DISTRICT CONSUMER DISPUTES REDRESSALCOMMISSION, KANDHAMAL, PHULBANI
C.C.NO.14 OF 2020
Sri Prasanta Kumar Panda
S/O- Gadadhar Panda
AT- Amalapada, PO/PS- Phulbani Town
DIST- Kandhamal ……………………….. Complainant.
Versus.
1 . Regional Claim Manager
SBI, General Insurance Co.Ltd.
AT-4th Floor B-Block, Appeejay House 15
PO- Park Street, Kolkata
State- West Bengal
2. Debi Prasad Rath
S/O- Babu Kbhor Rath
AT- Brahman Sahi Phulbani
PO/PS- Phulbani Town
Dist- Kandhamal …………………………….. OPP. Parties.
Present: Sri Purna Chandra Mishra - President.
Sri Sudhakar Senapothi - Member .
For the Complainant: Mr.Pratap Chandra Bai. Advocate
For O.P No.1- Mr. V.V.Ramdas.Advocate
For O.P No.2 – None(Exparte)
Date of Argument: 01.06.2022
Date of Order: 22.06.2022
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JUDGEMENT
Sri Purna Chandra Mishra, President
The complainant Sri Prasanta Kumar Panda has filed this case against the Opp.Parties for repudiating his insurance claim illegally and praying therein for a direction to the O.P No.1 to make payment of Rs. 2, 68,788/-(Two lakhs sixty eight thousand seven hundred eighty eight) only with interest from the date of intimation till it is actually paid to the complainant and to pay compensation of Rs. 50,000/-(Fifty thousand) only towards harassment and a sum of Rs 20,000/-(Twenty thousand) toward cost of litigation.
1. Brief fact leading to the case is that the complainant is having a wine shop at village Khajuripada which is the only source of his livelihood by way of self- employment. The shop was insured with O.P No.1 i.e. SBI General Company Limited which was in force from 17.11.2017 to 16.11.2018. During the force of the policy, on the night of 09.05.2018 there was theft from his shop and thieves stole away 1816 nos. of wine bottles and cash of Rs.1, 30,000/-(One lakh thirty thousand). The matter was reported to police and a case was registered vide Khajuripada Ps. case No. 39 date 10.05.2011. After proper investigation police has already submitted final form before the Court Learned SDJM, Phulbani in C.T. Case No. 175 of 2018. The theft was intimated to O.P No.1 in writing and he submitted all relevant documents to the O.P for early settlement of the insurance claim. But the O.P repudiated the claim on the ground that the theft of stock is not part of FIR and cash is not part of the insurance cover. As his claim was repudiated, he has approached this Commission for the reliefs as prayed for in the complaint petition.
2. After receipt of the notice, the O.P No.1 appeared through his Advocate and filed written version. In his written statement the O.P No.1 stated that the insurance claim in question was processed after due perusal of all document received and within the prescient of terms and conditions of the policy. So there is no deficiency in service and unfair trade practice on the part of O.P No.1. The O.P admitted the fact of theft and also admitted regarding the validity of policy on the date of occurrence. On getting information on 10th May 2018, a claim was registered vide claim No. 505487 and the surveyor assessed the loss on 11th May
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2018 and submitted his report on 04.10.2018. It is the specific case of the O.P that as per the FIR lodged with police cash amounting Rs.1, 30,000/-(One Lakh thirty thousand)has been theft from his shop. Since the policy does not cover the cash loss under the burglary section and theft of stock had not been a part of police FIR no liability therefore, is attached to the O.P No.1. As the case in question is not covered under the insurance policy and the theft of stock is not part of police FIR they have rightly repudiated the claim and pray for dismissal of the case against them with exemplary cost.
3. The Complainant in support of his case has filed the copy of the repudiation letter dated 17.12.2018, copy of the FIR, copy of the final report, copy of the property seizure memo, the list of stolen IMFL bottles, copy of the statements u/s 164 of Cr.P.C.
On the other hand the O.P has filed the copy of the insurance policy, copy of the surveyors report, copy of the FIR and copy of the repudiation of letter in support of their case. None of the parties have adduced any oral evidence.
4. The only point which needs to be examined in this case is whether theft of the stock of wine was not part of the FIR and theft of Rs. 1,30,000/-(One Lakh thirty thousand) was the sole allegation in the FIR lodged with police.
5. The O.P in his written statement under “specific submission” in para-3 and in page 2 of the written statement have specifically pleaded that as per the FIR lodged with police cash amounting to IMR 1, 30,000(One Lakh thirty thousand) only had been reported to have been stolen from the shop. Since the policy doesn’t cover the cash loss under the burglary section and theft of stock had not been a part the police FIR, no liability therefore is attached to the O.P No.1”.
6. So in order to examine the truth in the written statement the FIR lodged with police needs to be examined. A bare reading of the FIR doesn’t reveal that the informant of the case has mentioned that there is theft of Rs.1, 30,000/-(One Lakh thirty thousand) only. Complete perusal of records filed by both the parties doesn’t reveal that the informant of the case has made such an endorsement in the FIR. We are astonished as to where from the O.P came to know that he has mentioned regarding theft of cash of Rs. 1,30,000/-(One Lakh thirty thousand) rather the FIR speaks that a sum of Rs. 1,30,000/-(One Lakh thirty thousand)
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which was the sale proceeds of the previous day, many articles and wine is there inside the shop, which implies that he has mentioned in the FIR regarding the availability of cash, other materials and wine in the shop room. It is crystal clear from the FIR that before entering into the shop room, he has lodged the FIR and has only stated what things were there inside the shop. So the assertion of the insurance company is beyond the documents on record and the O.P without properly going through the FIR has repudiated the claim, which is completely illegal and not acceptable in the eyes of the law.
7. The fact of theft is not disputed by the O.P No.1. The independent surveyor Mr. Kawaljit Singh in his report has stated the proximate cost of the loss is due to theft occurred by unknown miscreants and he has opined that the claim is quite genuine with respect to theft occurred and comes under purview of policy condition. The said surveyor has accessed the net loss to be 2,18,500/-(Two Lakhs eighteen thousand five hundred only) after all deduction. So also figure of loss of stock tallies with the police report. The independent IRDA licensed surveyor appointed by the insurance company as well as the independent investigation agency of the Govt. i.e. police have agreed unanimously in their respective reports that the fact of theft is genuine and the loss of stock is also genuine and there is no difference between the quantum of loss of wine from the shop caused due to theft.
8. So it is crystal clear from the discussion in the preceding paragraphs that the shop was validly insured on the date of occurrence and the theft is genuine and the loss of stock claimed by the complainant is genuine which is supported by the report by the surveyor and the police. The only reason for repudiation of claim is that the informant of the FIR has stated that a sum of Rs. 1, 30,000/-(One Lakh thirty thousand), has been stolen from the shop which is not covered under the policy and the loss by stock is not part of the FIR. FIR is only a report submitted by informant to police. It is not the document which is mandatorily should cover all the fact vividly. It is settled principle of law that FIR is not the encyclopedia of all the events. The insurance company should not have hastily closed the claim and should have waited for the outcome of the investigation made by police. In the instance case, the informant has intimated police regarding the occurrence and materials etc. which were there inside the shop on
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the night of 09.05.2018 when he closed the shop. The O.P has repudiated the claim by concocting a story of their own by telling that the Informant has intimated police regarding theft of cash and not the stock which is beyond records.
9. So in our considered view we come to the irresisting conclusion that the insurance company i.e. O.P.1 has repudiated the claim on a fake ground and the repudiation is completely illegal and is violative by the principle of natural justice.
10. As the O.P No-1 has repudiated the claim illegally a case of deficiency in service coupled with unfair trade practice is made out against the O.P No.1 and he is liable to compensate the complainant for the loss sustained by him and the harassment caused to him. Hence the order.
ORDER
The Complaint petition is allowed against O.P No.1 on contest and dismissed against OP.2. The O.P No.1 is directed to pay a sum of Rs.2,18,500/-(Two Lakhs eighteen thousand five hundred)only as per net loss assessed by the serveyor to the complainant within a period of thirty days with interest@7% per annum from the date of repudiation till it is actually paid to the complainant. The O.P No.1 is further directed to pay a sum of Rs.10,000/- towards the cost of litigation.
I Agree
MEMBER PRESIDENT
Pronounced in the open Commissioner today on this 22nd day of June 2022 in the presence of the parties.
MEMBER PRESIDENT
