NEW INDIA ASSURANCE CO. LTD Vs. RAM AVTAR

JUDGEMENT

(1.) This First Appeal has been filed by New India Assurance Co. Ltd., Appellant herein and Opposite Party before the Delhi State Consumer Disputes Redressal Commission (hereinafter referred to as the State Commission) against the order of that Commission which had allowed the complaint filed against it on grounds of deficiency in service by Ram Avtar, Respondent herein and Complainant before the State Commission.

(2.) In his complaint before the State Commission, Respondent/Complainant had contended that his Tata Sumo vehicle which was financed by M.G.F. India Ltd. and insured by Appellant/Insurance Company for a period of one year i.e. from 19.08.1997 to 18.08.1998, was stolen on 24.02.1998 when it was parked near Guru Teg Bahadur Hospital, Shahdara, Delhi. Respondent/Complainant on the same date lodged an FIR under Section 379 IPC at Police Station Seemapuri, Delhi. On 20.03.1998 Respondent/Complainant also submitted a claim form to the Appellant/Insurance Company and requested that an Investigator be appointed to look into the case of theft of the insured vehicle. On receipt of this information, Appellant/Insurance Company appointed one Sanjeev Nijhawan as Investigator, who sought certain clarifications of the theft of the insured vehicle which were replied to by the Respondent/Complainant. However, despite this, vide letter dated 19.03.1999 Appellant/Insurance Company unjustifiably repudiated the claim, after which Respondent/Complainant made a complaint to the Grievance Cell of the Appellant/Insurance Company, which was also rejected. It was further contended that the Police also could not recover the stolen vehicle and sent an untraced report on 25.05.1998. Being aggrieved by the deficiency in service on the part of Appellant/Insurance Company, Respondent/Complainant filed a complaint before the State Commission seeking a total compensation of Rs.5,35,000/- from the Appellant/Insurance Company, which included Rs.4,65,000/- being the insured value of the vehicle, Rs.50,000/- on account of tension and mental agony and Rs.20,000/- as litigation costs.

(3.) Appellant/Insurance Company, on being served, filed a written rejoinder denying the allegation that the claim was wrongly rejected. It was stated that the Respondent/Complainant informed the Appellant/Insurance Company about the theft of the vehicle only on 30.03.1998 i.e. approximately one month after the vehicle was allegedly stolen which was against the terms and conditions of the insurance policy which required the Insuree to give immediate intimation about the theft. The Investigator appointed by the Appellant/Insurance Company to enquire into the nature, cause, circumstances and genuineness of the claim after conducting the necessary enquiries concluded that there were serious reasons to doubt the genuineness of the claim. It appeared that the Respondent/Complainant took almost one month to give intimation about the alleged theft with a view to hide various facts and avoid detection of the fraud played by him on the Appellant/Insurance Company. Specifically it was contended that the Respondent/Complainant's contention that the vehicle was stolen outside Guru Teg Bahadur Hospital, where his brother was admitted for treatment, was not correct because the brother had actually expired 9 months prior to the theft. Further, it came to light during enquiries made by the Investigator that the vehicle which was hypothecated by the Respondent/Complainant in favour of M.G.F. India Ltd. had a specific clause that it could not be used for hire or reward whereas enquiries revealed that it was being used for hire and reward i.e. for commercial purpose and not for his personal use. In fact, the enquiries also revealed that the Respondent/Complainant was not running a soap factory and had a very modest financial status. The above facts were communicated to the Respondent/Complainant by the Appellant/Insurance Company vide letter dated 12.02.1999 specifically bringing to his notice the various anomalies and contradictions found in the statements made by him from time to time. It was also pointed out that the inordinate delay in informing the Appellant/Insurance Company about the theft of the vehicle was clearly against the terms and conditions of the insurance policy, according to which information about the theft should have been immediately conveyed to the Appellant/Insurance Company. Respondent/Complainant, however, did not reply to this letter and, therefore, the claim was rightly repudiated by the Appellant/Insurance Company.