Ramesh, a senior executive working in Delhi, purchased a Tata Sumo vehicle from Prime Motors on 27 th September, 2014 for a sum of ₹7,80,000. After getting the vehicle registered, Ramesh on 29 th September, 2014 got the
CS Professional · Insurance - Law and Practice · PYQS · December 2015
Ramesh, a senior executive working in Delhi, purchased a Tata Sumo vehicle from Prime Motors on 27 th September, 2014 for a sum of ₹7,80,000. After getting the vehicle registered, Ramesh on 29 th September, 2014 got the vehicle bearing no. DL2C-J-7250 insured comprehensively with Bright Insurance Co. for the period from 29 th September, 2014 to 28 th September, 2015. On 8 th November, 2014, Ramesh paid a visit to Noida for official work. He parked and locked the car on the side road adjoining the office and went for work at around 10:30 AM. After finishing his work around 3:30 PM, he came out to return to Delhi. To his surprise, he found the vehicle missing. He searched for the car frantically and on not finding it, lodged an FIR with the Noida police station for the missing car. Next day, he also informed Bright Insurance Co., the insurer in writing about the said theft of the vehicle. Despite vigorous efforts of the police, the vehicle could not be traced. Hence, after 90 days, the Noida police gave a non-traceable certificate/report to Ramesh, the complainant. Ramesh, thereafter, again pursued the matter of settlement of claim with the insurance company and submitted a copy of the purchase invoice of the vehicle alongwith driving license, proof of road tax payment and other relevant documents including the final report in support. Despite passage of over 21 days, the insurance company did not respond positively and kept delaying the matter on one pretext or the other. Aggrieved by this inaction on the part of the insurer, Ramesh after five weeks, filed a complaint with the District Forum. During the pendency of the complaint, the insurance company repudiated the claim on the ground that the vehicle was being used as a Taxi by Ramesh. The District Forum, after hearing both sides on 29 th March, 2015 allowed the complainant and directed the insurance company to pay Ramesh, the insured declared value of the vehicle, i.e., ₹7,80,000 alongwith interest @ 6% p.a. from four months after the date of lodging of claim till realisation. The District Forum also awarded ₹7,000 as costs. The insurance company, being aggrieved with this decision, filed an appeal before the State Commission. The plea highlighted the fact that the insurer was not liable to reimburse the loss of stolen vehicle as the same was being used as a taxi. This plea was rejected by the State Commission by observing that theft of the vehicle had nothing to do with the use of the vehicle. The appeal, therefore, was dismissed and the awarded amount was ordered to be released by Bright Insurance Co. to Ramesh. The insurance company being still not satisfied filed a revision petition before the National Forum. During arguments, both sides vehemently advocated their views. Finally, it was pointed out by the counsel of the insured that in the decided case of 'National Insurance Company Ltd. vs. Nitin Khandelwal' in 2008 (CPJ ISC 2008-SEC-259), the Supreme Court had held that, "in a case where the vehicle had been snatched or stolen, the breach of condition is not germane and the insurance company is liable to indemnify the owner of the vehicle where the insured owner has obtained a comprehensive policy for the vehicle in question." In view of the aforesaid judgment of the apex court in the earlier order of the State Commission in the 'Nitin Khandelwal case of 2008', the counsel for the insurance company did not press the point that insurer was not liable to reimburse for the stolen vehicle because it was being used as a taxi. Hence, the claim of Ramesh was finalised at 75% on 'non-standard basis' as upheld earlier by the Supreme Court in 2008 plus cost. In light of the above, answer the following questions: If you were the adjudicating authority and a case of this nature is brought before you for decision, what would be your stand? Elaborate with reasons.
Answer & Explanation:
If I were the Adjudicating Authority and the claim of this nature was brought before me, for decision, I would have settled the claim at 100% being a standard claim as there has been no violation of any warranty or condition of a Motor policy, as there is no evidence or proof to evidence such breach or violation of usage clause. The claim was lodged in time, regular follow-up was done by the insured, the delay and lack of decision making was only on the part of the Insurance Company and therefore they have to face the consequences. Hence, the payment must include the interest component, and the costs.
Topics: Insurance Claims
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