Tripura

West Tripura

CC/71/2016

Sri Swapan Saha. - Complainant(s)

Versus

The Divisional Manager, Oriental Insurance Company Ltd. - Opp.Party(s)

Miss. P.Ghosh, Mr. R.Das.

02 Feb 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
WEST TRIPURA :  AGARTALA

CASE   NO:   CC- 71 of 2016 

Sri Swapan Saha,
S/O- Late Lal Mohan Saha,
Chandigarh, Melagarh,
Sepahijala District, Tripura.        ....…..…...Complainant.

          VERSUS

The Divisional Manager,
Oriental Insurance Company Ltd.,
Agartala Division, Agartala,
West Tripura.                   ............Opposite party.

                 __________PRESENT__________
 SRI A. PAL,
PRESIDENT,
  DISTRICT CONSUMER  
DISPUTES REDRESSAL FORUM,
      WEST TRIPURA, AGARTALA. 

SMT. Dr. G. DEBNATH
MEMBER,
  DISTRICT CONSUMER 
DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.

SRI U. DAS
MEMBER,
  DISTRICT CONSUMER 
DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.

C O U N S E L

    For the Complainant    : Sri Rupak Das,
                      Payel Ghosh,
                      Advocate.
                     
    For the O.Ps            : Sri Partha Sarathi Chakraborty,
                      Advocates.

 

        JUDGMENT  DELIVERED  ON:   02.02.2017

J U D G M E N T
        This case arises on the petition filed by Swapan Saha. The case is filed against the Oriental Insurance Company Ltd. Petitioner's case in short is that he had business premise insured with the Oriental Insurance Co. Ltd. The date of commencement of policy was 29.10.14 and date of end of the policy was 28.10.15. It covers building, stock, furniture, fixtures and fittings. During the life time of the policy on 16.02.15 the shop premises was gutted. All particulars, the building, stock were damaged. Complainant informed the matter to O.P. insurance company. He also informed this to the office of the O.Ps. Produced all documents and requested the company officials for sanctioning the amount claimed. But O.P. refused to pay the insured amount. No surveyor was appointed to survey the damage caused by the fire. As a result he was deprived due to the deficiency of service by O.P. insurance company. Therefore, he filed this petition and claimed total compensation Rs.7,90,000/-. 

2.        O.P. Oriental Insurance Company Ltd. appeared, filed W.S denying the claim. It is stated that O.P. did not allow the surveyor of the Insurance company to assess the damage caused by the fire incident. Actually the premises was not gutted at all. Stock or other furniture were not damaged. A false story was placed before the Forum to get unlawful claim. 

3.        On the basis of contention raised by the parties following points cropped up for determination.
        (I) Whether the shop premise of the complainant was gutted or damaged by fire?
        (II) Whether the petitioner is entitled to get compensation for deficiency of service of insurance company?

4.        Petitioner produced the Policy Certificate, Legal Notice, reply of Legal Notice, Repudiation Letter, Claim Form, Cash Memos, extract copies of G.D. Entry
        Petitioner also produced the statement of affidavit of one witness i.e., the petitioner.

5.        O.P. on the other hand produced the statement on affidavit of one Goutam Banik and Surveyor, Sri Bijan Chakraborty.
        O.P. also produced 2 letters also appointment letter.

6.        On the basis of all the documents & evidence on record we shall determine the above points.

        Findings and Decision;
7.        We have gone through all documents and the evidence given by the parties. From the letter issued by the Insurance company it is found that one Bijan Chakraborty was appointed to assess the damage but he was not allowed to perform the survey as the surveyor could not assess the damage so the claim was repudiated as per letter dt. 05.03.15. We have gone through the policy certificate Exhibit- 1 Series.  It is found that for building sum insured was Rs.1 lakh. For stock Rs.3,50,000/- for furniture Rs.50,000/- was the sum insured as per policy. Premium was Rs.2,454/-, service tax was Rs.303/-. Premium was up to date. Total sum insured was Rs.5 lakhs. As per policy some documents are to be produced before the surveyor for assess the damage. Status report from the surveyor is to be obtained. 
        
8.        The contention of the Insurance company is that surveyor was appointed but he was not allowed to assess the damage. Petitioner did not cooperate with the Surveyor. Surveyor was Bijan Chakraborty. He by his letter informed Swapan Saha, petitioner that he was obstructed to visit the gutted shop. He did not disclose how he was obstructed. In case of obstruction he should take police help for visiting the place. There is no proof to support that he was obstructed when he tired to visit the place of occurrence. In support of fire incident petitioner produced the extract copy of G.D Entry. G.D Entry is signed by the Officer In charge, Melagarh P.S. Enquery was being made. Insurance company produced no evidence to support that no such fire incident was occurred at all. In a letter of correspondence with the petitioner or in the repudiation letter nowhere it is mentioned that fire incident did not take place. Claim was repudiated as the damage could not assessed by the Surveyor. Petitioner also did not appoint any surveyor for assessing his damage. As per terms of the policy immediately petitioner is to inform the Fire Brigade at nearest station, policy issuance officer. Complainant informed the policy issuance officer and also to the police station. He did not inform fire brigade.

9.         As per policy certificate petitioner is to produce certain documents and cooperate with the surveyor. He is to inform him cause of loss, the property effected, value of safe property, items  and value of salvage, amount payable under the policy etc. Those documents are to be submitted before the surveyor before departure from the place of occurrence. Surveyor is to submit his final report within 15 days after survey. Insurance company appointed the surveyor but the surveyor did not assess the damage because he was obstructed. In such a case insurance company repudiated the claim and did not appoint any other surveyor.

10.         From the evidence on record we are satisfied that there was a fire incident and the shop of the petitioner was damaged by such fire incident. Claim therefore appears to be maintainable. Petitioner's building cost was shown Rs.1,50,000/- but no documents produced to justify that the building was fully damaged. However the covering is for Rs.1 lakh. Oriental Insurance company should arrange the payment of this amount for the damage of the building. For the damage of the grocery goods the covering was Rs.3,50,000/-. No documents produced to support that the stock was available. According to the petitioner some articles was purchased on 10.02.15 before the fire incident and vouchers of those articles given. Those cash memos relates to Shyama Variteis. The articles purchased 4 days before the fire incident as per date written in the vouchers of items purchased on 10.02.15 and 12.02.15. Some items purchased on 15.02.15 and no date mentioned in respect of purchasing of other items. If after fire incident any item is purchased petitioner is not entitled to get the cost of those articles. No person or seller from Shyama varities was examined. Stock register also not produced. We have verified these cash memos and found that on 10.02.15 and 12.02.15 grocery articles valued Rs.1,32,000/- was purchased. Some articles were purchased two times. On scrutiny it is found that its value is about Rs.1 lakh. In our considered view this amount should be paid to Swapan Saha. For loss of furniture total coverage was Rs.50,000/- as per policy. No list of articles given and value of articles also not given. But to run the grocery shop some articles are necessary. We consider that its value will not be less than Rs.10,000/- petitioner did not cooperate in the matter of assessing the damage and he could not appoint any authorized surveyor for assessing his own damage. So he is not entitled to get the amount as claimed by him without proper scrutiny.

11.        Insurance company failed to render proper service. It repudiated the claim on the basis of report of the surveyor. No enquiry was made to find out the truthfulness of the surveyor report. Insurance company could appoint another surveyor and also could call the petitioner to convince him that assessment is necessary for satisfaction of the claim. Step was not taken by the insurance company. In our considered view it is deficiency of service by the insurance company. For this deficiency of service petitioner is entitled to get Rs.5,000/- from the insurance company. Both the points are decided accordingly.

12.        In view of our above findings over the two points we consider that insurance company shall pay the amount of Rs.1Lakh for the damage of the building and also again Rs.1 lakh for loss of damage of grocery goods Rs.10,000/- for loss of furniture. The covering was for Rs.5 Lacs. But this minimum amount should be given to the policy holder. Policy holder is not entitled to get more as he did not take step for assessing the damage. There was some deficiency of service by insurance company who did not take step for giving the minimum amount on assessment and also there was inordinate delay in the matter of satisfaction of the claim. So, Rs.5,000/- is awarded for deficiency of service. In total petitioner is entitled to get Rs.2,15,000/- only. We direct the Insurance company to pay this amount Rs.2,15,000/- to the petitioner within one month. If it is not paid it will carry interest @ 9% P.A.        

                       Announced.

SRI A. PAL
PRESIDENT,
DISTRICT CONSUMER  DISPUTES 
REDRESSAL FORUM,
WEST TRIPURA,  AGARTALA.

 

SMT. DR. G. DEBNATH,
MEMBER,
 DISTRICT CONSUMER DISPUTES 
REDRESSAL FORUM, 
WEST TRIPURA, AGARTALA    SRI U. DAS
MEMBER,
  DISTRICT CONSUMER 
DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.