms and conditions of the Insurance Policy the relevant part of which has been reproduced herein before which reflect that the insured can be compensated for the insured value of the stolen jewerllery.
So far as the quantum of compensation to be awarded to the complainant is concerned, the details of the stolen jewellery claimed by the complainant is as under:-
1.
Four Bangles of gold weighting about 50 gms
2. One Gold chain weighing about 40 grams
3. One Diamond Pendant set (Neckless set) worth rupees one lac
4. One Diamond Ear Rings (Tops) worth Rs.60,000/-
The total claim of the complainant is for Rs.2,95,000/-.
From the record it is established that the bangles six in numbers weighing 60 grams were insured with the opposite parties for Rs.54,000/- out of which four bangles were stolen and therefore the opposite parties are liable to pay Rs.36,000/- to the complainant for the theft of four bangles.
As per the Insurance Policy two chains of gold weighing 40 grams were insured with the opposite parties but according to the complainant one chain of 40 grams was stolen. Meaning thereby the insured chains were not stolen and therefore the complainant is not entitled for any compensation on this count.
The Insurance Policy further reflects that two Diamond Pendant were insured with the opposite parties for Rs.80,000/-. According to the complainant her one Pendant was stolen for which the complainant has claimed rupees one lac. But as per the Insurance Policy, the value of one Pendant cannot be taken more than Rs.40,000/- as the insured value of two Pendants was Rs.80,000/-. Thus, the opposite parties are liable to pay Rs.40,000/- to the complainant on account of theft of one Diamond Pendant.
So far as the claim of the complainant with respect to the theft of one diamond ear rings (Tops) worth Rs.60,000/- is concerned though the complainant has furnished the bill for the purchase of the aforesaid Diamond Ear Rings (Tops) but the same were not insured with the opposite parties and therefore, no relief can be given to the complainant for theft of Diamond Ear Rings (Tops).
As a sequel to the aforesaid discussions, we have arrived to the conclusion that the complainant is entitled to get the insurable benefits for Rs.76,000/- on account of theft of four gold bangles worth Rs.36,000/- and for Rs.40,000/- due to theft of one Diamond Pendant. The other items which are recorded in the claim application do not form part of the policy and therefore complainants claim with respect to the un-insured jewellery items is rejected being not insured. District Consumer Forum has failed to understand the above stated facts of this case, hence, the impugned order deserves to be modified.
Hence, this appeal is partly accepted and the impugned order is modified with the direction to the opposite parties to pay Rs.76,000/- to the complainant in all alongwith interest @ 9% per annum from the date of filing complaint till its realization. No interference with the order of the District Forum for granting of compensation of Rs.20,000/- on account of mental agony, harassment and litigation expenses.
The statutory amount of Rs.25,000/-
deposited at the time of filing the appeal be refunded to the appellants against proper receipt and identification in accordance with rules, after the expiry of period of appeal and revision, if any filed in this case.
Announced: Justice R.S. Madan 18.10.2012 President B.M. Bedi Judicial Member