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Supreme Court of India

OM PRAKASHversusRELIANCE GENERAL INSURANCE AND ANR.

Citation
2017 INSC 1001
Decided
4 October 2017
Disposal
Appeal(s) allowed

Holding

A claim for insurance loss cannot be rejected solely on the ground of a technically non‑compliant notice when the delay is satisfactorily explained and the loss is verified, as the Consumer Protection Act mandates a liberal construction favoring the consumer.

Summary

The appellant insured a truck with Reliance General Insurance, which was stolen on 23 March 2010. While assisting police in the search, the appellant delayed filing the insurance claim until 31 March 2010, citing an eight‑day gap due to police involvement. The insurer rejected the claim on the basis of a policy condition requiring immediate notice of loss, despite the investigator having verified the theft and the corporate claims manager approving a payment of Rs.7,85,000. The appellant filed complaints under the Consumer Protection Act, 1986, which were dismissed at the district, state and national consumer forums. The Supreme Court held that a delay caused by unavoidable circumstances, explained satisfactorily, cannot be a ground to deny a genuine claim, and that the insurer’s technical rejection violated the consumer protection legislation. Consequently, the Court set aside the lower orders, allowed the appeal, and directed the insurer to pay Rs.8,35,000 with interest to the appellant.

Issues considered

  • Whether a delay of eight days in notifying the insurer of a theft, caused by the insured's assistance to police, defeats the insurer's right to reject the claim under the policy's immediate notice condition.
  • Whether the Consumer Protection Act, 1986, requires a liberal construction that prevents insurers from denying genuine claims on purely technical grounds.
  • Whether the insurer is liable to pay the claim amount with interest despite the alleged breach of the notice condition.

Legislation cited

Subjects

insurance claimdelay in noticeconsumer protectionpolicy conditiongood faithliberal constructioninsurance lawConsumer Disputes Redressal Commission

Judgment

                          [2017] ll S.C.R. 893



                             OM PRAKASH                                       A
                                    v.
          RELIANCE GENERAL INSURANCE AND ANR.
                    (Civil Appeal No. 15611 of2017)
                           OCTOBER 04, 2017 ·                                 B

         [R.K. AGRAWAL AND S. ABDUL NAZEER, JJ.]
         Consumer Protection - Insurance claim - Delay in -
  Appellant insured his truck with respondent-company - The vehicle
  was stolen - Appellant along with the truck driver, went with the           C
  police officials for their assistance to search the vehicle - Thereafter,
  appellant reached his village and lodged insurance claim with the
· respondent-company - Pursuant thereto, Investigator appointed by
  respon-dent-company, who, after verification, confirmed the factum
  of theft - Consequently, the Corporate Claims Manager approved
  an amount towards the said claim of the appellant - Thereafter, the         D
  appellant made several requests and demands to the respondent-
  company, inter alia, seeking speedy processing and disposal of his
  insurance claim - However, the respondent-company repudiated
  the insurance claim of the appellant citing breach of condition, i.e.
  immediate information about the loss/theft of the vehicle - On the          E
  ground that Claim was filed after a delay of 8 days from the
  occurrence of theft - Held: Rejection of 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-- In instant case, the appellant has        F
  given cogent reasons for delay of 8 days in informing the respondent
  about the incident - Appellant was busy with the police in searching
  the vehicle - 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        G
  shelter to repudiate the insurance claims which have been otherwise
  proved to be genuine - Consumer Protection Act aims at providing
   better protection of the interest of consumers - It is a beneficial
 . legislation that desen,es liberal construction - Penal Code, 1860 -
   s.379.
                                                                              H
                                    893
894          SUPREME COURT REPORTS                      [2017] I 1 S.C.R.


A         Allowing the appeal, the Court
         HELD: 1. It is common knowledge that a person who lost
  his vehicle may not straightaway go to the Insurance Company
  to claim compensation. At first, he will make efforts to trace the
  vehicle. It is true that the owner has to intimate the insurer
B 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
c 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.
  The police had asked truck-driver and the owner to stay with
  them in order to help them for tracing out the truck. The police
D had also asked them to collect necessary documents in relation
  to the said truck. They were, consequently, busy with the
  Rajasthan Police in searching the vehicle. They visited many
  places in Rajasthan. The police had compelled the appellant to
  accompany them while searching the truck. It is only thereafter,
  the appellant went back and reached his village. Also, it would
E 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. Consumer Protection Act aims at providing better
F 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. [Paras 10, 11] [897-G-H; 898-A-B]
        2. In the instant case, the appellant has given cogent
G reasons for the delay of 8 days in informing the respondent about
  the incident. The Investigator had verified the theft to be genuine
  and the payment towards the claim was approved by the Corporate
  Claims Manager, which is just and proper. [Para 12] [898-C-D]


H
      OM PRAKASH v. RELIANCE GENERAL INSURANCE                                 895
                      AND ANR.

      CIVIL APPELLATE JURISDICTION : Civil Appeal No.15611                     A
 of2017.
       From the Judgment and Order dated 12.02.2014 of the National
 Disputes Redressal Commission" New Delhi in Revision Petition No.
 908 of2014.
        Harish Pandey, Manish Kumar, Ad vs for the Appellant.                  B

        Garvesh Kabra, Adv for the Respondents.
       The Judgment of the Court was delivered by
        S. ABDUL NAZEER, J. 1. Delay condoned. Leave granted.
         2. The appellant got his truck, bearing Registration No.HR-21-F-
                                                                               c
  0462, insured with Respondent No.1 herein, i.e. Reliance General
  Insurance Company Ltd., w.e.f. 10.03.2010 to 09.03.2011. The said
  vehicle was stolen from Chopanki, Bhiwari, Rajasthan on 23.03.2010 at
- about 9:00 p.m. Consequently, an FIR was lodged, on 24.03.2010, in
  Police Station Tapkura, District Alwar, Rajasthan, under Section 379         D
  IPC. Thereafter, the appellant visited the office of the first respondent
  but the office was found to be closed. Then the appellant went to the
  place of theft and met the driver and then he went to the concerned
  police official. On 29.03.2010, the appellant along with the truck driver,
  went with the police officials for their assistance to search the vehicle.
                                                                               E
  The appellant reached his village on 30.03.2010. On 31.10.2010, the
  appellant lodged the insurance claim with the respondent-company at
  Hissar and provided the necessary documents which were demanded
  by the respondent-company.
       3. Pursuant to the said claim, an Investigator was appointed by
                                                                               F
 the Respondent-company, who, after verification, confirmed the factum
 of theft. Consequently, the Corporate Claims Manager approved an
 amount ofRs.7,85,000/- for the said claim of the appellant. Thereafter,
 the appellant made several requests and demands to the respondent-
 company, inter alia, seeking speedy processing and disposal of his
 insurance claim. Finally, the appellant served a legal notice, dated          G
 09.08.2011, to the respondent-company. However, the respondent-
 company repudiated the insurance claim of the appellant citing breach
 of Condition No. 1, i.e. immediate Information about the loss/theft of the
 vehicle.

                                                                               H
896             SUPREME COURT REPORTS                        [2017) 11 S.C.R.


A         4. Being aggrieved, the appellant filed complaint before the,
  District Consumer Disputes Redressal Forum, Hissar (for short 'District
  Forum'), under Section 12 of the Consumer Protection Act, 1986, inter
  alia, seeking a direction to the respondent-company for payment of claim
  amount with an interest @ 18% per annum, along with compensation of
  Rs.1,00,000/- to the appellant. Written statement was filed by the
B
  respondents herein opposing the claim of the appellant. The District
  Forum, by order dated 13.06.2013, dismissed the complaint of the appellant
  thereby holding that there is no deficiency of service on the part of
  respondents.
C        5. The appellant herein filed an appeal challenging the said order
  of District Forum, before the State Consumer Dispute Redressal
  Commission, Haryana (for short 'State Commission') at Panchkula. The
  State Commission by an order dated 23.10.2013 dismissed the said appeal.
  This order was challenged by the appellant by way of Revision Petition
  before the National Consumer Disputes Redressal Commission (for short
D 'National Commission'). This Revision Petition has been dismissed by
  the National Commission by an order dated 12.02.2014. The appellant
  has questioned the legality and correctness of the said order in this appeal.
          6. Learned counsel for the appellant contended that the appellant,
  immediately after getting the information about the theft of the vehicle,
E went to the place of theft and met the police officials along with the
  truck driver. Consequently, he got busy with the police while visiting
  many cities in Rajasthan for the search of the said vehicle and returned
  to his village on 30.03.2010 and lodged the insurance claim on 31.03.2010
  before the Respondent-company. The appellant has assigned cogent
  reasons for the delay of 8 days in lodging the complaint. The National
F Commission has dismissed the petition filed by the appellant without
  taking into consideration the reasons assigned for the delay. It is argued
  that the Investigator appointed by the Respondent has verified the factum
  of theft and that the Corporate Claims Manager approved the report of
  Investigator, thereby recommending the payment ofRs.7,85,000/- towards
G claim.
             7. On the other hand, the learned counsel appearing for the
      respondents submits that as per the Condition No. 1 of the Insurance
      Policy, the information of theft oughttohave been given to the respondent-
      company immediately upon the occurrence of theft. The claim was filed
H
     OM PRAKASH v. RELIANCE GENERAL INSURANCE                                 897
           AND ANR. [S. ABDUL NAZEER, J.]

after a delay 8 days from the occurrence of theft. In the said                A
circumstance, the National Commission was justified in rejecting the
revision petition.
      8. We have carefully considered the submissions of the learned
counsel made at the Bar and perused the materials placed on record.
       9. The appellant, owner of the truck in question, is the resident of   B
Muzadnagar village, Tehsil Hansi, District Hissar, State ofHaryana. The
theft of the vehicle had taken place on 23.03.2010 at Chopanki, Bhiwari,
Rajasthan. The FIR was lodged in P.S. Tapukra, District Alwar on
24.03.2010 and the claim petition was filed on 31.03.2010. Dinesh, the
truck~driver, had filed an affidavit before the District Forum stating that   c
the owner of the truck had reached the place of occurrence of theft and
met him and also the concerned police official. The Police had asked
him and the owner to stay with them in order to help them for tracing out
the truck. The police had also asked them to collect necessary documents
in relation to the said truck. They were, consequently, busy with the
Rajasthan Police in searching the vehicle. They visited many places in        D
Rajasthan. The police had compelled the appellant to accompany them
while searching the truck. It is only on 29.03.2010, the appellant went
back and reached his village on 30.03.2010. The appellant had also filed
a similar affidavit before the State Commission explaining the reasons
for the delay in informing theft of the vehicle.                              E
       10. Condition No.1 of the Insurance Policy states that notice shall
be given in writing to the company immediately upon the occurrence of
any accidental loss or damage in the event of any claim and thereafter
the insured has to give all such information and assistance as the company
may require.                                                                  F
       11. It is common knowledge that a person who lost his vehicle
may not straightaway go to the Insurance Company to claim
compensation. At first, he will make efforts to trace the vehicle. 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       G
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
                                                                              H
898                SUPREME COURT REPORTS                      [2017) ll S.C.R.


A 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
B
  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.
         12. In the instant case, the appellant has given cogent reasons for
C the delay of 8 days in informing the respondent about the incident. The
  Investigator had verified the theft to be genuine and the payment of
  Rs.7,85,000/- towards the claim was approved by the Corporate Claims
  Manager, which, in our opinion, is just and proper. The National
  Commission, therefore, is not justified in rejecting the claim of the
D appellant without considering the explanation for the delay. We are also
  of the view that the claimant is entitled for a sum ofRs.50,000/- towards
  compensation.
              13. Hence, the appeal is allowed and the orders of the National
      Commission, State Commission and the District Forum are set aside and
E     the claim petition filed by the appellant is allowed. The respondents 1
      and 2 are directed to pay a sum of Rs. 8,35,000/- to the appellant with
      interest @ 8% per annum from the date of filing of the the claim petition
      till the date of payment. The payment, as above, shall be made within a
      period of 8 weeks from today.
F            14. There will be no order as to costs.


      Ankit Gtan                                                   Appeal allowed.


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