State Consumer Disputes Redressal Commission
Bundubhai Laljibhai Solanki vs Reliance Gen Ins Co Ltd on 22 February, 2021
Exhibit: 15
Date of filing: 16.12.2014
Date of disposal: 22.02.2021
Days of disposal: 2260 Days
BEFORE THE CONSUMER DISPUTES REDRESSAL COMMISSION
GUJARAT STATE, AHMEDABAD
COURT NO: 04
Appeal No. 1467 of 2014
Bundubhai Laljibhai Solanki,
Near Railway Station, Post Ider,
Dist. Sabarkantha, Ahmadabad -08 ...Appellant
V/s.
Reliance General Insurance.
3rd Floor, Ajay Bungalow,
Opp. HDFC, Mithakhali Six Road,
Navrangpura, Ahmadabad. ...Respondent.
BEFORE:
Smt. Jyoti P.Jani, Presiding Member.
APPEARANCE: Shri V.M. Pancholi, ld. advocate for the appellant.
Shri Darshil Parikh, ld. ad. for Mr. V.P. Nanavaty, Ld. Adocate for the respondent.
Order by Smt. Jyoti P.Jani, Presiding Member
1. Being aggrieved by and dissatisfied with the judgment and order rendered by the Consumer Disputes Redressal Forum, Himmatnagar on 26.08.2014 in Complaint No. 24 of 2014, the Page 1 of 12 R.I. DESAI A/14/1467 original complainant has filed the present appeal under Section 15 of the Consumer Protection Act, 1986 before this Commission. For the sake of the convenience, parties are hereinafter referred to by their original nomenclature.
2. Brief facts of the complainant are that, the complainant Mr. Bundubhai L. Solanki was the owner of truck No. GJ-9V-5141 and he was driving the said vehicle for livelihood of himself as well as family members. The complainant has purchased the truck and has availed the financial assistance from the Nalin Lease Finance Ltd. The complainant has locked his truck near a shop situated nearby his house on 12.01.2012. On the next day 13.01.2012 the appellant's mother went to purchase milk and at that time she has not seen the truck near the home. She informed about theft of truck to her son. The complainant approached Ider Town Police Station on the same day, however he was informed to search the vehicle. He failed and could not find his truck. On 20.01.2012 the complainant informed the Idar Town Police Station and lodged the FIR being I-CR No. 8/12. Meanwhile he informed about the theft to the Insurance Company on 12.01.2012. He put his claim before Insurance Company with all relevant documents. The respondent repudiated the claim on misrepresentation of facts. Therefore, the Page 2 of 12 R.I. DESAI A/14/1467 complainant filed present compliant before learned District Forum and claimed Rs. 4,00,000/- being IDV of the truck with cost and compensation.
3. The learned District Forum having ruled in favour of the opponent, the original complainant approached State Commission by way of this appeal. We have heard Ld. Advocate Shri V.M. Pancholi for the appellant and Ld. Advocate Mr. Darshil Parikh for the respondent.
4. The learned Advocate for the appellant Mr. V.M Pancholi argued that there was a delay of 08 days in filing FIR. He showed various documents on record. On page No. 39 which is FIR on record in which incident took place on 12/13.01.2012 and the same was registered on 20.01.2012. On page No. 36 claim form is submitted to the Insurance Company under the column of 'Details of accident' it shows date 12/13.01.2012. Learned Advocate for the appellant referred me to page No. 63 which is telephonic claim intimation to the Insurance Company and under the column of 'Loss details' the date of loss is 11.01.2012 and the time of loss is 5-00. Further at the bottom of same document under the 'Claim Registered Detail' the creation date is January 11, 2012 and the time is 10:28AM. The appellant argued that the vehicle has been stolen on 12/13.01.2012 and the intimation was made to the Page 3 of 12 R.I. DESAI A/14/1467 Insurance Company on 12.01.2012 but the letter on page no. 63 mentions the date as 11.01.2012. The learned Advocate argued that this is a computer generated document and there may be some technical mistake. The Truck is stolen on 12/13.01.2012 and there is no complaint of fraud by other side. The learned Advocate also took us to page no. 74 which is rejoinder produced before the learned District Forum and in the rejoinder reply it has been specifically stated that the complainant is not an educated person. He is a driver and is unaware of law. There is no allegation of fraud and the appellant has informed respondent on the date of loss of the vehicle i.e. on 12.01.2012. The opponent Insurance Company has wrongly closed the claim file. The learned District Forum has wrongly dismissed the complaint. The only ground taken by the learned District Forum while dismissing the compliant is late intimation to the police as well as late intimation to the Insurance Company. Learned District Forum has erred in holding that the Insurance Company has rightly repudiated the claim. The learned Advocate for the appellant has relied on following citation:
I. IV (2017) CPJ 10 (SC) in,
OM PRAKASH
V/s.
RELIANCE GENERAL INS. CO. LTD AND ANR
Page 4 of 12
R.I. DESAI A/14/1467
II. Hon'ble National Consumer Disputes Redressal Commission
in Revision Petition No. 2659 of 2013 in
ROYAL SUNDARAM ALLIANCE INSURANCE CO. LTD
V/s.
MANISH SHIVLALBHAI KALAVADIYA
decided on 27th August, 2019.
5. The learned advocate for the respondent Mr. Darshil Parikh also referred us to various documents produced on record. On page No. 63 of the document which we have already discussed above about telephonic instruction regarding loss details of the truck in which the date of loss is dated on 11.01.2012 at 5.00 O'clock and the documents has been created on January 11, 2012 at 10:28AM. It is argued by the ld. Advocate that when theft occurred on 12/13.01.2012 then how could complainant inform about the theft one day before to the Insurance Company. It means the truck must have been stolen long before 11.01.2012. The learned Advocate for the Insurance Company took us to document page No. 69, 70, 71 to show us that various documents were required from the complainant which were necessary to decide the claim. On page No. 73, the letter has been written by Insurance Company on 20.02.2013 and 09.04.2013 wherein they have asked to clarify regarding mismatch in the date of loss in FIR, intimation to Page 5 of 12 R.I. DESAI A/14/1467 Insurance Company and submission of pending documents. Insurance Company finally decided that as you have not met with the compliance, the claim file is closed. The learned advocate for the respondent has relied on following citations:
I. Ram Avtar Vs National Ins. Co. Ltd. Revision Petition No. 2731 of 2017 (NCDRC) II. Reliance General Ins. Co. Ltd. Vs. Ranjit Singh. Revision Petition No. 2149 of 2017 (NCDRC)
6. Heard learned Advocates for both the parties. Perused the order of the learned District Forum and the citations relied and produced by both the learned Advocates.
7. It is the case of the complainant that the complainant was the owner of the truck No. GJ-9V-5141 which is insured before the opponent Insurance Company. It is the case of the complainant that he locked his truck near a shop which is situated nearby the complainant's house on 12.01.2012 and on the next date that is 13.01.2012 the appellant's mother Hermiben went to purchase milk and at that time she has not seen the truck near the home, Page 6 of 12 R.I. DESAI A/14/1467 she informed her son. As per the submission, complainant approached Ider Police Station on the same day but he was asked to look around and inquire about his truck but he could not find the truck and he lodged the FIR being I-CR No. 8/12 on 20.01.2012. The complainant also informed the opponent Insurance Company on 12.01.2012 and has supplied all the documents.
8. The learned Advocate for the appellant has relied on the judgment of Hon'ble Supreme Court in the case of Omprakash [Supra]. We produce the relevant para 11, 12 and 13 as under:
11"It is common knowledge that a person who lost his vehicle may not straightway go to the Insurance Company to claim compensation. At first, he will make efforts to trace the vehicle. However, this condition should not bar settlement of genuine claims particularly when the delay in intimation or submission of documents is due to unavoidable circumstances. The decision of the insurer to reject the claim has to be based on valid grounds. Rejection of the claims on purely technical grounds in a mechanical manner will result in loss of confidence of policy holders in insurance industry. If the reason for delay in making a claim is satisfactorily Page 7 of 12 R.I. DESAI A/14/1467 explained, such a claim cannot be rejected on the grounds of delay. It is also necessary to state here that it would not be fair and reasonable to reject genuine claims which had already been verified and found to be correct by the Investigator. The condition regarding the delay shall not be a shelter to repudiate the insurance claims which have been otherwise proved to be genuine. It needs no emphasis that the Consumer Protection Act aims at providing better protection of the interest of consumers. It is a beneficial legislation that deserves liberal construction. This laudable object should not be forgotten while considering the claims made under the Act. "
12 "In the instant case, the appellant has given cogent reasons for the delay of 08 days in informing the respondent about the incident. The Investigator had verified the theft to be genuine and the payment of Rs. 7,85,000/- towards the claim was approved by the Corporate Claims Manager, which in our opinion, is just and proper. The National Commission, therefore, is not justified in rejecting the claim of the appellant without considering the explanation for the Page 8 of 12 R.I. DESAI A/14/1467 delay. We are also of the view that the claimant is entitled for a sum of Rs. 50,000/- towards compensation."
13 "Hence, the appeal is allowed and the orders of the National Commission, State Commission and the District Forum are set aside and the claim petition filed by the appellant is allowed. The respondent 1 and 2 are directed to pay a sum of Rs. 8,35,000/- to the appellant with interest @ 8% per annum from the date of filing of the claim petition till the date of payment. The payment, as above shall be made within a period of 8 weeks from today."
9. In Omprakash [Supra] it has been held that the claim of the insured should not be rejected purely on technical ground and in a mechanical manner which will result in loss of confidence of policy holders in insurance industry. It has been held that if reasons for late delay in submitting the claim are satisfactorily explained, such a claim cannot be rejected on the ground of delay. In the case of Royal Sundaram[Supra] before the Hon'ble National Commission in which it has been held that if certain condition of the policy which is not a fundamental condition is violated the Insurance claim can be settled on non-standard basis. The insurance Page 9 of 12 R.I. DESAI A/14/1467 company directed to pay the insurance claim on non-standard basis that is 75% of the IDV of the vehicle.
10. The learned Advocate Mr. Darshil Parikh has relied on the citation, in Ram avatar [Supra] but in that particular case, FIR was lodged after 08 days after the car was stolen and intimation of the theft, to the Insurance Company was given after 04 months and 14 days. In the present appeal FIR was lodged after 08 days but the Insurance Company was timely intimated, hence this judgment will not be binding.
11. The learned Advocate for the opponent referred to judgment of Hon'ble National Commission in Reliance General Insurance Company [Supra]. The theft of the vehicle was on 23.12.2011 and the FIR was lodged on 07.01.2012. In that case it was held that the delay of one month in lodging FIR and there was no valid explanation of the delay and the complaint was dismissed by Hon'ble National Commission.
12. It is the case of the complainant that there is delay of 08 days in filing the FIR. The order passed by Hon'ble Supreme Court in Omprakash [Supra] and Royal Sundaram Allianz Insurance [Supra] are binding precedent to this Commission. The decision of the insurer to reject the claim should be based on some logic and Page 10 of 12 R.I. DESAI A/14/1467 valid grounds. The Insurance Company should also see the merits and good spirits of their own clause, rejection of the claim purely on technical grounds in mechanical fashion will result the policy- holders losing the confidence in the insurance industry. The dispute created by the insurance company is regarding the date of loss 11.01.2012 and as per complainant the theft of the truck is on 12/13.01.2012. It is a mere difference of 01 day and the facts of the theft are proved. The narrow part that lies between the appellant and respondent is that there was late intimation and mismatch in the intimation date. FIR has been filed after 08 days of theft. The Insurance Company should not close the claim file on technical grounds. The learned District Forum has wrongly observed that the complainant has failed to inform police and Insurance Company in time. Complainant informed the respondent Insurance Company on the date of loss i.e. on 12.01.2012. There is delay of 08 days in lodging FIR. As discussed and relying on the citation of the Hon'ble Supreme Court in Om Prakash [Supra] and Hon'ble National Commission in Royal Sundaram Allianz Insurance Company Ltd [Supra], the appeal is required to be partly allowed. The Insurance Company is directed to pay the complainant on non-standard basis (75%) of the IDV of Page 11 of 12 R.I. DESAI A/14/1467 the vehicle. Hence, the order passed by the learned District Forum is required to be quashed and set aside. Accordingly the following final order is passed.
ORDER
1. The present Appeal No. 1467 of 2014 is partly allowed.
2. Order passed by the learned District Forum, Himmatnagar in C.C. No. 24 of 2014 is hereby quashed and set aside.
3. Opponent Insurance Company is ordered to pay 75% of the IDV of the truck i.e. Rs. 3,00,000/- [Rupees Three Lakh only] (75% of Rs. 4,00,000/-) with 6% interest from the date of filling of the complaint till its realization.
4. Opponent Insurance Company is ordered to pay Rs. 7,000/- [Rupees Seven thousand only] for cost and compensation to the complainant.
5. Office is directed to forward the free certified copy of this order to the respective parties.
Pronounced on 22nd February, 2021.
[Jyoti P. Jani]
Presiding Member
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