Haryana

Ambala

CC/154/2012

VIJENDER SINGH - Complainant(s)

Versus

OIC CO. - Opp.Party(s)

PAWAN YADAV

10 Mar 2017

ORDER

 

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM AMBALA

 

                                                          Complaint case no.        : 154 of 2012

                                                          Date of Institution         : 18.05.2012

                                                          Date of decision   : 10.03.2016

 

          Vijender Singh S/o Hatti Singh Partener Ms V.K. Enterprises at Highway         Saha Distt. Ambala.  

 

……. Complainant.

 

 

1. The Oriental Insurance Company Ltd. Registered Office, “Oriental House Asaf Ali Road, New Delhi – 11002.
2. The Oriental Insurance Company Ltd. Branch office, Near Vijay Cinema, Ambala City.

 

….…. Respondents.

 

 

BEFORE:   SH. D.N. ARORA, PRESIDENT

                   SH. PUSHPENDER KUMAR, MEMBER                             

 

 

Present:       Sh. Pawan Yadav, counsel for complainant.

                   Sh. Ashutosh Gupta, counsel for Ops.

 

ORDER:

                   In nutshell, brief facts of the present complaint is that the complainant Vijender Singh son of Hatti Singh Partner MS V.K. Enterprises is running a resort in the name and style of Red Hurt at Saha Distt. Ambala. The said resort building is insured with the insurance company vide cover note AMB No. 266813 for the period from 18.12.2010 to 17.12.2011 from Ambala City branch office on 10.12.2010, 11/20, agency code No. PNB with sum insured of 3.25 crore. On the night of 28.03.2011 there was violent storm came in the Distt. Due to heavy impact of storm one boundary wall i.e. north to west side of the resort and some glasses/mirror of complainant’s resort was broken. Further submitted that the complainant suffered huge damage in that storm and the condition of complainant resort is pitiable and its effects the business of complainant as the condition of the resort is not looking good due broken wall and glasses of the resort. Further submitted that on 03.04.2011, the Surveyor visits the site and took the photograph and assesses the cause and loss of damage of wall and glasses of the boundary wall. Further submitted that on the instruction of Surveyor, the complainant had started the construction work and repair the wall and glasses and submitted the Bill in the office of OP NO. 1 and they will pass claim of the complainant and after the construction of the boundary wall and glasses of the resort complainant submitted the original bill in the office of OP NO. 1 and all expenses of construction that is cost of repair of glass of Rs. 93946/- and of wall is 104000/- on 07.04.2011 and 11.04.2011 which is total amounting to Rs. 177946/- and Surveyor told to complainant that OP will pass the claim. On the direction of the Surveyor complainant paid the all the repair charges from his packet and the surveyor gave the assurance that Rs. 1,97,946/- would be reimbursed to complainant by the Ops but instead of reimbursing the claim of complainant by the OPs, they send the letter dated 02.08.2011 to complainant regarding some queries as mention at  Serial No. 3,4,13 in that letter and the OP No. 1 had mention wrong date of storm as 28.04.2011 instead of 28.03.2011 due to some clerical mistake and complainant had replied all the answer of queries of OP No. 1. Further submitted that the complainant approach the office of the OP No. 1 various time regarding the claims and meet there with Mr. Bholla and other officials of the OPs, but the OPs with ulterior motive put the matter on one way or the other. Further submitted that the complainant shock and surprise when the last time he visited in the office of OP No. 1 and asked about the pending claim from the concerned official of OP No. 1 and they told to complainant that the claim of the complainant has closed and they will not pay to the complainant a single penny which show clear deficiency and mal – practice in services on the party of the OPs. Hence, the present complaint.

2.                Upon notice, OPs appeared and filed written statement submitting that the present complaint involves commercial transaction and the complainant has insured his hotel and resort from the OP and has taken a policy for hotel and resort, which is commercial transaction.  As per the averments made in the complaint, the alleged loss as suffered by the complainant on 28.03.2011 and the complainant failed to inform the respondent regarding the alleged loss and damage suffered by him and got started the repairing the same without any approval of the OPs. Further submitted that the complainant informed the OP about the alleged loss and damage late in the evening on 01.04.2011, after lapse of three days and the OP appointed the Surveyor to assess the loss on 02.04.2011 and the Surveyor visited the spot on 03.04.2011 and he found that the complainant has got repaired the damage without any approval of the OP and in violation of the rules and terms & conditions of the policy. The complainant failed to inform the alleged damages to the OP immediately, which the required to be done immediately, as per terms and conditions of the policy, which is against the legal position and shows manipulation on the part of the complainant.

3                 To prove his version complainant tendered his affidavit as Annexure CW1/A along with documents as annexure C-1 to C-12 and close his evidence. On the other hand, counsel for OPs has also tendered affidavits as Annexure R-X alongwith with documents as Annexure R-1 to annexure R-8 and closed his evidence.

4.                We have heard learned counsel for the parties and carefully gone through the case file. It has been admitted by the OPs that they have insured the premises of complainant for the period of 18.12.2010 to 17.12.2011. The case of the complainant is that during the subsistence of the policy due to heavy storm which came on the night of 28.03.2011 in the vicinity of District Ambala, the premises of complainant suffered a huge damage in the storm and his loss was amounting to Rs. 1,97,946/-. It has been admitted by the complainant that he got constructed the wall and other suffering to the premises and submit the claim with OPs of a sum of Rs. 197946/-. However, the OPs did not released his genuine claim despite submitting of all the formalities. On the other hand, the counsel for the OPs has argued that they have rightly repudiated the claim of the complainant since the premises was got repaired by the complainant without intimating to the insurance company and thus, he has violated the terms and conditions of the insurance policy.

                   Perusal of Surveyor’s report Annexure R-2 has assessed a loss of                Rs. 82,305/- caused to the premises of complainant whereas the complainant is insisting that he has submitted a bills of Rs. 1,97,946/- of the loss caused to him so he is legally entitled to get the said amount and OPs has wrongly and illegally repudiated the same. After going through pleadings of the parties as well as record on file, we are of the view that the complainant is claiming that he has incurred a sum of Rs. 1,97,946/- to get repaired his premises but we cannot relied upon the version of complainant in support of which he has placed on file two bills Annexure C-1 and Annexure C-2 amounting of Rs. 93946/-. because mere producing of the bills of expenditure does not entitle to the complainant to get claim from the insurance company until and unless the bills are not supported by a report of Surveyor which could easily be arranged by the complainant but he has nothing to do with such sort. Further, the objection of OPs that the complainant without intimating to them has got repaired the premises which is violation of the insurance policy; seems to the genuine since it is a prime duty of a person who has got insured his premises to inform the insurance company in case of any loss caused to his insured premises. On the other hand, it is case of the OP that they have deputed the Surveyor who has assessed the loss to the tune of Rs. 82,305/- is the best person at the above said report has not been rebutted by the complainant by way of adducing evidence. So, we think it proper if a sum of Rs.82,305/- is awarded to the complainant as assessed by the Surveyor to the complainant. Accordingly, the complaint is partly allowed with costs and directed the OPs to comply with the following directions within thirty days from receipt of copy of the order:-

1. To pay the amount of Rs.82,305/-to the complainant along with interest @ 9% per annum from the date of filing the complaint till its realization.
2. Also to pay a sum of Rs. 5,000/- on account of costs of proceedings.

                   Copies of the order be sent of parties concerned as per rule. File be consigned to record room after due compliance. File after due compliance be consigned to record room.

Announced on :10.03.2017                                             Sd/-

                                                                                  (D.N. ARORA)

                                                                                       President

 

                                 Sd/-

     (PUSHPENDER KUMAR)

                                                                                       Member