Insurance companies cannotshirk responsibility

Pushpa Girimaji

There was a wedding in the family and I had taken out some gold jewellery and silverware from the bank locker. A day after the wedding, I thought of putting them back in the safe deposit locker. However, while I was on my way to the bank, I got a call from a friend about a medical emergency and I decided to first take her to the doctor and then go to the bank. At the hospital, I put the jewellery underneath the car seat, thinking that it would be safe there, particularly since my car had an electronic security system and I was parking inside the hospital compound. However, when I returned, to my utter shock, I found my car itself missing!

As I had insured the jewellery too from the same insurer, I asked the company to indemnify the loss of the car as well as the jewellery. But the insurance company is saying it will not pay for the loss of jewellery as I had breached one of the conditions of the policy, which required that I take due care and caution in securing the jewellery. Can you please help me?

Once the insurer repudiates the claim in writing, I would suggest that you file a complaint before the insurance Ombudsman for redress of your grievance. Give the precise facts of the case and an accurate assessment of the value of the jewellery lost by you. As the insurance company too will have a list of your jewellery and their valuation, this would not be difficult.

I remember a case very similar to yours decided by the Ombudsman. In this case, complainant Rakesh Bansal was to deposit the jewellery in his bank locker and then proceed to keep an appointment with a doctor at a hospital. When he found the parking lot at the bank full, he decided that he would meet the doctor first. So like you, he thought the jewellery would be safe underneath his seat. He kept it there, locked the car and left. And when he returned from the doctor, he found his car missing!

He was fortunate that in addition to the insurance cover for his vehicle, he had a householder’s policy covering the jewellery. Or so he thought until he had asked the insurer to indemnify his loss. The insurer, in this case too, argued that it would indemnify the loss of the car, but not the jewellery, as he had not taken ‘due care and caution’ to secure the jewellery, as required under the policy. Eventually, he lodged a complaint with the Delhi Ombudsman and even there the insurance company put forward the same argument.

The Ombudsman, however, dismissed the contention. The jewellery was hidden under the seat, the car was locked and parked in the hospital’s parking bay, the Ombudsman pointed out and directed the insurer to pay.( Shri SN Bansal Vs Oriental Insurance Company Limited, decided on 10-3-2008).

Another interesting case pertaining to theft of jewellery decided by the Ombudsman was in Shri Sadhan Chakraborty Vs The New India Assurance Company Ltd ( May 23, 2007). Here, after the policy holder made the claim, the insurance company did not send a surveyor or investigator for three months. And then, after the grills and the latch had been repaired by the policy holder, complained that there were no signs of ‘violent and forcible entry’ by the burglar and so the loss cannot be indemnified. The Kolkata Ombudsman held that this argument was unacceptable.

Where can I get the contact details of the insurance Ombudsman?

The Insurance Regulatory and Development Authority has created a website specifically for policyholders and I would suggest that you visit the site www.policyholder.gov.in. At the bottom, you will seen an icon saying ‘Ombudsman’ and if you click on that, it will take you to all relevant information pertaining to the Ombudsman, including the rules pertaining to the Ombudsman Scheme, how to lodge a complaint, the territorial jurisdiction and the addresses of the Ombudsmen, etc. I would also suggest that you visit the website of the General Body of Insurance Council (http://www.gbic.co.in/synopsis.html).

Here you can get to see the decisions of the Ombudsmen in different categories of cases pertaining to both life and non-life insurance. If you spend some time here, you can get decisions of the Ombudsmen in cases similar to yours. After you visit these two sites, you will be ready to challenge the rejection of your claim by the insurer!