Case Title: Gita Ram Negi vs The Oriental Insurance Company Ltd and others
Case No.: First Appeal No. 175/202
Summary
Oriental Insurance Company Limited was held accountable for a deficiency in service by the State Consumer Disputes Redressal Commission Shimla, led by Justice Inder Singh Mehta. The insurance company’s delayed notification of damage led to the rejection of a claim, which the complainant filed with the District Commission. The insurance company argued that the complainant had not followed the terms and conditions of the contract, and that the bank had contacted the insurance company as soon as it received the claim. The District Commission denied the complaint, and the complainant appealed to the State Commission for Consumer Disputes Redressal in Shimla.
The State Commission found that the insurance company was responsible for deficiency in service and unfair trade practice, as it was unlawful to reject the claim on the basis of delayed notice. The State Commission ordered the insurance provider to submit an insurance claim for Rs. 7,90,000 to the complainant, along with an extra payment of Rs. 50,000 for litigation costs.
About the case
Oriental Insurance Company Limited was held accountable for a deficiency in service by the State Consumer Disputes Redressal Commission Shimla (Himachal Pradesh) bench, which is led by Justice Inder Singh Mehta (President). The rejection of a claim was based solely on the insurance company’s delayed notification of the damage. The bench overturned the Shimla District Commission’s ruling and ordered the insurance firm to submit an insurance claim for Rs. 7,90,000 to the complainant, along with Rs. 50,000 to cover the costs of the case.
Sudharang, Tehsil Kalpa, District Kinnaur, Himachal Pradesh, is home to Mr. Gita Ram Negi (“Complainant”), who owned a two-story home there. The State Bank of India (“SBI”) provided a loan for the house’s construction, while Oriental Insurance Company Ltd. (“Insurance Company”) insured the asset. The Complainant’s house fell in late July 2014 as a result of floods, land erosion, and slides brought on by the heavy rains and snowfall in June 2013, especially in the Sudharang area. Even though the Complainant informed the insurance company of this, the insurance company rejected the claim without assigning a surveyor and told the Complainant it was false, unlawful, and without merit. After that, the complainant filed a consumer complaint against the bank and the insurance firm with the District Consumer Disputes Redressal Commission in Shimla, Himachal Pradesh (hereafter, the “District Commission”).
In response, the insurance provider confirmed the coverage but argued that the complainant had not followed the terms and conditions of the contract. It contended that the failure on the part of the Complainant to swiftly notify them of the loss in June 2013 hindered an inspection in a timely manner and the taking of steps to limit additional construction damage. In an attempt to have the case dismissed, the insurance firm refuted any service shortcomings and unfair business practices. In a second reply, the Bank claimed that it had contacted the insurance company as soon as it received the Complainant’s claim and pushed for an early settlement. It maintained that neither an unfair trading practice nor a service deficit existed on its end.
Upon evaluating the breach of the policy’s terms and conditions, the District Commission denied the complaint. As a result, the Complainant appealed to the State Commission for Consumer Disputes Redressal in Shimla. In order to choose a surveyor/loss assessor, the State Commission remitted the case back to the District Commission. But once more, the District Commission rejected the complaint. In order to challenge the complaint’s dismissal, the complainant went to the State Commission.
The State Commission stated that the Complainant’s residence sustained considerable damage in June 2013 as a result of floods, land erosion, and slides in District Kinnaur. The insurance company failed to hire a surveyor in a timely manner, causing the damage to occur on multiple occasions and making it impossible to provide an accurate time of claim notification. The State Commission found that the insurance firm was accountable for deficiency in service and unfair trade practice since it was unlawful to reject the claim on the basis of delayed notice, given the facts and circumstances. As a result, the State Commission rejected the District Commission’s ruling. The State Commission then ordered the insurance provider to give the complainant a total of Rs. 7,90,000/-. Additionally, the Complainant was to get an extra payment of Rs. 50,000/-as litigation costs.
