Order No.                 .

This is an application u/s.12 of the C.P. Act, 1986.

          Complainant by filing this complaint has submitted that complainant purchased one Householder’s Insurance Policy of the OP being insurance policy no.51010048110500000063 and that was continued without any lapse from 2002 to 2012. 

          Complainant purchased a colour television being Sony Triniton which was covered under the scheme of the said policy and after purchase the said Television faced problem with distortion of picture on and from 06-06-2012 and a preliminary intimation was lodged on 07-06-2012 with the OP1 with an assessed estimation of repairing cost of Rs.1,000/- by the complainant himself as the complainant himself a chartered engineer but the concerned person of the OP1 commented that such intimation was submitted without any proper estimate.  But complainant had served the intimation on 07-06-2012 but no response was meted out by the OPs towards repair of Sony Triniton CTV and at that material point of time EURO CUP, 2012 was in progress and the complainant was not ready to miss the same due to breakdown of his television.  Thereafter complainant called the technician from the authorized service centre of SONY namely M/s. Neosa Electronics and the distortion problem of the Sony Triniton CTV was restored on 09-06-2012 and the cost of worn out components replaced in the SMPS power circuit was Rs.1,200/- and the service charge of the technician of Rs.281/-and total Rs.1,4,81/- was spent by the complainant.  Complainant submitted the service job sheet dated 09-06-20012 as issued by M/s. Neosa Electronics along with the worn out components and submitted the same to one Mr. Babulal Saha, staff member of the OPs vide letter dated 11-06-2012 and complainant has claimed Rs.1,481/- as per insurance policy in respect of the breakdown of Sony Triniton CTV on 06-06-2012.  But the complainant’s claim was rejected by OP for which their claim hub’s letter dated 18-06-2012 with the remarks “prior permission not obtained from competent authority or survey should have been conducted for assessment of the loss i.e. for arriving at an estimated loss amount”.

          As per provision envisaged in the policy being Provisions Applying to Section XI, it is clear such aforesaid sum as claimed is legitimate and should be sanctioned by the OPs as per policy condition and the rejection was uncalled for and without any reasons and in this respect complainant has prayed for redressal and relief.

          OPs Insurance Company by filing written version has submitted no doubt it transpired on 07-06-2012 during the subsistence of the said policy, complainant intimated to this OP that his TV set’s image is not clear he needs to call a technician for service but no technicians estimate was submitted save and except self-estimated evaluation of the complaint himself.  But as per terms and condition of the policy at the time of claim or intimation their licensed technician or service centre estimate is must but that was not submitted by the complainant and if it would be submitted the OP shall engage a surveyor to assess the status of TV set but thereafter within a gap of 3 days the complainant on 11-06-2012 submitted a letter to the OP claiming thereby a sum of Rs.1,481/- as repairing cost and service charge for the repairing of the said TV set repairing by the technician and subsequently thereafter supplied a copy of tax invoice in support of the said repairing charges etc. but as per terms and conditions of the policy complainant did not act for which the complainant claim could not be settled and repudiated and further it has submitted that as per Clause 2 of the General Exceptions, the loss and damage caused by depreciation and wear and tear are not covered under the said policy and the complainant is to submit necessary quotation of repair of TV set, the OP could well engage a skilled surveyor to assess the prior reason and quotation of repair including verification of the fact as well as damage as alleged because case of regular wear and tear and it is not covered by the policy but OP was not granted the said opportunity by the complainant in gross violation of terms and condition of the subject policy for which his claim is not entertained and so rejected.  Further it is evident from the paragraph 11 of the complaint that in fact the component of TV set repaired was admittedly an worn out parts, i.e. the said component of TV which was repaired was affected by regular wear and tear and so same was not covered under general condition No.2 of the subject policy and when once the claim has been excluded by the four corners of the subject policy and the said fact has been communicated to the complainant on 18^th June, 2012 by the OP, the plea of further denial of notice of claim of lawyer of the complainant on the self-same cause of action does not arise at all when the claim has been denied as per the term of the policy for which complaint should be dismissed.

Decision with Reasons

On overall evaluation of the entire facts and circumstances of the compliant including the written version and also on proper estimation of the argument as advanced by the Lawyers of both the parties and further considering the particular provision of the terms and condition of the said policy it is clear that Section 6 – Television set, Video Cassette Player, Video Cassette Recorders, Company will indemnify the insured in respect of loss or damage of the television apparatus described in the schedule whilst contained or fixed in the insured premises by a) Fire lightning, explosion of gas in domestic appliances, b) Bursting and overflowing of water tanks, apparatus or pipes, c) Aircraft or articles dropped therefrom, d)Earthquake fire and/or shock, e) Flood, Inundation, Typhoon, Storm, Tempest, Hurricane, Tornado and Cyclone, f) Riot, Strike or Malicious Act, g) Burglary and/or House breaking or theft, h) Accidental External means and i) Mechanical or electrical breakdown.  Provided that the liability of the company in respect of such loss or damage in any one period of insurance is limited to the amount specified in the schedule.

          Considering the said Clause 6 of the policy it is clear that loss or damage of the television parts in case of such affairs the company will indemnify but for any sort of wear and tear of the said television no compensation can be granted in favour of the insured.

          After considering the spirit of Sub-Section 6 of the policy and also the present facts and circumstances it is clear that that TV set was not damaged due to such cause as noted down in the prevision para against the Section 6.  But in the present case after considering the service job sheet it has found that there was picture problem for which the repairing was required and the service centre repaired it and charged Rs.1,481/- and said repairing was required for wear and tear and that damage was not caused due to fire, lightning, bursting, earthquake, flood, riot, burglary accidental external means and/or mechanical or electrical breakdown.  So, in view of the above facts and circumstances and also considering the clause Section 6 with the terms and condition of the policy we find that the parties are guided by policy condition and the present repairing was made only for wear and tear but not for any other cause and at the same time it is found that mechanic did not mention that it was caused for any other cause except wear and tear.  At the same time it is proved that complainant has not mentioned on which date he purchased the television set because from the job working sheet,it is found that at the time of said repairing by the service centre it was not under warranty period.  But the instant problem was distortion of picture on 06-06-2012 in the CTV so in view of the above circumstances considering the material fact this Clause 6 of the said policy we are convinced that present problem distortion of picture of TV is not covered by the said insurance policy as enumerated in Clause 6 of the said policy Householder’s policy insurance clause of the New India Assurance Company Ltd. 

          At the same time it is specifically mentioned that in the general exception clause that company shall not be liable in respect of any loss, damage, inability or expenses caused by depreciation or wear or tear.  So, it is apparent that OP insurance company rightly rejected the claim as the present distortion of picture of the TV set was caused for depreciation or wear and tear and moreover such sort of problem was not for lightning, bursting, earthquake, flood, riot burglary or mechanical or electrical break down. 

          So, we are convinced to hold that the present claim of the complainant is not covered by the conditions of the policy – Householder’s Insurance Policy and so we are inclined to say that present complaint is not maintainable because this claim is not covered by the policy condition (General Exception) Section-VI of the said policy and accordingly repudiation was rightly made by the OP and there was no laches or deficiency on the part of the OP.

In the result, the case fails.

Hence,

Ordered

That the case be and the same is dismissed without any cost against the OP.