Chandigarh

DF-I

CC/405/2021

Surjit Kaur - Complainant(s)

Versus

Tata AIG General Insurance Co. Ltd. - Opp.Party(s)

Jatin Khullar

05 Mar 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-I,

U.T. CHANDIGARH

                                     

Consumer Complaint No.	:	CC/405/2021
Date of Institution	:	22/06/2021
Date of Decision	:	05/03/2024

1. Surjit Kaur age about 54 years wife of Sh. Sukhwinder Pal Singh Sondhi resident of H.No.204, Silver City main, Zirakpur, Punjab 140603 also resident of House No.438, Sector 22/A, Chandigarh.
2. Sukhwinder Pal Singh Sondhi son of Sh. Amar Chand Sondhi resident of House No.204, Silver City main, Zirakpur, Punjab-140603 also resident of House No.438, Sector 22/A, Chandigarh.

… Complainants

V E R S U S

1. Tata AIG General Insurance Company Ltd., Plot No. C-001, Unit No.810-816, 8^th floor, World Trade Tower, Sector 16, Noida, 201301, U.P, through its Managing Director.
2. Branch Manager, Tata AIG General Insurance Company Ltd., SCO 232-234, 2^nd floor, Sector 34/A, Chandigarh-160022.
3. Amit Munjal, Manager Surveyor, Tata AIG General Insurance Company Ltd., SCO 232-234, 2^nd floor, Sector 34/A, Chandigarh- 160022.
4. Authorized Signatory, Tata AIG General Insurance Company Ltd., SCO 232-234, 2^nd floor, Sector 34/A, Chandigarh-160022.
5. Axis Bank Ltd., through its Branch Manager, SCO No.156-157-158, Sector 17/B, Near DC office, Chandigarh-160017.

… Opposite Parties

CORAM :	SHRI PAWANJIT SINGH	PRESIDENT
	SHRI SURESH KUMAR SARDANA	MEMBER

                               

ARGUED BY	:	Ms. Tahira Bhatti, Advocate, Proxy for Sh. Rohit Khullar, Advocate for complainants
	:	Sh. Sahil Abhi, Advocate for OPs 1 to 4
	:	Sh. Shivoy Dhir, Advocate for OP-5

Per Pawanjit Singh, President

1. The present consumer complaint has been filed by Smt.Surjit Kaur and Sukhwinder Pal Singh Sondhi, complainants against aforesaid opposite parties (hereinafter referred to as OPs).  The brief facts of the case are as under:-

1. It transpires from the allegations as projected in the consumer complaint that on 29.11.2013, complainants had purchased a plot measuring 355 sq.yrds at Silver City Main Zirakpur, Punjab and for its purchase and construction of house (H.No.204) thereon (hereinafter referred to as “subject house”), complainants had obtained loan from SBOP, Chandigarh, which was later on taken over by Axis Bank (OP-5).  At the time of obtaining the loan, complainants had purchased a TATA AIG General Insurance policy (Annexure C-4) (hereinafter referred to as “subject policy”) from its agent/broker Axis Bank Ltd. covering fire and SPL Perils building, riot strike malicious damage, storm cyclone typhoon tempest and earthquake on payment of premium of ₹33,842/-. It was told to the complainants by the agent that the policy shall be deemed to have increased 10% of the original sum insured at the end of every 12 months period. At that time, complainants and their family members were residing in Govt. accommodation i.e. H.No.438, Sector 22-A, Chandigarh as well as in the subject house.  On the intervening night of 19/20.4.2019, at around 2:15 a.m. when the complainants were in their house at Chandigarh, a telephonic call was received from their chowkidar/caretaker namely Ashok Kumar that fire had taken place due to short-circuit in the subject house and immediately complainant No.2 rushed to the spot and found that the neighbour alongwith the said chowkidar had already taken initiative to control the fire and fire station had also been informed, but, nobody had come from there.  Though no human loss was caused in the said fire, but, everything was burnt into ashes. Complainants informed OPs 1 to 4 about the incident who sent their representative, Anil Munjal (OP-3) to the spot and he assured the complainants that the claim would be processed immediately. It was also assured by OP-3 that he will take away all the burnt material i.e. big batteries, main cable aluminum, electricity panel, servo marathon, tubular batteries etc. from the subject house. Thereafter complainants engaged an architect, who visited the subject house and prepared cost of damaged material to the tune of ₹10,08,800/- alongwith valuation report, copies of which are Annexure C-5 and C-6.  The matter was also reported to the police and DDR (Annexure C-7) was also recorded. Thereafter the complainants submitted all the documents including copy of DDR to OPs 1 to 4 with the request to take necessary action, but, with no result. After the fire incident, complainants alongwith their family members shifted to the subject house in order to take care of the same.  On 4.5.2019, complainant No.2 suffered breathing problem in the subject house and at the same time father of complainant No.2 had also faced the same problem, as a result of which he was admitted at Wings Hospital, Sector 25, Panchkula.  Thereafter the complainant had also taken medical leave from 6.5.2019 to 25.5.2019 due to bad health as OPs 1 to 4 had not removed the burnt material from the spot.  On 26.5.2019, OP-3 telephonically informed the complainants that their claim will not be processed in pursuance to the documents submitted despite of the fact that the complainants had actually suffered loss due to fire and the risk to that extent was also covered under the subject policy. The complainants were compelled to purchase the new electricity panels alongwith servo marathon and other material for the renovation of the subject house and the bills of the same are Annexure C-9 to C-15.  Earlier the complainants had filed a consumer complaint (CC/506/2019) before the learned District Commission-II, UT, Chandigarh who disposed of the same with the direction to the OPs to decide the claim as per IRDA norms within one month from the receipt of order with liberty to the complainants to file fresh complaint in case they are not satisfied.  However, OPs/insurer did not respond to the said order and nothing has been done by them as a result of which the complainants were compelled to file another consumer complaint (CC/659/2019) which was disposed of on 9.3.2021 with the direction to the OPs to consider the claim of the complainants by giving opportunity to them to submit the requisite documents.  In pursuance to the same, complainants submitted requisite documents with the OPs, but, they failed to do anything till date.  Copies of orders are Annexure C-16 and C-17. In this manner, the aforesaid act of the OPs amounts to deficiency in service and unfair trade practice. OPs were requested several times to admit the claim, but, with no result.  Hence, the present consumer complaint.
2. OPs resisted the consumer complaint and filed their separate written versions.
3. In their written version, OPs 1 to 4, inter alia, took preliminary objections of limitation, cause of action and concealment of facts.  However, it is admitted that the subject policy was purchased by complainant No.1 and that fire broke out in the subject house and information about the same was given by the complainants to the answering OPs.  It is further alleged that loss to the subject house was accordingly got assessed by the answering OPs through their surveyor and loss assessor in the light of the terms and conditions of the subject policy and as the complainants were asked to submit certain documents, which they did not submit, there is no deficiency in service on the part of the answering OPs and the consumer complaint of the complainant is liable to be dismissed.  It is further alleged that Amit Munjal after going through the documents had assessed loss to the tune of ₹71,145/- vide his report dated 15.6.2021 and thereafter complainants were asked to submit the documents within 7 days of the receipt of the letter so that the aforesaid amount could be transferred in their account, but, nothing has been done by the complainants and there is no deficiency in service or unfair trade practice on their part. On merits, facts as stated in the preliminary objections have been reiterated. The cause of action set up by the complainants is denied.  The consumer complaint is sought to be contested.
4. OP-5, in its written version, inter alia, took preliminary objections of maintainability and cause of action.  However, it is admitted that the earlier consumer complaints were filed by the complainants which were disposed of by the learned District Commission with direction to OPs 1 to 4 to process the claim of the complainants.  On merits, the facts as stated in the preliminary objections have been reiterated. The cause of action set up by the complainants is denied.  The consumer complaint is sought to be contested.
5. In replication to the written version of OPs 1 to 4, complainants re-asserted the claim put forth in the consumer complaint and prayer has been made that the consumer complaint be allowed as prayed for.

2. In order to prove their case, parties have tendered/proved their evidence by way of respective affidavits and supporting documents.
3. We have heard the learned counsel for the parties and also gone through the file carefully, including written arguments.
   1. At the very outset, it may be observed that when it is an admitted case of the parties that the subject house of the complainants was insured with the insurer/OPs 1 to 4 w.e.f. 20.4.2018 to 19.4.2023 on payment of premium of ₹33,842/- covering the benefits for fire and SPL Perils building, riot strike malicious damage, storm cyclone typhoon tempest and earthquake with sum insured of ₹12.00 lacs for each category and the subject house was burnt in fire on the intervening night of 19/20.4.2019 at around 2:15 a.m., as is also evident from the copy of DDR (Annexure C-7) and the complainants raised a claim for an amount of ₹10,08,800/- whereas OPs 1 to 4 have assessed loss to the tune of ₹71,145/-, as is also evident from the report (Annexure OP-6), the case is reduced to a narrow compass as it is to be determined if the OPs are unjustified in not settling the claim of the complainants to the tune of ₹10,08,800/- and the complainants are entitled to the reliefs prayed for in the consumer complaint, as is the case of the complainants, or if the insurer/OPs have rightly assessed the amount of loss at ₹71,145/- and the consumer complaint of the complainants, being false and frivolous, is liable to be dismissed, as is the defence of the OPs.
   2. In the backdrop of the foregoing admitted and disputed facts on record, one thing is clear that the entire case of the parties is revolving around the terms and conditions of the subject policy schedule alongwith the bills, having been produced by the complainants, and the report of the surveyor and the same are required to be scanned carefully for determining the real controversy between the parties.
   3. Perusal of copy of subject policy schedule (Annexure C-4/OP-1) clearly indicates that the same was issued to complainant No.1 by the insurer/OPs 1 to 4 which was valid w.e.f. 20.4.2018 to 19.4.2023 and has specifically covered fire and SPL Perils building, riot strike malicious damage, storm cyclone typhoon tempest and earthquake with sum assured of ₹12.00 lacs. Annexure C-5 is estimate of loss of subject house prepared by Guru Architects to the tune of ₹10,08,800/-. Annexure C-6 is valuation report of the subject house prepared by Guru Architects, which indicates that the value of the subject house, including construction and furniture, was assessed at ₹4,04,90,000/-. Annexure C-7 is copy of General Diary Details which indicates that the subject house was burnt in a fire incident due to short circuit.  Annexure C-9 to C-15 are copies of bills/tax invoices obtained by the complainants for the purchase of material for the reinstallation of the same in the subject house after the fire incident. 
   4. Pertinently, though the complainants through tax invoice (Annexure C-15), have also claimed an amount of ₹72,000/- for installation of (1) battery S.F. Exide and (2) 1050 Eco Watt Luminous, but, as the same were not covered under the subject policy, complainants are not entitled for the said amount.
   5. Perusal of remaining bills (Annexure C-9 to C-14) shows that the complainants had obtained the aforesaid bills in the month of May 2019, which clearly indicate the said bills pertained to the material purchased for the renovation of the subject house after the fire incident which occurred on the intervening night of 19/20.4.2019. As the complainants have failed to prove on record that the said material was purchased by them prior to the fire incident, the loss of the material is required to be assessed in the light of the report of the surveyor as well as the bills (Annexure C-9 to C-14), having been relied upon by the complainants, and the same are required to be scanned carefully.
   6. While assessing the loss of the subject house, the surveyor has though discussed the estimate of repair/replacement submitted by the insured vide Annexure – I (annexed with Annexure OP-2/page 62) to the tune of ₹10,08,800/-, but, he has assessed the loss to civil works and electric panel and miscellaneous wiring by giving details of the loss to the tune of ₹90,140.20.  In his report the surveyor has though found that while tiles and paint work was affected alongwith wires of different mm and flexible PVC pipes damaged and has also found that the electrical accessories fitted on front side of panel got affected, but, has failed to take into consideration major parts of burnt material i.e. panel electricity, servo marathon, main cable from meters to panel etc. Hence, it is safe to hold that the surveyor, while assessing the claim, has ignored the cogent and reliable evidence available on record and, therefore, the assessment made by the surveyor is not correct.
   7. Taking into consideration the material used by the complainants in place of the burnt material, bills (Annexure C-9 to C-14), it is clear that the complainants have spent only an amount of ₹7,59,194/- and not ₹10,08,800/- as claimed by them.  In this manner, loss is required to be assessed by taking into consideration the depreciation, salvage, under insurance and policy clause as has been applied by the surveyor in his report (Annexure OP-6) on the gross loss of ₹7,59,194/-. In this manner the loss to the subject house is assessed as per Annexure I, considered by the surveyor on the basis of computation as under :-

S.No.	Description	Amount (in ₹)
	Gross loss	7,59,194/-
	Less : depreciation @ 12.5%	94,899/-
	Less : Salvage	2,500/-
	Sub total	6,61,795/-
	Less : average clause @ 37.88%	2,50,688/-
	Adjusted Loss	4,11,107/-
	Policy clause : 5% of the claim amount subject to minimum ₹10,000/- in each and every event of loss is deducted towards the same.	10,000/-
	Net Loss	4,01,107/-

8. In view of the aforesaid discussion, it is safe to hold that complainants have partly proved the cause of action set up in the consumer complaint.  Hence, the present consumer complaint deserves to succeed against OPs 1 to 4 and they are liable to pay the aforesaid amount of ₹4,01,107/- to the complainants alongwith interest and compensation etc. for the harassment suffered by the complainants.
9. Though the OPs have also resisted the consumer of the complainant on the ground that the same is barred by limitation, however, when it is evident from the record that the complainants had earlier approached the learned District Commission-II twice by way of two consumer complaints and the same were disposed of with liberty to the complainants to file fresh complaint, if not satisfied, and till date OPs have not settled the claim, it is safe to hold that the present consumer complaint filed on 22.6.2021 is well within the limitation period.

4. In the light of the aforesaid discussion, the present consumer complaint succeeds, the same is hereby partly allowed and OPs 1 to 4 directed as under :-

1. to pay ₹4,01,107/- to the complainants alongwith interest @ 9% per annum w.e.f. 9.4.2021 onwards (i.e. one month after passing of order dated 9.3.2021 – Annexure C-17).
2. to pay ₹50,000/- to the complainants as compensation for causing mental agony and harassment;
3. to pay ₹10,000/- to the complainants as costs of litigation.

5. This order be complied with by the OPs within forty five days from the date of receipt of its certified copy, failing which, the payable amounts, mentioned at Sr.No.(i) & (ii) above, shall carry interest @ 12% per annum from the date of this order, till realization, apart from compliance of direction at Sr.No.(iii) above.
6. Since no deficiency in service or unfair trade practice has been proved against OP-5, the consumer complaint against it stands dismissed with no order as to costs.
7. Pending miscellaneous application(s), if any, also stands disposed of accordingly.
8. Certified copies of this order be sent to the parties free of charge. The file be consigned.

05/03/2024 hg	Sd/- [Pawanjit Singh] President
	Sd/- [Suresh Kumar Sardana] Member