2021 Supreme(Online)(NCDRC) 422
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
C. VISWANATH, PRESIDING MEMBER
BEENA ACHARYA – Appellant
Versus
MANAGER, ORIENTAL INSURANCE CO. LTD. – Respondent
Revision Petition No. 1261 of 2016
For the Appellants/Petitioners: Mr. Girija Shankar Singh
For the Respondents: Mr. Kishore Rawat
Insurance claims can be considered despite delays in notification if essential conditions are ultimately fulfilled.
Headnote:(A) Consumer Protection Act, 1986 - Claim processing - Revision petition against order of State Commission denying insurance claim due to delayed FIR and intimation - Delay in informing the police not excused; conditions of policy were breached - Appeals can allow claims even with delay if conditions met. (Paras 2-6)
(B) Policy violations - In cases where policy conditions are grossly violated, claims may be settled at a non-standard basis.
Result: Revision Petition partly allowed; Rs. 41,578/- awarded.
| Table of Content |
|---|
| 1. petitioner challenges order of the state commission. (Para 1) |
| 2. insurance claim rejected due to reported delays. (Para 2) |
| 3. arguments presented about delays and requirements under policy. (Para 4 , 5) |
| 4. key observations on fir delays and claim conditions. (Para 6) |
1. This Revision Petition has been filed by the Petitioner Smt. Beena Acharya challenging the order dated 18.02.2016 passed by Chhattisgarh State Consumer Disputes Redressal Commission, Raipur (in short, “the State Commission”) in FA No. 2015/456.
2. Brief facts of the case are that the vehicle of the Petitioner/Complainant was insured with the Respondent/Opposite Party. During the currency of the Policy, the vehicle was stolen on 03.08.2014. The Police registered an FIR on 15.08.2014. The Insurance Company received intimation on 12.09.2014. The Respondent rejected the claim on the ground that the Police was informed after 12 days and the Insurance Company was intimated after more than 30 days. The Petitioner filed a Consumer Complaint bearing No. CC/15/163 before the District Forum. The Complaint was resisted by the Respondent by filing written statement and stating that the Insurance Company was informed after about 1 month and 9 days from the date of theft and even the FIR was lodged after 12 days. The claim was, therefore, not payable as the Policy conditions were breached. The District Forum, however, allowed the Complaint and directed the Respondent to pay Rs.59,397/- to the Petitioner together with compensation of Rs.50,000/- and cost of litigation of Rs,5,000/-. The order was to be complied within one month, otherwise interest @9% per annum was payable on the insurance amount.
3. Aggrieved by the order of the District Forum, the Respondent preferred an Appeal before the State Commission being FA No.2015/456. The State Commission allowed the Appeal by order dated 18.02.2016 and dismissed the Complaint.
4. Hence, the present Revision Petition. Heard the Learned Counsel for both the Parties and perused the record. The Learned Counsel for the Petitioner stated that the Police was informed about the theft on 03.08.2014 itself. The Police, however, advised that the FIR would be lodged after inquiry. Police then filed the FIR on 15.08.2014. Thus, there was no fault of the Petitioner in giving information to the Police and it was the Police which had registered the FIR late. The Police filed the final report after investigation stating that the culprits could not be apprehended. Learned Counsel argued that the final report submitted by the Police was a sort of confirmation of the theft of the vehicle. In these circumstances, the Respondent was liable to pay the Insurance Claim of the Petitioner. With respect to the delay in intimating the Insurance Company, it was stated that in a recent judgment of the Hon’ble Supreme Court, the Court had not considered the immediate intimation to the Insurance Company as an essential requirement under the Policy in case of theft and even if there was some delay in giving information to the Insurance Company, the claim was to be allowed.
5. The Learned Counsel for the Respondent/Insurance Company stated that there was no averment in the Complaint in respect of giving intimation to the Police about the theft on 03.08.2014 as stated by the Learned Counsel for the Petitioner before this Commission. Clearly this was an afterthought. The fact was that the FIR had been lodged after 12 days on 15.08.2014. He also stated that it is true that Hon’ble Supreme Court in Om Prakash Vs. Reliance General Insurance and another, Civil Appeal No.15611 of 2017 , decided on October 4, 2017 had allowed the Insurance Claim even if there was some delay in giving intimation to the Insurance Company. The delay, however, had to be explained. The Complainant had not explained the delay in the present case. Even in the case of Gurshinder Singh vs Shriram General Insurance Co. Ltd. , and Anr. (Civil Appeal no. 653 of 2020) decided on 24.01.2020,