BEFORE THE DISTRICT FORUM:KURNOOL
Present: Sri K.V.H. Prasad, B.A., LL.B., President
Smt C.Preethi, M.A., LL.B., Member
Sri R.Ramachandra Reddy, B. Com., LL.B., Member
Tuesday the 28th day of February, 2006.
C.D.No. 58/2004
M.C.Mohan Rao, S/o M.Vittoba Rao,
Proprietor, M/s Sudha Textiles,
Hindu, aged 61 years,
R/o H.No.5/496, Opp. Park,
Sri Rajarjeswari Nagar, Adoni,
Kurnool Dist. . . . Complainant
-Vs-
1.The Branch Manager,
United India Insurance Co. Ltd.,
P.N.Road, Adoni.
2.The Divisional Manager,
United India Insurance Co. Ltd.,
Subhash Road, Meda Mansion,
Anatapur. . . . Opposite parties
This complaint coming on 23.02.2006 for arguments in the presence of Sri D.Srinivasulu, Advocate, Kurnool for complainant and Smt. C.M.K.Ranjani, Advocate, Kurnool for opposite parties No.1 and 2, and stood over for consideration, till this day, the Forum made the following.
O R D E R
(As per Sri K.V.H.Prasad, Hon’ble President)
1. This CD case of the complainant is filed under section 12 of C.P. Act, seeking direction on the opposite parties to pay him Rs.9 lakhs as policy amount, Rs.50,000/- as compensation for mental agony, Rs. 1,00,000/- as compensation for loss of business, Rs.2,000/- as costs, interest from the date of accident along with other remedies which the exigencies of the case demand.
2. TTTTtttttTTTThe case of the complainant in brief is that the complainant as a sole proprietor of M/s Sudha Textiles in shop No. 19/25 of Municiapl main road, Adoni obtained shop keepers insurance policy bearing No. 0510051/48/02/0017 from the opposite party for the period from 29.4.2002 to 28.4.2003 covering the risk of fire and allied perils, burglary, house breaking etc., to the furniture, fixtures, fittings and stock in trade of his shop paying a premium of Rs.2,972/- and for the same Corporation Bank of behalf of the complainant obtained an insurance policy for the period commencing from 31.1.2001 to 31.12.2002 as complainant has availed and loan from Corporation Bank by hypothecating stocks and sending monthly stock statements from 1.5.2000 onwards and the same being accepted by the bank. While such is so a fire accident occurred to said shop in his absence in the late hours of 8.6.2002 and entire stock gutted away with furniture and fixtures causing considerable damage. Inspite of events of the fire brigade to put it off. The fire accident was informed to opposite party by the complainant but as nobody turned up, the opposite parties were approached by the complainant personally and on receipt of a written requisition on 10.6.2002 the opposite party No.1 visited and inspected the said shop premises of the complainant on 11.6.2002 and required the complainant’s presence to the inspection of surveyor and on 18.6.2002 the surveyor appointed by opposite party No.2 inspected the said shop of the complainant and has taken the photographs and Video of the losses incurred in the said shop due to fire accident besides enquiring with landlord of shop premises and neighbouring shop owners as to occurrence and damage and seizing the destroyed account books, files and other documents, advising the complainant to prefer claim, promising its submission along with report, and the complainant complied the same on 25.6.2002 sending the needed under a covering letter through courier. In the absence of any response the complainant was constrained to remind surveyor for needful vide his letter dated 9.9.2002 marking its copy to Regional Office of the opposite party. Non response to it lead the complainant to address another letter on 30.12.2002 to Regional Manager of the opposite party seeking settlement of claim marking its copy to opposite party No.2. As there was no response to it also the complainant addressed another letter on 6.2.2003 to the Regional Manager renewing his request for early settlement marking its copies to opposite party No.2. For this the opposite party No.2 replied on 7.2.2003 requiring the complainant to submit the duly filed claim form, fire brigade report police record and other documents substantiating the claim. As the claim form in duplicate, list of furnitures and textiles, fire brigade certificate, electric bills, copy of letter prepared on its letter pad, trading profit and loss account, sales and income tax assessment orders, Corporation Bank current account and Xerox on monthly statements from 31.5.2002 were submitted to the surveyor already on 25.6.2002, the same was informed to the opposite party No.2 vide letter dated 20.2.2003 marking its copy and attested bills to R. Srinivasa Rao Surveyor, for filing his final report, as to letter of opposite party No.2 dated 7.2.2003 informs non submission of report by surveyor. But the opposite party No.2 vide his letter dated 24.2.2003 again required the complainant to submit all the record that was submitted to the surveyor for settlement of claim. Hence, the complainant complied the said direction by submitting all its copies to opposite party No.1 vide its letter dated 28.2.2003. In reply dated 15.4.2003 to the letter dated 7.4.2003 of the surveyor, the complainant has sent purchase bills required by the surveyor expressing his inability to send payment particulars, marking to opposite party No.2 its copy and enclosures. The copy of letter dated 13.6.2003 addressed to the surveyor by opposite party No.1 requiring for release of surveyors report was communicated to the complainant. On 24.6.2003 surveyor addressed to the complainant to send some more documents and simultaneously on 25.6.2003 the opposite party No.2 required the complainant to furnish income tax returns, sale tax returns, bank statement, audited balance sheet. The document sought by the surveyor were submitted by the complainant through its letter dated 2.7.2003 requesting for early settlement of claim. On 2.7.2003 the opposite party No.2 was informed as to the submission of the record sought already to the surveyor. On 3.7.2003 the opposite party No.2 addressed a letter requiring the complainant to submit bank statements from 1.6.2002 to 31.12.2002. sales tax returns for last 3 years including 2002-03 and the clarification for non submission of income tax returns for 2000-01 and 2001-02. The complainant replied to it on 11.7.2003 with reasons for non submission IT returns and for the inability to send bank statements for 1.6.2002 to 31.12.2002 as there were no transactions during said period. But the opposite party No.2 vide his letter dated 14.7.2003 required the complainant bank statements from 1.6.2002 to 31.12.2002 and information as to recovery of any amounts from debtors and payment to creditors and sales tax returns for 3 years. In reply to it the complainant submitted on 23.7.2003 bank statements from 1.6.2002 to 31.12.2002 and the reason for not filing sales tax returns as traders with less than 20 lakhs not required to submit sales tax returns enclosing there with a Xerox copy of letter of sales tax Commission which speak as such. As there is no response the complainant approached the Consumer Welfare Society, Adoni and the opposite party No.2 replied on 19.9.2003 to the said society that the surveyor report was not received due to non cooperative conduct of the complainant so the processing of claim shall be on receipt of surveyors report. The society taking up the said matter with the Regional Manager, Hyderabad id not bear any fruit the except a letter dated 22.10.2003 advising the opposite party No.2 to look into the matter. The conduct of the surveyor and insurance company in not submitting the report and settling the claim respectively except bending upon making such correspondence which is of any of much use, makes out deficiency of service on their parts and in ultimately repudiating the claim on 20-4-2004 after the complainant addressing the obudman, taking unduly abnormal time in stressing for unnecessary record which has any bearing in settlement of claim. Due to the said deficient conduct of the opposite parties the complainant suffered much mental agony.
3. In pursuance of the receipt of the notice of this Forum as to this case of the complainant, the opposite parties caused their appearance through their counsel, and contested the case filling the written version denying any of deficiency of service on its part and there by any of their liability to the claim of the complainant and so seeking dismissal of the complaint with costs.
4. The written version of the opposite parties besides questioning the justness and maintainability of the complainant’s case, allege the complaint averments does not call for any interference by the Forum as firstly the case of the complainant does not come within the scope of the Consumer Protection Act and the complainant is not “Consumer” as contemplated under the Act, secondly the enquiry in the claim of the complainant warrants an exhaustive detailed documentary and oral evidence with the complicated questions of fact and of law, the ascertaining of the bonafidies of the said is not possible in summary procedures of the Consumer Protection Act, and which could be done only by the Civil Courts, thirdly the complaint is in suppression of vital facts and suspicious as any police report was given and in the event of misrepresentation, non discloser of any material facts, voids the very policy under its condition No.2,5 and 7, fourthly the complainant over valued the claim while the surveyor appointed by the opposite party envisages, it, after due enquiry and examination, at Rs.47,721/- (i.e. Rs.27,721 towards value of the stock and Rs.20,000/- value of the furniture, fixtures, fittings effected in said fire accident), fifthly the complainant himself dragged the matter without cooperating properly by furnishing necessary material for settling the claim and so cannot blame the opposite party for his own mistakes, sixthly the obudsman closed the complaint finding the fakeness in the claim of the complainant, seventhly as the condition No.1,6 and 8 of fire insurance policy and condition No.2,5,7 of shop keepers insurance policy were violated by the complainant, eighthly as there is every doubt as to valuation of the stocks of Rs.8,30,000/- as the complainant defaulted payment of loan instalments to Corporation Bank and rent to owner of said premises, ninthly the reminiscences of the fire accident is not probablishing value of loss as Rs.8,30,000/- and tenthly the claim of the complaint was for wrongful gain on false material.
5. In substantiation of the contentions while the complainant’s side has relied upon the documentary record marked in Ex.A1 to A47 and his sworn affidavit and of the third party in reiteration of his case and the replies of the opposite parties to its interrogatories, the opposite parties side has relied upon documentary record marked in Ex.B1 to B4 and the sworn affidavit of the opposite party No.1 and evidence of RW-1 in reiteration of its case and on reply the complainant to its interrogatories.
6. Hence, the point for consideration whether the complainant has made out any deficiency of service of the opposite parties in the repudiation of his claim and there by any of their liability to the claim of the complainant.
7. The status of the complainant as insured being not denied by the opposite parties, the Ex.A1 and A2 which envisages the privy of the complainant as insured with the opposite parties (insurer) they do not require any further appreciation than what they envisage.
8. The Ex.A3 copy of the telegram dated 9-6-2002, and it envisages the intimation to the opposite parties as to the fire accident occurred to the complainant’s shop on 8-6-2002. This satisfies the compliance of the condition of the policy as to intimation of occurrence to the insurer by the insured.
9. The Ex.A4 to A46 takes reference to the correspondence mentioned in the complaint in between the complainant and the opposite parties. As they are not denied in the written version of the opposite party they stand not only bonafide but also for that what they envisage for there appreciation.
10. Now as to the justification or otherwiseness in the repudiation of the claim of opposite party in assessing as to any deficiency of service or otherwise on the part of the opposite parties.
11. The Ex.B4 mentions the terms and conditions of shop keepers insurance policy. In its serial No.5 dealing with the claims procedure under its sub head (A) requires lodging of report with the police only in the case of theft. Hence, in case of fire accident without any suspicion of any foul play attracting the provision of Penal Code, the insured is not obligated to lodge any police complaint. Therefore, the insurer cannot insist the insured for lodging any complaint with police especially in case of fire accident without any suspicion and for furnishing the copy of same the settle the claim of the insured.
12. The serial No.5 (B) of Ex.B4 warrants the insured to cause notice of event/occurrence to the insurance company immediately and within 14 day there after furnish detailed particulars of the amount of loss or damage together with such material substantiating the claim which the company may reasonably require. Except saying which the company may require as it is not specifying or naming in particular of the material which it may require reasonably to be furnished by the insured, it shall be sufficient if the insured furnishes that material as to loss or damaged which substantiates the same. The insured property under policy issued by the insurer is a cloth shop which has availed a loan from Corporation Bank under hypothecation of its stocks and in that regard it was sending periodical stock statements, which at no time were found fault by the said Corporation Bank. Hence, as to the probable stocks that was prior to the said fire occurrence the statement of stock furnished to the said Corporation Bank prior to 8-6-2002 remains highly relevant for consideration of the insurance company especially when there is any other reliable cross material casting any reasonable shadow of doubt even on the bonafidies of said statement of stock furnished to the Corporation Bank in earliest point of time to the said date of occurrence especially when the conditioin No.5 (B) of Ex.B4 is not specifying the detailed particulars of the evidence or document it may reasonably require the insured to furnish for settlement of claim, the insurer (opposite party ) is not remaining justified in asking for sales tax returns, income tax returns, bills etc., which may not bear any direct relevancy as to the stock position on the date of occurrence in for settling the dispute in controversy, especially when the latest statement of stock prior to occurrence reasonably takes the mind of its appreciation to now the stock position prior to occurrence.
13. Inspite of Ex.A44 certificate of tax consultant speaking of the exemption of IT returns and Ex.A38 speaking exemption of sales tax returns to traders who sales is lessthan 20 lakhs and Xerox copy of said to have been enclosed to their for favour of information and kind perusal to the insurer, the dodging on the matters for years together by the opposite parties on those pretests and submission of other record which do not bear relevancy or assist in assessing the claim of the complainant with reference to the damaged property or property put to loss, envisages utter deficiency of service on the part of the opposite parties in settlement of the claim and in ultimately repudiating the claim.
14. The fire services attendance certificate in Ex.A47 say the property involved in said fire accident as Rs.8 lakhs. Even though it says the value of the property saved as Rs.3,05,000/- but there is no material to the effect that the said property saved is worthy of trade. While such is so, the material on which the surveyor estimated the value at Rs.47,721/- is not placed by the opposite party side except filing the Ex.B1 and B2 and evidence of the surveyor as RW-1 which are not so self explanatory as to make any safe reliance and which is suffering from self consistencies as to the aspect of investigation whether it was done by said surveyor individually or in joint with others and for not placing that cogent material on which said conclusion of Ex.B1 and B2 were arrived.
15. The Ex.B3 is said to be a video taken at the shop of the complainant by the surveyor. Its display envisages the extensive damage occurred to the material of the shop of complainant. Even though to some of the cloth bondills there is a partial burnt damage on one side they appear to be not worthy of trading, the damage occurred has to be treated as considerable total damage.
16. As the Ex.A47 says the stock statements for 6/2002 showing the opening balance as Rs.8,59,231/- and the said being found a confirmation certificate of the Corporation Bank at its bottom and the said being in due course of business can be taken for granted safely till otherwise proved on any other cogent material. Hence, the opposite parties ought to have taken into consideration the material in said Ex.A47 i.e. value of the stock as Rs.8,59,231/- in the said shop, prior to the said occurrence and must have passed the claim accordingly without going or giving any undue importance to the bills of purchase of stock and tax returns which may leave a least bearing and relevancy on the value of the stocks which were effected in said fire accident especially when the said stock was confirmed by Corporation Bank in Ex.A47 to whom the said stocks were under hypothecation on account of the availment of loan by the complainant.
17. The opposite parties deficient conduct of service is further remaining in lime light in taking about 2 years for repudiation of claim stressing on material which may not require reasonably for adjudication of claim and not even allowing the claim of the complainant to the value of Rs.47,721/- assessed by its surveyor.
18. As the deficient service conduct of the opposite parties in adjudication of the complainants claim is remaining established by their conduct of undue delay adjudication and repudiation of claim and at one hand and assessing the loss at a lower web of Rs.47,721/- without any cogent substantiating material and in that circumstances the approach of the complainant to the Forum for redressal of his grievance is remaining bonafide and justifiable as the liability of the opposite parties for the claim of the complainant arising out of unreasonable repudiation of claim and causing mental agony at their delayed conduct at the matters.
19. Consequently, the complaint is allowed directing the opposite party jointly and severally to pay to the complainant Rs.8,59,231/- as claim of insurance for the lost stock involved in fire accident with interest at 12% from the date of fire accident and Rs.20,000/- as costs within a month of receipt of this order. The order claims made by the complainant are rejected for want of their substantiation.
Dictated to the stenographer, transcribed by him, corrected and pronounced by us, in the Open Forum, on this the 28th day of February 2006.
PRESIDENT
MEMBER MEMBER
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant:: For the opposite parties: Nil
RW-1 R.Srinivasa Rao
Exhibits Marked for the complainant:
Ex.A1 Policy schedule No.0511005/48/01/02514 total amount of Rs.1,618/-
Ex.A2 Policy No.051005/48/02/00017 policy period from 29-4-2002
to 28-4-2003.
Ex.A3 Telegram, Dt.9-6-2002
Ex.A4 Letter Dt.10-6-2002 addressed to opposite party No.1
Ex.A5 Letter Dt.25-6-2002 addressed to Sri.R.Srinivasa Rao, Surveyor
Ex.A6 Courier acknowledgement No.B5379592, Adoni, Dt.25-6-2002.
Ex.A7 Xerox copy of Fire Service Attendance Certificate R.C.No.F/CNo.46/02,
Dt.08-06-02.
Ex.A8 Xerox copy of letter Dt.9-9-2002 by Courier Service addressed to
R.Srinivasa Rao, Insurance Surveyor and Investigator
Ex.A9 Courier Ack.due No.A15930738 Dt.9-9-2002.
Ex.A10 Courier acknowledgement No.A15930737, Dt.9-9-2002.
Ex.A11 Letter, Dt.30-12-2002 by Courier Service addressed to Regional
Manager, United India Insurance Co.Ltd., Hyderabad
Ex.A12 Courier Ack.due No.B5880383, Dt.31-12-2002.
Ex.A13 Courier Ack.due No.B5880384, Dt.31-12-2002.
Ex.A14 Letter, Dt.6-2-2003 addressed to Regional Manager, United India
Insurance Co.Ltd., Hyderabad
Ex.A15 Courier Ack.No.A22113496, Dt.6-2-2003.
Ex.A16 Courier Ack No. A22113495, Dt.6-2-2003.
Ex.A17 Letter, Dt.7-2-2003 addressed to M.C.Mohan Rao, Complainant
Ex.A18 Letter, Dt.20-2-2003 addressed to Divisional Manager, United India
Insurance Co.Ltd., Anathapur.
Ex.A19 Speed post receipt No.ED681130455IN Dt.20-2-2003.
Ex.A20 Speed post receipt No.ED68113044IN Dt.20-2-2003.
Ex.A21 Letter, Dt.24-2-2003 addressed to M.C.Mohan Rao, Complainant by
opposite party No.2
Ex.A22 Xerox copy of letter, Dt.28-2-2003 addressed to Divisional Manager,
United India Insurance Co.Ltd., Anathapur by complainant
Ex.A23 Courier Ack.No.A23815526, Dt.1-3-2003.
Ex.A24 Courier Ack.No.A23815525, Dt.1-3-2003.
Ex.A25 Letter, Dt.7-4-2003 addressed to M.C.Mohan Rao, Complainant by
surveyor
Ex.A26 Letter, Dt.15-4-2003 addressed to R.Srinivasa Rao, Insurance Surveyor
and Investigator, Hyderabad.
Ex.A27 Courier Ack..No.A26302432, Dt.15-4-2003.
Ex.A28 Courier Ack..No.A26302433, Dt.15-4-2003.
Ex.A29 Letter, Dt.26-5-2003 addressed to R.Srinivasa Rao, surveyor by
Opposite party No.2.
Ex.A30 Letter, Dt.13-6-2003 addressed to R.Srinivasa Rao, Insurance
Surveyor, Hyderabad by opposite party No.1.
Ex.A31 Letter, Dt.25-6-2003 addressed to M.C.Mohan Rao Complainant by
opposite party No.2.
Ex.A32 Letter, Dt.2-7-2003 addressed to opposite party No.2 by complainant
Ex.A33 Courier Ack. No.A29921326, Dt.2-7-2003.
Ex.A34 Courier Ack. No.A29921324, Dt.2-7-2003.
Ex.A35 Xerox copy of letter Dt.2-7-2003 addressed to R.Srinivasa Rao,
Insurance surveyor & Investigator, Hyderabad.
Ex.A36 Letter, Dt.11-7-2003 addressed to Divisional Manager, United India
Insurance Company Ltd., Anathapur
Ex.A37 Letter, Dt.14-7-2003 addressed to M.C.Mohan Rao, complainant
Ex.A38 Letter, Dt.23-7-2003 addressed to opposite party No.2
Ex.A39 Courier bill No.7607199298, dt.23-7-2003
Ex.A40 Letter, Dt.19-9-2003 from opposite party No.2
Ex.A41 Letter, Dt.22-10-2003 addressed to Consumer Welfare Society, Adoni
Ex.A42 Letter, Dt.31-3-2004 from opposite party No.2
Ex.A43 (1)Telephone bills of opposite party No.2 and (2) Telephone bills made
to the R.Srinivasa Rao, Surveyor
Ex.A44 Certificate from tax consultant
Ex.A45 Letter Dt.3-7-2003 addressed to complainant
Ex.A46 Letter, Dt.24-6-2003 addressed to M.C.Mohan Rao, Complainant
Ex.A47 Monthly stock statement (Xerox copy) by M/s. Sudha textiles, Adoni
from May 2000 to May 2002.
Exhibits Marked for the opposite parties:
Ex.B1 Survey Report (R.Srinivasa Rao, Surveyor & Investigator)
Ex.B2 Investigation report
Ex.B3 C.D Cassette
Ex.B4 Terms and Conditions of shop keepers Insurance from United India
Insurance Co. Ltd., Chennai.
PRESIDENT
MEMBER MEMBER
Copy to:-
1. Sri. D.Srinivasulu, Advocate, Kurnool
2. Smt.. C.M.K.Ranjani, Advocate, Kurnool
Copy was made ready on:
Copy was dispatched on:
Copy was delivered to parties on:
