Haryana

Karnal

CC/32/2018

Deepak Kumar - Complainant(s)

Versus

HDFC ERGO General Insurance Co. Ltd - Opp.Party(s)

Sumer Chand Bhujang

27 Feb 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

                                                          Complaint No. 32 of 2018

                                                          Date of instt. 07.02.2018

                                                          Date of Decision 27.02.2019

 

Deepak Kumar son of Shri Bal Kishan resident of House no.38, village Shergarh Tapu, Tehsil and District Karnal.

                                                                         …….Complainant

                                        Versus

 

HDFC ERGO General Insurance Co. Ltd. Regd./Corporate office at 1^st floor, 165-166, Backbay Reclamation, H.T. Parekh Marg, Churchgate, Mumbai-400020, through its Manager.

                                                                    …..Opposite Party.

 

           Complaint u/s 12 of the Consumer Protection Act. 

 

Before    Sh. Jaswant Singh……President. 

      Sh.Vineet Kaushik ………..Member

                Dr. Rekha Chaudhary…….Member

 

 Present:  Shri S.C. Bhujang Advocate for complainant.

                   Shri Sanjeev Vohra Advocate for OP.

                                  

                   (Jaswant Singh President)

ORDER:                    

 

                      This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986 on the averments that the complainant had purchased a Home Suraksha Plus policy bearing no.2918200929754300000 of his house situated at Pritam Pura Colony, Budha Khera, Karnal and the tenure of said policy is from 11.12.2014 to 10.12.2019 from the opposite party (OP) and has paid Rs.62,485/- as premium amount to the OP. In the month of July, 2017 due to heavy rain the walls of the house of the complainant has been dislocated and a huge loss had been caused to the house of the complainant and due to the dislocation of the walls the fitting of water pipes and fitting of electricity has been completely broken /disturbed and the cracks came out in the walls, floors and roofs of the house of the complainant and in this regard the complainant made a complaint to the OP and requested for compensation of damage of house then OP appointed the surveyor to survey the property/house and the surveyor has not inspect the damaged property and made a false report and the OP also issued a letter to the complainant on 18.08.2017 and declined the claim of the complainant on the basis of false report of surveyor. Thereafter, the complainant many times approached to the OP for the claim of loss of house due to heavy rain, but the OP did not pay any heed on the request of the complainant and postponed the matter on one false pretext or the other and finally refused to pay the claim. Then complainant served a legal notice dated 10.11.2017 to the OP in this regard but it also did not yield any result. In this way there was deficiency in service on the part of the OP. Hence complainant filed the present complaint.

2.             Notice of the complaint was given to the OP, who appeared and filed written version raising preliminary objections with regard to maintainability; jurisdiction; cause of action; complicated questions of law and facts are involved, which cannot be decided in summary jurisdiction; and concealment of true and material facts. On merits, it is pleaded that the complainant had taken Home Suraksha Policy having policy no.2918200929754300000 valid from 11.12.2014 to 10.12.2019. The said insurance policy is peril based policy and the perils are specifically mentioned in the policy document. The liability under the policy is decided subject to the terms and conditions of the Insurance contract. It is further pleaded that the complainant reported the loss for damage against the insured building through call centre on 10.08.2017 whereas the loss as alleged by the complainant was 21.07.2017. That immediately after the loss was intimated, the OP duly appointed an IRDA authorized surveyor namely, SKAAD Insurance Surveyors and Loss Assessors Pvt. Ltd. During the course of survey it was found that the location where the survey is been conducted is not as per the Risk location as mentioned in the policy. It is further pleaded that complainant through his statement appraised the fact that the damages has occurred due to the Rain. That during survey it was found that there was no damage to the building rather the damages occurred to the tanks which were built outside the building and is not the part of the building, in order to prove this statement/observation made by the surveyor, the surveyor has taken the photographs of the loss location, which clearly shows that no damage is caused to the building. Further it was mentioned in the report of the surveyor under the cause of loss that “Heavy rain appears to be most probable cause of loss.”  Further, after the minute and physical verification, the surveyor came to the conclusion while deciding the liability of the OP against the dames as:-

. As per the policy, the risk location is “House  no.38, village Shergarh Tapu, Tehsil Karnal, Karnal Haryana-132001”  whereas the location of the loss is “House no.21, Pritam Pura Colony, Budhakhera, Karnal, Haryana.”

. The damaged tanks were built outside the building and not the part of the insured structure.

. There was no damage to the building structure.

. The occupancy described in the policy is-Residential, whereas the building is occupied as a factory.

. We also observed delay in intimation of loss.

Since OP liability does not exist for the subjected claim, however surveyor assessed the loss of Rs.9560/- for academic purpose only. It is further pleaded that as no loss and damage was not caused to the insured building and moreover, even otherwise as stated by the insured the damage as alleged was due to Rain, which is not among the covered perils. As the alleged loss was not covered under the policy and hence the claim has been rightly repudiated, vide letter dated 20.09.2017. There is no deficiency in service on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Complainant tendered into evidence his affidavit Ex.CW1/A and documents Ex.C1 to Ex.C6 and closed the evidence on 17.10.2018.

4.             On the other hand, OP tendered into evidence affidavit of Shweta Pokhriyal Ex.OP1/A and documents Ex.O1 to Ex.O9 and closed the evidence on 3.1.2019.

5.             We have appraised the evidence on record, the material circumstances of the case and the arguments advanced by the learned counsel for the parties.

6.             The case of the complainant is that complainant purchased a Home Suraksha Plus policy bearing no.2918200929754300000 of his  house situated at Pritam Pura Colony, Budhakhera, Karnal and the tenure of the said policy is from 11.12.2014 to 10.12.2019 from the OP and has paid Rs.62,485/- as premium amount to the OP. At the time of purchasing the said policy, the complainant was residing at village Shergarh Tapu, Karnal. In the month of July, 2017 due to heavy rain the walls of the house of the complainant has been dislocated and a huge loss had been caused. In this regard, complainant made a complaint to the OP and requested the OP for compensation of damage of house, then the OP appointed the surveyor and surveyor after inspecting the damage property made a false report and the OP issue a letter to the complainant on 18.08.2017 and declined the claim of the complainant on the basis of false report of surveyor. Thereafter, the complainant many times approached to the OP for the claim of the loss of house due to heavy rain, but the OP did not pay any heed on the request of the complainant and finally refused the claim of the complainant.

7.             On the other hand, the case of the OP is that the alleged house of the complainant damage due to heavy rain, the rain is not an insured peril under the policy obtained by the complainant. The complainant had taken Home Suraksha Policy. The complainant reported the loss for damage against the insured building through call center on 10.08.2017, whereas the loss as alleged by the complainant was 21.07.2017. The OP appointed surveyor, during the course of survey, it was found by the surveyor that the location where the survey is being conducted is not a part of the Risk Location as mentioned in the policy. As per the policy, the Risk Location is “House no.38, village Shergarh Tapu, Tehsil Karnal, Karnal Haryana-132001”  whereas the location of the loss is “House no.21, Pritam Pura Colony, Budhakhera, Karnal, Haryana.” The occupancy described in the policy is Residential, whereas the building is occupied as a factory. The claim of the complainant was rightly repudiated.

8.             As per the policy (Ex.C1/Ex.OP9) in the column of Risk Location address is house no.38, village Shergarh Tapu, Tehsil Karnal, Haryana mentioned. The correspondence address of the proposal is also house no.38, village Shergarhtapu, Tehsil Karnal, Haryana. As per the complainant and report of the surveyor, the damage house situated at Pritampura Colony, Budhakhera, Karnal. The said building was used as factory as per the report of surveyor, the said premises was not got insured by the complainant. Thus, we are of the considered view that the complainant is not entitled for the claim of the premises which was not got insured by him from the OP.

9.             Thus, as a sequel to abovesaid discussion, we do not find any merits in the complaint and the same is hereby dismissed. No order as to costs. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Dated: 27.02.2019

                                                                        President,

                                                           District Consumer Disputes

                                                           Redressal Forum, Karnal.

 

 

                     (Vineet Kaushik)     (Dr. Rekha Chaudhary) 

                        Member                       Member