Present (1) Nisha Nath Ojha,
District & Sessions Judge (Retd.) President
(2) Smt. Karishma Mandal,
Member
Date of Order : 03.05.2018
Smt. Karishma Mandal
- In the instant case the Complainant has sought for following reliefs against the Opposite party:-
- To direct the opposite party no. 1 and 2 to modify the order dated 27.03.2012 and pay the balance amount of Rs. 5,28,720/- with 12% interest.
- To direct the opposite parties to pay Rs. 1,00,000/- ( Rs. One Lac only ) as compensation.
- To direct the opposite parties to pay Rs. 25,000/- ( Rs. Twenty Five Thousand only ) as Litigation Costs.
- The facts of this case lies in a narrow compass which is as follows:-
The complainant has asserted that he has taken insurance policy with the opposite party no. 1 and 2 under standard fire and special perils policy for the period 13.09.2010 to 12.09.2011 and the total sum insured was of Rs. 12,00,000/- vide annexure – 1. During the coverage period of aforesaid policy fire broke in the night of 5/6.09.2011 at 1:30 AM and thereafter a sanha entry was made as will appear from annexure – 2. After breaking of fire the fire brigade was informed and four section of fire brigade reached to the spot but loss could not be averted and fire brigade assessed the loss to the tune of Rs. 12,00,000/- as will appear from annexure – 3. Thereafter Executive Electrical Engineer Fatuha was also informed regarding the fire in the godown/mill with a request to reconnect the electric connection as will appear from annexure – 4. The branch manager canara bank was also informed regarding the fire due to short circuit with a request to get the inspection through surveyor as will appear from annexure – 4 and 5. The complainant vide annexure – 6 submitted a claim form to opposite party no. 1 on 29.09.2011 showing the loss of Rs. 11,94,510/-. The opposite party no. 1 and 2 after observing all formality handed over cheque of Rs. 6,65,780/- to staff of the complainant without any forwarding letter which could have revealed the fact of being it a final settlement for indemnifying his loss of about Rs. 12,00,000/-. Thereafter the complainant vide annexure – 7filed a protest application requesting to pay the balance amount as the total claim of the complainant was about Rs. 12,00,000/-. The complainant thereafter got the copy of the claim disbursement voucher and surveyor report through Right to Information Act and he was surprised to see that signature on the disbursement voucher was not his signature. It appears from the surveyor report that 255 deduction has been recommended on flimsy ground of insured unit not being registered unit and insured himself issued purchased bill as will appear from annexure – 8. The complainant thereafter vide annexure – 9 requested opposite party no. 2 for releasing 25% of the insured amount which has been deducted on ridiculous basis as per recommendation of the surveyor. The aforesaid letter has been annexed as annexure – 9 and thereafter the complainant vide annexure – 10 gave a legal notice to opposite party for redressal of his grievance.
A preliminary objection cum written statement has been filed on behalf of opposite party no. 1 and 2 stating therein that the claim of the complainant has been settled on non – standard basis amounting to Rs. 6,65,780/- which was received by the complainant without any protest after putting his signature on discharge voucher after being fully satisfied and hence there is no deficiency on the part of opposite parties.
It has been further asserted that unit of the complainant was of commercial nature and hence he is not Consumer under the Consumer Protection Act.
Heard the learned counsel for the parties.
It goes without saying that the purpose of the insurance is to compensate the loss and not to earn the profit hence the insurance company cannot take such a plea that unit is of commercial nature. Hence the aforesaid submission of opposite parties appears to be misconceived.
It goes without saying that the complainant in Para – 6(g) of his claim application has specifically asserted that the aforesaid cheque of Rs. 6,65,780/- was handed over to the staff of complainant without any forwarding letter which could have revealed the fact of being its final settlement with respect to indemnifying his loss of Rs. 12,00,000/-. This fact is also clear from annexure – 7. There is no satisfactory reply of Para- 6(g) of the claim application as well as annexure – 7 because in Para – 15 of written statement it has been simply stated that the statement made in Para- 6(a to j) of complaint petition are matter of records which requires no comments. As the Para – 6(g) of the claim application has not been contradicted by opposite parties hence we are bound to accept the fact asserted by the complainant on oath that the aforesaid cheque was given to staff of complainant without any forwarding letter.
So far the quantum of insurance amount is concerned several fact asserted by the opposite parties in written statement has not been denied by complainant by filing rejoinder.
However, the Para – 10 of written statement ofopposite party 1 and 2 merit our attention which is as follows, “that after thorough and detailed investigation and inspection, the ‘Surveyor’ submitted its inspection – cum – final survey report dated 06.02.2012 of the alleged loss wherein assessment of loss to the tune of Rs. 8,95,062 was made”
From bare perusal of aforesaid fact it is crystal clear that the surveyor himself has asserted the loss of the complainant to the tune of Rs. 8,95,062/-.
In this contest we think it proper to quote facts stated in Para – 11 of written statement which is as follows, “that during the course of investigation it was found that insured unit was not a registered unit and few other irregularities as purchase bill were not available and insured himself issued purchase bill which may not be considered authentic, the surveyor recommended for settlement of claim on ‘Non – Standard Basis’ i.e. 75% of the assessed loss (Rs. 8,95,062/-).”
We are surprised that the surveyor has recommended to pay 75% of the total amount without valid basis and on imagination without disclosing the real fact. A unit is not registered is no valid ground.
In our opinion when the surveyor himself has asserted loss of Rs. 8,95,062/-, hence the opposite parties were bound to consider the fact liberally and pay the aforesaid amount but the same has been referred on “Super Technical Nature”.
In our opinion by not allowing the claim of Rs. 8,95,062/- as per surveyor report the opposite parties have committed gross deficiency and complainant is entitled to receive the rest amount of Rs. 2,29,282/- because Rs. 6,65,780/- has already been paid to the complainant.
For the reason stated above we direct the opposite party no. 1 and 2 to pay the rest amount of Rs. 2,29,282/- ( Rs. Two Lac Twenty Nine Thousand two Hundred Eighty Two only) to the complainant within the period of two months from the date of receipt of this order or certified copy of this order failing which opposite party no. 1 and 2 will pay 10% interest on the above mentioned amount of Rs. 2,29,282/- ( Rs. Two Lac Twenty Nine Thousand two Hundred Eighty Two only) till its final payment.
Opposite party no. 1 and 2 are further directed to pay Rs. 25,000/- ( Rs. Twenty Five Thousand only ) to the complainant by way of compensation and litigation costs within the period of two month.
Accordingly this complaint stands allowed to the extent referred above.
Member President
