National Insurance Co. Ltd vs Regional Office

IA 16474 of 2019 seeking condonation of delay in filing of Appeal is allowed and the delay is condoned.

The present Appeal, under Section 19 of the Consumer Protection Act, 1986 (for short "the Act") is filed against the order dated 25.06.2019 of the State Consumer Disputes Redressal Commission, UT Chandigarh (for short "the State Commission") in Complaint No.347 of 2018.

The brief facts of the case are that the Respondent (hereinafter called as "the Complainant") purchased a Prosche 911 Carrera S car on 26.07.2013 which was insured with the Appellant vide policy issued on 26.07.2017 for a total consideration of 1,13,000/-. The vehicle was insured on the relevant date, i.e., on 04.02.2018 when it met with an accident. Intimation of the accident was sent to the Petitioner on 09.02.2018. Since no one had received injuries, no FIR was registered and only a declaration was given to the effect. The vehicle was inspected by the Opposite Party No.3, namely, Zenica Performance Car Pvt. Ltd. (arrayed so in Complaint) and submitted the quotation of repairs on 10.02.2018 for a total sum of 32,84,212/-. As the engine of the vehicle suffered damage and needed replacement, a surveyor was appointed on 15.02.2018 who submitted his report on 13.03.2018. However, a repudiation letter was issued on 10.08.2018. Aggrieved by the act of the Appellant, the Complainant filed the Complaint before the State Commission.

The Appellant in their Written Statement did not dispute the fact that on the date of accident, there was a valid insurance policy. Their contention was that there was a delay of 5 days in giving intimation of the accident and that there was violation of condition no.1 of the policy as the vehicle was not taken to the workshop within 72 hours of the incident but was taken on 10.02.2018. It was also contended that the Add-on to Private Car Package Policy also required that the intimation of the accident be sent to the Appellant within 24 hours. It was also contended that since the vehicle was imported and engine had to be brought from foreign country, the engine protection Add-on to Private Car Package Policy is not applicable to imported vehicle. On these counts, the claim was repudiated.

Zenica Performance Car Pvt. Ltd. did not appear before the State Commission and were proceeded ex parte. Opposite Party No.4 (as arrayed in Compliant) although filed its Written Statement, had submitted that the dispute was between the Complainant and the Insurance Company and therefore, no liability can be raised against them.

The Complainant filed the rejoinder to the Written Statement of the Appellant which stated that he had never been supplied with the terms and conditions of the policy by the Insurance Company.

The parties led their evidence before the State Commission. After hearing the arguments of the parties and perusing the evidence on record, the State Commission reached to the conclusion that the vehicle had met with an accident on 04.02.2018 and at that time there was a valid insurance policy covering damages to the vehicle. The State Commission has also relied on a document Annexure C-8 which is a copy of the Accidental Service Quote and reached to the conclusion that the vehicle was inspected by Zenica Performance Car Pvt. Ltd. and submitted a quotation on 10.02.2018 showing that the vehicle had suffered a damage worth of 32,84,212/-. The State Commission also perused the copy of the policy along with the terms and conditions of Add-on to Private Car Package Policy filed by the Appellant and also perused the surveyor report who had assessed the claim of the Complainant to the tune of 27,86,026/-.

The State Commission also had dealt with the contentions and argument of the Appellant regarding delay in intimating the fact of accident which was made on

09.02.2018 and whether this reason was sufficient to deny the claim of the Complainant. It has also dealt with the contention of the Insurance Company that as per the clause 3.6 of the Add-on to Private Car Package Policy, the vehicle was to be taken to the workshop within 72 hours of the accident.

On the basis of the evidences, the State Commission concluded that the terms and conditions of the policy were never supplied to the Complainant and that no evidence has been led by the Insurance Company to prove that the Complainant had received the terms and conditions along with the policy or subsequently. It has also relied on IRDA circular and the findings of Hon'ble Supreme Court in the case of "R. Amudha vs. The Manaer, UTI Bank, Madurai And Others, 2013 SCC Online Mad 1517" wherein the Hon'ble Supreme Court has held that "where the claim is found to be genuine, merely delay in intimation cannot be a ground to reject the claim " and held that the delay was not fatal in this case. It then held that in view of this, the rejection of the claim of the Complainant on this ground was unjustified. As regards the ground of repudiation of the claim on the ground that the subject vehicle is an imported vehicle and engine protection Add-on to Private Car Package Policy is not applicable for imported vehicles, the State Commission concluded that this reason for repudiation was meritless.

This order is impugned before us. Similar contentions have been raised before us. However, during the course of arguments, learned Counsel for the Insurance Company on instructions concedes that Add-on to Private Car Package Policy would also be applicable for the imported vehicles.

It is argued by learned Counsel that the delay in this case is not mere delay which has occurred as violation of clause 1 of the policy but that Add-on to Private Car Package Policy also states that the intimation had to be sent within 24 hours and therefore, this case has to be treated differently and also there is a violation of clause 3.6 of the engine protection Add-on to Private Car Package Policy.

We have given thoughtful consideration to the arguments of learned Counsel. On enquiry by the Commission, learned Counsel has failed to bring to our notice any evidence on record which can show that the copy of the terms and conditions of Insurance Policy and Add-on to Private Car Package Policy, had been supplied to the Complainant. Learned Counsel has argued that the Complainant which is a big company ought to have been aware of such terms and conditions. We do not agree with this argument of learned Counsel. It is the duty of the Insurance Company to supply all the terms and conditions of an insurance policy to the policy holder. There cannot be any presumption under law on the terms and conditions. As regards the delay in intimating the Insurance Company is concerned, the Hon'ble Supreme Court in R. Amudha's case (supra) on which the State Commission has also relied, has clearly held that "where the claim is genuine the delay in intimation cannot be a sole ground for rejection of the case." There is no plea that the accident had not occurred or that the car did not suffer damages in the accident dated 04.02.2018.

We found no merit in the Appeal. The impugned order is based on evidences before the State Commission. The present Appeal has no merit. It is dismissed along with all the pending applications in limine .