DISTRICT CONSUMER DISPUTES REDRESSAL FORUM PALAKKAD Dated this the 24th Day of December 2011 Present : Smt.Seena H, President : Smt. Preetha.G. Nair, Member : Smt. Bhanumathi.A.K, Member Date of filing: 16/03/2011 (C.C.No.48/2011) Sunil Jain, S/o.Mahavir Chand, Proprietor, Tushar Flooring Selection, Opp.Sitharam Motors, NH47, Kadamkode, Karingarapully, Palakkad Taluk – 678 559 (Adv.John John) - Complainant V/s Oriental Insurance Company Ltd., Shobha TSM Complex, R.S.Road, Opp.Town Railway Station, Palakkad. (Rep.by its Manager) - Opposite party (By Adv.S.T.Suresh) O R D E R By Smt.PREETHA G NAIR, MEMBER The complainant is a business man dealing in trading different types of tiles. He had availed a Standard Fire And Special Peril insurance policy No.442000/11/2010/648 from the opposite party. The complainant had availed the policy in order to cover the risk to his trading materials such as marble slab and tiles, granite slabs and tiles, tiles, ceramic wash basins etc. The period of the policy was from 31/10/2009 to 30/10/2010. On 14/6/2010 due to heavy wind and rainfall, the insured stock got damaged, due to the insured peril. Hence the fact of the damage was immediately intimated to the opposite party without any delay. Even though the damage to stock and building was intimated to the opposite party on 15/6/2010, they had not bothered to come and inspect the property for assessing the damage. Inspite of the urgency and repeated requests made by the complainant, the Insurance Surveyor / Loss assessor had visited the premises on 23/6/2010. The complainant had submitted all the details along with claim for damaged stock of Rs.7.33 lakhs and damage to the building of Rs.1.63 lakhs. After the inspection the insurance surveyor informed the complainant that for want of the 1. Copy of the purchase bill of damaged items 2. Copy of the stock statement given to the bank 3. Copy of the balance sheet and profit and loss statement for the year 2009-2010, he is not in a position to submit his report to the insurance company. Thereafter the complainant had forwarded all the documents. The opposite party, without conducting proper enquiry and appreciating the available evidence with an intention to make unlawful enrichment and undue profit, informed the complainant that they are unable to entertain the claim and hence the claim stands closed. The non conduct of timely enquiry and inspection by the opposite party and rejection after claim, amounts to deficiency in service. The complainant has sustained a total loss of Rs.7.33 lakhs due to the damage caused to the insured articles. Hence the complainant prays an order directing the opposite party to pay an amount of Rs.8,33,000/- with 12% interest and cost of the proceedings. Opposite party filed version stating the following contentions. The opposite party admits that the complainant has availed the policy and the period was from 31/11/2009 to 30/10/2010. It is incorrect to state that the insured stock was damaged and it occurred due to the insured peril. The surveyor deputed by the opposite party visited the shop building on 15/6/2010 and 22/6/2010 immediately on receiving the intimation. The complainant did not furnish the required data’s and papers to process the claim in time to the surveyor. However the insurance surveyor conducted a detailed enquiry with available materials. The surveyor has categorically stated in the report that the damage is not due to heavy wind. If there is heavy wind or storm there will be damages to the buildings or trees in the near area. The loss was due to heavy and continuous rain the made up soil has settled, the floor below the tiles stack yielded, the stock unbalanced and fallen over the pillar of the shed and the shed damaged. As the damages to the shed or stock are not due to any of the insured perils of the policy availed the opposite party is not liable to compensate and the claim was rightly repudiated. The surveyor had given ample opportunity to the complainant to produce the report from the meteorological department to prove the existence of storm on the date of loss. But the complainant was not able to furnish the report. No insured peril has operated. The opposite party is not liable to pay any amount towards compensation or any account to the complainant. Hence the opposite party prayed that dismiss the complaint with cost. Both parties filed affidavit and documents. Ext.A1 and A2 marked on the side of the complainant. Ext.B1 to B4 marked on the side of the opposite party. Insurance Surveyor was examined as DW1. The complainant was examined as PW1. Matter was heard. Issues to be considered are 1. Whether there is any deficiency in service on the part of opposite party ? 2. If so, what is the relief and cost ? Issue No.1 Admittedly the complainant has availed the policy from the opposite party. The incident was happened during the policy period. Both parties have not produced the weather report from the meteorological department. In Ext.B3 VI:- Loss destruction or damage directly caused by storm, cyclone, typhoon etc. No where stated the loss caused by heavy storm without rain. At the time of cross examination the surveyor deposed that 10 B fort unit\v apIfnepÅ wind BWv storm. IqsS agbpmhmw. CÃmXncn¡mw. The opposite party has not produced evidence to show that loss is not caused by heavy storm. The opposite party issued the valid policy to the stock of marbles. The opposite party stated that if there is heavy wind there will be damages to the buildings or trees in the near area. In the present case damage was noted in the insured shed. The surveyor in findings of the survey in Ext.B2 report stated that on verification it was found that due to heavy rain the filled mud has become wet and the floor sunk unevenly. The damaged items of stock were noted in Ext.B2 by the surveyor. But the surveyor has not calculated the total loss of damage. The complainant has not produced evidence to show the total loss of damage. The complainant stated that he has sustained a total loss of 7.33 lakhs due to the damage caused to the insured articles. The complainant has not produced evidence to show that he has sustained a total loss of Rs.7.33 lakhs. The surveyor noted the list of damaged items of stock in the shop. But the complainant has not produced the prize list of stock. At the time of examination the complainant deposed that the documents to the list of damaged items given to the opposite party. But the complainant has not filed application to call for the documents. The opposite party stated that the total claim of Rs.8,33,000/- made out in the complaint without any rhyme reason or bonafides. In Ext.B2 the Surveyor noted the damaged items of stock. On the available evidence we find that the insured articles have damaged due to heavy rain and wind. But the complainant has not produced evidence to prove the total loss of Rs.7.33/- lakhs. So we cannot considered the total loss. In view of the above discussions we are of the view that there is deficiency in service on the part of opposite party. In the result the complaint partly allowed. We direct the opposite party to pay complainant an amount of Rs.1 lakh (Rupee One lakh only) as compensation for mental agony and pay Rs.1,000/- (Rupees One thousand only) as cost of the proceedings. Order shall be complied within one month from the date of receipt of order, failing which the complainant is entitled for 9% interest per annum for the whole amount from the date of order till realization. Pronounced in the open court on this the 24th day of December 2011 Sd/- Seena.H President Sd/- Preetha G Nair Member Sd/- Bhanumathi.A.K. Member APPENDIX Exhibits marked on the side of the complainant Ext.A1 – Insurance Policy bearing No.442000/11/2010/648 dtd.29/10/0 9 Ext.A2 - Letter dated 3/12/10 sent by opposite party to the complainant Exhibits marked on the side of the Opposite parties Ext.B1 – Copy of repudiation letter issued by opposite party to the complainant dated 21/3/11 Ext.B2 – Copy of Surveyor Report dated 30/11/2011 Ext.B3 – Policy conditions of Standard Fire and Special Perils Policy (Material Damage) Ext.B4 – Copy of letter sent by complainant to the Grievance Cell of opposite party dated 23/10/10 Complainant examined PW1 – Sunil Jain Witness examined on the side of the opposite party DW1 – P.Sugumaran Cost Allowed Rs.1,000/- allowed as cost of the proceedings. | 
