Insurance Ombudsman directs Oriental Insurance to pay burglary claim

DELHI OMBUDSMAN CENTRE Case No.GI/13/OIC/12 In the matter of Sh. A. B. Handa Vs Oriental Insurance Company Ltd. AWARD DATED 11.4.2013 NON SETTLEMENT OF BURGLARY CLAIM

  1. This is a complaint filed by Sh. A.B. Handa (herein after referred to as the complainant) against the decision of Oriental Insurance Company Ltd. (herein after referred to as respondent Insurance Company) relating to Burglary Claim.
  2. Complainant stated that he had taken a house holders policy bearing no. 214303/48/2012/35 for the period 04.04.2011 to 03.04.2012 covering building and contents including house hold articles, jewellery, kitchen ware and other valuables. Unfortunately, on 21.09.2011, burglary took place in his premises, when he had gone to Krishna Nagar to meet his brother and was informed by his neighbor, about the incident. He immediately rushed to his house and found that his house had been burgled by breaking up the main door. The whole house had been ransacked and jewellery items, silver ware, camera, watch and Rs. 8000 were stolen. The police was informed immediately, which after inspecting the site registered FIR no. 262/11 dated 21.09.2011 under section 454 and 380 of IPC. Company was also informed on the same day about the theft. Company deputed surveyor Sh. Kapil Mohan to assess the loss who visited the premises inspected the loss and raised certain queries. All his queries were relpied and details were filled in the claim form. However, the claim was rejected by the insurance company. He has come to this forum with a request to instruct the insurance company to pay him a claim of Rs. 2,20,600 along with penal interest from the date of loss. During the course of hearing, it was pleaded by him that claim was payable as he sustained a loss due to burglary in the house during the currency of the policy. Company was not justified to deny the claim. Items which were stolen were insured.
  3. Representative of the company pleaded that claim was not payable as insured had not taken reasonable care.
  4. I have considered the submissions of the complainant as well as of the representative of the company. I have also perused the surveyor report and repudiation letter. After due consideration of the matter, I hold that company was not justified in repudiating the claim because insured had suffered, loss due to burglary in his houses during the currency of the policy. Thus, in my considered view claim was payable and the same should have been allowed. Accordingly an Award is passed with the direction to the insurance company to make the payment of Rs. 2,20,600 being assessed loss by the surveyor.
  5. The Award shall be implemented within 30 days of receipt of the same. The compliance of the same shall be intimated to my office for information and record.
  6. Copies of the Award to both the parties.

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