Chandigarh

DF-II

CC/659/2019

Surjit Kaur - Complainant(s)

Versus

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

Rohit Khullar Adv. & Jatin Kullar Adv.

09 Mar 2021

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-II

U.T. CHANDIGARH

 

Consumer Complaint No.	:	659/2019
Date of Institution	:	22.07.2019
Date of Decision	:	09.03.2021

 

                                       

                       

 

 

1. Surjit Kaur age 52 years wife of 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 H. No. 204, Silver City main, Zirakpur Punjab-140603.

Complainants

Versus

 

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, 2nd 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.

 

BEFORE:
		SHRI RAJAN DEWAN,	PRESIDENT
		SMT.PRITI MALHOTRA,	MEMBER
		SHRI B.M.SHARMA	MEMBER
Argued by:-
	Sh.Jatin Kullar, Adv. for the complainant
	Sh.Sahil Abhi, Advocate for the OPs No.1 to 4 Sh.Shivoy Dhir, Adv. for OP No.5.

 

      

PER PRITI MALHOTRA, MEMBER

1.         Briefly stated, the facts of case as alleged by the complainants are that  they purchased the plot at Silver City main Zirakpur, Punjab measuring 355 sq yards vide Registered Sale deed dated 29/11/2013 by availing loan from SBOP Chandigarh which was later on taken over by Axis Bank, Sector 17, Chandigarh. At the time of obtaining the loan, they purchased Tata AIG General Insurance from its agent which covers fire and SPL Perils building, Riot Strike malicious damage, storm cyclone typhoon tempest and earthquake to the tune of Rs.4,80,00,000/- (Rupee Four Crore Eighty Lacs only) by paying premium of Rs 33,842/-.  It has further been averred that the agent/ broker/ opposite parties have assured that the sum insured under the policy shall be deemed to have increased 10 % of the original sum insured at the end of every 12 month period and in case of fire and SPL perils building, riot strike malicious damage, storm cyclone typhoon tempest and earthquake, the complainants shall be given the benefits of sum insured mentioned in the policy. It has further been averred that they along with their family members are residing at in the Govt. Accommodation i.e. House No.438, Sector 22/A, Chandigarh and also used to stay for 2-3 days and more in a week at House No. 204, Silver City Main, Zirakpur, Punjab where they have hired a chowkidar/caretaker. It has further been pleaded that on intervening night of 19/20-04-2019 at about 02:15 AM, the complainants received telephonic call from the chowkidar/caretaker namely Ashok Kumar that fire took place due to short circuit at the house and complainant No.2 immediately reached the house at Zirakpur and found that fire took place due to short circuit and the neighbourers alongwith the Chokidar had taken initiative to control the fire. The chowkidar/ caretaker also tried to inform the Fire Station from his mobile phone but nobody respond from the fire station side and luckily no human life received any harm. They informed the incident of fire to the representative of the Insurance Company telephonically and their representative namely Sh.Amit Munjal Manager/Surveyor Head visited the house and assured the complainants that he will get the approval of the claim amount/ loss due to the fire incident and he asked them to submit some documents for processing the claim. OP No.3 also assured the complainants that he will take away all the burnt material i.e. big batteries, main cable aluminum, electricity panel, servo marathon, tubular batteries, 3 invertors, one CCTV Camera etc. from the premises  and will disburse the claim amount. The complainants engaged an Architect who prepared the cost of damaged material to the tune of Rs 10,08,800/- along with the valuation report of House No.204, Silver City Main, Zirakpur, Mohali, Punjab. The complainants also registered DDR No. 35 dated 20.04.2019 at Police Station, Zirakpur, District Mohali, Punjab regarding the incident.  It has further been averred that they submitted the valuation report of the damaged electrical material, other building material and house in question, DDR along with the forwarding dated 22/04/2019 to the OPs No.1 to 4 and requested them to release the insurance claim and to take away the burnt material, which was lying in the corridor of the house but they postponed the matter on one pretext or other. It has further been averred that on 04/05/2019, the complainant No.2 suffered breathing problem etc due to which he was admitted to Wings Hospital Sector 25, Panchkula for his treatment and after discharge, he also took treatment from PGI Chandigarh. Likewise, the father of the complainant namely Amar Chand Sondhi, aged about 82 years also suffered breathing problem etc and admitted to Wings Hospital Sector 25, Panchkula for his treatment.  It has further been averred that on 26.05.2019, OP No.3 telephonically refused to pass/disburse the claim. Alleging that the aforesaid acts of omission and commission on the part of the OPs amount to deficiency in service and unfair trade practice, the complainant has filed the instant complaint.     
2.         In their written statement, OPs No.1 to 4 while admitting the factual matrix of the case has pleaded that the complainants obtained Standard Fire and Perils and Policy valid from 20.04.2018 to 19.04.2023 for a total sum insured of Rs.1,20,00,000/- with excess clause of 5% or Rs.10000/- of the claim amount which is more.  It has further been pleaded that on receipt of the claim, they deputed an independent IRDA licensed Surveyor and Loss Assessor Sh.Amit Munjal who personally visited the spot of the incident for inspection on 20.04.2019 and took the photographs and recorded the alleged damages in the presence of the complainant No.2 and requested him to arrange joint meeting with the repairer before carrying out any repair or replacement so that the extent of damges could be verified.  On 26.05.2019, it came to the knowledge of the surveyor that the complainants already got the affected property repaired/replaced without intimation to the surveyor and  as such he visited the insured premises on 26.05.2019 and took photographs of the site post repairs/replacement and sent letters dated 11.07.2019 & 05.08.2019  requesting the complainants to submit duly signed claim form, discharge voucher/claim consent note and detail and value of each part/accessory replace in electronic panel however, they failed to submit.  It has further been pleaded that the surveyor submitted his report dated 12.08.2019 and revealed the cause of loss as fire on the intervening night of 19/20.04.2019 due to busting of batteries fitted to invertors installed in the space under the stair and that the fire was controlled with the help of tenant/neighbourers.  It has further been pleaded that the surveyor assessed the net loss to the tune of Rs.41,003/-.  It has further been pleaded that the complainant has failed to submit the requisite documents despite writing numerous letters and as such the claim file was closed on account of non-submission of the documents. The remaining allegations have been denied, being false. Pleading that there is no deficiency in service on their part, a prayer for dismissal of the complaint has been made.
3.         In its separate written statement, OP No.5 has stated that its role is only as a facilitator/referral agent and the actual insurance policy was issued by OPs No.1 to 4 and there exists no privity of contract between the complainant and the Bank to claim the insurance from the Bank and as the complaint qua it deserves to be dismissed.  It has further been pleaded that OP No.3 (Surveyor) was appointed by OP No.1 and he has already prepared his report and assessed the loss incurred by the complainant and the loss, if any, is to be paid by OPs No.1 to 4. The remaining allegations have been denied, being false.  Pleading that there is no deficiency in service on its part, a prayer for dismissal of the complaint has been made.
4.         The complainant filed separate rejoinder to the written replies of OPs No.1 to 4 & OP No.5 controverting their stand and reiterating the averments as made in the complaint.
5.         We have heard the Counsel for the contesting parties  and have gone through the documents on record.

6.             It is pertinent to mention that earlier also the complainants have filed a consumer complaint i.e. CC/506/2019 and the same was disposed of vide order dated 4.6.2019 with following order:-

“We have gone through the contents of the complaint and have perused entire record.  As per counsel for the complainant, the claim was lodged on 22.4.2019 with Ops No. 1 to 4 but they did not   settle the claim of the complainants.    We are of the opinion that the OPs should first decide the claim of the complainant as per IRDA norms. Accordingly, Ops are directed to decide the claim of the complainants as per norms of IRDA, within one month from the date of receipt of this order.  Liberty is given to the complainants to file fresh complaint, in case they  are not satisfied with the decision of the OPs.  Accordingly the complaint stands disposed off.”

                Thereafter, the present complaint has been preferred on 9.3.2021 stating that the OPs did not settle the claim. 

 

7.             From the available record and considering the arguments of both the parties, admittedly, the complainant No.1-Smt.Surjit Kaur availed Master Policy No.1901217889 valid from 20.4.2018 to 19.4.2023 (Ann.C-4) from the OPs covering ‘fire and SPL Perils Building’ ‘Riot Strike Malicious Damage’, Storm Cyclone Typhoon Tempest, Earthquake against her House No.204, Silver City, Rajpura, Punjab 140603.  There is no dispute that the Fire broke out at the said insured building/house of the complainants during the intervening night of19/20-04-2019 at about 02:15 AM.  The matter was reported to the Police and as such DDR No.35, dated 20.4.2019 at Police Station Zirakpur, District Mohali, Punjab was registered.  There is also no dispute that the fire which broke out at the said insured house of the complainants got extinguished with the help of neighbourers and the care taker Mr.Ashok Kumar, as the phone was not picked-up by any of the officials of the Fire Brigade Department despite making calls by the care taker of complainants.

8.             The complainants timely intimated the OPs about the fire incident and the Surveyor was appointed by the OPs and suggested the complainants to file their claim with OPs.  It is a matter of record that the Surveyor appointed by the OPs assessed the loss to the tune of Rs.41003/- vide Report Ann.OP-2.

9.             From the record, it is gathered that the claim file of the complainant has been closed by the OPs on account of non-submission of the documents and neither they paid the amount so assessed by the Surveyor till date.

10.           The complainant has vehemently argued that the complainant has suffered a loss to the tune of Rs.10,08,800/- as assessed by M/S Guru Architects, Zirakpur, engaged by the complainants, vide report Ann.C-4.

 

11.           Taking into consideration the above facts & circumstances of the case and that the claim case of the complainants has been closed for non-submission of documents, we are of the considered view that the complainants be given an opportunity to submit the requisite documents with OPs and the OPs should decide the claim of the complainant on merits.  Accordingly, we dispose of this complaint with direction to the complainant to supply all requisite documents to the OPs with regard to his claim and the OP Insurance Company shall decide the claim of the complainant promptly within 30 days from the receipt of documents from the complainant.  However, the complainant shall be at liberty to file a fresh complaint in case he is not satisfied with the claim so decided/settled by the OPs. 

 

                Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room.

Announced 09/03/2021	Sd/-
	(RAJAN DEWAN) PRESIDENT
	Sd/-
	(PRITI MALHOTRA) MEMBER
	Sd/-
	(B.M.SHARMA) MEMBER