The complainant entrusted 42 cartons of garments to the petitioner under invoice no. 1833 dated 22.11.2010. The value of the goods according to the complainant was Rs. 10,67,128/-. When the goods arrived at the destination, only 14 out of 42 cartons of the goods were delivered. The complainant called upon the petitioner to deliver the remaining goods. Having failed in his efforts to get the remaining goods from the petitioner, the complainant filed a complaint before the concerned District Forum, seeking payment of Rs. 6,82,082/- as the price of the undelivered goods, Rs. 40,924/- towards interest and Rs. 1 lakh towards damages for harassment, besides litigation expenses.
(2) The petitioner did not put in appearance despite service by publication. The notices sent to the petitioner through ordinary process were received back with the report “left without address”. After recording exparte evidence of the complainant, the District Forum allowed the complaint and directed the petitioner to handover the remaining goods or in the alternative refund a sum of Rs. 6,82,082/- to the complainant alongwith interest at the rate of 9% per annum from the date of the complainant. A sum of Rs. 10,000/- was also awarded as compensation and cost of litigation.
(3) Being aggrieved from the order of the District Forum, the petitioner approached the State Commission by way of an appeal. Since there was a delay in filing the appeal, an application seeking condonation of delay was also filed alongwith the appeal. The State Commission, vide its order dated 07.06.2013 dismissed the application as well as the appeal filed by the petitioner. The order passed by the State Commission was challenged by the petitioner before this Commission. Vide order dated 28.11.2013, this Commission allowed the application seeking condonation of delay in filing the appeal and directed the State Commission to decide the complaint on merits. Vide impugned order dated 21.04.2014, the State Commission dismissed the appeal filed by the petitioner. Being aggrieved from dismissal of its appeal, the petitioner is before us, by way of this revision petition.
(4) Two main submissions have been made by the learned counsel for the petitioner. The first submission is that the theft of the goods took place on account of the reasons beyond the control of the petitioner and therefore it is not liable to pay any amount to the complainant. The second submission is that the complainant did not prove the value of the goods before the District Forum. In our view, neither of the contention raised by the learned counsel for the petitioner is tenable. The petitioner did not file any written statement before the District Forum nor did it lead any evidence before the said forum. Even before the State Commission, there was no evidence on behalf of the petitioner. Thus, it can not be verified as to under what circumstances, the goods of the complainant had got stolen. Consequently, the petitioner has failed to establish that the theft of the goods took place on account of reasons beyond its control. The onus would be upon the petitioner carrier to establish either that the loss of the goods was an act of God or that it happened on account of reasons beyond its control. That having not been done, the petitioner does not stand absolve of its liability towards the consignor of the goods.
(5) As regards the value of the stolen goods, we find from a perusal of the order of the District Forum that the complainant had produced, before the said forum, copies of the invoice Ex. C2 to C7, a copy of the consignee, copy issued by the petitioner company and the copies of final inspection report dated 23.11.2000. The invoice produced by the complainant were sufficient to prove the value of the goods. Therefore, it cannot be said that no evidence was led by the complainant to prove the value of the stolen goods.
(6) For the reasons stated hereinabove, we find no merit in the revision petition and the same is hereby dismissed.
V. K. JAIN, J PRESIDING MEMBER
DR. B.C. GUPTA MEMBER
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI
REVISION PETITION NO.2719 OF 2014
(From the order dated 29.04.2014 in FA No.72/2014 of Haryana State Consumer Disputes Redressal Commission)
WITH IA/4442/2014 (STAY)
National Insurance Co. Ltd. Through its duly Constituted attorney, Manager, National Insurance Co. Ltd. R.O. – 1 Level 4, Tower – II, Jeevan Bharati, 124, Connaught Circus, New Delhi – 110001.
The complainant, owner of a Bolero vehicle bearing registration no. HR 22G 5477, got the said vehicle insured with the petitioner for the period from September 08th, 2011 to September 07th, 2012. The vehicle was stolen in the area of Gurunanakpura Mohalla, Fatehabad, in the night intervening 11/12.04.2012. A report with the concerned police station was lodged on the same day and was duly registered bearing FIR No. 162 of the Police Station City, Fatehabad. The Insurance Company was informed of the theft after five days. A claim was later lodged with the Insurance Company. The claim was repudiated by the Insurance Company solely on the ground that the theft had not been reported to the Insurance Company immediately after it had taken place and consequently, there was a breach of the terms and conditions of the Insurance policy. Being aggrieved from the repudiation of his claim, the complainant approached the District Consumer Disputes Redressal Forum, Fatehabad. Vide order dated 12.12.2013, the Commission dismissed the complaint, accepting the plea taken by the Insurance Company.
(2) Being aggrieved from the order of the District Forum, the complainant approached the State Commission, Haryana by way of her appeal. Vide impugned order dated 29.04.2014, the State Commission allowed the appeal and directed the Insurance Company to pay the Insured Declared Value to the complainant alongwith interest at the rate of 9% per annum. Being aggrieved from the order of the State Commission, the Insurance Company is before us, by way of this revision petition.
(3) The learned counsel for the petitioner submits that as per the terms and conditions of the Insurance policy, the insured was under an obligation to report the theft immediately to the Insurance Company and therefore it ought to have reported to them on 12.04.2012 itself. In support of his contention, the learned counsel relied upon the decision by the Hon’ble Supreme Court in Oriental Insurance Co. Ltd. vs. Parvesh Chander Chadha, Civil Appeal No. 6739 of 2010, decided on 17.08.2010 and the decision of this Commission in New India Assurance Co. Ltd. vs. Trilochan Jane, FirstAppeal No. 321 of 2005, decided on 09.12.2009.
(4) A perusal of the decision of the State Commission would show that the State Commission, in allowing the appeal filed by the Insurance Company, relied upon a circular dated 20.09.2011, issued by the Insurance Regulatory And Development Authority (IRDA). The said circular reads as under:-
To :All life insurers and non-life insurers
Re: Delay in claim intimation/documents submission with respect to
i. All life insurance contracts and
ii. All Non-life individual and group insurance contracts
The Authority has been receiving several complaints that claims are being rejected on the ground of delayed submission of intimation and documents.
The current contractual obligation imposing the condition that the claims shall be intimated to the insurer with prescribed documents within a specified number of days is necessary for insurers foreffecting various post claim activities like investigation, loss assessment, provisioning, claim settlement etc. However, this condition should not prevent settlement of genuine claims, particularly when there is delay in intimation or in submission of documents due to unavoidable circumstances.
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 policy holders 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.
The insurers are advised to incorporate additional wordings in the policy documents, suitably enunciating insurers’ stand to condone delay on merit for delayed claims where the delay is proved to be for reasons beyond the control of the insured.
(5) The learned counsel for the petitioner submits that the aforesaid circular applies to only Life Insurance Policies and Health Insurance Policies, but does not apply to the General Life Insurance Policies such as Motor Vehicle Insurance Policies. However, a careful perusal of the circular does not support the contention raised by the learned counsel. It would be seen from a perusal of the circular that it refers not only to Life Insurance contracts, but also to “All Non-life individual and group insurance contracts”.
Non-Life Insurance includes not only Health Insurance, but also the General Insurance such as Insurance of Motor vehicles. In the second paragraph of the circular, IRDA observed that the IRDA, inter-alia, referred to “loss assessment” by the insurer. The loss assessment does not come in Health Insurance, it comes in General Insurance such as accident or theft of Motor vehicles. The body of the circular does not give any indication that its scope is confined to Life Insurance and Health Insurance policies. Even after order of the State Commission, the petitioner has not taken any clarification from IRDA to the effect that the circular dated 20.09.2011 applies only to Life Insurance Policies and Health Insurance Policies and does not apply to General Insurance Policies such as insurance policies of Motor Vehicle. Therefore, we cannot accept the contention raised by the learned counsel for the petitioner in this regard.
(6) It is an admitted case that the theft was reported to the concerned Police Station immediately after it was detected on 12.04.2012. Thus there was no delay in reporting the theft to the police. As regards the delay in reporting the theft to the Insurance Company, the complainant gave the following explanation in the complaint:-
“2. That the said vehicle of the complainant was stolen on the intervening night of 11.04.2012/12.04.2012 at 3.00 a.m. from Gurunanakpura Mohalla, Fatehabad Tehsil & District Fatehabad and the intimation about the theft of the said vehicle was given to the police and F.I.R. No. 162 dated 12.04.2012 was registered in PS: City, Fatehabad Tehsil & District Fatehabad under section 379 of Indian Penal Code and the complainant also intimated immediately the respondent about the theft of his above said vehicle but the respondent did not take the information in writing about the theft of vehicle under the garb that the written information shall be taken only after all the formalities in this regard have been completed such as F.I.R., registration certificate and policy number etc. have been submitted by the complainant with the respondent. It is stated that policy and registration copy of the vehicle were in the stolen vehicle and as such the complainant thereafter obtained the duplicate copy of policy of insurance from Ratia office since the same was not given to the complainant from the respondent’s Fatehabad Office. The complainant had made the payment of Rs. 50/- for taking the duplicate copy of policy of insurance. The complainant for the purpose of getting the benefits of insurance of the said vehicle from the respondent completed all the formalities of the respondent as directed by the respondent and the complainant was assured that the sum insured shall be paid to the complainant very soon.”
In our view, considering the explanation given by the complainant for the delay in reporting the matter to the Insurance Company, it should not have repudiated the claim, merely on account of delay in bringing the theft to its knowledge, particularly when there was absolutely no delay in lodging the FIR with the police. It is not as if the circumstances of theft conveyed to the Insurance Company were different from the circumstances of the theft conveyed to the police. Therefore, no prejudice was caused to the Insurance Company on account of 4/5 days delay in bringing the theft to its knowledge. Had the complainant not been prompt in reporting the theft to the police, it could probably have seen some merit in the repudiation of the claim, but when the matter was immediately reported to the police, the insured had nothing to gain by delaying the report of the matter to the Insurance Company.
(7) As regards the decision of the Hon’ble Supreme Court in Parvesh Chander Chadha (supra), we find that in the said case, the theft took place on 18.01.1995 and the matter was reported to the police on 20.01.1995, whereas the report was given to the appellant after four months on 22.05.1995. Thus, there was delay of more than four months in reporting the matter to the Insurance Company. Moreover, the judgment does not indicate that any plausible explanation was given by the insured for not bringing the matter to the notice of the Insurance Company immediately after the theft had taken place. On the other hand, in the case before us, the complainant/insured had given a plausible explanation, which has been accepted by the State Commission and we see no reason to take a different view as regards the plausibility of the said explanation.
(8) As far as the decision of this Commission in Trilochan Jane, (supra)is concerned, we find that there was a delay of nine days in reporting the matter. Even the theft in the FIR with the police was lodged after two days and the insured did not give any explanation to the Insurance Company for the delay in reporting the matter to the police and to the Insurance Company. It was in these circumstances that this Commission held that the Insurance Company was justified in repudiating the claim. Moreover, the circular issued by IRDA came much later, this judgment having been rendered on 09.12.2009.
(9) For the reasons stated hereinabove, we find no merit in the revision petition and the same is, therefore, dismissed.
V. K. JAIN J.
DR. B.C. GUPTA
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI
REVISION PETITION NO. 2715 OF 2014
(From the order dated 20.01.2014 in Appeal No. FA/13/136 of Chhattisgarh State Consumer Disputes Redressal Commission)