Heard learned counsel for both the sides.
2. The captioned complaint case is filed u/s 17 of the Consumer Protection Act (hereinafter called the ‘Act’ in short) by the complainant against the opposite parties for settlement of its insurance claim for an amount of Rs.33,44,738/-.
3. The factual matrix of the complainant’s case is that complainant had purchased a contractors All Risks Insurance Policy bearing No. 034003/44/33/1299/96 from the opposite parties for works contract covering the period from 11.6.1996 to 17.6.1997. It has purchased the policy for the construction in respect flood embankment-cum-ring road of Sambalpur Town, 1st Phase, Reach-II, Sub-Reach-III from R.D. 6 KM to 7 KM for an amount of Rs. 2,98,00,000/-. It is alleged inter alia that during subsistence of the policy, there was a flood in river Mahanadi causing heavy damages in the embankment and ring road for which the complainant lodged insurance claim of Rs. 33,44,738/- before the opposite parties. It is alleged that although the complainant has submitted all the documents in respect of its claim, but the opposite parties did not settle the claim. Therefore, complaint has been filed.
4. The opposite parties filed written statement stating with reference to policy in respect of construction of flood embankment cum ring road of Sambalpur Town, 1st phase, covering the risk of loss of materials for the period from 11.6.1996 to 17.6.1997 which was extended upto 16.6.1998 with specific stipulation that any damage upto 11.6.1996 could not be covered under the said Policy. However, after receiving the claim, they found that the claim form has not been submitted for which they have issued the letter, but the complainant submitted an extract of the alleged loss amounting to Rs. 33,44,738/-. It is alleged by the opposite party that on 5.11.1997, the Surveyor was engaged and the Surveyor has asked for certain document with regard to alteration and addition of the work done on the site etc. It is also the case of the opposite party that on 14.11.1997 the complainant was requested to submit R.A. Bills with relevant measurement sheets duly certified by the Irrigation Department Authorities, statement of loss with details about dates and quantities duly certified by the project authority, cause of loss together with details of so-called flood or heavy rainfall and copies of departmental progress. It is further averred that on 21.7.1999 the complainant requested the O.P. for early settlement of its claim, but it was informed to the complainant that final survey report is still awaited. But the complainant without waiting for the result, filed the complaint petition.
5. After going through the pleadings of both the parties, the only issue emerged for decision is that
(i) Whether the complainant has proved the case of deficiency in service on the part of the opposite party?
ANALYSIS
ISSUE NO.I
6. It is admitted fact that the complainant has purchased contract insurance policy from opposite party. It is not in dispute that the complainant has to prove the deficiency in service on the part of the opposite party. It is also not in dispute that there was flood in which there was damage to the embankment. The only plea of the complainant is that in spite of submission of the documents, the opposite parties did not settle the matter, but the opposite parties denied the charge. In fact, we find from the record that there is surveyor’s report but the same has not been submitted to the complainant. However, after hearing both the parties, we are of the view that the matter should be disposed of after the claim form under the Act is filed. Further, unless the claim form has been submitted, the insurer is not able to proceed ahead as per submission of both the parties. The opposite parties are required to supply the claim form to the complainant immediately for which there is delay in settling the claim. Issue no.I is answered accordingly.
CONCLUSION
7. In view of the facts situation, we hereby direct the complainant to submit the claim form along with other documents to the opposite parties, who is to settle the claim within a period of 45 days from today keeping in mind the nature of the policy and other conditions and pay the settled amount to the complainant within seven days of the settlement of claim.
8. The complaint petition is accordingly disposed of. No cost.
Supply free copy of this order to the respective parties or the copy of this order be downloaded from Confonet or Website of this Commission to treat same as copy supplied from this Commission.
