The fact of the case in nutshell is that the complainant Rajesh Dutta, the proprietor of Ruchira Enterprise runs a business having goodown to store his business items at Kamakhyaguri, Alipurduar. He used to keep edible oil, soap, candy and various items for his business purpose. And he insured his goodown and all business materials by a policy for the period between 15/03/2016 and 14/03/2017. The risk covered for Rs. 20,00,000/- for goodown and Rs. 60,00,000/- for good items. On 30/06/2017 a fire took place in his goodown due to short circuit and some furniture and papers was damaged in the said fire. And for which he submitted a claim before the insurance company but subsequently, he withdrew the said claim because the items  destroyed in the said fire was not covered with the insurance. Thereafter on 06/07/2017 in the night another fire broken out in the goodown and fire brigade was called there and somehow the fire was managed to defuse but severe loss has to be sustained on the part of the complainant as the business items was completely destroyed including the building and the furniture thereon. He intimated the accident to the insurer through G-mail on 06/07/2017 and one Pradip Saha, a surveyor was appointed to assess the losses. The complainant sustained a loss of Rs. 63,74,609/- in the said accident. And he furnished the claim before the insurance company along with stock estimates and others. He also handed over all the relevant documents and papers to the subsequent investors Astha Insuvision who was appointed as a surveyor by the insurance company. The surveyor subsequently, confined to the losses to the tune of Rs. 21,37,743/-. The complainant was not agreed with the assessment work of Astha Insuvision and for that reason, he has raised protest against the said report but insurance company wanted to settle the claim on the basis of surveyor’s report to the tune of Rs. 21,37,743/- which is very unfair on the part of the insurance company whereas the complainant has actually sustained a loss to the tune of Rs. 63,74,609/- and more amount but the insurance company has approached him to accept Rs. 21,37,609/.  He was bound to accept the said money under the coercion and threat. The complainant has received the said amount only with an expectation that the balance amount would be paid in in the near future. But the insurance company has virtually denied to make the balance payment to the tune of Rs. 43,36,866/-. So, the complainant has registered the instant consumer complaint. The insurance company has contested the consumer complaint by submitting the written version and contended that after the incident of fire dated 06/07/2017 while the insurance company was got intimation of the said accident then and then one P. Saha was appointed as loss assessor and surveyor to estimate the loss. P. Saha visited the spot and started preliminary inquiry and he has asked the complainant to produce some documents but the complainant could not furnish the relevant documents which were sought for from him by P. Saha and for that reason the assessment work of P. Saha was abandoned. Subsequently, this OP appointed one Astha Insuvision Insurance Surveyor holding the license of IRDA who has conducted the survey very categorically and after completion of survey report he arrived to the conclusion that the net loss of the complainant which he has sustained in the incident came to the tune of Rs. 21,39,883/- and for that reason, the insurance company after deduction of necessary charges settled the amount to the tune of Rs. 21,39,883/-. And sent the disburse voucher to the address of the complainant for full and final settlement of the claim. He was again asked to send the duly signed loss voucher within 7 days from the date of letter on 25/06/2018 failing which the insurance company would assume that the petitioner was not interested on his claim. Then on 03/07/2018 by an e-mail the complainant informed the insurance company that he was ready to accept the offered amount as a part payment. In reply to the said e-mail dated 03/07/2018 the insurance company subsequently, mentioned him by counter e-mail that Rs. 21,39,883/- was the final amount for the full and final settlement of the claim and insurance company would not be liable for any further payment in connection with the captioned loss and claim. Thereafter, the complainant has furnished the signed loss voucher, cancelled cheque and disbursement voucher by which he has received the final settlement to the tune of Rs. 21,37,357/- after deducting Rs. 2526/- as premium. The OP had paid the claim for the loss sustained by the petitioner in full and final settlement and without raising any objection has accepted the same and for that reason the complainant was not entitled to get any balance amount and there was no deficiency of service on the part of the OP and for that reason, the instant complaint should be dismissed. The complainant in support of his case examined himself and he was cross examined on the part of the National Insurance Co. One KK Subba the Branch Manager of Birpara Branch has been examined as OPW- I and he was cross examined by the complainant side. Both the parties have submitted all the material documents and all the documents has been considered in this case at the time of final hearing. The argument of both sides was heard.

D E C I S I O N  W I T H   R E A S O N S

The admitted position is that the complainant has got an insurance coverage through Insurance Company for his goodown and business items to the tune of Rs. 80,00,000/- by paying the insurance premium and the fire accident took place within the policy period and he then and then furnished the claim before the insurance company with fire brigade report, panchayat report and the copy of the police information report. The insurance company at the first instance has appointed one PK Saha an independent surveyor who has visited the spot and inquired from the complainant. But he could not complete the process of assessment as because some documents could not be supplied to him by the complainant at the time of assessment and for that reason, he asked the complainant to produce some documents. But due to latches on the part of the complainant the surveyor P. Saha could not complete the process of assessment and left the work. Subsequently, the Astha Insuvision was appointed by the insurance company to conduct the process of assessment of losses and to survey after thorough inspection and considering all the aspects of this incident including the material documents which were placed before him, he assessed the loss to the tune of Rs. 21,39,883/-. And he has submitted the final report before the insurance company and copy of the same was handed over to the complainant. The complainant was disagreed with the said amount and he claims that actually he sustained a loss of more than Rs. 63,00,000/- in the said fire accident and for that reason, he was not intended to settle the claim amount assessed by the assessor Astha Insuvision. He raised his claim for Rs. 63,00,000/- and more and for such accident the insurance company was adamant to settle the claim on the term of the complainant and they fixed their settlement to the amount assessed by the assessor and from there the instant dispute started. The insurance company sent loss voucher for counter signature of the complainant in order to settle the claim but it was not returned back to the insurance company. On the other hand, the complainant/claimant sent a G-mail informing the insurance company that he was intended to accept the said settle amount Rs. 21,39,883/- as part payment and he expected that balance amount would be paid in future. The insurance company then categorically by counter g-mail addressing to the complainant mentioned that the amount of Rs. 21,39,883/- was the final settlement and if the complainant again was disagreed with the same amount then the claim would be forfieted and closed. Subsequently, on the basis of such insurance company’s g-mail, the complainant was agreed to settle the amount and he did not raise any further claim before the insurance company and accepted the settle amount by encashment of cheque. Now the question arises whether after full settlement and after accepting the settlement amount can the complainant again reagitate the matter before the Fora. The dispute raises with allegation that the insurer has defaulted him not paying the actual losses which he has sustained in the accident.

During the course of hearing Ld. Advocate of the OP submitted before this Commission that the goodown where the business items of the complainant was stocked the business items of the father of the complainant also was stocked there. And the complainant could not produce the stock register before the assessor to justify his actual stock which was got in fire and for that reason, the complainant has nothing to do but to settle the claim as per report of surveyor. He further argued that the insurance company has disbursed the settlement amount as final and full settlement and not as part payment and after agreeing with the said settlement and after acceptance of the settlement amount the complainant again claims for further amount and there was no deficiency of service on the part of the insurance company in this particular matter. The complainant in his cross examination clearly admits the fact that he could not submit the stock register before the surveyor as the stock register was destroyed by fire. He further admitted in cross examination that in the same building the goods of his father were also stored there. In cross examination he further admits that he did not put any objection in lossvoucher as part payment and did not put any endorsement over the disburse voucher as part payment. Ld. Advocate of the complainant during the course of the argument mentioned that the complainant is a small business man. He is a small type of trader and he has sustained a huge loss in the fire accident and without reimbursement of the insurance company he was unable to continue his business and under the pressure of the insurance company he was bound to agree with the amount settled by the insurance company. He time and again raised his objection to accept the assessed amount estimated by the surveyor and for that reason, he wanted to accept the money as part payment but Insurance Company has forced him to put his signature in the disburse voucher and to accept the said money otherwise he was unable to revive his business. Ld. Advocate of the complainant further argued that when the first assessor P. Saha started to conduct the assessment process and without any specific reason the insurance company has abandoned his work and the report of first surveyor Mr. P. Saha should be accepted in this case and the subsequent report of assessment submitted by Astha Insuvision is liable to be rejected. In reference to his argument he referred a judicial decision reported in AIR 2010 SC 3035. After going through the said referred judgment of Hon’ble Supreme Court, we find that the case was different with our present case. In our case in hand the first surveyor could not complete the process of assessment for want of papers which could not be supplied to him by the complainant and for that reason, he could not submit the report. Subsequently, to complete the process of assessment the insurance company has appointed Ashtha Insuvision for proper assessment. The Ld. Advocate of the complainant referred a judicial decision of Hon’ble NCDRC reported in 2004 (2) WBLR (CPNC) 20187 where after part payment the second claim of the complainant was refused by the insurance company but ultimately the claim of the complainant was sustained by the order of Hon’ble NCDRC. After going through the said judicial decision it reflects that in that particular case the two policies and two payments were made towards those policies. But here in this particular case, only one insurance coverage was there. Ld. Advocate after referring another  judicial decision of Hon’ble NCDRC reported in (2004) WBLR (CPNC) 297 mentioned the amount received under pressure the claimant could not be debarred from claiming further amount. But here in our case at the time of accepting the said amount the claimant did not put any endorsement for his disagreement with the said amount and after receiving the payment not sent any single letter addressing to the insurance company on the part of the claimant to speak that he was disagreed with the said amount and has accepted only as part payment seeking balance amount in near future.

Ld. Advocate of the NIC in his argument referred a judicial decision reported in (iv) (2016) CPJ 35 (NC) where the petitioner has not raised the issue of coercion or any threat communication before acceptance of payment subsequent claim was not justified one. Undisputedly, in this case the cheque amount for full and final settlement was received by the complainant. And after acceptance of the said money no further communication was made on his part to the insurance company to raise his protest against the settled amount. The critical principle of insurance law is that once a party accepting the payment as full and final satisfaction without any protest at the time of receiving the said amount then in future, he is debarred to put forward further claim for any balance payment. So, the considered view of the Commission is that in this particular case at the time of receiving the final settlement the complainant was agreed to accept the proposed amount as finally settled by the insurance company on the basis of assessment report. The consumer fora has nothing to do to entertain the appeal of the insured for any further payment. And no deficiency of service in this regard has been reflected on the part of the National Insurance Company. Therefore, the instant consumer complaint case is liable to be dismissed.