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Smart Summary

Summary of Opinion — National Consumer Disputes Redressal Commission

Factual and Procedural Background

(Based exclusively on the provided opinion)

The respondents (complainants) are farmers who insured a tractor (No. HR-51-A/4760) with the petitioner, United India Insurance Company Limited, for the period 09.08.2008 to 08.08.2009 under policy/cover note no. 687209. The tractor was stolen on 12.06.2009 from the grain market, Hathin. The complainants state that they lodged a complaint with the local police on 13.06.2009 but the police did not register an FIR; an FIR (No. 353 under Section 380 IPC) was recorded only on 25.10.2009 on the direction of the Superintendent of Police. The insurance company was informed on 02.12.2009, and an untraced report was prepared by the police.

The insurer repudiated the claim by letter dated 16.06.2010, citing delay in lodging the FIR and delay in intimation to the insurer. The complainants served a legal notice on 23.11.2010 and filed a consumer complaint in the District Forum, Palwal seeking Rs.4,02,000 (price of tractor) with interest @18% p.a., Rs.50,000 as compensation and Rs.11,000 as litigation expenses.

The District Forum allowed the complaint and directed the insurer to pay Rs.4,02,000 with interest @9% p.a. from the date of filing the complaint, pay Rs.10,000 as compensation for mental agony and Rs.5,500 as litigation expenses. The insurer appealed to the State Commission, Haryana, which by order dated 09.10.2014 dismissed the appeal. The insurer filed the present revision petition before the NCDRC challenging the State Commission's order.

Legal Issues Presented

  1. Whether the insurer validly repudiated the claim on grounds of delayed intimation to the police and delayed intimation to the insurance company (i.e., violation of Policy Condition No.1).
  2. Whether the failure to submit the claim within the time specified by the policy (Condition No.5 — claim to be submitted within 14 days) disentitles the complainants to full relief.
  3. Whether delay in intimation can be condoned in the light of IRDA guidelines (circular dated 20.09.2011) and relevant Supreme Court authority, and if so, on what basis and to what extent.
  4. Whether, in a theft case, the claim amount should be limited to the Insured Declared Value (IDV) rather than the market/price amount awarded by the fora below.

Arguments of the Parties

Petitioner's (United India Insurance Company) Arguments

  • Both fora below failed to consider violations of intrinsic Policy Conditions No.1 and No.5: immediate intimation to police and insurer (Condition No.1) and submission of claim within 14 days (Condition No.5).
  • The tractor was stolen on 12.06.2009 but FIR was lodged only on 25.10.2009 and the insurer was informed on 02.12.2009 — clear violation of policy conditions that deprived insurer and police of effective investigation.
  • Due to delay, police and insurer could not properly investigate or recover the vehicle, giving culprits time to remove/dismantle the vehicle; the delay raises the possibility of complainants' connivance.
  • Relied on Supreme Court authority (Oriental Insurance Co. Ltd. v. Parvesh Chander Chadha) and a decision of this Commission (New India Assurance Co. Ltd. v. Trilochan Jane) to support rejection/diminution of liability for delayed intimation.
  • State Commission improperly relied on IRDA circular dated 20.09.2011 to excuse delay; petitioner urged dismissal of complaint or at least reduction in liability.

Respondents' (Complainants) Arguments

  • Both the District Forum and State Commission gave concurrent findings in favour of the complainants; scope of revision is limited and factual re-assessment is inappropriate.
  • Contrary to insurer's assertion, a complaint was filed at the concerned police station on 13.06.2009 and the respondents have a copy bearing the station seal — this satisfies the policy requirement to inform police.
  • As the FIR was not recorded initially by police, the complainants pursued higher authorities and FIR was recorded only after orders of the Superintendent of Police on 25.10.2009; the bank was also informed and the bank was to notify the insurer.
  • Relied on the Supreme Court decision in Om Prakash v. Reliance General Insurance & Anr. (Civil Appeal No.15611 of 2017, decided 04.10.2017) and the IRDA circular to argue that delay in informing insurer does not automatically disentitle a genuine claim and that claim deserves to be allowed.

Table of Precedents Cited

Precedent Rule or Principle Cited For Application by the Court
Oriental Insurance Company Ltd. v. Parvesh Chander Chadha, Civil Appeal No.6739 of 2010 (decided 17.08.2010, SC) Policy-holder's duty to inform insurer immediately about theft; delayed intimation deprives insurer of the right to inquire and investigate, potentially justifying denial of claim. The petitioner's counsel relied on this authority to argue repudiation. The Court noted the principle but distinguished on facts (degree of delay) and used the principle in assessing whether insurer was deprived of investigation opportunities.
New India Assurance Co. Ltd. v. Trilochan Jane, 2009 SCC OnLine NCDRC 201 Supports dismissal/diminution of claim where there is delay in informing the insurer (even a delay of 9 days was held fatal in that Commission's decision). Relied upon by petitioner's counsel to support insurer's position; the Court recorded that this decision was cited to show that delay has been treated strictly by tribunals.
Om Prakash v. Reliance General Insurance & Anr., Civil Appeal No.15611 of 2017 (decided 04.10.2017, SC) Illustrates that a claim may be allowed despite late intimation; Supreme Court allowed a claim where intimation was delayed by 8 days and held that delay can be condoned if properly explained. The respondents relied on this judgment to support allowance of the claim despite delay. The Court considered it and distinguished the present case on the basis that the delay here exceeded five months (much longer than eight days) and that the delay was not satisfactorily explained.
Amalendu Sahoo v. Oriental Insurance Co. Ltd., II (2010) CPJ 9 (SC) Where policy conditions are violated under a motor insurance, a tribunal may still consider allowing a portion of the claim (not necessarily full), and authorities have indicated the possibility of partial allowance (the decision referenced a figure of up to 75%). The Court relied on this authority and the IRDA circular to justify a middle-course approach: although some policy conditions were violated, allowance of part of the claim was appropriate. The Court applied the principle to permit 50% of the IDV in this case.

Court's Reasoning and Analysis

The Court examined the chronological facts and the relevant policy conditions strictly as stated in the record. The key dates considered by the Court were: theft on 12.06.2009; an alleged complaint to police on 13.06.2009 (as per complainants); FIR recorded on 25.10.2009; insurer informed on 02.12.2009.

The Court analysed policy Condition No.1 (requirement to inform police and insurer immediately in case of theft) and Condition No.5 (requirement to submit claim within 14 days). The Court found that even if a complaint was presented to the local police on 13.06.2009, the insurer was not informed in time (notification only on 02.12.2009) and the FIR was recorded only on 25.10.2009. On these facts the Court concluded that both conditions were violated: (a) insurer was deprived of the opportunity to investigate promptly; and (b) the claim was not submitted within the 14-day period.

The Court considered the petitioner's contention that the delay prevented proper police and insurer investigation and raised doubts about the genuineness of the theft (including possible connivance). The Court also considered the respondents' contention that prompt steps had been taken to inform police (complaint on 13.06.2009) and that the bank/other intermediaries were involved.

The Court reviewed the authorities cited by both sides. It observed that Om Prakash (where intimation was delayed by 8 days and the Supreme Court allowed claim) was distinguishable because the present delay exceeded five months and the delay had not been properly explained. The Court acknowledged the IRDA circular (20.09.2011) directing insurers to consider delayed claims on merits and the Amalendu Sahoo principle permitting partial allowance where conditions are breached.

Balancing these factors, the Court found some evidence supporting genuineness (a complaint allegedly lodged at the local police station on 13.06.2009 and the police 'untraced report'), but also noted the material breaches of the policy which prevented effective early investigation by the insurer and police. Relying on Amalendu Sahoo and IRDA guidance, the Court adopted a compromise: allowing part of the claim rather than full indemnity, while also correcting a separate error by the fora below regarding the correct monetary basis of award (IDV versus price of tractor).

Holding and Implications

Final Disposition:

PARTLY ALLOWED — The revision petition is partly allowed.

Direct consequences and orders issued by the Court (as stated in the opinion):

  • The Insurance Company is directed to pay Rs.1,71,000 (which is 50% of the IDV of Rs.3,42,000) to the respondents.
  • The sum is to carry interest at the rate of 7% per annum from the date of the order of the District Forum, i.e., from 30.10.2013, until realization.
  • The District Forum's award of Rs.10,000 as compensation for mental agony and harassment is set aside on the ground that the respondents themselves delayed submission of the claim.
  • The District Forum's award of litigation costs of Rs.5,500 is maintained.
  • The orders of the fora below are modified to the extent indicated above (reduction of monetary award to 50% of IDV, withdrawal of mental agony compensation, continuation of litigation costs).

Broader implications: The opinion applies existing Supreme Court authority and IRDA guidance to reach a middle course in cases of delayed intimation where some indicia of genuineness exist but material policy conditions were breached. The Court did not state or create any new legal precedent; the decision modifies relief between the parties in this specific factual matrix.

Prepared from the text of the NCDRC order dated 13 Feb 2019 in Revision Petition No. 2089 of 2015 (United India Insurance Company Limited v. Aji Pal & Ors.). This summary contains only information expressly appearing in the provided opinion.

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    United India Insurance Company Limited Petitioner(S) v. Aji Pal And Others (S).

    NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION

    NEW DELHI

    REVISION PETITION NO. 2089 OF 2015

    (Against the Order dated 09/10/2014 in Appeal No. 931/2013 of the State Commission Haryana)

    1. UNITED INDIA INSURANCE COMPANY LIMITED ...........Petitioner(s) Versus

    1. AJI PAL & 2 ORS. ...........Respondent(s)

    BEFORE:

    HON'BLE MR. PREM NARAIN,PRESIDING MEMBER For the Petitioner : Mr. Amit Kumar Singh , Advocate For the Respondent : Mr. Surender Singh Bastta, Advocate Dated : 13 Feb 2019

    ORDER

    This revision petition has been preferred against the order of the State Consumer Disputes Redressal Commission, Haryana, (in short 'the State Commission') dated 09.10.2014 wherein the State Commission dismissed the appeal preferred by the Petitioner. Hence the petitioner filed the present revision petition before this commission.

    2. Briefly put, facts relevant for the disposal of the petition are that the complainants/respondents are farmers and they got their tractor bearing no. HR-51-A/4760 insured with the Opposite Party insurance company/petitioner for the period from 09.08.2008 to 08.08.2009 against the policy cover note no. 687209. On 12.6.2009, the tractor of the complainant had been stolen by unknown persons from the grain market, Hathin. The complainant lodged a complaint on 13.6.2009 with the police but the police did not register the FIR. FIR No. 353 under Section 380 IPC was recorded on 25.10.2009 on the direction of Superintendent of Police. The insurance company was also informed on 02.12.2009. Untraced report was prepared by the Police. The complainants filed claim with the Insurance Company but the petitioner repudiated their claim vide letter dated 16.06.2010 on the ground of delay in lodging FIR and delay in intimation to the insurance company.

    3. Complainant served a legal notice dated 23.11.2010 to the petitioner company. Complainant further alleged that there was deficiency in service on the part of the OP and complainant had suffered due to that. So complainant filed a consumer complaint in the District Forum, Palwal praying for the direction to the OP/petitioner to pay Rs.4, 02, 000 along with interest @ 18% pa as insured sum of the vehicle; Rs. 50, 000/- as compensation and Rs.11, 000/- as litigation expenses.

    4. District Forum allowed the complaint and directed the Opposite Party to pay Rs.4, 02, 000/- price of tractor with interest @ 9% pa from the date of filing of this complaint till realization of the amount within 30 days from the receipt of this order to the complainant. The OP was also directed to pay Rs.10,000/- as compensation towards mental agony, harassment and for rendering deficiency in services along with Rs.5500/- as litigation expenses.

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    5. Aggrieved by the order of the District Forum opposite party made an appeal before the State commission, Haryana. However, State Commission vide its order dated 9.10.2014 dismissed the appeal.

    6. OP has approached this Commission in revision petition against the above said order of the State Commission.

    7. Heard the learned counsel for both the parties and perused the records.

    8. The learned counsel for the petitioner stated that first of all both the fora below have not considered the violation of intrinsic conditions No.1 & 5 of the policy. On 12thof June 2009 the tractor was stolen and FIR was lodged on 25.10.2009 and the Insurance Company was informed on 2.12.2009. Clearly, the condition No.1 has been violated which envisages that in case of theft the police must be informed immediately and Insurance Company is also to be informed immediately so that the search and investigation may proceed effectively. Due to delay in intimation to the police and to the Insurance Company neither the police nor the Insurance Company could properly investigate the matter for recovery of the vehicle. It gave sufficient time to the culprits to take away the vehicle far off and to dismantle the same for their benefits. In this regard, learned counsel referred to the decision of the Hon'ble Supreme Court in Oriental Insurance Company Ltd. Vs. Parvesh Chander Chadha, Civil Appeal No.6739 of 2010, decided on August 17, 2010 (SC) wherein Hon'ble Supreme Court has held the following:-

    "In terms of the policy issue by the appellant, the respondent was duty bound to inform it about the theft of the vehicle immediately after the incident. On account of delayed intimation, the appellant was deprived of its legitimate right to get an inquiry conducted into the alleged theft of vehicle and make an endeavor to recover the same. Unfortunately, all the consumer foras omitted to consider this grave lapse on the part of the respondent and directed the appellant to settle his claim on non-standard basis. In our view, the appellant cannot be saddled with the liability to pay compensation to the respondent despite the fact that he had not complied with the terms of the policy."

    9. The learned counsel for the petitioner further also relied upon the judgment of this Commission in New India Assurance Company Limited Vs. Trilochan Jane, 2009 SCC OnLine NCDRC 201, wherein this Commission has dismissed the complaint on the basis of delay of only 9 days in informing the Insurance Company.

    10. Further the learned counsel for the petitioner Insurance Company stated that claim is to be submitted within 14 days as per condition No.5 of the Insurance Policy whereas in the present case the intimation was given after 5 months to the Insurance Company. Thus, this condition is also violated. The State Commission has allowed the complaint relying upon a circular dated 20.9.2011 of the IRDA wherein it is mentioned that Insurance Companies may not reject a genuine claim even if filed with delay. The question is whether this is a genuine claim. Had the FIR been lodged immediately the genuinity of the claim would have been established. But in the present case even the FIR has been lodged after 4 months. The complainant is relying on the "untraced report" submitted by the police but the question is that when the FIR was lodged so late there was no other alternative for the police but to submit the said report as no investigation was possible. As neither the police nor the Insurance Company

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    was timely informed the connivance of the complainants in the theft of the said tractor cannot also be ruled out. In these circumstances, the learned counsel requested that the order of the State Commission be set aside and the complaint be dismissed.

    11. On the other hand the learned counsel for the respondents/complainants stated that both the fora below have given concurrent findings and have allowed the complaint and under these circumstances the scope under the revision petition is quite limited as the facts cannot be reassessed by this Commission in the revision petition. It was further stated by the learned counsel for the respondents that it is wrong to say that Police was not immediately informed. In fact a complaint was filed with the concerned police station on 13.6.2009 itself and the copy was received by the respondents which bears the seal of the concerned police station. The requirement under the policy is only to give intimation to the police and this condition has been met by presenting a complaint to the police on the next day of theft. As the FIR was not lodged by the police the respondents had to approach the higher authorities and only after the orders of the Superintendent of Police FIR was lodged by the concerned police station on 25.10.2009. The intimation was also given to the bank and the bank was supposed to inform the Insurance Company. Learned counsel referred to recent judgment of Supreme Court in

    Om Prakash Vs. Reliance General Insurance & Anr., Civil Appeal No.15611 of 2017, decided on 04.10.2017, wherein Hon'ble Supreme Court has allowed the claim even when the Insurance Company was informed quite late. In the light of this judgment and the circular dated 20.9.2011 of IRDA, the revision petition of the petitioner Insurance Company deserves dismissal and order of the State Commission needs to be upheld.

    12. I have given a careful consideration to the arguments advanced by both the parties and have examined the record. The condition No.1 of the Policy clearly stipulates that in case of any damage or loss Insurance Company should be immediately informed and in case of theft police should also be intimated. In the present case the FIR has been lodged on 25.10.2009 and intimation to the Insurance Company has been given on 02.12.2009 whereas the theft of tractor had occurred on 12thJune 2009. Even if the version of the respondents/complainants is taken to be true that a complaint was given to the local Police Station on 13.6.2009 even then the condition is violated as the Insurance Company was not informed in time. It is also to be noted that the judgment of Hon'ble Supreme Court in Om Prakash Vs. Reliance General Insurance & Anr. (supra) relates to a case where the intimation was given to the Insurance Company after a delay of 8 days whereas in the present case there is a delay of more than 5 months. Moreover, Supreme Court has held that the delay can be condoned if it is properly explained. In the present case the delay has not been properly explained. Clearly the Insurance Company could not get the opportunity to investigate the matter and to help police in future investigation. In addition condition No.5 has also been violated as claim has not been submitted to the Insurance Company within 14 days of the incident. Thus, basically two conditions have been violated in the present case. It is true that the IRDA has issued guidelines to all the general Insurance Companies to examine the claims on merits received with delay if the claims seem to be genuine. Though in the present matter the FIR has been lodged on 25.10.2009 but a complaint was given to the local Police Station on 13.6.2009, therefore, to some extent the genuinity of the theft can be assumed because this fact has not been controverted by the Insurance Company and is also supported by the fact of 'untraced report' submitted by the police. Hon'ble Supreme Court in Amalendu Sahoo Vs. Oriental Insurance Co. Ltd., II (2010) CPJ 9 (SC) has held that if some conditions of the policy are

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    violated under a motor insurance, then it can be considered to allow claim up to 75%. As two conditions have been violated in the present case, relying upon the complaint filed with the local police on 13.6.2009 and the IRDA circular dated 20.9.2011as well as guidelines given by the Hon'ble Supreme Court in Amalendu Sahoo Vs. Oriental Insurance Co. Ltd. (supra), I deem it appropriate to allow 50% of the Insurance claim.

    13. It is also seen from the orders of the fora below that they have allowed claim as submitted by the respondents for Rs.4,02,000/- which is the price of the tractor whereas the tractor was insured for Rs.3,42,000/- only. Both the fora below have not considered this aspect that in a case of theft only the IDV can be allowed. Hence, both the fora below have erred in allowing a claim of Rs.4,02,000/- instead of Rs.3,42,000/- which was the IDV of the tractor under the Insurance policy.

    14. Based on the above discussion, the revision petition is partly allowed and the Insurance Company is directed to pay Rs.1,71,000/- (50% of the IDV of Rs.3,42,000/-) along with 7% interest from the date of the order of the District Forum i.e from 30.10.2013. Accordingly, the orders of the fora below stand modified in this regard. As the respondents have themselves delayed the submission of claim they are not entitled to any compensation for mental agony and harassment and the order of the District Forum for award of Rs.10,000/- as compensation is set aside. However, the order in respect of award of cost of litigation of Rs.5,500/- is maintained.

    ......................

    PREM NARAIN

    PRESIDING MEMBER

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    United India Insurance Company Limited Petitioner(S) v. Aji Pal And Others (S).
    (Feb 13, 2019)