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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION AT NEW DELHI
Suresh Chandra, Presiding Member and
AVM J. Rajendra, AVSM, VSM (RETD), Member
New India Assurance Company Ltd. – Petitioner
versus
Khushi Ram Tayal (Since died) – Respondent
Revision Petition No.358 of 2024 with
IA Nos.2036, 2037 & 12922 of 2024
Decided on 21.3.2025
Consumer Protection Act, 1986 – Section 21(b) [Consumer Protection Act, 2019 – Section 58(1)(b)] – Revision – Services – Insurance – Fundamental breach – What is termed as – On facts, the failure on the part of the insured in stating the facts about the previous policy, does not by itself constitute a fundamental breach of the insurance policy entailing the repudiation of the claim. Further, the OP insurer also had opportunity to ascertain the veracity of the claim of NCB, and call upon the insured to pay the entire premium due. This was not done. At the same time, however, it is also an uncontested position that the complainant had purchased the car in question in September 2013 and initially obtained insurance policy from Bharti Axa. Within a year, the car was involved in two accidents on 14.09.2014 and 03.08.2015. He then switched the insurance cover to Tata AIG, and the car met with another accident on 07.12.2015. The complainant then again shifted back to Bharti Axa on 10.01.2015 before changing again on 10.10.2016 to The New India Assurance Co. The accident now in question occurred on 28.09.2017. Thus, this is the fourth accident within four years of purchasing the car. The said non-disclosure of the previous accidents was with respect to the same car and claims made under the respective policies by the complainant. Therefore, obtaining of the insurance policy in question by the complainant, by claiming non-entitled NCB cannot be termed as an act without knowledge of its consequences. [Paras 15 to 18]
Result: Petition disposed off.
JUDGMENT
AVM J. Rajendra, AVSM, VSM (RETD), Member—This Revision Petition is filed under Section 58(1)(b) of the Consumer Protection Act, 2019 (‘the Act’) challenging the Haryana State Consumer Disputes Redressal Commission, Panchkula (‘State Commission’) order dated 14.09.2023 dismissing Appeal No.387 of 2019 and setting aside the District Consumer Disputes Redressal Forum, Panipat (‘District Forum’) order dated 28.03.2019.
2. As per report of the Registry, there is 2 days delay in filing this Revision Petition. In the interest of justice, the delay is condoned.
3. For convenience, the parties in the present matter are referred to as mentioned in the complaint before the District Forum. Khushi Ram Tayal is the complainant (Respondent herein) while New India Assurance Co. Ltd. is the Opposite Party (OP) (Petitioner herein).
4. Brief facts of the case, as per the complainant, are that he owned a Renault Duster car Registration No. DL-13-C-6572. It was insured with New India Assurance Company Limited from 10.10.2016 to 09.10.2017. The Insured Declared Value (IDV) of the car was Rs.8,20,000. On 28.09.2017, the car was involved in an accident. The complainant promptly informed both the police and the insurance company. The police registered a DOR/GD No. 42 on 28.09.2017. The insurance company appointed a surveyor, who inspected the vehicle and concluded that it was a total loss. However, the insurer repudiated the claim on 26.03.2018, alleging that the complainant had obtained the insurance policy by submitting a false declaration. Consequently, the complainant filed a complaint before the District Forum, citing deficiency in service on the part of the insurance company.
5. Upon receiving notice, the OP insurer filed its written version, contesting the complainant’s claims and contended that he delayed reporting the accident by six days. The surveyor’s report dated 12.12.2017 assessed the loss at Rs.6,14,900 on a net salvage basis, with a recommendation to cancel the car’s Registration Certificate (RC). The OP insurer justified the repudiation of the claim, asserting that the complainant had misrepresented facts to avail “No Claim Bonus” from a previous insurer, Tata AIG Insurance Co while obtaining the current policy. The OP insurer obtained further detailed history of the complainant that the car was purchased in September 2013 and initially insured with Bharti Axa. It was involved in accidents on 14.09.2014 and 03.08.2015. He switched later to Tata AIG, and another accident occurred on 07.12.2015. He returned to Bharti Axa on 10.01.2015 before switching again to The New India Assurance Co. on 10.10.2016. The latest accident occurred on 28.09.2017. The OP denied all other allegations made by the complainant.
6. The District Forum, vide Order dated 28.03.2019, dismissed the complaint as under:
“16. Admittedly, insured vehicle met with an accident on 28.09.2017. Matter was reported to the police by driver Kapil Kumar on 28.09.2017 as per DDR (Ex.C-3). The insurance company was intimated on 03.10.2017 by the complainant vide letter Ex.R-6 after delay of 6 days. The complainant filed his sworn affidavit Ex.CW1/A wherein he has not given any explanation why he has given intimation to the insurance company after 6 days. No doubt, if the complainant succeeds in explaining the delay to the satisfaction of the Forum, then merely on delay itself, the claim of the complainant cannot be repudiated by the insurer. In the present case no explanation has been submitted by the complainant for this delay in intimating the insurance company. In judgment Kulwant Singh’s case (Supra) referred on behalf of the complainant, there was no delay in lodging FIR with the police. The complainant submitted a plausible explanation for delayed intimation. It was held that no prejudice has been caused to the insurance company on account of this delay and repudiation of the claim was held unjustified. There is no explanation in this case what to talk of plaus
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