SMT. S. S. ALI
Case of the complainant, in short, is that he took an insurance policy being no. 0G-14-2422-4001-00000649 in respect of her business shop after paying necessary insurance premium to the OP and the said policy was valid for the period from 12-07-2013 to 11-07-2014, that on 24-08-2013 all the stock and goods of her business shop got damaged due to devastating flood that affected Panskura area and she lodged her claim with the OP for compensating the damage but the OP has not settled her claim till date, hence the case.
In support of her claim, complainant submitted photocopies of papers related to the insurance policy, repudiation letter of OP dt. 16-12-2013, stock statements, certificate from Panskura Municipality dt. 12-09-2013, recommendation from local Councilor, GD copy, photograph of the flood affected shop etc.
On notice the OP turned up to contest the case. They filed their WV as well as WNA whereby they inter alia denied all the material allegation of the complainant. It is stated by the OP that after getting information from the complainant on 31-08-2013 about flood, they deputed their surveyor who visited the spot on 01-09-2013 and requested the complainant to provide stock book, purchase invoice etc.; that complainant was able to show damaged materials worth Rs. 2,000/- and that their surveyor sent a letter to the complainant on 03-09-2013, but they have not received any reply from the complainant; that as per surveyor report the possibility of washing out of stock from the godown which was filled with 3 ft. water is quite remote; that based on the report of independent surveyor and after thorough scrutiny of the claim papers of the complainant, they repudiated the claim of the complainant by a speaking and reasoned letter dt. 16-12-2013 and informed the complainant about their decision and therefore, there was no deficiency in service on the part of the insurer and accordingly the instant case is liable to be quashed.
In their defense the OP submitted policy schedule and detail particulars of Standard Fire and Special Perils Policy, Surveyor Report dt. 16-09-2013, repudiation letter dt. 06-12-2013, stock report for the month of August 2013 being submitted by complainant etc.
Points for determination
- Whether there is any deficiency in service on the part of the OP?
- Whether the complainant is entitled to any relief as sought for?
Decisions with reasons
Point nos. 1&2:
Both the points are taken up together for discussion for the sake of convenience.
None of the parties adduced any evidence. They have relied on their photocopies of documents produced on record as per lists.
We have heard the ld. Advocates appearing for both sides (parties) at considerable length, have perused the entire materials (photocopies of documents) placed on record including the contentions of them.
It appears from the materials on record that there is no dispute as to the fact that the complainant purchased the insurance policy in respect of product Standard Fire and Special Perils Policy in the name of business as -New Kakali Enterprise- being no. OG-14-2422-4001-00000649 from the OP, which was valid from 12-07-2013 to 11-07-2014 for amount of Rs. 5,50,000/- for her godown and that the incident of flood had occurred over several area of East Medinipur due to heavy continuous rain started from 22-08-2013 and also for releasing of huge water from Kangsabati Barrage in Mukuntmanipur.
According to the OP (as it appears from its written version and papers produced on record) after receiving information about incident of flood from the complainant on 31-08-2013, the IRDA licensed surveyor, deputed on the part of the OP, visited the spot of the complainant on 01-09-2013 and requested to provide stock book, purchase invoices etc. but the complainant failed to produce any such documents by stating that she was not maintaining any book and records, for which assessment of loss could not be done. It is also contended by the OP in his W/V that the said surveyor again sent a letter dt. 03-09-2013 to the complainant in this regard but the complainant did not give any reply. Thereafter, the OP has repudiated the complainant’s claim by sending a letter dt. 16-12-2013 to the complainant.
According to the complainant, though the OP, after opening a claim file by appointing a surveyor in pursuance of her claim application for assessing loss of damage in respect of the said policy, but ultimately the OP did not pay any insurance claim.
It appears from the copy of the said policy along with the schedule of Standard Fire and Special Perils Policy produced by the OP on record that the loss of damage directly caused by flood has also been covered in respect of item no. VI of the said schedule (4 sheets) in relation to the policy. Moreover, in the letter dt. 16-12-2013 of the OP, addressed to the complainant for repudiation of her claim, nowhere it is mentioned that the policy was covered for only fire and not for others.
That being so, we are unable to accept the subsequent contention of the OP as made in para 2 of his written argument dt. 01-08-2014 that the policy was covered for only Fire and not for others as alleged.
It is a fact that the complainant could not show any stock register/papers or sale receipts of the purchased articles/materials in connection with her business to the surveyor on 01-09-2013 on the ground of drifting of the same (documents) due to flood on 24-08-2013 for which the surveyor was unable to assess the total claim of loss of damage as claimed by the complainant and there was no supportive document for the closing stock dt. 01-09-2013 produced by the complainant before the surveyor even after subsequent letter dt. 03-09-2013 of the surveyor to the complainant.
But still facts remain that the surveyor found some damaged materials on the spot as shown by the complainant on 01-09-2013 to him and the value of the said damaged articles/materials was Rs. 2,000/- (approximate). Then the question arises as to why the surveyor and/or the OP, without allowing the claim to some extent as to the loss of damaged articles/materials in favour of the claim, they repudiated the policy claim totally but no cogent explanation is given by the OP, which indicates deficiency in service on the part of the OP.
Considering the facts and circumstances of the case, as also in view of the materials on record, we are of the considered view that it would not be unjust but reasonable if we direct the OP to pay Rs. 15,000/- to the complainant towards loss of her damaged articles, caused due to flood occurred on 24-08-2013 in relation to her said policy along with litigation cost of Rs. 2,000/-.
The above two points are, thus, disposed of with the above observations and findings.
Hence, it is
ORDERED
that the instant case be and the same is allowed in part on contest against the OP. The OP is directed to pay Rs. 15,000/- to the complainant towards loss for damaged articles and litigation cost of Rs. 2,000/- within 40 days from the date of this order i.d. the complainant is at liberty to execute this order in accordance with law in which case, the OP shall be liable to pay fine at the rate of Rs. 100/- per day from this day till full and final settlement.
