Tamil Nadu

StateCommission

A/282/2017

T.Kadarkarai Nadar - Complainant(s)

Versus

The Manager, Shriram General Insurance Company Ltd., & anr - Opp.Party(s)

S.Rajeswari

14 Mar 2023

ORDER

 

IN THETAMIL NADU STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

CHENNAI – 600 003.

BEFORE        Thiru.S.KARUPPIAH                           PRESIDING JUDL MEMBER

                      Thiru. R VENKATESAPERUMAL                                     MEMBER

 

FA.No.282/2017

 

(Against the Order made in C.C. No.499/2012 dated 28.4.2015 on the file of

D.C.D.R.C., Coimbatore)

DATED THE   14^th DAY OF MARCH  2023

 

 T. Kadarkarai Nadar,

Son of T.Kadarkarai Nadar,

No.11, 12, NGR Road,

Annavaniga Valagam,

Palladam.                                                                       ..Appellant/complainant

                                                   Vs

1. The Manager,

Shriram General Insurance Company Limited,

Nagappa Complex, IInd Floor,

1076, Mettupalayam Road,

North Coimbatore,

Coimbatore – 641 002           

 

2.The Manager,

Shriram General Insurance Company Limited,

E-8, EPIP, RIICO,

Sitapura,

Jaipur – 302 022                                                  ..Respondents/opposite parties

 

Counsel for the Appellant/complainant             : M/s S.Rajeswari

Counsel for the Respondents/opposite parties  : M/s Micheal Marie Antony

 

This appeal is coming  before us for the hearing on 13,3.2023, we heard both side arguments and upon perused the documents, this commission made the following :

 

 

ORDER

THIRU. S. KARUPPIAH, PRESIDING JUDICIAL MEMBER.    

 

           This appeal is preferred by the appellant/complainant against the order passed in CC.No. 499/2012 dated 28.4.2015, on the file of DCDRC, Coimbatore.

 

The facts which are necessitated the complainant to make a claim is as follows;- 

 

1.        The case of the complainant is that  the complainant running a grocery business for his livelihood in the name and style of “Dhanam Stores”. The opposite parties are the insurance company, the complainant insured the premises and stock materials with the opposite parties and availed two different insured policies, one is for Burglary standard policy and another one Standard Fire & Perils policy. The policy coverage period is from 7.1.2011 to 6.1.2012. Whilso, On 5.2.2011, unfortunately a fire broken out in the above business place, immediately the same was informed to the Fire Service and the fire was put off the fire.  This fact was informed to the police and informed to the Insurance Company. Insurance Company sent their approved surveyor and they inspected the accident place.

2.       The complainant made a claim with the opposite party and after much prolonged requests,  on 5.5.2011, his claim was repudiated  as the complainant didnot followsome policy conditions mis-represented his business as departmental store,infact he was actually running a godown in the above place. Questioning the repudiation and alleged deficiency in service, the complaint is filed seeking a direction to direct the opposite parties to pay the insurance claim amount and also to pay a sum of Rs.50,000/- towards compensation.

3.       The opposite parties in the written version admitted the existence of policy coverage at the time of fire accident. But they categorically stated that the policy was only for running a business as departmental store but the place was used for godown. As per records submitted by the complainant himself proved that the place was used as godown and so there was a violation of policy condition and the claim is highly repudiated.

4.       After receiving both side affidavit as well as documents Ex.A.1 to A.11 and Ex.B.1 to B.7, the District Commission dismissed the complaint.

5.       Aggrieved by the dismissal, the complainant preferred this appeal on the following grounds:

6.       That the District Commission order was erroneous and the District Commission failed to note that the policy coverage is for the goods and the building thereon and there is no connection with business purpose, so the repudiation as if the place was used for godown is not acceptable, hence the District Commission order is liable to be set aside and the appeal is to be allowed.

7.       In the appeal, both sides filed their written arguments and both sides counsels submitted the facts mentioned earlier  and reiterated their own versions . For a query put to the learned counsel for the insurance company, the learned insurance company counsel produced the interim report submitted by the surveyors which was available with him as documents for our perusal. We deal with these documents/letters at an appropriate place hereunder. :

8.       The complainant conducted the business by name and style of Dhanam Stores and obtained the insurance policy from 7.1.2011 to 6.1.2012 with a policy No. 421012/11/11/000011 and the said policy was availed for the above mentioned address which  as marked as Ex.A.1. In the insurance policy, the location of the place is shown as Patel Road, near Indian Bank, Palladam . To be more specific. It is not a case of insurance company that the fire was broken up some other places that the insured place. The description in the policy further covers shops dealing in goods, otherwise not provided for including laundries, battery charging service stations, Dry cleaning, Amusement parks, hoarding, Neon signs and Sports Galleries, outdoor stadiums, departmental store.

 

9.       Moreover in the policy, the premium was though collected for Rs. 36 lakhs, the break up particulars demonstrated that the building was insured for Rs.6 lakhs, stock of grocery was insured for Rs.25 lakhs and stock in process for Rs.5 lakhs. It is also an admitted fact that the complainant made a claim for the loss suffered due to the fire accident. The incidents of fire and loss to the complainants were admitted, it was also admitted that the insurance company sent surveyor to assess the damage. However, by the repudiation letter  dated 5.5.2011 under Ex.A.6, the insurance company refused the claim stating that the complainant running only a godown in the place of insured and not departmental store as mentioned in the insurance claim. Since the nature of business of departmental store is different from nature of godown. They stated that the repudiation is a valid one.

10.     At this juncture, it is not necessary for us to find out the difference between the business of the departmental store and godown purpose. But we want to ascertain even if there is a difference then what was the impact in the contract of insurance it makes? Suppose assuming that  there is some difference and  the complainant informed the insurance company that at the place insured, he was running a departmental store, will it amounts to malafied mis-representation or will it affect the basic principle of contract of insurance. Now, we on verifications of all the records found that the fire broken up only at Dhanam stores near Indian Bank, Palladam, and as already pointed out it is not the  case of the insurance company  that the fire was broken out some other place, than the insured place.

 

11.     Furthermore, it is not a case of the insurance company that the complainant was running two different types of business, One as  Departmental store and another one as godown. When there were no two places and two businesses and actually the insurance place and the accident place are one and the same, then the question of repudiation is wheather valid or not is to be analysed.

 

12.       As we elaborately discussed,  earlier the policy was taken for the place at Patel Road and the building alone was insured for Six lakhs and grocery was insured for Rs.25 lakhs. When the insured articles are grocery, then whether it is used for Departmental stores or godown became immetrial. The insurance is for the groceries stored in the building. Once the insured goods found damaged and the purpose of storage is not connected with fire accident the insurance company is bound to Honour the claim.

13.       Suppose in the insured place if some cloths or cotton are stored or  the insurance company can repudiate the claim since the insurance particles are different in nature. Here, the insurance covered only to the grocery material and the purpose for stocking as a godown or for day today business lost its importance.

 To sum up, we hold

(i)that as per the policy, fire broken out only at the location of the risk stated in the policy,

(ii) the loss of articles damaged and insured were one and the same,

(iii) the purpose of  keeping those articles is for business either as Departmental store or as godown,hence the loss alone is important and the repudiation by the insurance company is not valid and as per the policy conditions, they are liable to compensate the loss and to disperse the claim amount which was legally entitled.

14.       Unfortunately, the complainant as well as the insurance company did not produce any documents along with their pleadings to prove the claim amount by the complainant as well as the loss assessed by the opposite party. So that we put the question to bothsides and only at this juncture, the learned counsel for the insurance company submitted a report stated in the beginning.,  On perusing the interim report, we found that the insured claimed approximately Rs.30 lakhs towards his loss of articles, but the insurance company surveyor in the interim report, assessed the damage only around to Rs.2,33,768/-. Though both parties did not rely upon their documents in the pleadings, so considering this documents which was not a final conclusion and not relied upon by both sides in their written version, considering the facts and circumstances of the case, which is pending from 2012 to till date for more than 10 years, we wish to award on non-standard basis and fixed the compensation as Rs.10 lakhs towards payment of insurance claim and fixed Rs.25,000/- towards compensation for deficiency in service, in not  honouring the claim in time.  We further reiterate that the above amount was fixed by us only today,. So the insurance company is liable to pay the same within  one month from the date of receipt of this order, failing which it carries interest at 9% p.a.  including the compensation.

15.       Since the District Commission failed to appreciate the place of risk as well as the Insurance coverage for the particles, which  forced us to interfere its finding and its award.  Hence we set aside the District Commission order and allowed the appeal with cost of Rs.5000/-.

 

1)    In the result, the appeal is allowed.

2)  The order passed by the District Commission, Coimbatore in CC.No. 499/2012 dated 28.4.2015 is set aside.

3)     The Respondents/opposite parties are directed to pay Rs.10,00,000/- (Rupees Ten Lakhs only) on non-standard basis towards insurance claim and also to pay a sum of Rs.25,000/- towards compensation for deficiency in service.

4)      The above amount is directed to be paid within a month from the date of receipt of this order, failing which it carries interest at the rate of 9% p.a  from this date till realization.

 

5)     We also award a sum of Rs.5000/- towards cost.

 

 

R VENKATESAPERUMAL                                                   S.KARUPPIAH

            MEMBER                                                           PRESIDING JUDL MEMBER

 

 

 

                       

 

Corrected