BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KURUKSHETRA.
Complaint No.208 of 2018
Date of Instt.:1.10.2018
Date of Decision:30.11.2021.
1.Pawan Kumar son of Sh.Lala Ram resident of Peer Wali Gali Babain District Kurukshetra, Haryana.
2.Manisha Devi w/o Sh.Pawan Kumar resident of Peer Wali Gali Babain, District Kurukshetra, Haryana
…….Complainant. Versus
1.HDFC ERGO General Insurance Company Limited, Registered & Corporate Office, HDFC House 1st Floor, 165-166, Backbay Reclamation H.T.Parekh Marg, Churchgate, Mumbai – 400020 through its Managing Director.
2.HDFC ERGO General Insurance Company Limited, Customer Service Address 6th Floor, Leela Business Andheri Kurla Road, Andheri Mumbai – 400059 through its customer Service Manager.
3.HDFC Bank Limited, Babain District Kurukshetra through its Branch Manager.
….…Opposite parties.
Complaint under Section 12 of Consumer Protection Act.
Before Smt. Neelam Kashyap, President.
Shri Issam Singh Sagwal, Member.
Ms.Neelam Member.
Present: Sh.Shekhar Thakur Advocate-complainant in person.
Sh.Atul Mittal Advocate for OP No.1 and 2.
OP No.3 ex parte.
.
ORDER
This is a complaint under Section 12 of the Consumer Protection Act, 1986 moved by Pawan Kumar etc. against HDFC ERGO etc -the opposite parties.
2. The brief facts of the complaint are that the complainant in the year of 2015 purchased a 5 Marla residential house situated at village Babain District Kurukshetra from its registered owner Sh.Jasmer Singh son of Awan Ram resident of village Bir Kalwan Sub Tehsil Babain District Kurukshetra vide sale deed No.2033 dated 20.03.2015. It is further submitted that in the month of November 2016, the complainants jointly took home loan from the OP No.2 by placing original sale deed with Bank and the OP No.2 got issued a Sarv Suraksha Plus Policy bearing certificate No. 29502015539400000 from OP No.1 and 2 i.e. HDFC ERGO Insurance Company Limited covering the period of 9.11.2016 to 8.11.2021 by receiving Rs.6590/- as premium and as per the cover detail given in the cover note, it covers loss of job, Accidental Death Benefits, Permanent total disability, Permanent Partial Disability, Accidental Hospitalization, Critical losses, Credit shield insurance, Garage cash, House Holder Coverage with sum assured of Rs.1,50,000/- The complainants are living in their new household i.e. residential house situated at Peer Wali Gali Babain District Kurukshetra, at the time of taking the loan from OP No.3 and the time of effecting the aforesaid insurance policy. The complainants gave their original sale deed of the house situated at Peer Wali Gali, Babain District Kurukshetra to the OP No.2 at the time of loan. It is further submitted that on 30.11.2016, while the complainants went to their shop in a day time and they got message from their neighbor shop keeper Sh.Ranbir Singh that he received a telephone call from Dimple son of Baldev Singh r/o Peer Wali Gali Babain about two stranger persons were coming out from the house of the complainants from back side and when the complainant no.1 alongwith said Ranbir Singh reached the house , they observed that a theft has been committed and some cash gold items have been stolen by thives and the complainant got registered FIR No.0228 dated 30.11.2016 with the Police Station Babain District Kurukshetra and loss of goods was assessed about Rs.15000/- despite gold items were stolen. Consequently a loss has been lodged with the OP No.2 and 3 but till date no claim has been received of the theft at the house of the complainant’s house which took place on 30.11.2016. It is also submitted that on 19.3.2018 while the complainants had gone to Panipat for meeting their relatives and while coming back from Panipat, they found that fire was spread from the lobby’s temple and due to such fire, all curtains and tables lied at the lobby were completely damaged and due to such fire the whole POP was falling from the roof and due to such fire, all electricity fitting, fan, doors white wash and other house hold items were also damaged completely and the complainant got registered a GD No.022 at Police Station Babain on 19.3.2018 about the fire incident causing loss of Lacs. The complainant lodged a claim with the OP No.2 and 3 by filing the claim form of OP No.2 and 3 showing the loss of Rs.3,50,000/- with all supported documents and bills but the said claim was closed without giving any reason to the complainant. When the complainant contacted the agent of the bank, he stated that the claim has been closed due to their earlier address i.e. village Bint mentioned in the cover note village Bint 144, Bhagwan Nagar, Kurukshetra. The complainant also sought information under the RTI Act application dated 14.5.2018 about these facts but no information was supplied despite more than four months have been elapsed since from the date of submission of RTI application which amounts to deficiency in service on the part of the Ops. Thus, the complainant has filed the present complaint alleging deficiency in services on the part of the Ops and prayed that the Ops be directed to pay the claim or sum assured alongwith the compensation for the mental harassment caused to them and the litigation expenses.
3. Upon notice, OP No.1 and 2 appeared and filed written statement disputing the claim of the complainant. It is submitted that the complaint has been filed in respect to the House Holders coverage under section 6 of the policy wherein loss of contents of the insured house is covered in respect of the specified perils. It is submitted that the complainant has never lodged any claim with the OP against the alleged theft in his house. It is submitted that the occurrence allegedly took place on 30.11.2016 in the house of the complainant has never been intimated to the answering Ops. It is also submitted that the claim of fire loss taken place on 18.3.2018 was registered. The claim was duly processed by the OP and closed the same as no claim vide letter dated 22.5.2018. On lodging the claim the Ops duly appointed J.C.Gupta and Co. Insurance SLA Pvt. Limited who is an IRDA accredited independent Surveyor and Loss Assessor who visited the spot on 23.3.2018 and submitted the detailed report dated 10.5.2018. On scrutiny of documents i.e. inspection at the site, statement of Mrs. Manisha (wife of the insured) and during the survey, surveyor observed that the loss location is different from the risk location and based on the same, the OP’s liability does not exist and the claim is not admissible under the purview of the policy and the claim had rightly been closed as No Claim vide letter dated 22.5.2018 sent to the complainant through registered post. The complainant had taken insurance in respect of property situated at Binat 144, Bhagwanpur, Kurukshetra Haryana whereas the loss has taken place at house No.39, Saini Colony, Babain Kurukshetra Haryana. This it is categorically clear that the property where fire took place was never insured by this OP and for this loss, the OP cannot be held liable. Thus, it is submitted that there is no deficiency in services on the part of the Ops and prayed for dismissal of the present complaint.
4. The complainant in support of their case have filed affidavits Ex.CW1/A, to Ex.CW7/A and tendered documents Ex.C-1 to Ex.C-20 and closed their evidence.
5. On the other hand, the Ops No.1 and 2 in support of their case have filed affidavit Ex.RW1/A and tendered documents Ex.R-1 to Ex.R-10 and closed their evidence.
6. We have heard the learned counsel for the parties and gone through the material available on the case file.
7. The learned counsel for the complainant while reiterating the averments made in the complaint has argued that in the year of 2015 purchased a 5 Marla residential house situated at village Babain District Kurukshetra from its registered owner Sh.Jasmer Singh son of Awan Ram resident of village Bir Kalwan Sub Tehsil Babain District Kurukshetra vide sale deed No.2033 dated 20.03.2015. It is further submitted that in the month of November 2016, the complainants jointly took home loan from the OP No.2 by placing original sale deed with Bank and the OP No.2 got issued a Sarv Suraksha Plus Policy bearing certificate No. 29502015539400000 from OP No.1 and 2 i.e. HDFC ERGO Insurance Company Limited covering the period of 9.11.2016 to 8.11.2021 by receiving Rs.6590/- as premium and as per the cover detail given in the cover note, it covers loss of job, Accidental Death Benefits, Permanent total disability, Permanent Partial Disability, Accidental Hospitalization, Critical losses, Credit shield insurance, Garage cash, House Holder Coverage with sum assured of Rs.1,50,000/- It is also argued that the complainants are living in their new household i.e. residential house situated at Peer Wali Gali Babain District Kurukshetra, at the time of taking the loan from OP No.3 and the time of effecting the aforesaid insurance policy. The complainants gave their original sale deed of the house situated at Peer Wali Gali, Babain District Kurukshetra to the OP No.2 at the time of loan. It is further submitted that on 30.11.2016, while the complainants went to their shop in a day time and they got message from their neighbor shop keeper Sh.Ranbir Singh that he received a telephone call from Dimple son of Baldev Singh r/o Peer Wali Gali Babain about two stranger persons were coming out from the house of the complainants from back side and when the complainant no.1 alongwith said Ranbir Singh reached the house , they observed that a theft has been committed and some cash gold items have been stolen by thives and the complainant got registered FIR No.0228 dated 30.11.2016 with the Police Station Babain District Kurukshetra and loss of goods was assessed about Rs.15000/- despite gold items were stolen. Consequently a loss has been lodged with the OP No.2 and 3 but till date no claim has been received of the theft at the house of the complainant’s house which took place on 30.11.2016. It is also submitted that on 19.3.2018 while the complainants had gone to Panipat for meeting their relatives and while coming back from Panipat, they found that fire was spread from the lobby’s temple and due to such fire, all curtains and tables lied at the lobby were completely damaged and due to such fire the whole POP was falling from the roof and due to such fire, all electricity fitting, fan, doors white wash and other house hold items were also damaged completely and the complainant got registered a GD No.022 at Police Station Babain on 19.3.2018 about the fire incident causing loss of Lacs. It is further argued that the complainants lodged a claim with the OP No.2 and 3 by filing the claim form of OP No.2 and 3 showing the loss of Rs.3,50,000/- with all supported documents and bills but the said claim was closed without giving any reason to the complainant. When the complainant contacted the agent of the bank, he stated that the claim has been closed due to their earlier address i.e. village Bint mentioned in the cover note village Bint 144, Bhagwan Nagar, Kurukshetra. The complainant also sought information under the RTI Act application dated 14.5.2018 about these facts but no information was supplied despite more than four months have been elapsed since from the date of submission of RTI application which amounts to deficiency in service on the part of the Ops. Thus, the complainant has filed the present complaint alleging deficiency in services on the part of the Ops.
8. On the other hand, learned counsel for the OP while reiterating the contentions made in the written statement has argued that the complaint has been filed in respect to the House Holders coverage under section 6 of the policy wherein loss of contents of the insured house is covered in respect of the specified perils. It is submitted that the complainant has never lodged any claim with the OP against the alleged theft in his house. It is submitted that the occurrence allegedly took place on 30.11.2016 in the house of the complainant has never been intimated to the answering Ops. It is also submitted that the claim of fire loss taken place on 18.3.2018 was registered. The claim was duly processed by the OP and closed the same as no claim vide letter dated 22.5.2018. On lodging the claim the Ops duly appointed J.C.Gupta and Co. Insurance SLA Pvt. Limited who is an IRDA accredited independent Surveyor and Loss Assessor who visited the spot on 23.3.2018 and submitted the detailed report dated 10.5.2018. On scrutiny of documents i.e. inspection at the site, statement of Mrs. Manisha (wife of the insured) and during the survey, surveyor observed that the loss location is different from the risk location and based on the same, the OP’s liability does not exist and the claim is not admissible under the purview of the policy and the claim had rightly been closed as No Claim vide letter dated 22.5.2018 sent to the complainant through registered post. The complainant had taken insurance in respect of property situated at Binat 144, Bhagwanpur, Kurukshetra Haryana whereas the loss has taken place at house No.39, Saini Colony, Babain Kurukshetra Haryana. This it is categorically clear that the property where fire took place was never insured by this OP and for this loss, the OP cannot be held liable.
9. In this case, obtaining of insurance policy by the complainant from the Ops, fire in the house of the complainant and loss caused to the complainant remains not in dispute. However, claim of the complainant has been repudiated by the Ops No.1 and 2 vide letter Ex.O-1 dated 22.05.2018 on the ground that complainant had taken insurance in respect of property situated at Binat 144, Bhagwanpur, Kurukshetra Haryana whereas the loss has taken place at house No.39, Saini Colony, Babain Kurukshetra Haryana. We have perused the sale deed Ex.C-1 and by this sale deed the complainant had purchased the property situated in village Mauza Babail Sub Tehsil Babain district Kurukshetra and the complainant got insured the said property alongwith house holds vide Ex.C-2. In the said insurance policy in the column of correspondence address “Binat -144, Bhagwanpur, Kurukshetra is mentioned. In the letter Ex.C-3 correspondence address is mentioned same as in the insurance policy. Thus, the Ops have wrongly considered the correspondence address of the complainant as the insured property. In the mark “E” insured property shown is situated in Mouza Babain district Kurukshetra whereas the correspondence address is shown as House No.144, village Bint Bhagwanpur District Kurukshetra. The complainant has purchased the property situated in Babain and the said property was got insured. In the mark “F” insured property is shown situated at village Mouza Babain. In the electricity bill mark ´”B” residential address of the complainants is shown at village Babain and thus, the Ops considering the residential of the complainant at village Binat has wrongly repudiated the claim of the complainant.
The surveyor of the OP no.1 and 2 have assessed the loss of Rs.43,500/- vide surveyor report Ex.R-4. It is pertinent to mention here that the complainant has placed on the file bills worth more than Rs.5.00 lacs but the sum assured under the said policy is Rs.1,50,000/-. Therefore, in our view the complainant is entitled to Rs.1,50,000/- as compensation for loss so caused in their house due to fire for which the complainants have obtained the insurance policy. For not making the payment of said amount, there is deficiency in services on the part of the Ops.
10. In view of our above discussion, we direct the OP No.1 and 2 to make the payment of Rs.1,50,000/- to the complainant alongwith interest @ 6% per annum from the date of filing of the present complaint i.e.1.10.2018 till its actual realization. The OP No.1 and 2 are also directed to pay the compensation of Rs.10,000/- for the mental harassment and agony caused to him and Rs.5000/- for the litigation expenses. The OP No.1 and 2 are further directed to make compliance of this order jointly and severally within a period of 30 days from the date of preparation of the copy of this order, failing which the complainant shall be at liberty to initiate proceedings u/s 25/27 of the Consumer Protection Act. The complaint qua OP No.3 stands dismissed. File be indexed and consigned to the record room after due compliance.
Announced in the open Commission.
Dated 30.11.2021. President.
Member Member.
