STATE CONSUMER DISPUTE REDRESSAL COMMISSION
BIHAR, PATNA
Appeal No. 221 of 2016
Manager, Cholamandlam MS General Insurance Co. Ltd. I.G. Complex, Third Floor, Near Lalita Hotel, West Boring Canal Road, Patna- 800013
… (Opposite Party no. 1)/Appellant
Versus
1. Birendra Kumar Rai, S/o- Late Govind Rai, Resident of Boksha, PS- Buxar (Mufassil), District- Buxar, M/s Govind Rice Mill, Boksha via Gajadharganj, PS- Buxar (Mufassil), Buxar
…. Complainant /Respondent 1st Set
2. Zonal Manager, Central Bank of India, Zonal Office, Maurya Lok Complex, Patna
3. Regional Manager, Central Bank of India, Regional Office, Gaya, P.S & District- Gaya
4. Branch Manager, Central Bank of India, Buxar
…. (Opposite Parties nos. 2 to 4)/Respondent 2nd Set
Counsel for the Appellant: Adv. Rajesh Chandra Narayan
Counsel for the Respondent no. 1: Adv. Anirudh Mishra
Counsel for the Respondent-Bank: Adv. Binod Bihari Sinha
Before,
Hon’ble Mr. Justice Sanjay Kumar, President
Mr. Ram Prawesh Das, Member
Dated 17.04.2023
As per Sanjay Kumar, President.
O r d e r
Sufficient cause has been shown for not filing this appeal within time. For the reasons as stated in the application for condonation of delay in filing the appeal, the delay is condoned.
Present appeal has been filed on behalf of appellant/Opposite party no. 1 Cholamandalam General Insurance company Ltd. for setting aside the judgment and order dated 17.03.2016 passed by the Ld. District Consumer Disputes Redressal Forum, Buxar in Complaint case no. 22 of 2015 whereby and whereunder Ld. Forum has directed appellant to pay Rs. 7,00,000/- (seven lacs) to the complainant as compensation for damages/loss within 45 days failing which interest @8% shall become payable.
Briefly stated the facts of the case is that complainant is proprietor of Govind Rice Mill and has a cash credit account with limit of Rs. 36,00,000/- in the Central Bank of India (Buxar Branch) (O.P. no. 2 to 4) and all business transaction were operated from this account.
The mini rice mill was insured by appellant/O.P. no. 1 insurance company and premium of which was paid by the Bank from the account of complainant. Total sum assured amount of building, shed, Machinery and stock was Rs. 36,00,000/- for which Rs. 21,035/- was paid as premium amount.
On 31.05.2014 at about 2:45 AM all of a sudden thunder storm came which damaged the wall, shed of rice mill, stock of rice and machinery worth Rs. 9,39,950/- (nine lacs thirty nine thousand nine hundred fifty) got damaged information of which was given to the bank as well as insurance company.
A surveyor namely Chandra Shekhar Prasad was appointed by the insurance company who visited the spot on 04.06.2014 for verification and submitted his report regarding damage caused to the rice mill. The claim was repudiated by letter dated 04.03.2015 on the ground that the location of rice mill is different as given in the policy paper against which complainant filed a complaint case before the District Consumer Forum, Buxar for payment of compensation for the loss caused by natural calamity and for setting aside repudiation letter dated 04.03.2015.
On notice opposite party no. 1 (insurance company) appeared and filed its written statement stating therein that neither any FIR has been lodged in the local police station nor there is any investigation report of police. It was further stated that in policy paper the location ofmini rice mill is given as Ara Buxar road whereas same is located in Boksha village which is 15 KM away from Buxar Ara road and same being in violation of terms and conditions of insurance policy as such the claim was repudiated.
Written statement was filed on behalf of Central Bank of India (opposite party no. 2 to 4) in which they have stated that loan was provided to the complainant for business purposes and the rice mill was insured by the opposite party no. 1 (Cholamandalam Insurance company) and premium for insurance was paid to the insurance company by the bank within time as such there is no deficiency in service on part of opposite party no. 2 to 4 (Central Bank of India).
The District Consumer Forum, Buxar after hearing the parties and considering the material available held that thunder storm damaged the rice mill of the complainant which was insured by opposite party no. 1 and surveyor was appointed by the insurance company who made spot verification of the rice mill and found that rice mill suffered damage on account of thunder storm and assessed the damage caused to the rice mill and submitted his final report to the insurance company. However, insurance company repudiated the claim of complainant on the ground that location of rice mill is different from the location as stated in the proposal form and insurance policy.
The District Consumer Forum held that the rejection of claim on flimsy ground is not sustainable and accordingly directed the insurance company to pay compensation of Rs. 7,00,000/- (seven lacs) for the loss suffered by the complainant. Aggrieved by which appeal has been preferred by the Cholamandalam Insurance company.
The two issues raised in this appeal for consideration by State Commission are as follows:
- Whether the repudiation of claim on the ground that Rice Mill was not found at the place as mentioned in proposal form and policy paper is justified or not.
- Whether compensation of Rs. 7,00,000/- granted by District forum without considering surveyor report and without any evidence is sustainable in law.
The claim of complainant was repudiated on the ground that address of the
Rice Mill as given in policy document as Ara-Buxar road but actual location
is Boksha village which is 15 KMs away from Ara-Buxar Road.
As this is the sole ground on which claim of complainant has been rejected as such appellant are estopped from raising any other ground to repudiate the claim.
It is submitted on behalf of appellant that claim was rightly repudiated as location of Rice Mill was found different from location as given in policy paper. It is submitted on behalf of counsel for claimant that documents of the policy were filled up by the representatives of bank and insurance company. Proposal form was submitted by the Bank and after being satisfied the insurance company accepted the proposal of insurance. The Rice Mill is situated at link road of Ara-Buxar main road.
This Commission does not find that location as given in proposal from of policy paper and location as stated in survey report are different. The address given in proposal form and policy paper were not complete and specific. Moreover, the insurance was made by Bank and only premium was paid from CC account of complainant as such this Commission does not find any infirmity and error in the finding recorded by District Consumer Forum that repudiation of claim on said ground is erroneous and incorrect.
On the basis of surveyor report loss is assessed by District Forum and if there is no challenge to surveyor report, same is accepted However present case surveyor report has not been considered by District Forum and without any evidence and material available on record, District Consumer Forum has directed appellant-insurance company to pay compensation of Rs. 7,00,000/- . There is no basis on which District Forum has arrived at said figure as such judgment and order of District Forum is set aside as far as same relates to grant of compensation.
The surveyors are appointed under the insurance Act, 1938 and their reports are the basis for settling the insurance claim. Their reports are generally accepted until there are some cogent reasons to disbelieve the same. The Honble Supreme Court in the case of Sri Venkateswara Syndicate v. Oriental Insurance Company Limited & Anr., III (2009) CPJ 81 (SC)=(2009) 8 SCC 507, has observed the following:
“31. The assessment of loss, claim settlement and relevance of survey Report depends on various factors. Whenever a loss is reported by insured, a loss adjuster, popularly known as loss surveyor, is deputed who assesses the loss and issues Report known as Surveyor Report which forms the basis for consideration or otherwise of the claim. Surveyors are appointed under the statutory provisions and they are the link between the insurer and the insured when the question of settlement of loss or damage arises. The Report of the Surveyor could become the basis for settlement of a claim bij the insurer in respect of the loss suffered by the insured.
For the reasons as stated above appeal is partly allowed and case is remanded to District Consumer Forum, Buxar to consider and decide the quantum of compensation afresh on the basis of surveyor report and other materials available on record.
(Ram Prawesh Das) (Sanjay Kumar,J)
Member President
Md. Fariduzzama
