This revision petition has been filed by the petitioner, Jaswinder Kaur against the order dated 29.7.2015 passed by the State Consumer Disputes Redressal Commission, Himachal Pradesh (for short, State Commission) in First Appeal No. 04/2015. Brief facts of the case are that the petitioner/complainant had insured her vehicle with the respondent and during the 2. currency of the insurance, on 7/8-2-2009 the vehicle was stolen and the police was informed vide D.D. No.4A dated 8.2.2009, though FIR has been lodged on 18.2.2009 The petitioner filed the claim with the insurance company on 2.3.2009 alongwith documents. The claim was ultimately repudiated vide letter dated 24.8.2009 mentioning that the insurance company had not received the relevant documents. Aggrieved with the repudiation letter, the petitioner/complainant filed a consumer complaint no.46/2010 before the District Forum. The complaint was resisted by the OP/insurance company on the ground that all the relevant documents were not submitted alongwith claim form and even on demand. there was huge delay of 22 days which was violation of the terms and conditions of the policy. The District Forum however after considering the evidence and submissions made by both parties, allowed the complaint and ordered the OP/respondent to pay IDV of Rs.9,50,000/- with interest @ 9% p.a. from the date of filing of the complaint till realization alongwith Rs.25,000/- as litigation cost. -1- . Aggrieved with the order of the District Forum, the OP/respondent preferred First Appeal No.04/2015 before the State 3 Commission which was allowed vide order dated 29.7.2015 and the order of the District Forum was set aside and the complaint dismissed. Hence, the present revision petition. 4. . Heard the learned counsel for the parties and perused the record. 5 . The learned counsel for the petitioner stated that the police was informed on the same date i.e. 8.2.2009 and the D.D. No. 6 4A was recorded with the police. However, the police lodged FIR only on 18.2.2009. The delay in lodging the FIR thus is not important as the police was informed on the same day i.e. 8.2.2009 and the requirement under the policy is only to give intimation to the police in the cases involving theft, The claim was straight away submitted to the insurance company on

2.3.2009 alongwith al the documents. The preparation of the claim has taken some time and that is why there was some delay in filing the claim before the insurance company. Though the insurance company was informed orally by the complainant about the incident of theft however, no written communication was sent at that time to the insurance company. That mistake has happened due to the fact that the complainant is not an educated person and she is only class 4 pass. The delay in informing the th insurance company has happened inadvertently and the truth of the incident is corroborated from the information given to the police and recorded vide D.D. No.4A by the police as well as on the basis of the FIR. The police had investigated the matter and had also filed the Untraceable Report. The learned counsel further referred to IRDA Circular No.IRDA/HLTH/MISC/CIR/216/09/2011 dated 20.9.2011, wherein it has been directed that claim should not be repudiated only on the ground of delay in informing the insurance company and genuinety of the claim must be seen. The genuinety of the present claim is fully proved from the FIR and the Untraceable Report and therefore, delay cannot be considered as a ground for repudiation of the whole claim. It was further submitted by the learned counsel that the delay was not the ground for repudiation. In fact the claim was repudiated only on the ground that relevant documents were not supplied by the complainant to the insurance company alongwith the claim. In this regard, the learned counsel stated that in para -6 of the complaint, it has been clearly mentioned by the complainant that all the documents were submitted alongwith claim form on 2.3.2009. The insurance company in its reply to this para has only stated that the contents of para 6 of the complaint are admitted to the extent that claim was registered by the complainant on 2.3.2009, hence, there is 22 days delay on the part of the complainant in lodging the claim. The learned counsel contended that no specific denial has been mentioned in the reply about the averment of the complainant that all the documents were sent alongwith claim form. This clearly proves that the repudiation was based on false facts and all the documents were with the insurance company. Moreover, the letters alleged to have been sent by the insurance company to the complainant for submitting the documents, were never received by the complainant and they have been created only to deny the claim of the complainant. . The learned counsel for the petitioner argued that the delay in submission of the claim to the insurance company was not 7 a point of repudiation in the repudiation letter. Hence, the same could not have been considered by the State Commission, even if the same was raised in the appeal filed by the appellant. In support of his arguments, learned counsel referred to the judgment passed by this Commission in Jagjit Singh Vs. M/s. Cholamandalam MS General Insurance Company Ltd. and another, wherein it has been observed as under: R.P. No.305 of 2011, decided on 15.2.2017,

9. Regarding intimation to the Insurance Company, the complainant has explained in the grounds of Revision Petition that he is a resident of village Jakhauli, District Sonepat in Haryana, which was situated 20 to 25 kms away from the headquarters of District Sonepat. The office of the Insurance Company is located at Chandigarh. The complainant has stated that he visited the office of Amit Batra, an agent of the Company to know the telephone number and address of the office of the Insurance Company. The toll-free telephone number of the Insurance Company was also obtained from the said Amit Batra. It is the case of the complainant that a written request about the incident was lodged on 26.08.2006 at the Chandigarh address of the Insurance Company, although the same had been denied by the said Company. The complainant has further stated in the grounds of the Revision Petition that the Insurance Company had not even given him the benefit of postal transit period. On behalf of the petitioner, a circular dated 20.09.2011 from the Insurance Regulatory & Development Authority has been produced, which makes it clear that the condition of giving intimation to the Insurance Company within a specified number of days should not prevent settlement of genuine claims, when there was delay in intimation or in submission of documents due to unavoidable circumstances. It is evident, therefore, that there was no justification in holding that the delay of 9-10 days in the receipt of intimation by the Insurance Company was fatal to the outcome of the case.

. On the other hand, learned counsel for the respondent/insurance company stated that first of all, the insurance company 8 was not informed immediately after the incident of theft. Even the FIR has been lodged with delay of 9 days and the insurance company has been informed after a delay of 22 days, though it is alleged that police was informed and police has recorded D.D. No.4A dated 8.2.2009. However, it is seen from the FIR that the DD as well as FIR were lodged by the concerned driver and not by the owner of the vehicle. Even though the police recorded the DD No.4A, the complainant could have lodged the FIR. After receiving the claim on 2.7.2009, the insurance company had written many letters, particularly dated 20.4.2009, 11.5.2009, however, no rely was given by the complainant and therefore, finally on 24.8.2009, the claim was closed as No Claim as no details and documents were submitted by the petitioner/complainant. . The learned counsel for the respondent further mentioned that in 9 R.P. No.2463 of 2013, Shriram General Insurance this Commission has allowed the revision Company Ltd. and another Vs. Gurshinder Singh, decided on 17 March, 2015, th petition filed by the insurance company where there was a delay of 52 days in intimation to the insurance company. Here also the delay is substantial and claim cannot be allowed. Similarly, in RP No.2724 of 2016, Har Sharan Prasad Patel Vs. M/s. , this Commission has rejected the revision Reliance General Insurance Company Ltd., decided on 17 March, 2017 th petition filed by the complainant against the order of the State Commission dismissing the insurance claim of the complainant on the ground that there was a delay of 146 days in giving the intimation to the insurance company. It was stated by the learned counsel that this Commission has taken a consistent view that if there is substantial delay in giving intimation to the insurance company, then the genuineness of the claim is doubtful and the claim could not have been accepted. . I have given a thoughtful consideration to the arguments advanced by the learned counsel for the parties and have 10 examined the material on record. It is seen from the repudiation letter dated 24.8.2009 that the repudiation was made only on the ground that the complainant did not supply the concerned documents to the insurance company. Para 6 of the complaint reads as under:

That the complainant on the demand of the opposite party submitted all the documents i.e. copy of the registration certificate, copy of insurance policy, copy of FIR and copy of final untraced report and the order of Ass. Commissioner of Police to the opposite party for payment of total loss of the truck. The opposite party registered the claim no.1044505 on

2.3.09 of the complainant under the aforesaid insurance policy.

. The insurance company in reply to this para has submitted the following: 11

That the contents of the para no.6 of the complaint admitted to the extent that claim was registered by the complainant on 02.03.2009. Hence, there is delay of 22 days on the part of the complainant in lodging the claim.

. From the above comparison, it is seen that the insurance company has not denied specifically that these documents were 12 not received by them. The District Forum in its order has already analyzed this issue and has observed the following:

5. The complainant is xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx. The OP has brought on record the letter Annexure O-4 which has been shown to the sent to the complainant on 11.5.2009 seeking current photographs, address proof, ID proof, original R.C. if lost From No.26 in duplicate and 1+1 key if lost from declaration to process the claim of the complainant. The complainant in her affidavit has specifically mentioned the submission of these documents i.e. copy of R.C. copy of insurance policy, copy of FIR and copy of final untraced report to the Assistant Commissioner of Police, Shalimar Bagh, Delhi and she has further filed an affidavit that the original R.C. , insurance policy, routine permit had been stolen alongwith truck . However, the keys were handed over to the surveyor of the OP and the finance company refused to supply the NOC till entire payment is made and she has further made declaration in case the truck is traced she will not claim the same.

. From the above examination, one thing is clear that most of the required documents were submitted by the complainant 13 and no specific document was mentioned in the repudiation letter to examine the matter any further. So far as the question of delay in giving intimation to the insurance company is concerned, it is seen that this ground is not mentioned in the repudiation letter. Honble Supreme Court in M/s. Galada Power and Telecommunication Ltd. Vs. United India Insurance Co. Ltd. & has held the following:- Anr. Etc., Civil Appeal Nos.8884-8900 of 2010, decided on July 28, 2016

12. The National Commission has relied upon Clause 5 and on that basis has rejected the claim by putting the blame on the complainant. The letter of repudiation dated 20th September, 1999, which we have reproduced hereinbefore, interestingly, does not whisper a single word with regard to delay or, in fact, does not refer at all to the duration clause. What has been stated in the letter of repudiation is that the claim lodged by the complainant does not fall under the purview of transit-loss because of the subsequent investigation report. It is evincible, the insurer had taken cognizance of the communication made by the appellant and nominated a surveyor to verify the loss. Once the said exercise has been undertaken, we are disposed to think that the insurer could not have been allowed to take a stand that the claim is hit by the clause pertaining to duration. In the absence of any mention in the letter of repudiation and also from the conduct of the insurer in appointing a surveyor, it can safely be concluded that the insurer had waived the right which was in its favour under the duration clause. In this regard, Mr. Mukherjee, learned senior counsel appearing for the appellant has commended us to a decision of High Court of Delhi in Krishna Wanti v. Life Insurance Corporation of India[1], wherein the High Court has taken note of the fact that if the letter of repudiation did not mention an aspect, the same could not be taken as a stand when the matter is decided. We approve the said view.

. From the above judgment of the Honble Supreme Court, it is clear that no new points for repudiation can be raised by the 14 insurance company and even if they are raised, the consumer fora are not supposed to consider them. . It is true that there is a delay of 22 days in giving intimation to the insurance company and this is a violation of terms and 15 conditions of the policy. However, as this was not mentioned as reason for repudiation in the repudiation letter, the complainant cannot be denied of his claim only on this ground. Moreover, the IRDA vide Circular has issued the following directions to the insurance No.IRDA/HLTH/MISC/CIR/216/09/2011 dated September 20, 2011 companies:

The insurers decision to reject a claim shall be based on sound logic and valid grounds. It may be noted that such limitation clause does not work in isolation and is not absolute. One needs to see the merits and good spirit of the clause, without compromising on bad claims. Rejection of claims on purely technical grounds in a mechanical fashion will result in policyholders losing confidence in the insurance industry, giving rise to excessive litigation. Therefore, it is advised that all insurers need to develop a sound mechanism of their own to handle such claims with utmost care and caution. It is also advised that the insurers must not repudiate such claims unless and until the reasons of delay are specifically ascertained, recorded and the insurers should satisfy themselves that the delayed claims would have otherwise been rejected even if reported in time.

From the above, it is seen that delay in submission of claim cannot be taken as a ground for repudiation of the genuine 16. claims. In the present case, the claim seems to be genuine to a great extent as the intimation to the police was given on the same day i.e. 8.2.2009 and finally the police lodged FIR on 18.2.2009. The Police also filed Untraced Report on 18.3.2009. The insurance company has not filed any evidence to show that the claim is not genuine. Therefore, whatever evidence is available on record, goes on to show the genuineness of the claim. Thus, delay of 22 days in submitting the claim cannot be given that much importance so as to dismiss the whole claim of the complainant. . Furthermore, in 17 R.P. No.305 of 2011, Jagjit Singh Vs. M/s. Cholamandalam MS General Ltd. and another, decided , this Commission has allowed the insurance claim where the intimation was given with delay of 26 days. on 15.2.2017 . From the foregoing examination, it is brought out that the main reason of repudiation that he complainant did not file the 18 relevant documents with the insurance company stands falsified and is not substantiated. Thus, the repudiation letter has not withstood the scrutiny and is not sustainable and liable to be set aside. Moreover, the question of delay in intimation to insurance company does not seem to be a relevant question to be decided in the present case as it was not raised in the repudiation letter and keeping in view the Circular of the IRDA referred above as well as the judgement of the Apex Court in Jagjit Singh Vs. Therefore, I am inclined to consider the insurance claim of the M/s. Cholamandalam MS General Ltd. and another (supra). complainant/petitioner. Honble Supreme Court in the matter of Amlendu Sahoo Vs. Oriental Insurance Company, (Civil has allowed the insurance claim to be considered for settlement upto 75% of the Appeal No.2703/2010 decided on 25.3.2010 claim if some condition of the Motor Policy is violated. Here one condition has been violated that the insurance company was not informed immediately after the incident and there is a delay of 22 days. Following this judgment, I deem it appropriate to allow 50% of the insurance claim keeping in view the circumstances of the case and the delay in intimation to the insurance company. . Based on the above discussion, the revision petition is partly allowed and the order of the State Commission is set aside 18 and the respondent/OP/insurance company is directed to pay 50% of the insurance claim i.e. Rs.4,75,000/- (50% of the IDV value) to the petitioner /complainant alongwith interest @ 6% p.a. from the date of order of the District Forum i.e. 15.12.2014. Accordingly, the order of the District Forum stands modified. This order be complied with by the insurance company within 45 days, failing which additional interest @ 4% p.a. shall be payable by the insurance company from the date of this order till actual payment. ...................... PREM NARAIN PRESIDING MEMBER