NCDRC

NCDRC

FA/310/2018

USHA PAUL - Complainant(s)

Versus

BAJAJ ALLIANZ GENERAL INSURANCE CO. LTD. & ANR. - Opp.Party(s)

MR. SOMRAJ GANGOPADHYAY & MR. SOUVIK CHATTERJEE

29 Aug 2024

ORDER

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
 
FIRST APPEAL NO. 310 OF 2018
(Against the Order dated 29/01/2018 in Complaint No. 382/2015 of the State Commission West Bengal)
1. USHA PAUL
W/O. SRI. BISWAJIT PAUL. R/O. BASANTA NAGAR, NEAR CHANDMARI, P.O.-GHURNI, P.S.-KOTWALI.
NADIA-741103
WEST BENGAL.
...........Appellant(s)
Versus 
1. BAJAJ ALLIANZ GENERAL INSURANCE CO. LTD. & ANR.
PLOT NO. F-2, 3RD FLOOR, B-BLOCK, NEW TOWN, RAJARHAT.
KOLKATA-700156
2. THE UNITED BANK OF INDIA.
UNITED TOWER, , HEMANT, BASU SARANI.
KOLKATA-700001
...........Respondent(s)

BEFORE: 
 HON'BLE MR. SUBHASH CHANDRA,PRESIDING MEMBER

FOR THE APPELLANT :

Dated : 29 August 2024
ORDER

For the Appellant                 Mr. Manish Shukla, Advocate 

Mr. Rishabh Dubey, Advocate  

               

For Respondent no.1            Mr. Navneet Kumar, Advocate

Mr. Ashwary Kathed ,Advocate

 

For Respondent no.2            Ms. Arti Singh, Advocate

 

       

ORDER

 

1.     This First Appeal under Section 19 of the Consumer Protection Act, 1986 (in short, ‘the Act’) challenges the order of the State Consumer Disputes Redressal Commission, West Bengal, Kolkata (in short, ‘the State Commission’) in Complaint Case No. 382 of 2015 dated 29.01.2018 dismissing the complaint on contest without costs.

2.     Relevant facts of the case, in brief, are that the Appellant had obtained a Standard Fire and Special Perils Insurance Policy (‘the Policy’) from the Respondent No.1 for the period 16.10.2014 to 15.10.2015 in respect of stock kept in her shop which was the insured premises. Due to a fire in the intervening night of 4th & 5th June, 2015, a claim of loss for Rs.24,34,352/- was filed with the Respondent No.1 (Insurance Co.). Based on the report of a Surveyor appointed under Section 64 UM of the Insurance Act 1938, who visited the insured premises and assessed the admissibility of the claim, Respondent No.1 repudiated the claim, vide letter dated 29.09.2015 citing  breach of General Condition No.7 & 8 of the Policy on the ground that the insured did not comply with the requirements of the Policy as it did not provide the required documents to substantiate the loss and no details of purchase of various quantities of goods stated to have been stored were provided to the Surveyor. Being aggrieved, the Appellant approached the State Commission through a consumer complaint which came to be decided against her, on contest, by way of the impugned order. The Appellant is before this Commission praying to set aside the impugned order dated 29.01.2018 and to pass any other order deemed fit and proper.

3.     We have heard the learned counsel for both the parties and carefully considered the material on record.

4.     The case of the Appellant is that the Appellant was running a grocery-cum-stationery wholesale and retail shop for which a loan of Rs.14.50 lakhs was obtained by her from the United Bank of India Respondent No.2 on 08.09.2014. Two Insurance Policies for Burglary and a Standard Fire and Special Perils Policy respectively were obtained on her behalf to secure the stocks by the Bank with Respondent No.1. Thereafter, another ‘All Risk Policy’ was also issued on 21.10.2014 at the instance of the said Bank. Due to an unfortunate fire in the intervening night of 4th – 5th June, 2015, which was duly intimated to the Police and Fire Brigade, the Appellant suffered considerable losses regarding which intimation was given to the Respondent No.1 Insurance Co. The surveyor Shyamal Kumar Dey visited the premises on 05.06.2015 and again on 06.06.2015 with Mr. Subrata Bose and conducted detailed inspections. According to the Appellant, the premises were cleaned as per oral instructions in the presence of the Surveyor and Loss Assessor on 10.06.2015 prior to which, on 09.06.2015, as advised by the Bank, a claim was submitted to the Respondent No.1. Appellant submits that she was in touch with the Surveyor between 10.06.2015 and 17.08.2015 and provided all the required documents as requisitioned. The repudiation of the claim on 29.09.2015 was challenged by her before the State Commission which came to be dismissed by the impugned order against which she had filed this appeal since Respondent had been liable for deficiency in service and unfair trade practice under the Act. Reliance was placed on the judgements of this Commission in Future Generali India Insurance Co. Vs. Mohd. Raees & Anr., in RP no. 2128 of 2019 dated 13.11.2019 and New India Assurance Co. Ltd. Vs. Sehrawat India (P) Ltd. 2009 3 CPJ 4 decided on 17.04.2009 and Hadimba International Ltd. Vs. United India Insurance Co. Ltd., in CC no.58 of 2001 decided on 15.12.2009. According to the Appellant, the cause of fire was not in dispute and the repudiation of the claim on the ground that documents sought had not been provided or that evidence on the insured premises did not indicate that the loss of stocks claimed was incorrect.

5.     Per contra, the contention of the Respondent is that the repudiation was based on the Appellant failing to provide the documentary evidence to substantiate the quantum of the claim by not disclosing certain documents and also forging relevant documents. According to the Respondent, the Appellant failed to provide the complete postal addresses of her suppliers and none of the alleged suppliers came forward to authenticate the cash memos and bills furnished by the Appellant. It was also contended that based on the report of a handwriting expert appointed by the Respondent, the bills provided were found to actually pertain to a single supplier. It was contended that the repudiation was based on the Surveyor’s Report which was not countered by the Appellant to be arbitrary or perverse as held by this Commission in Oriental Insurance Co. Ltd. Vs. Mehta Wool Store, [III (2007) CPJ 317 (NC)] and in the judgment of the Hon’ble Supreme Court in United India Insurance Co. Ltd. Vs. Roshan Lal Oil Mills Ltd., (2000) 10 SCC 19.

6.     Respondent No.2 submitted that there was no connection between it and the claim of the Appellant with Respondent No.1. According to  Respondent No.2, the insurance coverage was taken by the Appellant  voluntarily and the loan account had become a Non-Performing Asset (NPA) due to defaults committed by the Appellant in repaying dues, as a result of which recovery under SARFAESI Act, 2002 had been initiated by it on 23.07.2015 for a sum of Rs.15,01,647/-.

7.      The State Commission vide its order dated 29.01.2018 has held that:

The instant claim of the Complainant was primarily repudiated on the ground that the documents furnished to corroborate such claim were found to be fabricated/manufactured. Although the Ld. Advocate appearing on behalf of the Complainant argued at length, he quite consciously refrained from answering uncomfortable issues being flagged by the Surveyor. The following aspects are worth noting:

 

The Surveyor repeatedly asked the Complainant to furnish complete postal address of the suppliers, but to no avail. Although some phone numbers were provided to the Surveyor by the Complainant, none of the referred persons came forward to authenticate the cash memos/bills being furnished by the Complainant.

 

Although the Surveyor did not mince his words in dubbing the cash memos/bills as manufactured/fabricated, Complainant made no concerted effort to prove the Surveyor wrong by adducing evidence from the concerned vendors.

 

The Surveyor, in his report, noted that, out of the total loan amount of Rs. 14,50,000/-, a sum of Rs.14,35,000/- was transferred to the accounts of Complainant's near relations though she had no business relationship with them. For some obscure reasons the Complainant maintained studded silence in the matter.

 

Another anomaly noticed by the Surveyor was in respect of the purchase value declared by the Complainant. On one hand, the Complainant declared that she purchased goods worth Rs. 4,71,693/- on 30-05-2015. On the other, since she declared that there was no opening stock on 30-05-2015, according to the Surveyor, if that was indeed true, in that case, Complainant purchased goods worth Rs. 20,22,656/ on that day. Curiously, the huge anomaly between Rs.4,71,693/- and Rs.20,22,656/- is not explained by the Complainant.

 

Rightly or wrongly, the OP No. 1 submitted report from a Document Expert, who, after examining the disputed bills/cash memos of different companies opined that the same was prepared by the same person. However, the Complainant made no such endeavour to prove the said expert wrong by adducing report from another Expert in the field.

 

As a claimant, it was the primary responsibility of the Complainant to prove her case. We afraid, the Complainant miserably failed to discharge her responsibility in this regard.”

 

[ Emphasis supplied ]

8.     During the course of arguments, Counsel for the Appellant placed reliance on this Commission’s order in Branch Manager, State Bank of India Vs. Saraswati Paul Branch, Revision Petition No.358 of 2017 dated 04.09.2023.  However, the ratio of this judgement which pertains to deficiency in service on account of delay by a Bank in obtaining insurance cover is not applicable in the instant case since that is not a fact in dispute.

9.     From the submissions made and the material available on record, it is evident that the claim of the Appellant has been repudiated on the grounds that she failed to provide the requisite documents sought from her by the Surveyor in order to establish the quantum of stocks held in her shop for which purpose she had obtained a loan from the bank and the insurance cover to indemnify her against loss due to burglary or fire or special perils. Consequently, the claim was considered inadmissible under General Condition No.7 & 8 of the said Policy. Appellant has not been able to bring on record any document to counter this conclusion of the Respondent or to indicate, leave alone substantiate, that the claim of the Surveyor appointed by the Respondent No.1 under Section 64 UM was arbitrary or perverse. The contention of the Respondent that the bills were fraudulent because the agencies from which these were reportedly generated had not come forward to authenticate the same has also not been countered by the Appellant by way of any affidavits.

10.   In Sri Venkateswara Syndicate Vs. Oriental Insurance Company Ltd. & Anr. in CA No. 4487 of 2004 dated 24.08.2009, (2009) 8 SCC 507, it has been held by the Hon’ble Supreme Court that:

a surveyor’s report in cases of claims under a valid policy is an essential requirement under Section 64UM and that the Surveyor’s report constitutes an important document that must be considered.

The appellant has not been able to establish through documentary evidence that this Report was either arbitrary or perverse.

11.   In the light of the discussions above, I do not find any reason to disturb the findings of the State Commission which are balanced and based upon the evidence produced before it. The First Appeal is therefore disallowed and the order of the State Commission is affirmed. Parties shall bear their own costs.

12.   Pending IAs, if any, stand disposed of with this order.

 

 
......................................
SUBHASH CHANDRA
PRESIDING MEMBER

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