This revision petition has been filed by the petitioner Ajit Singh against the order dated 24.4.2015 of the State Consumer Disputes Redressal Commission, Haryana, (in short ‘the State Commission’) passed in Appeal No.834 of 2014.
2. Brief facts of the case are that after purchasing the vehicle in 2009, the petitioner became registered owner of white Bolero SLX Car bearing registration No.HR-48/5387, Engine No.GA 94E 49174, Chassis No.92F 90965 and Model 2009. On 15.6.2010 , the petitioner renewed his insurance policy with the respondent No.1 vide policy no.110407/31/10/01/00003764 valid from 15.6.2010 to 14.6.2011. The vehicle in question was financed by the respondent No.3. On 19.10.2010, the petitioner parked his aforesaid vehicle in front of his house No.551, Sector -23, HUDA Bhiwani. On 20.10.2010, when the petitioner came out of his house then he noticed that his aforesaid Bolero Car was not there. Instantly first the petitioner tried to trace the car and immediately informed the police post Sector-13, Bhiwani and registered the FIR No.241, dated 20.10.2010 under Section 379 IPC in Police Station Civil Lines, Bhiwani. On 22.10.2010, the petitioner informed the respondent No.1 and respondent No.3 vide filing Motor Claim Form with the respondent No.1. On 03.12.2010, respondent No.3 also informed about the theft of the aforesaid Bolero Car to the respondent No.1. On 06.12.2010, the respondent No.2 rejected the claim of the petitioner on the ground that the petitioner had not informed about the theft of the vehicle immediately to the respondent Insurance Company. On 20.04.2011, the police station civil lines Bhiwani filed untraced report in regard to the aforesaid Bolero Car. On 27.08.2011, the petitioner filed consumer complaint no.388 of 2011 before the District Consumer Disputes Redressal Forum, Bhiwani, (in short ‘the District Forum’) under Section 12 & 13 of the Consumer Protection Act, 1986 against the respondents. On 19.04.2012, the respondent No.1 and 2 filed the joint reply to the complaint before the District Forum. On 25.7.2014, the District Forum allowed the complaint and directed the Insurance Company as follows:-
“1. To pay insured amount along with interest @12% per annum from the date of repudiation till its realization.
2. To pay Rs.2200/- as litigation charges.
The compliance of the order shall be made within 45 days from the date of receipt of certified copy of the order.”
3. On 14.09.2014, being aggrieved by the order dated 25.07.2014 passed by the District Forum in CC No.380 of 2011, the respondent No.1 and 2 along with respondent No.4 filed the Appeal No.834 of 2014 under Section 15 and 17 of the Consumer Protection Act, 1986 before the State Commission. On 24.04.2015, the State Commission allowed the Appeal No.834 of 2014 filed by the respondents No.1,2 &4 and set aside the order dated 25.07.2014 passed by the District Forum.
4. Hence the present revision petition.
5. Heard the learned counsel for both the parties and perused the record. Learned counsel for the petitioner stated that the theft of the car occurred on 20.10.2010 and the FIR in the matter was lodged on 21.10.2010. The claim was sent to the Insurance Company as well as to the financier respondent No.3 on 22.10.2010. The financier also wrote a letter informing the theft to the Insurance Company on 07.12.2010. The Insurance Company has come up with the assertion that the intimation/claim was received by them on 03.12.2010. The State Commission has agreed with the assertion of the Insurance Company and has considered the claim/intimation to the Insurance Company to have been given with a delay of 47 days. The State Commission has not considered the circular issued by the Insurance Regulatory and Development Authority (IRDA) being Circular No. IRDA/HLTH/MISC/CIR/216/09/2011 dated 20.09.2011, wherein all the Insurance Companies have been asked not to reject the insurance claim on the ground of delay in submission of the claim, if the claim is genuine. In the present case, the FIR was lodged on the next day i.e. on 21.10.2010 and there was no delay in filing the FIR. The police have already filed untraced report on 20.04.2011. These facts clearly proved that the theft was genuine and consequently the claim was also genuine. Had the complainant had any intention to defraud the Insurance Company by making a false claim, the FIR may not have been lodged immediately after the theft. There is no force in the argument of the learned counsel for the Insurance Company that the FIR has been filed with delay whereas the requirement under the policy is to file the FIR immediately in cases of theft. The complainant came to know about the theft of the vehicle only on 20.10.2010 and then he tried to search the vehicle locally and when the vehicle could not be traced, then intimation was given to the police on the very next day and the FIR was also lodged. Thus, there is no delay in filing the FIR. The fact is that the intimation was given to the Insurance Company in the form of the claim on 22.10.2010, however, the Insurance Company has denied the same and has asserted that claim was received on 03.12.2010. The State Commission has agreed with the assertion of the Insurance Company, though, the assertion of the Insurance Company is not factually correct. Thus, the order of the State Commission is based on the wrong facts and even the circular of IRDA has not been considered and therefore, the order of the State Commission deserves to be set aside and the insurance claim of the petitioner/complainant is required to be approved.
6. On the other hand, learned counsel for respondent Nos.1,2 & 4/ Insurance Company stated that the intimation in writing was received only on 03.12.2010 informing the theft of the insured vehicle. Had there been any intimation sent on 22.10.2010, the Insurance Company would have appointed surveyor/investigator for the same. Moreover, it is pertinent to note that no reminder or no other reference was sent to the Insurance Company informing that the intimation/claim was sent on 22.10.2010. It was further stated by the learned counsel that this issue has been examined in detail by the State Commission and the State Commission has found that there has been a delay of 47 days in giving intimation to the Insurance Company, which is clear violation of condition no.1 of the policy. As there was no intimation given to the Insurance Company, the Insurance Company could not make any effort to recover the insured vehicle in association with police. A valuable right of the Insurance Company is lost due to this delay in intimation and therefore, the Insurance Company has rightly dismissed the claim due to violation of condition no.1. The circular issued by the IRDA is only an advice that a genuine claim should not be refused even if filed with delay. This circular also mentions that the delay is required to be properly explained. The circular does not imply that even if the delay is not explained, the same may be condoned.
7. Learned counsel for the respondent No.3 stated that he supported the claim of the petitioner/complainant.
8. I have given a thoughtful consideration to the arguments advanced by the learned counsel for the parties and have examined the record. In the present case, the District Forum has allowed the payment of insured amount of the vehicle. The State Commission has accepted the appeal of the Insurance Company and has dismissed the complaint on the ground that the intimation to the Insurance Company was given with a delay of 47 days. It is to be noted that the IRDA vide circular dated 20.09.2011 has issued instructions to all the general Insurance companies and these instructions read as under:-
“The insurers’ decision to reject a claim shall be based on sound logic and valid grounds. It may be noted that such limitation clause does not work in isolation and is not absolute. One needs to see the merits and good spirit of the clause, without compromising on bad claims. Rejection of claims on purely technical grounds in a mechanical fashion will result in policyholders losing confidence in the insurance industry, giving rise to excessive litigation.
Therefore, it is advised that all insurers need to develop a sound mechanism of their own to handle such claims with utmost care and caution. It is also advised that the insurers must not repudiate such claims unless and until the reasons of delay are specifically ascertained, recorded and the insurers should satisfy themselves that the delayed claims would have otherwise been rejected even if reported in time.”
9. On the basis of the IRDA circular, the genuine claims are to be properly considered and are not to be rejected on the basis of delay in filing the claim. In the present case, the assertion of the petitioner is that he filed the claim on 22.10.2010, which has been denied by the Insurance Company and the assertion of the Insurance Company is that they received claim on 03.12.2010. The financier of the vehicle i.e. respondent No.3 also sent a letter to the Insurance Company informing about the theft of the vehicle on 07.12.2010. The complainant has also stated that on 22.10.2010, Insurance Company as well as the financier was informed. As the claim has been received by the Insurance Company on 03.12.2010 and the financier also wrote letter on 07.12.2010, it fortifies the fact that the claim was only lodged somewhere in December, 2010 only, otherwise the financier should have also written some letter informing the theft to the Insurance Company prior to December, 2010. I am convinced that no claim was submitted on 22.10.2010 and the intimation/claim was only submitted in December, 2010.
10. If one considers the circular of the IRDA and the above fact, then it is important to note that the vehicle was stolen on 20.10.2010 and the FIR was lodged on 21.10.2010 and untraced report has been filed by the police on 20.4.2011, therefore, the claim of the petitioner/complainant seems to be genuine and consequently capable of being settled. However, the Insurance Company has clearly lost the opportunity to trace and recover the stolen vehicle in association with police. It is to be considered that on one side the claim seems to be genuine and capable of being settled but on the other side, one cannot close his eyes to the fact that the delay in intimation to the Insurance Company has denied the Insurance Company an opportunity of investigating the matter and to trace and recover the vehicle in association with police. Hon’ble Supreme Court in Amalendu Sahoo Vs. Oriental Insurance Co. Ltd., II (2010) CPJ 9 (SC) has observed that if any condition of the policy is breached under Motor Insurance, the claim may be settled on non-standard basis upto an amount of 75% o
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f the claim otherwise being admissible. Thus, after considering the circular of IRDA and also taking into account the last opportunity of the Insurance Company for investigation, search and recovery of the vehicle due to huge delay in giving intimation to the Insurance Company as well as relying on the judgment of the Hon’ble Supreme Court in Amalendu Sahoo Vs. Oriental Insurance Co. Ltd. (supra), I am of the view that the claim of the petitioner/complainant can be settled at 50% of the insured amount. 11. Based on the above discussion, revision petition no.2947 of 2015 is partly allowed and the insurance claim of the petitioner is directed to be settled at 50% of the insured amount along with interest @5% p.a. from the date of filing of the complaint i.e. 27.08.2011 till actual payment. Thus, the order of the State Commission dated 24.04.2015 is set aside and the order dated 25.07.2014 of the District Forum stands modified accordingly. The Insurance Company will also pay Rs.5,000/- (rupees five thousand only) as cost of litigation to the petitioner/complainant. This order be complied with by the Insurance Company within a period of 45 days from the date of receipt/service of this order.