NATIONAL INSURANCE CO. LTD. vs SURESH KUMAR

This revision is directed against the order of the State Commission Delhi dated 28.05.2013 in First Appeal No. 683 of 2009 whereby the State Commission allowed the appeal preferred by the respondent complainant against the dismissal of his complaint No. 410 of 2008 and directed the petitioner insurance company to pay a sum of Rs. 3,50,000/- to the complainant against his insurance claim within 30 days failing which it was directed that petitioner shall pay interest @ 10% p.a. from the date of receipt of the impugned order till the realisation of amount.

Briefly stated facts relevant for the disposal of the revision petition are that in the first round, the respondent filed a consumer complaint in the District Forum alleging that he got his truck bearing No.HR-62-0445 insured with the petitioner opposite party with IDV Rs.3,50,000/-. The period of insurance was from 02.09.2003 to 01.09.2004. The vehicle was stolen on 14.11.2003. The theft was reported to the police vide FIR No. 757 of 2003 dated 19.11.2003. It was alleged by the complainant that he filed an insurance claim but the petitioner opposite party failed to settle the claim despite of the complainant having met the officers of the opposite party on several occasions.

The complaint was resisted by the opposite party mainly on the plank that there was no cause of action to file consumer complaint because no insurance claim was filed by the opposite party.

The District Forum vide its order dated 12.09.2007 disposed of the complaint with following directions : In view of the above discussion, the Forum orders parties as under: 1. The complainant will file claim form as per the requirement and rules of OP alongwith all necessary documents within a month from the date of this order.

OP will decide on the claim application of the complainant strictly within 90 days from the date of submission of claim form by the complainant.

With above directions, the complaint is disposed off.

Pursuant to the order of the District Forum, the respondent filed his insurance claim which was repudiated by the insurance company. Being aggrieved of the repudiation of the insurance claim, the respondent filed fresh consumer complaint against the petitioner being complaint no.410 of 2008.

The petitioner opposite party resisted the complaint. In the written statement, it was admitted that the truck was insured with the insured company w.e.f. 02.09.2003 to 01.09.2004. According to the complainant, the insurance claim was repudiated because intimation of theft was not immediately given in writing in violation of the terms and conditions of the insurance policy.

The District Forum on consideration of the pleadings and evidence came to the conclusion that insurance claim was rightly repudiated because the complainant in violation of condition no.1 of the insurance policy failed to immediately report the theft to the police as also the insurance company. Being aggrieved of the order of the District Forum, the respondent complainant approached the State Commission in appeal and the State Commission vide impugned order allowed the appeal, set aside the order of the District Forum and directed the petitioner insurance company as noted above. Being aggrieved of the order of the State Commission, the petitioner opposite party has filed the instant revision petition.

Learned Ms. Meenakshi Midha, Advocate for the petitioner insurance company has contended that the impugned order of the State Commission is against the facts. Expanding on the argument, learned counsel for the petitioner has taken us through condition no.1 of the insurance policy and submitted that impugned order has been passed in total disregard of the aforesaid condition including the fact that the complainant failed to intimate the theft to the insurance company within a reasonable period.

Respondent on the contrary has argued in support of the impugned order. He has contended that he had orally informed the petitioner insurance company about the theft of his

truck on the same day. The respondent further contended that he even intimated the theft of the truck to the police on telephone number 100 on the same day and he cannot be faulted because the police delayed the registration of FIR.

We have considered the rival contentions. The short question which needs answer in this revision petition is whether or not the respondent complainant has violated condition no.1 of the insurance company. The said condition is reproduced as under: ""The policy and the schedule shall be read together and any word or expression to which a specific meaning has been attached in any part of this policy or the schedule shall bear the same meaning wherever it may appear.

Notice shall be given in writing to the Company immediately upon the occurrence of any accidental 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 require. Every letter, claim writ summons and / or process or copy thereof shall be forwarded to the Company immediately on receipt by the insured. Notice shall also be given in writing to the company immediately the insured shall have knowledge of any impending prosecution inquest or Fatal inquiry in respect of any occurrence which may give rise to a claim under this policy. In case of theft or criminal act which may be the subject of a claim under this policy the insured shall give immediate notice of the policy and co-operate with the Company in securing the conviction of the offender.

On reading of the above, it is clear that as per the insurance contract, the respondent complainant was required to give immediate notice in writing about the loss of truck due to theft to the insurance company. Stand of the petitioner insurance company is that requisite information of theft was not given immediately whereas according to the complainant, he gave oral intimation of theft to the insurance company on the same day. The aforesaid plea of the complainant is not acceptable for the reason that complainant has nowhere alleged in the complaint that he intimated the insurance company orally about the theft of the truck. Otherwise also, even if oral intimation is given, it is not compliance of condition no.1 which requires the insured to give immediate notice in writing. Further, it is admitted case of the parties that legal notice dated 01.09.2005 was sent by Sh. Vijender Dhankar, Advocate on behalf of the respondent to the concerned Divisional Manager of the petitioner insurance company. On perusal of the copy of the said notice also, we find that there is not even a whisper about any intimation about the theft given to the petitioner insurance company. Thus, it is evident that respondent complainant in violation of condition no.1 of the insurance contract has failed to give immediate intimation in writing about the theft of the truck to the insurance company.

In the matter of Oriental Insurance Co. Ltd. Vs. Parvesh Chander Chadha in Civil Appeal No. 6739 of 2010 arising out of SLP (C ) No. 12741 of 2010 decided on 17.08.2010, Hon''ble Supreme Court held thus: "Admittedly, the respondent had not informed the appellant about the alleged theft of the insured vehicle till he sent letter dated 22.05.1995 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 not 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 19.09.1995 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 20.01.1995 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."

In view of the discussion above and the law laid down by the Apex Court, the insurance company was justified in repudiating the insurance claim in view of violation of terms and conditions. The State Commission in its impugned order has totally ignored the above aspect of the matter. Therefore, impugned order cannot be sustained.

In view of the discussion above, we allow the revision petition, set aside the impugned order and dismiss the complaint.