DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, PALAKKAD

Dated this the 8^th  day of April, 2024

Present     :   Sri. Vinay Menon V., President

                   :  Smt. Vidya A., Member                                                Date of Filing: 29/10/2022   

              CC/210/2022

Chiju C.,

S/o Chandran,

8/25, Poovathinkal House,

Kadukkamkunnu, Malampuzha,

Palakkad – 678 651.                                                   -           Complainant

(By Adv.  Muhammed Hashim)

                                                                                                  Vs

1. The Manager,

Bajaj  Allianz GIC,

Door No.11, 1^st Floor, Managlam Towers,

Opp. Private Town Bus Stand,

Palakkad .

2. The Managing Director,

Bajaj Allianz House, Airport Road,

Yerawada, Pune – 411 006.

3. The Manager,

Bajaj Allianz, Raagavis Centre – Ground,

1^st & 2^nd Floor, 21A, Nethaji Nagar,

Nanjundapuram Main Road,

Ramanathapuram, Coimbatore – 641 045.              -       Opposite parties

(OPs by Adv. P. Prasad)      

O R D E R

By Sri. Vinay Menon V., President

1. Skeletal pleadings, requisite for judicial appreciation of disputed facts, are that complainant’s residential building suffered damages to a tune of Rs. 9,00,000/- in a storm, while being insured under Standard Fire and Special Perils policy issued by the O.P.s. But complainant’s claim was rejected by the O.P.s based on the report of an Approved Surveyor. Aggrieved thereby, this complaint is filed.
2. Complaint pleadings are admitted by the O.P.s, except the pleading that there is deficiency in service. They contended that claim was rejected based on the Surveyor’s report that cause of loss is not due to any one of the perils covered under the Standard Fire and Special Perils policy issued to the complainant. Damage was caused in heavy monsoon. They sought for dismissal of the complaint.
3. Upon a studied consideration of the pleadings and   counter pleadings, the following issues were framed for adjudication:

1. Whether the damage to the complainant’s house was due to normal wear & tear or due to storm and heavy rain fall?
2. Whether the damage caused to the complainant’s house is covered under Standard Fire and Special Perils policy issued by the OP?
3. Whether the repudiation of claim was as per the terms and condition of the policy?
4. Whether there is any deficiency in service on the part of opposite parties?
5. Whether the complainant is entitled to the reliefs claimed?
6. Any other reliefs?

4.          (i)      Evidence of complainant  comprised of proof affidavit and Exhibits A1 to A6.   

(ii)      OP filed proof affidavit. Exts. B1 to B3 were marked.

            Issue Nos.1 & 2

5.         Complainant’s case is that during the subsistence of a Standard Fire and Special Perils Policy, his residential building suffered damages amounting to Rs.9 lakhs in a storm. But his claim was repudiated based on the report of an approved surveyor. O.P.s contend that claim was repudiated as the damage was caused due to monsoon.

6.         (1)        Ext. A1 is a welcome letter issued by the OPs to the complainant. In the part dealing with Additional Covers, under the Sub-heading 4 – Fire and Special Perils including earthquake, clause D is shown as “Storm, Cyclone, Typhoon, Tempest – building”. The coverage is upto Rs.10 lakhs. The same is the content in item 11 of Ext. B2 transcript. Thus, in-order to avail the benefit under the policy, the damage ought to have been caused by a Storm, Cyclone, Typhoon or Tempest.

(2)        Ext.A2 is the letter of repudiation. Reason for repudiation stated as herein below:

1. “Due to monsoon rains damage to roofing structure of bamboo purlins and bamboo and tiles were broken and cracks in the wall is noted.
2. Damage to building due to normal wear and tear of roofing structure and wall damages
3. The proximate cause of loss is not due to any one of the perils covers under the   standard fire and special perils policy issued and held by you”.

7.         Report of the approved surveyor who inspected the damages to the residential building of the complainant was marked as Ext.B1. We went through the contents of Ext.B1. There is nothing in Ext.B1 to show that the damage to the residence of the complainant suffered due to storm or any events like Cyclone, Typhoon or Tempest that is contained in Ext.A1 or Ext. B2. Even though the complainant had filed an application as I.A. 56/2024 to cross examine the deponent of the proof affidavit filed by O.P., he had failed to take any steps challenging the contents of Ext. B1 or to disprove the contents therein.

8.         It was the bounden duty on the part of the complainant to prove by calling for documents maintained by the meteorological department to prove that the geographical location wherein the complainant’s residence is situated suffered from storm, cyclone, typhoon or tempest. In the absence of such a document, we cannot automatically come to a conclusion that the complainant’s location suffered from storm.

9.         Resultant to reasons stated in paras 7 and 8, we hold that the complainant has failed to prove his case that his house was damaged due to any of the factors contained in Ext.A1.

             Issue Nos. 3 to 6

10.       Based on the observations and findings in issue Nos.1 & 2 we hold that repudiation of the claim was in line with the terms and conditions of the policy.

11.       We therefore hold that there is no deficiency in service on the part of the opposite parties in repudiating the claim of the complainant.

12.       Complainant is not entitled to any of the reliefs sought for.

13.       Holding as above, we dismiss the complaint.

14.       Considering the facts and circumstances of the case, we direct the parties to suffer their respective costs.

                        Pronounced in open court on this the 8^th  day of April,  2024.         

                                                                                      Sd/-                                                               

                                                                                             Vinay Menon V

                                                        President

                                                          Sd/-

   Vidya.A

                       Member     

APPENDIX

Exhibits marked on the side of the complainant

Ext.A1   -  Copy of welcome letter

Ext.A2  –  Original letter of repudiation

Ext.A3 -   Copy of lawyer’s notice, postal receipts and postal acknowledgment of notice issued

                  to OP2

Ext.A4  -  Copy of lawyers notice, postal receipts and postal acknowledgment of notice issued to

                 OP1

Ext.A5  – Copy of lawyers notice, postal receipts and postal acknowledgment of notice issued to

                 OP3

Ext.A6   – Series of 6 photographs

Exhibits marked on the side of the opposite party:

Ext.B1  -  Original survey report dated 28/7/2022

Ext.B2   - Copy of policy certificate and terms and conditions

Ext.B3    - Copy of letter of repudiation

Court Exhibit:  Nil

Third party documents:  Nil

 Witness examined on the side of the complainant: Nil

Witness examined on the side of the opposite party:   Nil   

Court Witness: Nil

NB : Parties are directed to take back all extra set of  documents submitted in the proceedings in accordance with Regulation 20(5) of the Consumer Protection (Consumer Commission Procedure) Regulations, 2020 failing which they will be weeded out.