Delhi State Commission Holds ICICI Lombard Liable For Deficiency In Service Over Wrongful Repudiation Of Insurance Claim

Brief Facts of the Case

The complainant insured their car with ICICI Lombard General Insurance/insurer for a specific coverage period. Following an accident, the complainant submitted a claim, but the insurer did not process it. Despite multiple follow-ups and a legal notice, the insurer failed to respond or settle the claim. Alleging deficiency of service, the complainant approached the District Commission. The District Commission allowed the complaint and directed the insurer to refund an amount of Rs.2,40,331 with 10% interest rate, pay Rs. 5,000 for compensation and Rs. 5,000 as litigation costs. Aggrieved, the insurer appealed before the State Commission of Delhi.

Contentions of the Insurer

The insurer claimed the complainant did not notify them of the accident as per policy terms. They argued no claim was recorded in their system and emphasized the procedural requirements for filing claims, which they alleged the complainant did not fulfill. The insurer also contested the District Commission's judgment, stating that equating the legal notice with the required accident intimation was erroneous.

Observations by the State Commission

The Commission observed that the complainant promptly lodged an FIR and sent a legal notice, which the insurer did not deny receiving. The complainant's failure to strictly adhere to the procedural requirements was not deemed a valid reason to dismiss the claim. The Commission referenced Reliance General Insurance Co. Ltd. vs. Ram Awadh Singh and Oriental Insurance Co. Ltd. vs. Rajinder Singh, emphasizing that the complainant's actions were sufficient to establish compliance. The Commission upheld the District Commission's decision, citing clear deficiency in service by the insurer.

Case Title: ICICI Lombard General Insurance Co. Ltd. Vs. Mr. Inderjeeet Singh

Case Number: F.A. No. 15/2016