National Insurance Co. Ld vs Rajesh Kumar

V.K. Jain, J

The complainant owned a vehicle which he had got registered with the petitioner company for the period from 02.07.2012 to 01.07.2013. The said vehicle met with an accident on 25.03.2013 when a cow suddenly came in front of the vehicle. The accident resulted in injuries to a person namely Sajjan Singh who later expired. A report was lodged with the concerned Police Station on the same day but intimation in writing to the insurer came to be given only on 28.03.2013, as is evident from the written version available on record. Since the vehicle was unattended after the injured had been taken to the hospital, it got burnt due to short-circuiting. It was noticed on 28.03.2013 and another report was lodged with the concerned Police Station.

The claim not having been paid, the complainant approached the District Forum by way of a Consumer Complaint.

The complaint was resisted by the petitioner primarily on the ground that there was delay of three days in intimating the accident and the vehicle was left unattended for three days. The investigator appointed by the insurer opined that the accident was the handy work of the complainant itself.

The District Forum having allowed the Consumer Complaint and having directed payment of Rs.3,76,713/- to the complainant alongwith 9% interest, the petitioner approached the concerned State Commission by way of an appeal. Since the complainant also was itself dis-satisfied with the order passed by the District Forum, he also approached the State Commission by way of an appeal. Vide impugned order dated 16.10.2018, the State Commission dismissed the appeal filed by the insurer while allowing the appeal filed by the complainant and directed the insurance company to pay the IDV of the vehicle alongwith 9% interest. Being aggrieved from the order passed by the State Commission, the insurer is before this Commission by way of this Revision Petition.

As far as the delay in intimating the loss to the insurer is concerned, there is an adequate explanation given by the complainant for the said delay. A person had got seriously injured in the accident and had to be hospitalized. Later on, he succumbed to the injuries sustained in the accident. The primary contention at that time would be attending the injured in the hospital instead of rushing to the insurer to intimate the accident. The genuineness of the accident stands established from the report lodged with the concerned Police Station on 25.03.2013 itself. In Om Prakash Vs. Reliance General Insurance & Anr. (2017) 9 SCC 724, Hon'ble Supreme Court inter-alia observed and held as under:

It is true that the owner has to intimate the insurer immediately after the theft of the vehicle. However, this condition should not bar settlement of genuine claims particularly when the delay in intimation or submission of documents is due to unavoidable circumstances. The decision of the insurer to reject the claim has to be based on valid grounds. Rejection of the claims on purely technical grounds in a mechanical manner will result in loss of confidence of policy-holders in the insurance industry. If the reason for delay in making a claim is satisfactorily explained, such a claim cannot be rejected on the ground of delay. It is also necessary to state here that it would not be fair and reasonable to reject genuine claims which had already been verified and found to be correct by the Investigator. The condition regarding the delay shall not be a shelter to repudiate the insurance claims which have been otherwise proved to be genuine. It needs no emphasis that the Consumer Protection Act aims at providing better protection of the interest of consumers. It is a beneficial legislation that deserves liberal construction. This laudable object should not be forgotten while considering the claims made under the Act.

Therefore, in my opinion, in the facts and circumstances of the case, mere delay of three days in intimating the loss to the complainant would not be fatal to the claim of the complainant.

Condition no. 4 of the insurance policy reads as under:

The insured shall take all reasonable steps to safeguard the vehicle from loss or damage and to maintain it in efficient condition and the company shall have at all times free and full access to examine the vehicle or any part thereof or any driver or employee of the insured. In the event of any accident or breakdown, the vehicle shall not be left unattended without proper precautions being taken to prevent further damage or loss and if the vehicle be driven before the necessary repairs are effected any extension of the damage or any further damage to the vehicle shall be entirely at the insured's own risk.

It is thus, evident that after the accident, the vehicle should not have been left unattended. The purpose of the above referred condition is to ensure that the vehicle, while left unattended, is not stolen or does not meet with an accident in the meanwhile. Therefore, the above referred term of the insurance policy is mandatory. Had the vehicle not been left unattended, there would have been no short-circuiting and further damage to the vehicle would not have taken place. Therefore, the damage which happened after 25.03.2013, when the vehicle was left unattended, in my view is not payable by the insurer.

On a perusal of the report of the surveyor, I find that on repair basis, he assessed the loss to the complainant at Rs.53,543.97/-. In my view, the aforesaid amount should be paid to the complainant for re-imbursement of the damage to the vehicle on 25.03.2013.

For the reasons stated hereinabove, the impugned orders are modified and the complaint is disposed of with a direction to the insurer to pay the aforesaid amount of Rs. 53,543/- to the complainant alongwith interest @ 9% per annum w.e.f. six months from the date of the lodgment of the claim till the date of payment.

The spare paper-book, if available, be supplied to the learned counsel for the respondent.