Correct documents help in claims

Radheshyam Vaishnav owned a truck. When his previous policy was due to expire, he approached L&T General Insurance on August 11, 2013, for insuring the vehicle. The insurer inspected the truck on August 17, 2013, and accepted the premium of Rs 33,000 the same day. It also issued a proposal form which Vaishnav filled up and submitted the following day. Vaishnav was told that the policy would be prepared during the day and that he could use the truck from August 19.

On August 19, when Vaishnav asked for the insurance policy, he was told that it would take two days to issue it, but he could use the truck since it was insured.

The truck, unfortunately, met with an accident on August 21. Vaishnav immediately intimated the insurance company. To his shock, the company stated that the policy had been issued for the period August 23, 2013, to August 22, 2014, so it did not cover the accident.

Vaishnav had a legal notice issued, but his claim was not settled. Being aggrieved, Vaishnav filed a complaint before the Raigad District Forum at Alibag where he alleged that the insurer had deliberately covered the truck for a period after the accident and it had also deliberately delayed depositing the cheque for payment of premium and the amount had been credited to the company's account on August 30.

The insurance company contested the case. It denied having either inspected the vehicle on August 17 or having received the proposal form on August 18. It also claimed that the vehicle was inspected on August 22 and the proposal was received August 23, so the policy had been issued on that day. The Forum concluded that Vaishnav was correct and ordered payment of the insured value of Rs  1.17 million.

L&T General Insurance challenged this order in appeal, reiterating its stand. It contended that the District Forum had failed to appreciate the correct facts and had wrongly held it liable. The State Commission observed that the proposal form specifically mentioned that insurance coverage was sought for the period August 19, 2013, to August 18, 2014, so the inference was that it had been submitted before that date. Hence, the Commission believed Vaishnav's statement that he had submitted the proposal on August 18.

The Commission also observed that the police complaint recorded that the accident had occurred on August 21. So the insurer’s contention that it had inspected the vehicle on August 22 was obviously false. Also, the insurer did not produce its report that the inspection was carried out on August 22.

The Commission held that the Forum had correctly appreciated the facts and the evidence, and had rightly held the insurance company liable to settle the claim.

Accordingly, by its order of July 13, 2018, delivered by Judicial Member D R Shiraso along with Justice A P Bhangale, the Maharashtra State Commission dismissed the insurance company's appeal and held it liable to pay the insured value of Rs 1.17 million along with 9 per cent interest from the date of the order. In addition, Rs 10,000 was awarded to Vaishav towards costs for defending the appeal.

The writer is a consumer activist