BEFORE THE A.P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION
AT HYDERABAD.
F.A. 1536/2008 against C.C. 138/2007, Dist. Forum, Kurnool
Between:
1) United India Insurance Company Ltd.
Rep. by its Branch Manager
Branch Office, H.No. 2-415-B
N.K. Road, Nandyal
2) United India Insurance Company Ltd.
Rep. by its Divisional Manager
Divisional Office, Near State Bank,
Kurnool. *** Appellants/
Opposite Parties
And
1) Smt. N. Khursheed,
W/o. Late Dr. N. Abdul Malik
2) N. Jubeda, D/o. Late Dr. N. Abdul Malik
Age: 12 years, Minor.
3) N. Shaheensha, D/o. Late Dr. N. Abdul Malik
Age: 11 years
(Being minors Rep. by their mother R1)
All are R/o. 26-607, Devanagar
Nandyal Town, Kurnool Dist. *** Respondents/
Complainants
F.A. 1537/2008 against C.C. 139/2007, Dist. Forum, Kurnool
Between:
1) United India Insurance Company Ltd.
Rep. by its Branch Manager
Branch Office, H.No. 2-415-B
N.K. Road, Nandyal
2) United India Insurance Company Ltd.
Rep. by its Divisional Manager
Divisional Office, Near State Bank,
Kurnool. *** Appellants/
Opposite Parties
And
1) Smt. N. Khursheed,
W/o. Late Dr. N. Abdul Malik
2) N. Jubeda, D/o. Late Dr. N. Abdul Malik
Age: 12 years, Minor.
3) N. Shaheensha, D/o. Late Dr. N. Abdul Malik
Age: 11 years
(Being minors Rep. by their mother R1)
All are R/o. 26-607, Devanagar
Nandyal Town, Kurnool Dist. *** Respondents/
Complainants
Counsel for the Appellants: M/s. V. Sambasiva Rao.
Counsel for the Respondent: M/s. A. Jaya Raju
CORAM:
HON’BLE SRI JUSTICE D. APPA RAO, PRESIDENT
SMT. M. SHREESHA, MEMBER.
&
SRI R. L. NARASIMHA RAO, MEMBER
MONDAY, THIS THE TWENTIETH DAY OF SEPTEMBER TWO THOUSAND TEN
Oral Order: (Per Hon’ble Justice D. Appa Rao, President)
*****
1) These appeals are preferred by the opposite party insurance company against the order of the Dist. Forum directing it to pay the amount covered under the policies together with compensation and costs.
2) Since the appellants in both the appeals are one and the same pertaining to the amounts covered under the policies, though the Dist. Forum passed separate orders, and that common questions of fact and law are involved, we are of the opinion that these matters can be conveniently disposed of by a common order.
3) The case of the complainants in brief is that complainant No. 1 is the wife and complainant Nos. 2 & 3 are children of late Dr. N. Abdul Malik. The deceased Dr. Malik had taken shopkeepers’ insurance policy including the fire and allied perils for Rs. 1 lakh towards medicines, furniture etc. (C.C. 139/2007) and another standard fire and special perils policy for Rs. 2,50,000/- (C.C. 138/2007) covering the period from 12.7.2004 to 11.7.2005 covering the medicines, property of the health clinic etc. While so on 22/23.11.2004 at about 3.00 a.m. in the early hours the shop was electrocuted and the entire medical equipment and furniture etc. were destroyed. On a report the police registered a case in Crime No. 156/2004 as accidental fire due to electrical short-circuit. Despite submission of claim the insurance company did not settle the claim, and therefore they filed C.C. No. 138/2007 claiming Rs. 2,50,000/- and C.C. 139/2007 claiming Rs. 1 lakh towards the amounts covered under the policies together with compensation and costs.
4) The insurance company resisted the case. While admitting issuance of policies it alleged that the assured opened his clinic under the name and style of Noble Health Clinic and A.M. Medical & General Stores located at Noorani Complex, Nandyal. On receipt of report it has deputed a surveyor to assess the loss. He found that the said premises was in flames and in the meantime the fire brigade came and put off the fire. On enquiry it came to learn that the assured had no drug license for running the health clinic, and for storage of medicines. Almost all the medicines which were found in the clinic were samples with expiry dates. Therefore it need not indemnify. He never submitted any returns under AGPST/CST. The assured did not give an opportunity to the surveyor to make inventory of stocks or medicines destroyed. The police suspected that in order to claim the insurance amount the assured might have poured kerosene on expired medicines, and set fire and cleverly manipulated the entire record. The surveyor assessed the loss of furniture, fixtures and fittings at Rs. 23,585.75 covered under the policy in C.C. 138/2007 and at Rs. 29,500/- covered under the policy in C.C. No.139/2007. Since the claim was untenable it prayed for dismissal of the complaint with exemplary costs.
5) The complainants in proof of their case filed the affidavit evidence of complainant No. 1 and got Exs. A1 to A11 marked while the appellants filed the affidavit evidence of its Branch Manager and got Exs. B1 to B8 marked.
6) The Dist. Forum after considering the evidence placed on record opined that the complainants are entitled to the amount covered under the policies together with compensation and costs of Rs. 10,000/- each.
7) Aggrieved by the said decision, the insurance company preferred these appeals contending that the Dist. Forum did not appreciate either facts or law in correct perspective. It ought to have seen that the drug license for running the medical shop was expired long back about 6 years ago, and that the complainants were not entitled to any of the amounts. Apart from it they did not produce APGST/CST in order to prove that he was entitled to the amount. Besides that the very fire accident was created for the purpose of laying insurance claim, and therefore prayed for dismissal of the complaints with costs.
8) The point that arises for consideration is whether the order of the Dist. Forum is vitiated by mis-appreciation of fact or law?
9) At the outset we may state that there was no dispute that the first complainant’s husband late Dr. Malik took two policies standard fire and special perils policy Ex. A1 covering the said perils pertaining to his medical shop as well as furniture etc for Rs. 1 lakh (C.C.138/2007) and Rs. 2,50,000/- (C.C. 139/2007) covering the period from 12.7.2004 to 11.7.2005. It is also not in dispute that on 22/23.11.2004 there was fire accident. On a report the police registered a case in Crime No. 156/2004 evidenced under FIR Ex. A2. Panchanama of scene of offence was conducted vide Ex. A3, and the Station Fire Officer; Nadyal gave certificate Ex. A5 mentioning that the supposed cause of fire as “Electric origin”. The Sub-Inspector of Police made preliminary enquiry under Ex. A4, and found that there was no foul play. He also mentioned that both rooms wherein the furniture and medicines were kept were burnt. He was categorical in stating that the fire accident occurred due to electrical short circuit. He observed that “in both of the rooms he found furniture and medicines. The bath rooms were burnt into ashes. He came to know that the fire accident was occurred due to electrical short circuit in the rooms accidentally. The medicines and furniture that were in both of the rooms were completely burnt away into ashes.”
10) The insurance company appointed Sri M. S. Prasad, surveyor who after gathering some information somehow opined that the very accident itself was suspicious. The assured might have poured kerosene, and set fire in order to claim insurance amount. Curiously neither the surveyor nor the insurance company informed this offence to the police. The surveyor for the reasons best known did not verify the investigation made by the police under Ex. A4. We may state that the surveyors are not enjoined to investigate into the offence, and pronounce their verdict, more so, when the police found that the incident was due to electrical short circuit, and there was no foul play. A contrary report by the surveyor without any basis cannot be accepted. The insurance company did not file the affidavit evidence of the surveyor to state the grounds under which he could state that the incident was suspicious and was committed in order to recover the amount covered under the policies.
It has become a routine for the insurance companies to obtain a report from the surveyors to its liking in order to deny the just claim of the complainants. The other contention that was raised was that the medical shop for which insurance policy was taken was not having license to deal in medicines. We may state that the insurance company while issuing the policy did verify as to the credentials of the assured whether he had license to deal in medicines or not. Except stating that there is no license, and that the medicines are expired and that most of them are samples, no panchanama or inventory whatsoever was conducted in order to prove the said fact. The insurance company ought to have informed the police to make a mention about these aspects in the Panchanama conducted by them. It is not as though they were not present. Ex. A3 is the Panchanama conducted on the date of incident in the presence of the investigating officer. It is too late a day to contend that the medicines were expired, and that the assured was not having requisite license to run the medical shop etc. Having issued the shopkeeper’s policy after verifying the stock they are estopped from contending that the medicines or stock in trade do not add up to the amount covered under the policy. Obviously the assured is no more, the complainant a widow and the minor children could not have gathered all the material in order to substantiate as to the worth of medicines etc. The insurance company after verifying the value of these medicines, stocks, and furniture etc., had issued the policies, and it does not lie in their mouth to state that they are expired etc. We are of the opinion that the Dist. Forum has considered these facts in correct perspective. We do not see any merits in the appeal.
11) In the result the appeals are dismissed confirming the order of the Dist. Forum. The respondents/complainants are entitled to costs of Rs. 5,000/- in each appeal. Time for compliance four weeks.
1) _______________________________
PRESIDENT
2) ________________________________
MEMBER
3) ________________________________
MEMBER
Dt. 20. 09. 2010.
*pnr
