NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
J.M. Malik, Presiding Member and Vinay Kumar, Member
BRIJ BHUSHAN - Appellant
Versus
NATIONAL INSURANCE COMPANY LTD. AND ANR. - Respondents
Revision Petition No. 33 of 2012 against Order dated 24.8.2011 in First Appeal No. 1453 of 2006 of State Commission, Punjab
Decided on : 22-08-2012
Mr. Mukund Gupta, Advocate, for the Appellant; None., for the Respondent
The obligation of the insured to act in good faith and the principle of equity influenced the court's decision to dismiss the revision petition.
Headnote:
Insurance Claim - Consumer Dispute - Indian Motor Tariff 2002, Insurance Act 1938 - [Indian Motor Tariff 2002, Insurance Act 1938] - The court discussed the repudiation of the insurance claim based on the misrepresentation of facts and entitlement to no claim bonus. The court highlighted the principle of equity and the obligation of the insured to act in good faith. The interpretation of the Indian Motor Tariff 2002 and the Insurance Act 1938 influenced the court's decision to dismiss the revision petition.
Fact of the Case:
The insurance claim for a truck involved in an accident was repudiated by the insurance company based on the insured's misrepresentation of facts and entitlement to no claim bonus.
Finding of the Court:
The State Commission's decision to dismiss the revision petition was upheld, as the insured failed to justify the entitlement to no claim bonus and was found to have fraudulently misrepresented the facts to the insurance company.
Issues: Misrepresentation of facts, entitlement to no claim bonus, validity of the insurance policy, deficiency of service by the insurer.
Ratio Decidendi: The insured's failure to act in good faith and the fraudulent misrepresentation of facts led to the dismissal of the insurance claim. The principle of equity and the obligation of the insured to do equity influenced the court's decision.
Final Decision: The revision petition was dismissed, and no costs were awarded.
ORDER
Vinay Kumar, Member - The revision petitioner Mr. Brij Bhushan has challenged the decision of the Punjab State Consumer Disputes Redressal Commission, in First Appeal No. 1453 of 2006. The matter arose out of an insurance claim which had been repudiated by the respondent National Insurance Company Limited. The District Forum has allowed the claim as per the assessment of loss by the Surveyor appointed by respondents/OPs. However, the appeal against the order of the District Forum was allowed by the State Commission, dismissing the complaint.
2. Brief facts of the case, as seen from the record, are that a truck owned by the appellant/Complainant was insured with the respondents/OPs for Rs. 9.7 lakh. During the period of operation of the policy, the truck met with an accident on 4.1.2004. The Surveyor appointed by the Insurance Company made an assessment of loss and the Complainant, allegedly with the oral consent of the Surveyor, got the vehicle repaired, spending over Rs. 5.5. lakh. The respondent/National Insurance Company repudiated the claim on 23.6.2005 giving the following reasons
"On going through the documents, including your representation dated 26.4.2005 and the circumstances, the competent authority, after due application of mind, has observed that, since you have deliberately and fraudulently misrepresented and misled the company, while getting benefit of 55% NCB, transferred on your new truck No. Pb-13-I-5375, you have breached the principle of utmost good faith, which is the foundation of the contract of insurance in question. Moreover, you have utterly failed to justify your entitlement of 55% discount on the premium as well as indemnity against the loss caused to your vehicle in an accident dated 4.1.2004. As per the Indian Motor Tariff 2002, framed by the tariff advisory committee, a statutory body under the Insurance Act, 1938, you are not entitled to any own damage claim, since in the light of general regulation No. 27, all the benefits under Section-I of the policy of insurance, stand forfeited in the given circumstances of this case. Hence your claim, with regard to the accidental damages dated 4.1.2004, caused to vehicle No. Pb-13-I-5375, is hereby repudiated and we are not liable to pay any amount as claimed by you."
3. In the consumer complaint before the District Forum Sangrur, challenging the repudiation of the claim, the case of the Complainant before the District Forum was that the vehicle was insured after paying full premium advised by the agent of the opposite parties, who had also informed him that he would be entitled to no claim bonus. The same was allowed by the Branch Manager of the Insurance Company. After repair of the vehicle all the bills and estimates were submitted to the Branch. If in the opinion of the Branch Manager, he was not entitled to no claim bonus' (NCB), the former should have sought payment of additional amount of premium within 21 days of issuing the cover note. It was alleged that the question of no claim bonus' was raised by the OP only after he had lodged the claim for damage to the vehicle in the accident of 4.1.2004 i.e. several months after issue of the cover note.
4. On the other hand, the case of the OP/Insurance Company was that its authorized agent was informed by the Complainant that his old vehicle was insured with another Insurance Company and had been sold. The insurance of the previous vehicle was claimed to have been shifted to the new vehicle. Therefore, the benefit of NCB was allowed, believing his statement. But, on verification with the previous insurer, it was discovered that the cover note 602984 of 10.3.2002, mentioned by the Complainant, was actually issued in the name of one Balwinder Singh. The Complainant also wrote to the Division Manager, National Insurance Company, Sangrur on 27.10.2004 that the vehicle mentioned earlier belonged to him and had been sold and that the insurance was shifted to his new vehicle.
5. We have carefully perused the re