DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II
Udyog Sadan, C-22 & 23, Qutub Institutional Area
(Behind Qutub Hotel), New Delhi-110016.
Case No.857/2007
M/s JVMD
House No.10, Bharat Vihar,
Lakarpur, Behind Charms Wood Village,
Sector-39, Faridabad,
Haryana ….Complainant
Versus
National Insurance Co. Ltd.
Through its Divisional Manager,
Division No.30,
L-2, 1st Floor,
Green Park Extension,
New Delhi-110016 ……Opposite Party
Date of Institution : 02.08.07 Date of Order : 10.06.16
Coram:
Sh. N.K. Goel, President
Ms. Naina Bakshi, Member
Sh. S.S. Fonia, Member
O R D E R
From a reading of the complaint it appears that the complainant has arrayed the Insurance Co. as OP-1 and the surveyor as OP-2. However, Insurance Company is the sole OP.
Briefly stated, the case of the Complainant is that the Complainant firm dealing in the business of Garments Exports had taken an insurance policy No.354900/46/05/75000237 from OP for the period from 14.09.2005 to 13.09.2006 for a total premium of Rs.6943/- which included Rs.643/- as service tax. On 24.12.2005, there was a burglary in the premises of the Complainant “when some which was lying in the insured premises”. Immediately after gaining knowledge about the burglary, the Complainant through Sh. S.C. Kachroo lodged an FIR on 24.12.2005 at P.S. NIT, District Faridabad. On 24.12.2005, the complainant requested the OP to register its claim and OP appointed the Surveyor Sh. G.S Narang to find out the loss and assess the same. They provided all the documents and records which were available with them. They expected that the Surveyor would finalize the assessment of the loss within a reasonable period of time i.e. 2-3 months but the Surveyor submitted the report in the month of July, 2006. As no reply was received, he wrote a letter to OP on 17.08.2006 to expedite the settlement of the claim. When no reply was received, the complainant sent a reminder on 06.10.06 to the OP. He received a letter dated 30.10.06 from the OP wherein it was mentioned that the complainant had not submitted the trading account and the final report of the police but the Surveyor had not asked the complainant to submit the same. The same had been forwarded to the OP on 01.12.06. The complainant received a letter dated 19.04.2007 from the OP wherein it was mentioned that the claim was being closed as “no claim”. The OP had already appointed a Surveyor to investigate and assess the loss and the OP rejected the claim without any reason. Hence, there is a deficiency in service on the part of OP. The Complainant has prayed as under:-
- Direct the OP to pay full claim amount of Rs.1,85,304/- to the Complainant.
- Direct the OP to pay Rs.20,000/- towards mental tension and agony suffered by the Complainant.
- Direct the OP to pay Rs.20,000/- as cost of litigation.
OP in the written statement has stated that the OP had granted an insurance policy bearing No.354900/46/05/75000237 to the Complainant covering the period from 14.09.05 to 13.09.06. The Complainant informed them that a theft had taken place in its premises by an employee on 24.12.05 and an FIR was lodged with the police. On receipt of the theft information OP appointed Sh. G. S. Narang (loss assessor) as an Assessor to investigate and assess the loss. The Complainant did not submit to the Surveyor stock statements, trading account certified by their auditors on the date of loss to arrive at quantum of loss. The Surveyor submitted his report on 10.07.06 and stated that as:
“There is no evidence of theft following upon an actual forcibly and violent entry or exit from the premises. The same has also been admitted by the Complainant in written complaint to the police authorities hence it is not a case of burglary or housing breaking. Theft of goods has been affected by in convenience of the insured’s guard hence the claim falls under the standard exclusion (II).
In view of the above, the claim is not tenable.”
OP has stated that as per the report of the Surveyor the entire matter was placed before the competent authority, who after going through the entire material on record came to the conclusion that the claim lodged by the Complainant was not payable and repudiated the claim vide letter dated 19.04.07. OP has further stated that all the claims are paid strictly according to the rules and terms and conditions of the contract entered between the parties. Therefore, there is no deficiency in service on their part. OP has prayed for dismissal of the complaint.
Complainant has filed rejoinder to the written statement of OP reiterating the averments made in the complaint.
Complainant has filed affidavit of Sh. S.C. Kachroo, CEO in evidence. On the other hand, affidavit of Sh. P. Marwah, AR and affidavit of Sh. Gurdeep Singh Narang, Surveyor have been filed in evidence on behalf of the OP.
Written arguments have been filed on behalf of the parties.
We have heard the arguments on behalf of the OP and have also gone through the file very carefully.
It is not in dispute that the Complainant had taken an insurance policy No.354900/46/05/75000237 from OP for the period from 14.09.2005 to 13.09.2006 and theft took place in the premises of the Complainant on 24.12.05. The Complainant informed the OP as well as lodged an FIR on 24.12.05. The OP has filed the terms and conditions governing the policy (copy Annexure R-1). The OP vide letter dated 19.04.07 (copy annexure C-8) informed the Complainant that as per the policy exclusion clause 11 the company was not liable in respect of loss and damage where any inmate or member of the insured’s household or his business staff or any other person lawfully in the premises in the business was concerned in the actual theft or damage to any of the articles or premises or where such loss is involved or damage has been expedited or in any way assisted or brought about any such person.
From the perusal of the FIR itself, there is every reason to believe that the staff of the complainant staying in the factory premises was a part of the theft which took place in the factory premises. During investigation the OP came to the same conclusion vide letter dated 19.4.2007 which we mark as mark ‘A’ for the purposes of identification. Therefore, we are not inclined to believe that the claim of the complainant was refuted on illegal grounds or not according to the terms and conditions of the insurance policy in question. Therefore, we hold that the case of the complainant fell within the exclusion clause (ii) of the terms and conditions of the policy in question.
It stands proved that OP had rightly repudiated the claim of the Complainant as the same fell within the exclusion clause (ii) of the terms and conditions of the policy. Accordingly, we dismiss the complaint with no order as to costs.
Let a copy of this order be sent to the parties as per regulation 21 of the Consumer Protection Regulations. Thereafter file be consigned to record room.
(S.S. FONIA) (NAINA BAKSHI) (N. K. GOEL) MEMBER MEMBER PRESIDENT
Announced on 10.06.16.
Case No. 857/07
09.06.2016
Present – None.
Vide our separate order of even date pronounced, the complaint is dismissed. Let the file be consigned to record room.
(S.S. FONIA) (NAINA BAKSHI) (N. K. GOEL) MEMBER MEMBER PRESIDENT
