IMPORTANT POINTS
(1) Once insurer fails to mention particular ground for repudiation and processes claim with some positive action, Insurer cannot subsequently raise that ground and repudiate claim.
(2) Contractual obligation of Insurer is strictly governed by terms of policy – Once it is established that there has been breach of terms and conditions of policy especially involving statutory compliance, Insurer cannot be fastened with liability.

ORDER

Dr. Sudhir Kumar Jain, Member.—Briefly stated relevant facts of the case are that the respondent/the complainant/the applicant/Sunil Kumar (hereinafter referred to as “the respondent”) purchased a Bolero car Model S.L.X. M.D.J. T.C. chassis No. 82A15811 engine No. GA84A20396 (hereinafter referred to as ‘the vehicle’) for a sale consideration of Rs.5,83,500 on 31.01.2008. The respondent on 05.02.2008 took a fully covered insurance from the respondents/the non-applicants/the New India Assurance Company Limited/the petitioner (hereinafter referred to as ‘the petitioner’) for the period with effect from 05.02.2008 to 04.02.2009. The petitioner established the declared value of the vehicle to the tune of Rs.5,69,525 and paid the premium amount of Rs.17,812. The respondent on 02.05.2008 had gone to Bhiwadi, District Alwar for personal work from where said vehicle was got stolen. The respondent immediately lodged FIR in the Police Station Bhiwadi. The police after investigation submitted the untraced report on 26.07.2008 before the concerned Court. The respondent submitted the claim along with annexed requisite documents with the petitioner. The petitioner registered the claim bearing No. 31/08/01/90000041 under policy No. 31/07/01/00003790 and issued a registered notice dated 03.12.2008 to the respondent and asked to fulfill certain formalities. The respondent had complied with notice dated 03.12.2008 but the petitioner did not pay the claim amount. The respondent thereafter sent a legal notice dated 01.07.2009 to the petitioner. The petitioner sent a notice dated 16.07.2009 to the respondent whereby the petitioner rejected claim of the respondent. The respondent being aggrieved filed the consumer complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as “the Act”) titled as Sunil Kumar v. The Regional Manager, The New India Assurance Company Limited and Others against the petitioner before the District Consumer Dispute Redressal Forum, Jaipur (hereinafter referred to as “the District Forum”). The respondent prayed that the petitioner be directed to pay entire insured amount of Rs.5,69,525 along with interest at the rate 9% per annum besides Rs.1,00,000 towards mental agony and harassment and Rs.11,000 towards cost of the complaint.

2. The petitioner filed reply to contest claim of the respondent. The petitioner in preliminary objections stated that the vehicle was insured with the petitioner for the period with effect from 05.02.2008 to 04.02.2009 under the terms and conditions of the insurance policy and provisions of Motor Vehicle Act, 1988 including registration certificate. The respondent gave information on 21.07.2008 about alleged theft of vehicle to the petitioner i.e. after two and half months. The petitioner vide letter dated 22.07.2008 asked explanation from the respondent regarding delay in giving information of the alleged theft to the petitioner. The petitioner also appointed Tarun Kumar, an independent and competent Investigator to investigate the actual facts in respect of alleged theft of vehicle. The Investigator submitted detailed inquiry report dated 03.01.2009. The petitioner asked the respondent to submit requisite documents vide letters dated 22.07.2008, 12.08.2008, 03.12.2008, 05.01.2009 and 15.01.2009 but the respondent did not furnish the requisite documents. Accordingly the petitioner vide letter dated 03.02.2009 rejected claim of the respondent under category of “No Claim”. The petitioner did not commit any deficiency in service. The petitioner in reply, on merits, denied allegations of the respondent as mentioned in the complaint.

3. The respondent submitted affidavit and documents which are Annexures 1 to 8. The petitioner submitted affidavits of Rajender Kumar Bansal, Rakesh Kumar and Tarun Kumar and documents which are Annexures RI to R8.

4. The District Forum in order dated 04.08.2015 considered the issue whether the petitioner by not accepting claim of the respond