Rajnish Kumar v. Insurance Ombudsman Chandigarh and Anr

IN

Rajnish Kumar

Insurance Ombu and another

BEFORE: HO Present: Mr

Mr

Mr *** VINOD S. BHA

1.

Cha (Annexure P-6) submitted by the

2.

Lea purchased a use

07.11.2017. Sin got it renewed fr Limited valid fr the vehicle was Surbhi Khatri. T incident, the pet Delhi on 29.12. On the next day am, he found th THE HIGH COURT OF PUNJA AT CHANDIGARH

CWP-118

Date of D

Versus udsman Chandigarh

ON'BLE MR. JUSTICE VINO . Suresh Kumar Sharma, Advoca . Dharamvir Sharma, Advocate f . Vishal Aggarwal, Advocate fo *

ARDWAJ, J. (ORAL) allenge in the present petition passed by the Insurance Ombu e petitioner was dismissed on co arned counsel for the petitioner ed Skoda Rapid Car bearing regi nce the Insurance Policy of the s from respondent No.2-Bajaj Allia rom 23.01.2018 to 22.01.2019. transferred in favour of the peti The vehicle was being used by t titioner had gone to his sister's 2018 and had parked his car ne y i.e. 30.12.2018, when the pet hat the car was missing. He m AB AND HARYANA 807-2021

Decision : 10.09.2024

…Petitioner

….Respondents OD S. BHARDWAJ ate for for the petitioner. or respondent No.2. n is to order dated17.07.2020 udsman whereby the application onjectures and surmises.

contends that the petitioner had istration No.UK-06AH-5199 on said car was about to expire, he anz General Insurance Company The Registration Certificate of itioner from the erstwhile owner the petitioner. On the day of the house at Indra Colony Narela, ear her house at about 9.00 pm. itioner came out at around 7.00 made enquiries from the nearby n d n e y f r e , . y

locals, and on n about it. A Ge registered at Po into FIR No.23 Narela. Since t report was subm the Court of M North District, submitted the Authority, Udha the computer fil seeking the tran lodged by the p documents as d however, the re petitioner with thereof, a com Ombudsman wh Insurance Ombu "21 & C On by par insu com pre with 21 2 not finding the same he submi eneral Diary No.011A dated olice Station Narela (Rohini) w 3 dated 01.01.2019 under Sect the whereabouts of the vehicle c mitted by the Investigating Agen Ms. Jasjeet Kaur, Additional Chi Rohini Courts, Delhi on 07.02 information regarding theft o am Singh Nagar (Uttrakhand), le of his car be closed so that n nsfer of registration certificate o petitioner with the responden demanded by the Company we spondent-Insurance Company re an observation that the same mplaint was filed by the pe hich was also declined. The oper udsman dated 17.07.2020 reads t 1) Result of Personal hearing w Conclusion) perusal of all documents in the the insurance company and s rties during whatsapp video urance company vide dated mpliance of certain document evious insurance policy, vehicle h duly stamped from dealer, P

tted a complaint to the police

30.12.2018 was immediately which was eventually converted tion 379 IPC at Police Station could not be traced, an untraced ncy which was also accepted by ief Metropolitan Magistrate-01,

2.2019. The petitioner had also of his car to the Registering on 27.02.2019 and prayed that no one could take advantage of of the vehicle. A claim was also nt-Insurance Company. All the ere submitted by the petitioner, epudiated the claim filed by the e were not tenable. Aggrieved etitioner before the Insurance rative part of order passed by the thus: with both parties (Observations e complaint file, SCN submitted submissions made by the both conferencing, it is seen that d 01-08-2019 has asked for ts. These documents included e purchase bill from the dealer PUC certificate of the vehicle, e y d n d y , o g t f o e , e d e e s d h t r d r

pro unt reg don thro give ord thef Utt reg the the disc hin Adm has the is s sup valu onl 12-and sale stat pur He sale whi thro it is onl scap own 21 3 oper existence proof of vehicle traced report and address pr gistration. Complainant stated ne but still insurance company is ough compliance requirements, en untraced report from North der dated 07-12-2019. Hence, th ft of the vehicle under the insu tarakhand is asked by insura gistration of vehicle is from ART certificate of registration it is se name of complainant on 03-closed this fact to this forum o ts about misrepresentation of missibility of the claim depends u s rightly investigated the case or part of complainant. On going seen that insurance company ma ppressed previous policy detail ue of vehicle at the time of tak line portal. It is observed that t -2018. Company pointed that t d concealed many material facts e deed of vehicle and key of the tement of complainant during w rchased the policy online throug has purchased vehicle on cash e deed document with him. He ich he had with him to the i ough the documents and submis s seen that there is no dispute w line through company portal. apegoat of higher IDV at the tim n online mechanism is at fau

before incident, court accepted roof of Uttarakhand place of that this compliance has been s not giving his claim. On going it is seen that complainant has h District, Rohini Court, Delhi, here is no dispute with regard to urance policy. Address proof of ance company since place of TO Udham Singh Nagar. From een that vehicle is transferred in -11-2017 Complainant has not or in his complaint which also f facts. But at the same time upon as to whether the company r there is a misrepresentation on through documents in the file, it ain plea is that complainant had ls along with actual purchase king the policy from us through theft of vehicle occurred on 30-the insured has misrepresented s with regard to IDV of vehicle, e vehicle. On other hand, as per whatsapp video conferencing, he gh portal of insurance company. h payment and doesn't have any e had given the key of vehicle insurance company. On going ssions made by both the parties, with regard to purchase of policy Complainant can't be made me of claim payment when their ult. Further, after purchase of d f n g s

o f f m n t o e y n t d e h - d

r e

y e g

y e r f

insu disc ther dec cla can afte the con Self on enh com ver in pur give wha pur tho evid com pur abs mis veh with Mrs Sur Tat Aut ther Kar 21 4 urance policy, insurance comp crepancy to complainant. Insu re is misrepresentation of fa clared Value on the part of com im amount from the insurance nnot take the shelter with regard er due acceptance of proposal ir office at the time of claim. ntribute in respect of IDV. f video-inspection report is carr 21-01-2018 at 12.23 pm. It hancement/appreciation of veh mment with regard to extra fitti rsion/ modification by complaina the vehicle. Further, there is rchase price of the vehicle by en any details with regard t atsapp video conferencing, com rchased the vehicle for Rs 8 usand rupees) in cash. He was dence which could justify h mplainant failed to produce rchase deed, proper cash rec sence of these indispensible doc srepresentation of facts before in hicle previously met with an acci h Tata AIG insurance company s Surbhi Khatri. Insurance per 16 to 09-11-2017. The Tata AI rbhi Khatri and the vehicle wa ta AIG. Thereafter, the damage tomall to Randhawa Motors reafter Randhawa motors had s rnal in 2,65,000/- and from Vija

pany should have brought this urance Company pointed that acts with regards to Insured mplainants in order to grab the company. Insurance Company d to age of vehicle and IDV too and underwriting the policy by But certain other factors also ried out by complainant himself t is evident that there is no hicle in anyway. There is no ing for accessories or improved ant which have been carried out also a dispute with regard to complainant since he has not to previous insurance. During mplainant accepted that he has 8,80,000/- (Eight Lacs Eighty told to show some documentary his purchase of vehicle. But any document like sale and ceipt for his vehicle. As such cuments clearly hints about the nsurance company. The alleged ident when the same was insured and the owner of the same was riod with Tata AIG was 10-11-IG had settled the claim of the as sold to Shriram Automall by ed vehicle was sold by Shriram with RC for 2,40,000/- and sold the vehicle to Vijay Motors ay Motors the complainant had s t d e y o y o f o o d t o t g s y y t d h e d d s - e y m d s d

bou Fur bea com was doc the stat the ben fina also insu com reg veh veh insu the is h Tak sub wha dism

Hen

3.

Agg the present petit

4.

Wr affidavit of Sau 21 5 ught the alleged stolen vehicle rther, it is seen from certific aring no.UK-06-AH-5199 is mplainant on 03-11-2017 and th s Mrs Surbhi Khatri. But comp cument to show as to when he ha principle of indemnity is a defi tes that an insurance policy sha policyholder that exceeds their nefit to an amount that restores ancial state they were in prior t o be made to take advantage o urance company from public f mplainant has miserably failed gard to purchase of his vehicle, hicle and also non-disclosure of hicle in his name to forum als urance company is in order and ir decision. Keeping in view the hereby dismissed and no relief is AWARD king into account the facts & cir bmissions made by both the atsapp video conferencing, th missed on merits. nce, the complaint is treated as c grieved against the award passed ion has been preferred. ritten statement on behalf of urav Khullar, Senior Executive

e bearing no. UK-06-AH-5199. cate of registration of vehicle transferred in the name of he earlier owner of the vehicle plainant has not produced any ad purchased the vehicle. Since, ining aspect of insurance, and it all not provide compensation to r economic loss. This limits the s the policyholder to the same to the loss. Complainant cannot or make profit for misdeeds of fund pool. In the instant case, to produce any document with , any enhancement done in the f facts with regard to transfer of so. Hence, the decision of the d no interference is required in e above facts, the said complaint granted. rcumstances of the case and the parties during the course of he said complaint is hereby closed." d by the Insurance Ombudsman, f respondent No.2, by way of e Legal, Bajaj Allianz General

e f e y

t o e e t f

h e f e n t e f y , f l

Insurance Comp respondent-Insu submitted that t Company had

06.04.2019, 02. the previous in stamped, PUC c of the said docu no deficiency o claim applicatio in lodging of t Company and th It has also been policy, was Rs. Insurance Comp with an accident Khatri to Shri R vehicle was the Rs.2,40,000/- an vehicle in questi the original sale conveyed. The TATA AIG sho Randhawa Moto petitioner played the abovesaid fa 21 6 pany Limited has been filed, w urance Ombudsman was stated t there is a material concealment repeatedly sought documents

05.2019, 10.05.2019, 25.06.201 nsurance policy, vehicle purch certificate amongst others. It ha uments demanded had not been fu on the part of the Insurance Co on. It has been further averred th the FIR which aggravated the hus, the Insurance Company was n averred that earlier IDV of th .7,30,000/- wherein the vehicle pany. The said vehicle, which w t and being a total loss vehicle Ram Auto Mall by way of settlem ereafter sold to Randhawa Moto nd subsequently, to Vijay Motor ion was purchased by the petitio e price, for which the vehicle copy of the earlier Insurance owing sale of vehicle @ Rs.2,25 ors had also been led in eviden d a fraud by declaring the IDV acts. It was further submitted th

wherein the order passed by the to be correct and it was further of facts and that the Insurance vide letters dated 03.01.2019, 19 and 01.08.2019 pertaining to hase bill from the dealer duly as been further averred that most furnished and as such, there was ompany in not entertaining the hat there was delay of two days e loss caused to the Insurance s not liable to honour the claim. he vehicle, as per the previous was insured with TATA AIG was make of the year 2015, met e was sold by its owner Surbhi ment with TATA AIG. The said ors by Shri Ram Auto Mall for rs Karnal for Rs.2,65,000/-. The oner from Vijay Motors and that was purchased, had not been e Policy, communication from 5,000/- and certificate issued by nce. It was also averred that the @ Rs.8,61,884/- by concealing hat second original key had not e r e , o y t s e s e . s G t i d r e t n m y e g t

been submitted second key sub Company is not exonerated by th

5.

Lea that the petition the respondent-concealment/ m owner prior to t and the ownersh registered own Rs.8,61,884/- a Insurance Policy information was the risk. The res of the vehicle, a the premium. H Insurance Ombu were irrelevant loss of the vehi matter to the po the petitioner on coming to know police converted not a case of d part of the polic 21 7 by the petitioner with the Insu bmitted was a duplicate key. t liable to pay the claim and tha he Insurance Ombudsman. arned counsel appearing on beh er had disclosed all material inf -Company during issuance o misrepresentation on the part of the date when the car was sold i hip was transferred in his name in ner. The respondent accepted and never made it mandatory y and status of the vehicle prior s not material and crucial for a d spondents cannot now be permitt at the time of settling the insuran He further argues that the conclu udsman were conjectural and and immaterial for entertaining cle. It is also argued that ther lice. As a matter of fact, the inc n 30.12.2018 itself i.e. on the sam w about theft and the General d the said General Diary into an delay by the petitioner in appro e in registration of the FIR cann

urance Company and that the Consequently, the Insurance at the Company has been rightly half of the petitioner has argued formation that was asked for by of the policy. There was no f the petitioner. The registered in his favour was Surbhi Khatri n November, 2017 from the said d premium on the IDV of to give details of the earlier r to its purchase. Thus, the said decision relating to underwriting ted to dispute the declared value nce claim, after having accepted usions drawn by the respondent-based upon circumstances that g the claim of the petitioner for re was no delay in reporting the cident of theft was reported by me very day and immediately on Diary was also recorded. The FIR on 01.01.2019. Thus, it is oaching the police. Delay on the not be read as a reason to deny e e y d y o d i d f r d g e d - t r e y n e s e y

the claim to the has already been any nature what disputed. It w Investigator of t may have consp any such eviden declined.

6.

Lea that the discrepa caused to the pe for Rs.2,40,000/ petitioner was c sale consideratio entire considera He contends tha value, at which petitioner to fu reiterated that t which is unnatu Insurance Ombu car having been the car at the tim order passed by

7.

I ha the relevant mat 21 8 e petitioner. It was further subm n filed and there is no suspicion tsoever. Hence, the loss of the v was also not the case of the the Insurance Company at any p pired for a clandestine removal o nce, the conclusion becomes c arned counsel for the responde ancies noticed were crucial for etitioner. He contends that the ve /-, could not have the IDV of the called upon to submit the eviden on, however, the specific stand ation money had been paid in ca at to assess the loss, if any, it i the vehicle had been purchase urnish those documents, the cla the petitioner has also not subm ural, and the said lapse cannot be udsman has drawn the probabili n left in the dashboard of the car me of incident. Thus, there is n y the Insurance Ombudsman. ave heard learned counsel for the terial available on record.

mitted that a cancellation report n or attribution of a foul play of vehicle by way of theft cannot be e Investigating Agency or the point of time that the petitioner of the vehicle. In the absence of conjectural and is liable to be ent, on the other hand, submits r ascertaining the theft and loss ehicle, initially having been sold e vehicle as Rs.8,61,884/-. The nce/proof of the payment of the d of the petitioner was that the ash, which is highly improbable. is necessary to know the actual d, and that due to failure of the aim was rightly declined. It is mitted both the duplicate keys, e ignored outrightly and that the ity of second original key of the which facilitated the removal of no illegality or perversity in the e parties and have gone through t f e e r f e s s d e e e . l e s , e e f e h

8.

Inso Policy as well a second hand ve counsel for the information was Policy. If an in the same cann processing the c commercially pr vehicle, when t prominence whe

9.

Fur may even other The sufficiency valid and enfor when its value w the vehicle was person to get t Hence, there can may not be the Hence, irrespect purchased, the I the declared valu in law that a pr and affection an entering into an 21 9 ofar as the aspect of the non di as the non-submission of the rec ehicle was purchased is concer Insurance Company that the de s not a mandatory pre-requisite nformation was immaterial at th not be pressed as an essentia claim lodged by the insured. Onc rudent not to verify the value o the Policy is being issued, the sa en the claim is to be paid. rther, the production of a receip rwise be irrelevant for determin of sale consideration is not the ceable contract. Besides, the v was settled and hence, had more repaired and made roadworthy the damaged vehicle repaired f n be numerous possibilities due indicator of the correct value of tive of the consideration of val Insurance Policy was not issued ue as accepted by the responde roperty may be sold for differen nd sufficiency of consideration enfroceable contract.

sclosure of the earlier Insurance ceipt of payment for which the rned, it is not disputed by the eclaration/furnishing of such an e for issuance of an Insurance he time of issuance of a Policy, l information, at the time of ce the insurance company feels it or insurance track record of the aid aspect cannot be given undue pt of the subsequent sale price ning the value of the property. e pre-requisite of entering into a vehicle was a total loss vehicle e of a scrap value. Undisputedly, . It may not be necessary for a from the authorized workshop. to which the sale consideration f the vehicle, in the instant case. lue of vehicle for which it was d on the purchase value but for ents. It is well accepted position nt considerations/or out of love may not be a pre-requisite for e e e n e , f t e e e . a e , a . n . s r n e r

10.

Fur respondent-Insu respect to the p box which is the the second origi drawn only on conduct of a re established, step getting it repair original key has not in the glove the effect that a conclusions draw generally approv Insurance Polici was insured and case within th repudiated/decli

11.

I f based upon rem probable on test of claim was to cogent evidence Insurance Omb the petitioner i registered on the 21 10 rthermore, it is also well estab urance Ombudsman has drawn probability of second original ke e case set up by no one. No per inal key in the glove box. A pre an ordinary conduct of a reaso easonable person is not to be pping into the shoes of the person ed for his use, it would rather b s been kept in such safety wher box of the car. The law in this suspicion cannot partake the re wn on distant probabilities to re ved by the Court for dishonouri ies are meant for safeguarding d for declining the liability, an In he fold where the claim f ined. find that the entire claim of the r mote conjectural conclusions t of ordinary prudence. Since th o be discharged by the respond e has been led by them, I find tha budsman are erroneous. There h in reporting the matter to the p e day of the incident itself and t

blished from the record that the a conjectural conclusion with ey having been left in the glove rson of ordinary prudence keeps esumption of fact, if any, can be onable person. An exceptional accepted unless such claim is n buying a total loss vehicle and be a situation where the second re it becomes non-traceable and regard is further well settled to equirement of proof. Conjectural epudiate the claim would not be ing the claim of an insured. The the interest of the person who surance Company must bring its for insurance can be validly respondent and its defences are and hypothesis which is not he burden to justify repudiation ent-Insurance Company and no at the conclusions drawn by the has been no delay on the part of police and a General Diary was the same was converted into an e h e s e l s d d d o l e e o s y e t n o e f s n

FIR. An untrac Investigating Ag The respondent respect to cland petitioner being

12.

Eve Insurance Comp an order passed is being decided which for about case, notwithsta in larger interest

13.

The

17.07.2020 pass Insurance Comp in relation to In and within a per this order along present writ peti

September 10, 2 ps

21 11 ce report was submitted by the gency suspect the petitioner of h -Insurance Company also did n destine removal of the vehicle in collusion. en though ordinarily a perso pany) has the liberty to approac by the respondent-Insurance Om d since the same has already rem t 4 years before this Court. He anding existence of an alternati t of substantial justice. e present writ petition is acco sed by the Insurance Ombudsma pany is directed to release the d nsurance Policy No.OG-18-990 riod of two months from the dat gwith interest @ 6% per annum ition till its release.

(V 2024

police and at no point did the having indulged in any foul play. not express any suspicion with e at the instance or /with the on aggrieved (other than the ch the Consumer Courts against mbudsman, however, this matter mained pending for 7 years out of ence, the merits of the present ve remedy, have been gone into ordingly allowed. Order dated an is set aside. The respondent-dues admissible to the petitioner, 06-1801-00110422, as per law te of receipt of certified copy of m from the date of filing of the VINOD S. BHARDWAJ) JUDGE : : e . h e e t r f t o d - , w f e