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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
V.B. Gupta, P.M.
ALKESH SAINI - Appellant
Versus
SBI GENERAL INSURANCE COMPANY LIMITED AND OTHERS - Respondents
First Appeal No. 47 of 2015. (Against the Order dated 02/12/2014 in Complaint No. 14/2014 of the State Commission Himachal Pradesh).
Decided on : 18-02-2015
Karan Chauhan, Advocate, for the Appellant; None for the Respondents, for the Respondent
A litigant approaching the court with unclean hands and concealing material facts is not entitled to relief.
Headnote:
Insurance - Validity of Insurance Claim - [V.B. Gupta, (P.M)] - [Insurance] - [Insurance Act, 1938, Section 45] - The court discussed the validity of the insurance claim and the issue of suppression of material facts and mis-statement by the appellant. The court highlighted the evidence presented, including the inspection report, statements of witnesses, and the order of the Insurance Ombudsman, to conclude that the appellant obtained the insurance policy by concealing material facts and through fraudulent means. The court cited the principle that a litigant approaching the court with unclean hands and concealing material facts is not entitled to relief.
Fact of the Case:
The appellant's house was insured, but the insurance claim was repudiated by the respondents on the ground of suppression of material facts and mis-statement. The appellant claimed that his house was intact at the time of insurance, while the respondents presented evidence showing that the house had already collapsed before the insurance policy was obtained. The Insurance Ombudsman also dismissed the complaint, supporting the repudiation of the claim.
Finding of the Court:
The court found that the appellant obtained the insurance policy by concealing material facts and through fraudulent means. The court held that the appellant did not approach the court with clean hands and, therefore, dismissed the appeal with punitive costs.
Issues: The main issue was whether the respondents were justified in repudiating the appellant's insurance claim on account of suppression of material facts and mis-statement.
Ratio Decidendi: The court applied the principle that a litigant approaching the court with unclean hands and concealing material facts is not entitled to relief. The court relied on the evidence presented, including the inspection report, statements of witnesses, and the order of the Insurance Ombudsman, to conclude that the appellant obtained the insurance policy by concealing material facts and through fraudulent means.
Final Decision: The court dismissed the appeal with punitive costs of Rs. 20,000 and directed the appellant to deposit the punitive cost within four weeks.
ORDER
V.B. Gupta, (P.M) - Appellant/Complainant being aggrieved by order dated 2.12.2014 passed by H.P. State Consumer Disputes Redressal Commission, Shimla (for short, 'State Commission') vide which his complaint was dismissed with cost of Rs. 10,000/-, has filed present appeal.
2. Appellant's case is, that he constructed house at site, bearing Khasra Nos. 805, 875 & 896 in Mauza Majeth, Tehsil & District Shimla, after getting plan approved from the Municipal Corporation, Shimla. Entire structure was four-and-a-half storeyed, out of which he owned two storeys plus attic. It was occupied by him for his residence.
3. It is alleged, that on 14.08.2012, appellant was contacted telephonically by an official of Respondent/Opposite Parties, for insurance of his aforesaid house. On 19.08.2012, appellant was again contacted by the respondents telephonically and was told that a local Surveyor had inspected his house and respondents were ready to insure the same. Upon that, appellant paid a premium of Rs. 5,593/- online and his house was insured, vide policy effective from 21.08.2012 (15.55 hours). On 22nd August, 2012, at 7.30 am, due to landslide and heavy rain, the insured house was completely damaged. Intimation of the damage was given to the respondents. A Surveyor was deputed. Appellant was required to submit certain papers, which he submitted promptly. However, respondents repudiated the claim, vide letter dated 01.01.2013, on the ground that "claim fell outside the ambit of the policy, being prior to policy inception date". Appellant approached the Grievance Cell of the respondents, but the said Cell rejected his representation/complaint, vide communication dated 07.06.2013 on the ground that the building had already been damaged, when the insurance was sought. Appellant then approached Insurance Ombudsman, Chandigarh, by making a complaint. The Ombudsman also dismissed his complaint, vide order dated 05.03.2014. It is alleged by the appellant that his house was intact on the date of insurance. The damage took place on 22.08.2012, at 7.30 am and a report with the police as also Patwari was lodged after damage had taken place. Since, the house was insured for the sum of 40.00 lacs and that it having completely and totally damaged, therefore, he is entitled to the entire amount, for which it was insured.
4. Respondents contested the complaint and took the plea that none of their officials ever approached the appellant, for insurance of his house nor was the house ever inspected by any of their officials. As a matter of fact, Aruna Saini, sister of appellant (who is appellant in F.A. No. 48 of 2015), paid the premium online from a branch of State Bank of India, from a place in Jalandhar District of Punjab State, on 21.08.2012. On the basis of that payment of premium, policy document was issued, effective from 21.08.2012 (15.55 hours) on 23.08.2012. The proposal form for seeking insurance was submitted on 23.08.2012.
5. It is further alleged, that partial damage to the house of appellant had taken place on 19.08.2012 and this fact was concealed by the appellant at the time of seeking insurance. It is further stated that Surveyor-cum-Investigator deputed by respondents, collected record from various offices, including that of S.D.O. (Civil) and Police Station, which indicated that landslide had occurred on 19.08.2012, in which house of one Sangita Devi had been completely damaged and partial damage to the building in which insured's residence was located, was also caused. Appellant had concealed this fact while filling in the proposal form, as in the said form he stated that the property was in a good state of repair and would be maintained so at all times. Thus, on account of suppression of material facts and mis-statement that the building was in good state of repair, the claim has been repudiated.
6. The State Commission vide its impugned order dismissed the complaint with cost of Rs. 10,000/-.
7. Being aggrieved, appellant has fil
