DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, JHARSUGUDA

CONSUMER COMPLAINT CASE NO. 22 OF 2016

Sanjay Pradhan (48 yrs),

S/O- Chaturbhuja Pradhan,

RO: AT- Mahimanagar, Bandhbahal,

PO-Bandhbahal Colony, PS- Banharpali, 

Dist: Jharsuguda, Odisha, Pin-768 217…………….….………………Complainant.

Versus

1. Branch Manager,

The Magma HDI General Insurance Company Ltd,

AT- Bombay Chowk, PO- Industrial Estate,

PS/Dist- Jharsuguda (Odisha).

2. The Branch Manager,

The Magma HDI General Insurance Company Ltd,

AT- 1^st floor, Opposite SBI Uditnagar Branch,

Ghafoor Colony, PO/PS- Uditnagar,

Rourkela, Dist- Sundargarh, 769012 (Odisha).

3. Manager, The Magma HDI General Insurance Company  Ltd,

AT- Magma House, 24 Park Street,

Kolkata- 700016 (WB).……..………………………………….…………..Opp. Parties.

Counsel for the Parties:-

For the Complainant                                       Abdul Zalil, Adv. & Associates.

For the Opp. Party No.1, 2 & 3                       Shri A.K.Mishra, Adv &. Associates.

Date of Order: 22.02.2017

Present  

                                            1. Shri S.L.Behera, President.

                                            2. Shri S.K.Ojha, Member.

                                            3. Smt. A. Nanda, Member (W).

Shri S. K. Ojha, Member : - The brief facts of this complainant’s case is that, the complainant has purchased one Caterpillar / CAT 32002  Hydraulic excavator amounting Rs. 62,00,000/- only from Tractors India Pvt. Ltd. for his own purpose for the work of extracting stone from quarry to obtain the work through bidding process. The said machine has been insured with the O.Ps valid from dtd.31.07.2015 to 30.07.2016. Within the insurance period i.e. on dtd. 02.01.2016 a piece of stone fallen towards the machine and the bucket cylinder of machine brook down completely and also it was bent. For such accidental damage the complainant informed and claimed for insurance before the O.Ps. As per the instruction of O.Ps the complainant purchased one new bucket cylinder by paying Rs.1,32,199/- only but

the O.Ps repudiated the insurance claimed on the ground of policy condition. The condition No 2 on the strength of which the O.Ps have repudiated the legal claim of the complainant speaks “excess for claim arising out of perils other than Aog: 3% of the sum insured subject to minimum of Rs. 1,00,000/- only where the complainant has lodged claim of Rs.1,32,199/- only. Hence, this case.                                              

            The O.Ps. Insurance company appeared and filed written version through their learned counsel admitting the fact of insurance and submitted that the excavator was insured at Rs.62,00,000/- only under 10.79% of under insurance. As per the term and condition of policy No.2 mentioned on itself of the policy “Excess for claims arising out of peril others than AOG : 3% of the sum assured subject to minimum  of Rs.1,00,000/”-. As per the policy condition the policy cover if the loss is more than 3% of the sum assured i.e. 3% of Rs.62,00,000/- = Rs.1,86,000/- . In this case the loss is Rs. 1,29,699/- which is less than the coverage policy i.e. Rs. 1,86,000/-only, the claim was repudiated and duly intimated to insured vide letter dtd. 09.02.2016. Denying in any deficiency in service the O.Ps. prayed for dismissal of the case. 

Heard from the parties, gone through the case record and documents available. The O.Ps did not challenge on the incident of accident held on dtd. 02.01.2016 so also within the period of validity of insurance, rather opposed on the fact of policy condition. The matter of dispute runs only around the policy condition. The Insurance Policy Condition No.2 reveals that, “Excess For Claims Arising Out Of Perils Other Than Aog : 3% Of The Sum Insured Subject To Minimum Of Rs. 100000/”-. Basing on fact of 3% of the sum insured i.e Rs. 1,86,000/-only where after deduction of salvage, the cost of repairing is Rs. 1,29,699/- only, the O.Ps repudiated the claim but in addition the condition itself says that, “Subject To Minimum Of Rs. 100000/”-.  The complainant has incurred net loss of Rs.1,29,699/-only as assessed by the surveyor also.

As per the policy condition the complainant itself is eligible for insurance claim hence, we are in considered opinion to allow the complaint petition by directing the O.P NO.2 (the Policy issuing branch) to pay a sum of Rs. 1,29,699/- (Rupees one lakh twenty-nine thousand six hundred ninety-nine) only towards insurance claim along with pay a sum of Rs. 8,000/- (Rupees eight thousand) only towards harassment , mental agony and cost of case within 30 (thirty) days from the date of receipt of this order, failing which the O.Ps shall be liable for interest @ 10% per annum on the above mentioned awarded amounts till realization.

Accordingly the case is disposed of.

Order pronounced in the open court today on this the 22^nd day of February 2017 copy of this order shall be communicated to the parties as per Rule.

                            I Agree.                                     I Agree.

                                        .

                        S.L.Behera, President              A. Nanda, Member (W)                        S.K.Ojha, Member                                                                                                               Dictated and corrected by me.

                      S.K. Ojha,  Member