Karnataka

Belgaum

CC/114/2015

Abhay S Bongale - Complainant(s)

Versus

The Authorised Person Bajaj Allianz General Insurance Co Ltd - Opp.Party(s)

S S Shippurkar

06 Jun 2017

ORDER

                 

ADDITIONAL  DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BELAGAVI

C.C.No.114/2015

 

                       Date of filing: 25/02/2015

 

                                                                                                                 Date of disposal:06/06/2017

 

P R E S E N T :-

	(1)	Shri. A.G.Maldar, B.Com,LL.B. (Spl.) President.
	(2)	Smt.J.S. Kajagar, B.Sc. LLB. (Spl.)  Lady Member.

 

 

COMPLAINANT       -

M/s. Shiv Shanti Auto, Authorized Service Centre, Nipani, Tq: Chikodi, Dist. Belgaum. Rep. by its Sole Priprietor, Sri. Abhay Shankar Bongale, Age:  Years, Occ: Business, R/o: Nipani, Tq: Chikodi.                  (Rep.by Sou. S.C.Shippurkar, Adv.)

- V/S -

 

OPPOSITE PARTIES  -

1.         2.

The Authorized Person, Bajaj Allianz General Insurance Co. Ltd., Madewale Arcade, 1st Floor, Hasanu Manzil, Club Road, Belagavi – 590 001.   The Authorized Signatory, Bajaj Allianz General Insurance Co. Ltd., G.I. Plaza, Airport Road, Yerwade, Pune – 411 006.                         (Rep. by Sri.S.P.Chaugule, Adv.                                          for Op.No.1 & 2)

 

JUDGEMENT

 

By  Sri.A.G. Maldar, President.

 

 

1.      This is a Complaint filed by the complainant under Section 12 of the Consumer Protection Act, 1986 (herein after referred to as Act) against the Opposite Parties (in short the “Ops”) directed to reimburse the insurance claim of Rs.52,511/- together with interest @ 18% p.a. from the date of claim till its realization and any other reliefs etc.,

 

2.      The facts of the case in brief are that;

 

          It is case of the complainant that, the complainant is running the Business of Agency of Two Wheeler and Maintaining the show room at Nipani and further the complainant entered insurance contract with the OP/Company through the Ratnakar Bank Ltd., Branch at Nipani for the year 01.09.2013 to 01.09.2014 which covers stock, furniture’s and fixtures, plant and machineries’, which building of show room, front glass of show room, under policy No.OG-14-1713-4001-00000537 and claim No.43574789 dtd: 11.02.2014 and further on 10.02.2014 one customer unknowingly dashed the front glass of the show room of the complainant and broken the glass, the complainant intimated thee said fact to the OP/company. Then, the OP Surveyor Mr.Upendra visited the spot and make the survey of the incident and he snapped the photos of the spot of incident. On his second visit, he advised the complainant to replace the glass at their own costs and assured that, the OP will deposit the claim amount in the bank account. Accordingly, the complainant obeyed the instructions of the surveyor and has sent the bills to OP office by RPAD, but till today the OP has not been deposited said amount, inspite of repeated request, but the OP/company postpone the same on one or the other reason and giving false assurance to the complainant, this attitude of the Ops, it amounts to deficiency of service on the part of the Ops. 

         

Finally, the complainant has issued legal notice on dtd: 23.09.2014 to the Ops to reimburse the insurance claim amount and the said notice was duly served to the Ops. But, the Ops neither made payment nor replied to the said notice, this attitude of the OPs, the complainant has suffered heavy loss and sustained mental agony. Hence, the complainant has constrained to file this complaint.

 

3.      After receipt of said notice to the Opponents, the Ops have appeared through their Counsel and resisted the claim of the complainant is that, the contents of para 1 to 5 of the complaint denied by OPs and it is further OP contended that, the complainant has not at all mentioned regarding the exact date of the incident which has taken place in the show room about the broken glass and further contended that, no complaint has been lodged regarding the said incident and immediately he has not informed to the OP and there is an abnormal delay in informing about the incident and further the complainant has lodged the claim of the OP/Insurance Company and further after verifying the claim form, the OP/Insurance Company got appointed IRDA approved independent surveyor namely Sri. P. Upendra to assess and investigate the loss and accordingly, the said surveyor has investigate and submitted his report to the OP to the tune of Rs.38,061/- subject to terms and conditions of the policy.

 

          It is further case of the OP that, after going through the documents and insurance policy with terms and conditions, it has been noted that, a visitor to the show room lost his balance and hit the show case and the glass got damaged and further the said insurance policy i.e. Standard fire and special peril policy and it is found that, the policy covers impact damages caused only, due to impact by any Rail/Road Vehicle or Animal and accordingly, the loss occasioned by visitors impact does not fall under policy purview and further contended that, the Policy coverage No.7 which details impact and recital of the said glass found in the policy which is accompanied by terms and conditions reads thus; Loss of or visible physical damage or destruction cause to the property insured due to impact by any Rail/Road vehicle or Animal by direct contact not belonging to or owned by

a.the Insured or any occupier of the premises or

b.there employees while acting in the course of their employment and accordingly the said fact of non coverage was intimated to the insured complainant by RPAD letter by repudiating the claim of the complainant.  

 

Further the OP.No.1/insurance company has rightly and legally repudiated the claim of the complainant. On this count also the complaint of the complainant is liable to be rejected and there is no negligence or deficiency in service on the part of the OPs and prayed for dismissal of the complaint.

 

 

4.      Both parties have filed their affidavit in support of their case and on behalf of complainant has produced 04 documents i.e. Policy Schedule, Office copy of legal notice, Postal receipts, Postal Acknowledgements and Fire Claim Form, which are marked as Ex.P-1 to Ex.P-5. On the contrary the OP.No.1 has produced 7 documents i.e. Insurance policy with terms and conditions, Claim form, Insured letter, Survey report dtd: 18.02.2014, Survey report dtd: 28.03.2014, Bill dtd: 18.02.2014 and Repudiation letter, which are marked as Ex.R-1 to Ex.R-7, for sake of our convenience, we have marked P & R series. Heard the argument on both sides.

 

 

Now, on the basis of these facts, the following points arise for our consideration:

 

1. Whether the complainant has proved that, there is deficiency of service on the part of the OP for not settled the claim amount?

 

 

2. What order?

 

 

5.      Our findings to the above points are as under:

 

                              

1. In the negative.
2. As per the final order for the following:

 

 

                                R E A S O N S

 

 

 

6.      POINT NO:1:-  We have perused the pleadings of the parties and the evidence and documents placed on record and the argument of complainant taken as heard and Op counsel vehemently argued in respect of policy condition. The specific case of the OP that, the loss caused to the showroom front glass, the same is not come under the perview of policy coverage, in this regard, the OP has appointed a surveyor one Mr.P. Upendra to assess the loss caused to the front glass of showroom and the said surveyor has given survey report, wherein he has mentioned regarding liability that, “the policy issued is covering the risk of standard fire and special policy, the damages are of accidental nature caused by the customer, such risks and damaged does not fall under the policy issued. Hence, there will be no liability under this policy issued”. 

 

          In order to established the said contention the OP.No.1 has produced the insurance policy which is marked as Ex.R-1 and survey report dtd: 18.02.2014 and 28.03.2014 which are marked as Ex.R-4 & R-5 the said survey report has not challenge by the complainant, hence it is deemed that it is admitted and even he has not make effort to disprove the same by cross examination to the OP/Insurance Company  and repudiation letter issued to the complainant which is marked as Ex.R-7 and it is evident that, in Ex.R-1 the policy condition No.7 as reproduce below;

 

Loss of or visible physical damage or destruction cause to the property insured due to impact by any Rail/Road vehicle or Animal by direct contact not belonging to or owned by:

a.the Insured or any occupier of the premises or

2. There employees while acting in the course of their employment.

 

            Admittedly, the loss caused to the front glass of showroom is by the customer which has mentioned in the complaint pleadings by the complainant himself, it is crystal clear that, when any loss caused to the any property of insured and damage or destruction cause to the property of insured due to impact by any Rail/Road vehicle or Animal by direct contact not belonging to or owned by

 

1. the Insured or any occupier of the premises or

(b) there employees while acting in the course of their

    employment.

 

           By detail scanning the above condition, it is clearly shows that, a damage caused to the property of the insured by customer is not cover and the loss caused to the front glass of showroom which is not come in any one of the above clause i.e. a & b. Therefore, the contention raised by the OPs are accepted and it has merit and force in the contention and the same has been proved by the OP as alleged in the written version as well as affidavit of evidence by producing cogent, material document which are already marked.

 

           Therefore, the repudiation of claim of the complainant by the OP is proper and justifiable, so in our consider view that, there is no deficiency of service on the part of the OP and the complainant has not established the case as alleged in the complaint and there is no any material evidence to show that, there is deficiency of Ops.      

 

          There is no dispute that, complainant has insured Two Wheeler showroom under the policy of standard fire and special peril under the policy No.OG-14-1713-4001-00000537 by paying premium amount of Rs.5,828/-, the policy is inforce from 04.09.2013 to 02.09.2014. The complainant has issued legal notice and claim form to the Ops for claiming damage of Rs.52,511/- together with interest @ 18 % p.a. In order to establish the allegation as pleaded in complaint, he has produced only legal notice and insurance policy, it is not disputed by the Ops regarding legal notice and insurance policy. But, disputed regarding claim which is not entitled and the complainant has not convenience to this Forum under what circumstances the OP/insurance company has to indemnify the insured property, for that, the complainant has not produced any single document and supporting affidavit evidence to hold that, the Ops are liable to indemnify the complainant.

 

          So, in our consider view, the complainant has failed to establish as alleged in the complaint and affidavit evidence and even the complainant has not disproved the contention raised by the OP and even the complainant has not made effort to substantiate his case as alleged in the complaint. So, the contention of the complainant cannot be believable and OP discharges their duty in pursuance of terms and conditions of insurance policy. Therefore, in our consider view, the complainant has failed to substantiate with cogent and material documents and acceptable affidavit evidence as such the case as alleged in the complaint and there is no deficiency of service on the part of the OPs. Accordingly, we answer this Point negative. Hence, we proceed to pass the following;

 

O R D E R

 

For the reason discuss above, the complaint filed by the complainant U/s 12 of the C.P. Act – 1986 is here by dismissed.

 

No order as to costs. 

 

(Order dictated, corrected and then pronounced in the open Forum on: 6^th  day of June 2017).

   

 

Sri. A.G.Maldar,     President.

Smt. J.S. Kajagar,    Lady Member.