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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Ajit Bharihoke, Presiding Member, Mrs. Rekha Gupta, Member
M/s. Surya Electronics —Appellant
versus
United India Insurance Co. Ltd.
& Anr. —Respondents
First Appeal No.47 of 2010
(Against the Order dated 12.1.2010 in Complaint No. 9/2008 of the State Commission Chhattisgarh)
Decided on 15.12.2015

Advocates:
Counsel for the Parties:
For the Appellant:Mr. Sanchit Guru, Advocate
For the Respondents:Mr. Rajesh Gupta, Advocate

IMPORTANT POINT
If any fraudulent claim is submitted by insured or someone on his behalf to obtain benefit under policy insurance company shall be within its right to forfeit all benefits under policy.

Headnote:Consumer Protection Act, 1986—Sections 17, 19 and 21—Insurance—Shopkeepers Insurance Policy—Theft of goods in burglary—If any fraudulent claim is submitted by insured or someone on his behalf to obtain benefit under policy insurance company shall be within its right to forfeit all benefits under policy—Complainant had filed fraudulent claim to derive undue benefit in respect of electronic items which were not purchased by him—State Commission was right in holding that insurance company was justified in repudiating insurance claim—Appeal dismissed. (Paras 10 and 11)

       Result: Appeal dismissed.

       

ORDER

The appellant being aggrieved of the order of the Chhattishgarh State Consumer Disputes Redressal Commission (in short, “the State Commission”) dated 12.1.2010 has preferred this appeal.

2. Briefly stated, facts relevant for the disposal of this appeal are that the appellant/ complainant obtained a shopkeepers insurance policy from the opposite party for insuring his shop as well as goods in stock for trade. The insurance policy was valid w.e.f. 29.8.2006 to 28.8.2007 and the insurance policy extended insurance against peril of burglary, house braking etc. The sum insured was Rs.54,00,000.

3. It is the case of the complainant that on the night intervening 9th and 10th September, 2006 a burglary took place at the shop of the complainant and the goods worth Rs.36 to 40 Lakhs were stolen. The intimation of the burglary was given to the police as well as insurance company. A surveyor was appointed and the surveyor vide his report dated 29th April, 2008 came to the conclusion that the complainant has been able to establish the loss of 142 mobile sets worth Rs.5,73,274 and he could not substantiate the loss because of burglary regarding other items. Thereafter, a supplementary survey report was given stating that M/s Techno Enterprises, from whom the complainant allegedly purchased the other electronic items apart from 142 mobile sets in their affidavit filed before the Commercial Tax Officer denied having sold these allegedly stolen electronic items to the complainant. Taking into account the supplementary survey report, the insurance company took the view that the claim submitted by the complainant was fraudulent. Accordingly, the claim was repudiated. The complainant being aggrieved of the repudiation of the claim the appellant filed a consumer complaint.

4. The opposite party on being served with the notice of the consumer complaint filed a written statement resisting the complaint. In the written statement opposite party claimed that the insurance claim was rightly repudiated because it was a fraudulent claim.

5. The State Commission on consideration of pleadings and the evidence of the parties after duly considering the survey report as also the supplementary survey report came to the conclusion that the insurance company was justified in repudiating the claim and there was no deficiency in service. Thus, the complaint was dismissed. This has led to filing of the appeal.

6. Learned Shri Sanchit Guru, Advocate for the appellant has contended that the impugned order is not sustainable because the State Commission has ignored the fact that in the first survey report the surveyor on the basis of entries in rough note book of the complainant had calculated that there was a loss of 142 mobile sets worth Rs.5,73,274 due to burglary which were not purchased from M/s Techno Enterprises, therefore, on the basis of survey report at least the aforesaid sum of Rs.5,73,274 should have been awarded to the complainant against his insurance claim. No other argument has been advanced.

7. Learned Shri Rajesh Gupta, Advocate on the contrary has argued in support of the impugned order. He has drawn our attention to the special exception clause 7 in the insurance contract wherein it has been provided that company shall not be liable to pay any claim under the insurance policy if fraudulent means or device are used by the insured or any one acting on behalf of the insured to obtain any benefit under this policy and in such circumstance all benefits under the policy shall be forfeited. In support of this contention, learned counsel has relied upon the judgment of this Commission in the matter of Best Food International v. National Insurance Co. Ltd. & Anr., IV (2009) CPJ 77 (NC), wherein it has been held as under:

“It is well settled principle of insurance that the contract of insurance is that of utmost good faith, and in the present case, it is vitiated by fraudulent act of the complainant, who furnished fabricated documents in support of their cl










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