Paduman Singh Vs. Manager, United India Insurance Company Limited - Court Judgment

R.S. Sharma, President:

1. This appeal is directed against the order dated 08.03.2013, passed by District Consumer Disputes Redressal Forum, Raigarh (C.G.) (henceforth œDistrict Forum") in Complaint Case No.153/2012, whereby the complaint of the appellant/ complainant, has been dismissed

2. Briefly stated, the facts of the complaint case filed by the appellant/complainant before the District Forum are : that the appellant/complainant, is registered owner of the vehicle bearing registration No.C.G.13-C-8872. The said vehicle has been purchased by the complainant/appellant with the help of finance provided by the Finance Company. The said vehicle was insured with respondent/O.P. under Policy No.191600/31/11/01/00003547 for the period from 06.09.2011 to 05.09.2012. On 10.09.2011 the complainant/appellant himself was driving the vehicle in question and was going to village Marahi, District Siwan (Bihar). Near Wadrafnagar, the vehicle dashed against a tree and the complainant/appellant and his friends sustained serious injuries. The vehicle was completely damaged. The complainant/appellant reported the matter to the Police Station Wadrafnagar (Balrampur). The complainant/appellant could not inform the O.P./Insurance Company immediately, as he was busy in his treatment for a long time. The O.P./Insurance Company appointed a Surveyor, who inspected the vehicle. The Surveyor instructed the complainant/appellant to get the vehicle repaired in the show room of any company and to send the bill with the claim form. As per the instruction of the Surveyor, the complainant / appellant got the vehicle repaired from the Budhia Auto Associates Private Limited, Korba, which is authorized show room of Tata Motors and in repairing of the vehicle the complainant/appellant incurred a sum of Rs.3,02,287/-. As the complainant/appellant, was not having amount for repairing of the vehicle, hence he obtained loan of Rs.3,00,000/- on interest and got the vehicle repaired. He also paid a sum of Rs.6,000/- per month towards interest on loan of Rs.3,00,000/-. The complainant/appellant had obtained loan for repairing of the vehicle because he thought that on receiving the amount from the Insurance Company he would pay the amount of loan with interest. After repairing of the vehicle, on 17.04.2012, the complainant submitted the claim form along with bill in the office of the O.P./Insurance Company, but the O.P./Insurance Company had not paid the amount incurred by him on repairing of the vehicle on account of which he was to pay interest @ Rs.6,000/- per month on loan amount till 17.04.2012. The complainant/appellant sent legal notice to the O.P./Insurance Company demanding amount of repairing expenses, which was received by the O.P./Insurance Company, but the O.P./Insurance Company did not pay the amount of repairing expenses. The complainant/appellant filed complaint before the District Forum.

3. The respondent/O.P. filed its written version and denied the allegation levelled by the appellant/complainant in the complaint and averred that the no accident was occurred from the vehicle of the complainant/appellant nor the complainant sustained serious injuries nor the complainant/appellant had gone to Kolkata for his treatment. The complainant intimated the O.P./Insurance Company regarding the incident after near about 3 months. On being received the intimation regarding the incident, the O.P./Insurance Company lodged claim and appointed Shri Brijesh Kumar as Surveyor. Surveyor submitted his Survey Report before the O.P./Insurance Company on 21.12.2011. The Surveyor has not given any instruction in respect of repairing of the vehicle in question. Neither the complainant/appellant had incurred a sum of Rs.3,02,287/- on repairing of the vehicle nor he had taken loan of Rs.3,00,000/ for repairing of the vehicle nor he paid a sum of Rs.6,000/- per month as interest on loan amount. The complainant/appellant produced the estimate regarding the repairing of the vehicle, which was not within the jurisdiction of the Divisional Office, therefore Divisional Office, Bilaspur requested the Regional Office for appointment of the Surveyor. The Regional Office, appointed Mr. Brijesh Kumar, as Surveyor, for conducting final survey. The Surveyor prepared the Final Survey Report and sent the same to the O.P./Insurance Company on 20.04.2012, which was received in the office of the O.P./Insurance Company on 26.04.2012. The Surveyor assessed the loss to the vehicle as Rs.1,98,476.50. After five days from the date of insurance, the vehicle in question met with an accident on 10.09.2011. As per the instructions of the Insurance Company if any claim is submitted within 05 days of date of existence of the policy, the same is held as Close Proximity Claim and detailed investigation is to be conducted, therefore, for detailed investigation the case of the complainant/appellant was sent to the Investigator. According to claim manual of the Insurance Company, the complainant/appellant has not lodged first information report properly. The complainant/appellant was required to lodge report or to inform in writing regarding the incident and to intimate the Insurance Company immediately, so the respondent/Insurance Company can conduct spot survey. The complainant/appellant, has not given intimation to the respondent/Insurance Company immediately, but he intimated the respondent/Insurance Company after three months of the date of the incident. The complainant/appellant violated the terms of the insurance policy, therefore, the O.P./Insurance Company has not committed any deficiency in service. The complainant/appellant is not entitled for any compensation. The complaint filed by the complainant/appellant, be dismissed.

4. District Forum, after having considered the material placed before it by both the parties, dismissed the complaint of the appellant/complainant on the ground that he gave delayed intimation the respondent/O.P.

5. Shri Amit Sharma, learned counsel for the appellant/complainant argued that vehicle bearing registration No.C.G.13-C-8872 met with an accident on 10.09.2011 and the complainant/appellant and his friends suffered serious injuries and appellant/complainant informed the concerned Police Station immediately and also sent intimation to the respondent/O.P./Insurance Company on 05.12.2011. The Surveyor instructed the complainant/appellant to get the vehicle repaired in the show room of any company and to send the bill with the claim form. As per the instruction of the Surveyor, the complainant / appellant got the vehicle repaired from the Budhia Auto Associates Private Limited, Korba, which is authorized show room of Tata Motors and in repairing of the vehicle the complainant/appellant incurred a sum of Rs.3,02,287/-. He further argued that the respondent/O.P./Insurance Company wrongly repudiated the claim of the appellant/complainant.

6. Shri M.L. Agrawal, learned counsel for the respondent/O.P./Insurance Company, has supported the impugned order.

7. We have heard learned counsel for both the parties and have also perused the record of the District Forum.

8. The appellant/complainant filed document no.1 i.e. legal notice dated 10.09.2012 sent by the complainant/appellant to the O.P./respondent/Insurance Company, document no.2 is acknowledgement of delivery of letter sent to the Branch Manager, United India Insurance Company Ltd. Branch Bilaspur (C.G.), document no.3 is letter dated 05.02.2011 sent by the complainant/appellant to the Branch Manager, United India Insurance Company Limited, Branch Bilaspur (C.G.) for providing claim amount, document “ 4 is motor vehicle cover Note. and private car package policy No.191600/31/11/01/00003547 for the period from 06.09.2011 to 05.09.2012, document no. 5 is Certificate of Registration of vehicle bearing No.C.G.-13-C”8872, document no.6 is driving licence of Mr. B.R. Singh, document no.7 is written complaint sent by Shakti Kumar Singh to Police Station, Wadrafnagar (C.G.) on 10.09.2011, document Nos.9 to 15 are money receipt issued by Budhia Auto Associate Pvt. Ltd. Korba (C.G.), document No.16 to 36 is Tax Invoice, document no.37 is Discharge Ticket of Jeewan Deep Samiti, 100 Bed Hospital, Wadrafnagar, Surguja (C.G.).

9. The respondent/O.P./Insurance Company also filed document Annexure 1 which is Survey Report (Final) dated 20.04.2012 of Shri Brijesh Kumar, Surveyor and Loss Assessor, Annexure A-2 is Private Car Package Policy Schedule.

10. From bare perusal of document 7, it appears that the appellant/complainant made written complaint on 10.09.2011 at Police Station, Wadrafnagar (C.G.) and the accident of the vehicle took place on 10.09.2011. It appears that First Information Report was lodged on the same day. The appellant / complainant sent intimation to the respondent/O.P. on 05.12.2011, whereas the accident took place on 10.09.2011 and intimation was conveyed to the respondent/ Insurance Company after near about 3 months.

11. In the case of New India Assurance Co. Ltd. v. Ram Avtar, I (2014) CPJ 29 (NC), Hon'ble National Commission held thus :

"8. We have heard the submissions made by the Counsel for the parties and also considered the evidence on record. The fact regarding the vehicle being insured by the Appellant/Insurance Company for a period from 19.8.1997 to 18.8.1998 is not in dispute. It is also an admitted fact that although an FIR was lodged with the Police on the same date, information in writing was conveyed to the Appellant/Insurance Company 35 days after the theft of the vehicle. When se specifically asked the Counsel for the Respondent/Complainant whether there was any plausible explanation for this delay, he stated that the information about the theft was conveyed to the Appellant/Insurance Company orally on the same date. However, we note that this fact was not mentioned in the complaint and no evidence to support this contention was produced either before the State Commission or before this Commission; not even the name of the official to whom the complaint was purportedly made was stated. We have perused the terms and conditions of the insurance policy and we note that the relevant provision inter alia reads as follows:

œConditions

1. Notice shall be given in writing to the Company immediately upon the occurrence of any accident or loss or damage and in the event of any claim and thereafter the insured shall give all such information and assistance as the Company shall required.?

Thus, as per the terms and conditions of the insurance policy, the Insuree was required to immediately inform the Appellant/Insurance Company about the theft of the vehicle which he admittedly failed to do. We are unable to accept the finding of the State Commission that this provision in the insurance policy is not mandatory but directory in nature since this issue is squarely covered and decided by the Honble Supreme Court in Parvesh Dhander Chadha (supra), in which case also pursuant to a vehicle having been stolen between 18.1.1995 and Police on 20.1.1995 but the Insuree did not inform the Insurance Company immediately about the incident as required under the terms and conditions of the insurance policy. The relevant part of the judgment of the Honble Apex Court is as follows:

œAdmittedly, the respondent had not informed the appellant about the alleged theft of the insured vehicle till he sent letter dated 22.2.1995 to the Branch Manager. In the complaint filed by him, the respondent did not give any explanation for this unusual delay in informing the appellant about the incident which gave rise to cause for claiming compensation. Before the District Forum, the respondent did state that he had given copy of the first information report to Rajender Singh Pawar through whom he had insured the car and untraced report prepared by police on 19.9.1995 was given to the said Shri Rajender Singh Pawar, but his explanation was worthless because in terms of the policy, the respondent was required to inform the appellant about the theft of the insured vehicle. It is difficult, if not impossible, to fathom any reason why the respondent, who is said to have lodged First Information Report on 20.1.1995 about the theft of car did not inform the Insurance Company about the incident. In terms of the policy issued by the appellant, the respondent was duty bound to inform it about the theft of the vehicle immediately after the incident. On account of delayed intimation, the appellant was deprived of its legitimate right to get an inquiry conducted into the alleged theft of vehicle and make an endeavour to recover the same. Unfortunately, all the Consumer Foras omitted to consider this grave lapse on the part of the respondent and directed the appellant to settle his claim on non-standard basis. In our view, the appellant cannot be saddled with the liability to pay compensation to the respondent despite the fact that he had not complied with the terms of the policy.?

12. In the case of Virender Kumar v. New India Assurance Co. Ltd., Through its Divisional Manager and Anr., 2012 (4) 595 (NC), Hon'ble National Commission held thus :

"4. We have given our anxious consideration to the above submissions. The question as to whether the insured can be said to have committed the breach of the terms and conditions of the policy in giving intimation after some delay i.e. delay of two days of the theft of an insured vehicle has been considered by this Commission in First Appeal No.321 of 2005 titled as New India Assurance Company Limited Versus Trilochan Jane decided on 09.12.2009, where on taking notice of delay of two days, Commission held as under :-

œLearned counsel for the respondent, relying upon the Judgment of Honble Supreme Court in National Insurance Company Limited Verses Nitin Khandelwal reported in (2008) 11 SC 256 contended that in the case of theft of vehicle, breach of condition is not germane. The said judgment was in a totally different context. In the said case, the plea taken by the Insurance Company was that the vehicle though insured for personal use was being used as a taxi in violation of the terms of the Policy. The plea raised by the Insurance Company was rejected and it was observed that in case of theft breach of condition is not germane. In the present case, the respondent did not care to inform the Insurance Company about the theft for a period of 9 days, which could be fatal to the investigation. The delay in lodging the FIR after two days of the coming to know of the theft and 9 days to the Insurance Company, can be fatal as, in the meantime, the car could have been travelled a long distance or may have been dismantled by that time and sold to kabadi (scrap dealer). In our view, the State Commission erred in holding that the respondent/complainant had reported the theft of the vehicle to the appellant-Insurance Company within a reasonable time. We are not going into the other question regarding violation of Condition No.5 of the Insurance Policy as we have non-suited the respondent / complainant on the first ground.?

13. Hon'ble National Commission in Vikram Singh Vs. Reliance General Co. Ltd. Through Its authorized signatory (Revision Petition No.3864 of 2012) decided on 02.04.2013. Relevant observations of the Hon'ble National Commission in paragraph no.4 read as under:-

"4. Supreme Court of India in Oriental Insurance Co. Ltd. Vs. Parvesh Chander Chadha “ Civil Appeal No.6739/2010 decided on 17.8.2010 dismissed the complaint holding that in terms of the policy issued by the insurance company, the insured was duty bound to inform about the theft of the vehicle immediately after the incident. Delay in intimation deprives the insurance company of its legitimate right to get enquiry conducted into the alleged theft of vehicle and make an endeavor to recover the same; that the insurance company could not be settled with the liability to pay compensation to the insured despite the fact that he had not complied with the terms of the policy. Relevant observations of the Supreme Court read as under.

Admittedly the respondent had not informed the appellant about the alleged theft of the insured vehicle till he sent letter dated 22.5.1995 to the Branch Manager. In the complaint filed by him, the respondent did not give any explanation for this unusual delay in informing the appellant about the incident which gave rise to cause for claiming compensation. Before the District Forum, the respondent did state that he had given copy of the first information report to Rajender Singh Pawar through whom he had insured the car and untraced report prepared by police on 19.9.1995 was given to the said Shri Rajender Singh Pawar, but his explanation was worthless because in terms of the policy, the respondent was required to inform the appellant about the theft of the insured vehicle. It is difficult, if not impossible, to fathom any reason why the respondent, who is said to have lodged First Information Report on 20.1.1995 about the theft of car did not inform the insurance company about the incident. In terms of the policy issued by the appellant, the respondent was duty bound to inform it about the theft of the vehicle immediately after the incient. On account of delayed intimation, the appellant was deprived of its legitimate right to get an inquiry conducted into the alleged theft of the vehicle and make and endeavour to recover the same. Unfortunately, all the consumer foras omitted to consider this grave lapse on the part of the respondent and directed the appellant to settle his claim on non-standard basis. In our view, the appellant cannot be saddled with the liability to pay compensation to the respondent despite the fact that he had not complied with the terms of policy."

14. In the case in hand, the delay in sending intimation to the respondent/Insurance Company, was about three months. Applying to ratio of above noted cases, the District Forum, was fully justified in taking view, it has taken. In our view, the order passed by the District Forum, does not suffer from any illegality, irregularity or jurisdiction error.

15. Therefore, the appeal filed by the appellant/complainant, being devoid of any merit, deserves to be and is hereby dismissed. No order as to the cost of this appeal.