Paresh Mohanlal Parmar v. National Insurance Co. Ltd.
2011-02-17
ASHOK BHAN, VINEETA RAI
body2011
DigiLaw.ai
Judgment :- NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION CIRCUIT BENCH AT AHMEDABAD, GUJARAT VINEETA RAI, MEMBER The present revision petition has been filed by one Paresh Mohanlal Parmar (hereinafter referred to as the ‘Petitioner’) against the order of the State Consumer Disputes Redressal Commission, Gujarat (hereinafter referred to as the ‘State Commission’) in favour of the National Insurance Company Ltd. and its Divisional and Regional Managers (hereinafter referred to as the ‘Respondents’). The facts of the case are that the Petitioner (original complainant before the District Forum) who deals in Nokia Mobile phones, had obtained a Shopkeepers’ Insurance Policy for the period from 09.08.2003 to 08.08.2004 from the Respondent/Insurance Company covering the risk of fire, theft, burglary etc. and paid the premium. During the currency of the policy, between 8.00 pm to 9.00 am of the night of 11-12.01.2004, 18 mobile phones costing Rs.68,000/- were stolen from his shop by one of his ex-employees who used duplicate keys to open the locks of his shop. Petitioner lodged a complaint with the Police Station, Rajkot and also intimated the Respondent/Insurance Company vide letter dated 12.01.2004 along with the details of the Nokia mobile phones that had been stolen. After the arrest of the culprit some of the mobiles were also recovered and were in police custody. Petitioner wrote another letter to the Respondent/Insurance Company on 25.03.2004 requesting for settlement of the claim. However, the Respondent/Insurance Company repudiated the claim on the ground that the incident is not covered under the term “burglary” or “housebreaking” as per the terms of the Shopkeepers’ Policy vide its letter dated 23.06.2004.
Petitioner wrote another letter to the Respondent/Insurance Company on 25.03.2004 requesting for settlement of the claim. However, the Respondent/Insurance Company repudiated the claim on the ground that the incident is not covered under the term “burglary” or “housebreaking” as per the terms of the Shopkeepers’ Policy vide its letter dated 23.06.2004. The Petitioner thereafter served a legal notice to the Respondent who again repudiated the claim on the grounds that the theft was not covered under the definition of “burglary” and /or “housebreaking” and as per the terms of the Shopkeepers’ Policy the definition of Burglary and/or Housebreaking is as follows: “The terms Burglary and/or Housebreaking shall mean theft involving entry into or exit from the insured premises by forcible and violent means or following assault of violence or threat thereof to the Insured or any employee of the Insured or member of the Insured’s family.” In the instant case there was no use of forcible or violent means as confirmed by Petitioner’s own statement that a duplicate key was used as also the report of the Forensic Science Laboratory which stated that no damage had been caused to the internal and integral part of the shop. Aggrieved by this, Petitioner filed a complaint before the District Forum seeking Rs.1,68,917/- as claim amount from 12.01.2004 along with 18% interest and Rs.25,000/- as compensation for mental agony and harassment apart from the cost of litigation. The District Forum after hearing both parties dismissed the complaint essentially by relying on the judgment of the Supreme Court in United Insurance Co. Ltd. Vs. Harchand Rai Chandan Lal – (2004) 8 SCC 644 wherein it was ruled that the element of force and violence is a condition precedent for burglary and housebreaking and if the element of violence or force is not present then the insurer cannot claim compensation against theft under the insurance policy. Under the policy in question, the definition of burglary and housebreaking has been clearly defined and since the policy is a contract between the parties, both parties are bound by the terms of the contract. Aggrieved by this order, Petitioners filed an appeal before the State Commission. The State Commission upheld the order of the District Forum on the same grounds and dismissed the appeal of the Petitioner. Hence, the present revision petition. Learned counsel for both parties were present.
Aggrieved by this order, Petitioners filed an appeal before the State Commission. The State Commission upheld the order of the District Forum on the same grounds and dismissed the appeal of the Petitioner. Hence, the present revision petition. Learned counsel for both parties were present. Learned counsel for Petitioner stated that the terms and conditions of the insurance policy were never explained to the Petitioner and furthermore along with the insurance proposal form only the cover note and the schedule of insurance policy were supplied. He cited the ruling of the Hon’ble Supreme Court of India in Modern Insulators Ltd. Vs Oriental Insurance Co. Ltd. – 2000 (LawSuit) SC 383 wherein it was held that it is not only the duty of the insured but also the duty of the insurance company and its agents to disclose all material facts in their knowledge since obligation of good faith applies to both equally. In the instant case, this principle was breached by the insurance company by not informing the insuree about the terms and conditions and, therefore, the claim could not have been repudiated. Counsel for respondent, on the other hand, has stated that the Shopkeepers’ Insurance Policy of which the proposal-cum-policy schedule is a part, has clearly defined burglary in the document itself. Therefore, there is no question of any ambiguity or holding back any information in this respect. In the instant case both the evidence of the Forensic Science Laboratory as well as the statement of the Petitioner himself clearly indicates that no force or violence was used to enter the premises/within the premises and, therefore, the case was not covered under housebreaking and burglary for which an insurance policy had been taken. A policy is a contract of good faith between the two parties and, therefore, the insured is bound by its terms and conditions and he cannot get out of his obligation by claiming ignorance of its terms and conditions. Keeping in view this fact and the settled law on the subject, as clearly enunciated in the order of the Supreme Court in Modern Insulators Ltd. (supra), the fora below had rightly repudiated the claim. We have heard the learned counsel for both parties and have gone through the evidence on record including the judgments cited by both parties in respect of their contentions.
We have heard the learned counsel for both parties and have gone through the evidence on record including the judgments cited by both parties in respect of their contentions. The fact that an insurance policy for burglary, housebreaking and theft was taken by the Petitioner is not in dispute. It is also not in dispute that no force or violence was used during the burglary and it was an ex-employee of the Petitioner who used a duplicate key to enter the premises and steal the Nokia mobiles phones. The Supreme Court in United India Insurance (supra) has clearly stated that in order to substantiate a claim, an insured has to establish that theft or burglary took place preceding with force or violence and if it is not established, then the insurance company will be well within the right to repudiate the claim of the insured. This is very much relevant in the instant case and therefore, the Respondent was fully entitled to repudiate the claim. The ruling of the Supreme Court in Modern Insulators (supra) would be of no help to the Petitioner in this case because these terms and conditions including the definition of burglary, housebreaking were very much a part of the contract of insurance and Respondent has not been able to show any evidence that he was not informed of the terms and conditions of the insurance policy. Under the circumstances, Respondent/Insurance Company was right in repudiating the claim. We thus see no infirmity in the orders of the State Commission which are upheld. However, for the benefit of consumers, we would like to observe that all insurance companies would be well advised to take note of the very sound advice and guidance given by the Hon’ble Supreme Court in United India Insurance Co.(supra), the relevant portion of which is as follows: “But before parting with the case we would like to observe that the terms of the policy as laid down by the insurance company should be suitably amended by the insurance company so as to make it more viable and facilitate the claimants to make their claim. The definition is so stringent in the present case that it given rise to a difficult situation for the common man to understand that in order to maintain their claim they will have to necessarily show evidence or violence or force.
The definition is so stringent in the present case that it given rise to a difficult situation for the common man to understand that in order to maintain their claim they will have to necessarily show evidence or violence or force. The definition of the workd “burglary” should be given a meaning which is closer to the realities of life. The common man understands that he has taken out the policy against theft. He hardly understands whether it should precede (sic be preceded with) violence or force. Therefore, a policy should be a meaningful policy so that a common man can understand what is the meaning of burglary in common parlance. Though we have interpreted the present policy strictly in terms of the policy but we hope that the insurance companies will amend their policies so as to make them more meaningful to the public at large. It should have the meaning which a common man can easily understand rather than become more technical so as to defeat the cause of the public at large.” The revision petition is dismissed with the above observations and with no order as to costs.