The Complainant has filed this case against the O.P. and praying for following Order/ Relief :-

1. Direction against the O.P’s to pay a sum of Rs. 8,10,000/- (Rupees Eight Lakhs and Ten Thousand) Only to the Complainant being claim No. 153900111791174971 against Policy No- 15390011163100000684  issued by the O.P.
2. Direction against the O.P. to pay a sum of Rs. 25,000/- towards pain, agony suffered by the Complainant.
3. Direction against the O.P. to pay a sum of Rs. 5,000/- to the complainant towards the cost of legal proceedings.

 BRIEF FACTS OF THE COMPLAINT

1. The Complainant is a businessman, he was carrying his electronics business under  the Name & Style of “ Duniya Dot Com” situated at Bazar Road, Opposite Shivmandir, Malbazar, P.O. & Dist- Mal, District- Jalpaiguri.
2. That the Duniya Dot Com is an proprietorship business and the Complainant is proprietor of the said business.
3. The Complainant purchased one Insurance Policy from the O.P. Being Insured’s Name- Duniya Dot Com, Prop- Achinta Dutta, Policy No. 15390011163100000684 by the O.P. Company and thereby the Complainant is an Consumer of the O.P.
4. That on 09.02.2018 after sunset and before the sunrise of 10.02.2018 at about 3.00-4.00 early morning that is, 3.00 a.m. – 4.00 a.m. of 10.02.2021 one incident of fire was broken out and due to the said fire whole shop including stocks, computer set, printer, furniture’ cash documents lying  in the said shop room was totally damaged.
5. That the Complainant lodged one written complaint before the Mal Police Station on 10.02.2018, intimation was given to the fire Station of that area and subsequently the Complainant through Insurance Agent submitted claim to the O.P.  Insurance Company in addition the Complainant deposits all Original Documents requires including the Original Insurance Policy to the O.P.
6. That on several occasions the Complainant asked the agent for claim and he personally visited the Office of the O.P. and all time the O.P. gives assurance that within a short period they will settle the claim of the Complainant.
7. That on 26.11.2019 the O.P. through the agent hand over one letter under the heading “ Loss Voucher” to the Complainant and asked to put signature and after gone through the said letter the Complainant came to learn that the Insurance Company wants to settle the claim of the Complainant at Rs. 95,000/-(Rupees Ninety Five Thousand Only) instead of loss of Rs. 8,10,000/- (Rupees Eight Lakhs Ten Thousand Only) without any basis and arbitrarily.
8. That the Complainant on 06.12.2019 replied the O.P. relating to letter dated 25.11.2019 and categorically stated that he was disagreed with the O.P. and praying for re-consider the settlement and the Complainant along with agent personally visited the Office of the O.P. and the Divisional Manager gave assurance that he will re-consider the same after scrutiny but it’s take further time to re-investigation. (Annexure “P-1”).
9. That in the month of February 2020 the Complainant took advice from its Agent as well as from his Advocate of Malbazar area and as per advise of those persons the Complainant waited for more time and from month of March 2020 the Complainant was unable to move further due to “CORONA’19” Pandemic Situation.
10.  That the Complainant and the agent on several occasions visited Office of the O.P. for settlement of the claim and they assured the Complainant that they will settle the claim after normalize of the pandemic situation. But the claim has not yet settled.
11. That, non-payment of claim amount to the Complainant by the OP. amounts to deficiency in service and for which the Complainant sustained monetary loss and suffered mental agony and the O.P. is liable to pay the claim amount as per terms and conditions of the Policy Being Claim No. 153900111791174971 and Policy No. 15390011163100000684 issued by the National Insurance Company Limited.
12. That the cause of action of this case arose on 25.11.2019 when the O.P. wants to settle the claim arbitrarily and on 06.12.2019 when the Complainant respond the letter dt. 25.11.2019 by praying for re-consideration of the amount and the cause of action is still continuing .

                      The Complainant in support of its Complaint has filed the following documents:-

1. Letter dated 25.11.2019 relating to Claim number- 153900111791174971, Insured’s Name- Duniya Dot Com, Prop- Achinta Dutta, Policy No- 15390011163100000684, issued by National Insurance Company Limited.
2. FIR dated 10.02.2018.
3. Intimation to fire station.
4. Reply to letter dated 25.11.2019.
5. Enlistment certificate, trade license, etc.
6. Income tax return.
7. Purchase bill dated 25/1/18 , 5/2/18 &  7/2/2018.

On receipt of notice the O.P. appears before this Commission through Vokalatnama, filed Written Version / denied all the material allegations of the Complainant. In the Written Version the O.P. has stated that , the case of the Complainant is not maintainable either on facts or law / the National Insurance Company Limited is not a necessary party / the Complainant has filed this case without havingcause of action / the case is barred by law oflimitation / the case is bad for non-joinder and miss joinder of necessary parties. In theWritten Version the O.P. has specifically stated that ,the statements of Para No. 1, 2, 3 & 5 of the Complaint are admitted by them and the statement of Para No. 4 of the Complaint the O.P. submits that , due to negligence of the Complainant the incident took place on 09.02.2018 after sun-set and before sun-rise on 10.02.2018.

The O.P. has further stated in the Written Version that the statements of Paragraph No. 5 & 6 of the Complaint are not admitted by them and the statements made in Paragraph No. 7 is concocted and fabricated and on 26.11.2019 the Complainant voluntarily and knowing fully on his consent settled his claim @ Rs. 95,000/-(Rupees Ninety Five Thousand Only) with the O.P. and put his signature on the Loss Voucher. The O.P. has further stated in the Written Version that the statements made in Paragraph No. 8 to20 are false , concocted and the denied the same.

By filing the Written Versionthe O.P. praying for dismissal of this case.

Having heard the Ld. Advocate of both the sides and on perusal of the Complaint, Written Version and documents of the parties the following points are taken to be considered by this Commission.

Points for consideration 

1. Whether the Complainant is a Consumer?
2. Whether the case is maintainable under the Consumer Protection Act 2019?
3. Whether there is any deficiency in service on the part of the O.P. as alleged by the Complainant?
4. Whether the Complainant is entitled for the relief sought?                                    

 Decision with reasons

All the points are taken up together for discussion to avoid unnecessary repetition and for the sake of convenience and brevity of this case.

In order to prove this case the Complainant has filed Written Evidence in the form of an Affidavit. In the Written Evidence the Complainant has corroborated the entire statements made in the Complaint. Specifically he has stated in his Evidence on which day he purchased the Insurance Policy from the O.P. and on which day the incident of fire was broken out in his shop and how much amount he sustained loss due to such breaking out of fire in the shop. The Complainant has also stated that the Insurance Policy was valid and effective when the incident of fire was broken out in his shop. The Complainant has further stated in his evidence that , he raised a claim for compensation from the O.P. and the O.P. has arbitrarily tried to settle the claim amount of Rs. 95,000/- (Rupees Ninety Five Thousand Only) instead of 8,10,000/- (Eight Lakhs Ten Thousand Only). The Complainant has further stated that on 06.12.2019 by making reply to the letter dt. 25.11.2019 he disagreed with the settled amount of Rs.95,000/- (Rupees Ninety Five Thousand Only) and asked to re-consider the amount but the O.P. has refused to pay the claim amount to the Complainant.

O.P. Insurance Company to falsify the case of the Complainant has filed Written Evidence in the form of an Affidavit and has corroborated the statements of their Written Version. In the Written Evidence the O.P. specifically stated that the fire was broken out in the shop of the Complainant due to his own negligent act and on 26.11.2019 the Complainant voluntarily and knowing fully well with his consent settled the claim @ Rs. 95,000/-(Rupees Ninety Five Thousand Only) with the O.P. and also put his signature on the Loss Voucher and for which the Complainant is not entitled to get any relief from this Commission. In the Written Evidence the O.P. has denied the allegations made against the Insurance Company and has stated that the Complainant has filed this case only to extort excessive amount of compensation from the O.P though the Complainant has no sufficient cause of action against the O.P.

Ld. Advocate of the Complainant files Brief Notes of Argument and during hearing of argument he submits that the Complainant has been able to prove this case against the O.P not only through filing of evidence butalso by producing documents before this Commission. He also argued that the incident of fire was broken out in the early morning of 10.02.2018 and the Complainant lodged the Written Complaint with the police of Mal Police Station and the Complainant submitted the claim to the O.P. through Insurance Agent (Code No. 9000145088) and on several occasions the Complainant along with the agent personally visited the Office of the O.P. who gave assurance to settle the claim but of no result. Ld. Advocate of the Complainant has further argued that on 26.11.2019 the O.P. through the agent hand over one letter under the heading “Loss Voucher” to the Complainant and asked him to put signature where from the Complainant came to know that the Insurance Company wants to settle the claim of the Complainant @ Rs. 95,000/- (Rupees Ninety Five Thousand Only) instead of 8,10,000/- (Eight Lakhs Ten Thousand Only) arbitrarily without having any basis and on 06.12.2019 the Complainant replied against the letter dt. 25.11.2019 ( Loss Voucher) and stated that the Complainant was not agreed with the O.P. and praying for re-consideration of the settlement but of no result. Ld. Advocate of the Complainant further argued that the Complainant has been able to prove his case by producing documents including Invoices for purchase of goods on 25.01.2018, 05.02.2018 and 07.02.2018 and also filed F.I.R. dt. 10.02.2018 , intimation with the Fire Station along with reply against letter dt. 25.11.2019.

Ld. Advocate of the O.P. filed Written Argument and during hearing of argument submits that the Complainant has failed to prove this case against the O.P. and the Complainant is not entitled to get any relief.Ld. Advocate of the O.P. further argued that previously after the incident of fire in the shop of the Complainant the Complainant voluntarily put his signature on the Loss Voucher knowing fully well aware that the O.P. settled the claim @ Rs. 95,000/- (Rupees Ninety Five Thousand) Only. He further argued that only to extort excessive amount of compensation from the O.P. Insurance Company the Complainant has filed this case though he is not a Consumer within the meaning of Section 2 (7) of the Consumer Protection Act, 2019. He further argued that, the incident of fire was taken place due to the negligent act done by the Complainant. By filing  Written Argument Ld. Advocate of the O.P.  prays for dismissal of the case.

Having heard the Ld. Advocate of both the side and on perusal of the Written Complaint, Written Version, and Evidence of the parties including the documents filed by them we find that the fact of breaking out of fire in the shop of the Complainant is admitted by the O.P. It is also admitted fact that, the Complainant was having effective Insurance Policy with the O.P. on the date of the incident. It is also fact that the Complainant raised a claim application with the O.P. praying for compensation due to Loss Sustained by him. From the record we also find that, previously the O.P. intend to settle the claim @ Rs. 95,000/- (Rupees Ninety Five Thousand) Only with the Complainant but the Complainant subsequently by making further application requested the O.P. to re-consider the said some of Rs. 95,000/- (Rupees Ninety Five Thousand) Only. From the record it further reveals that the Complainant has filed several documents regarding purchase of goods and in support of his claim the complainant filed several invoice. From the record it further reveals that the Complainant has filed Income-Tax Return for the Assessment Year 2016-17 where they have specifically stated the balance sheet as at 31.03.2016. He also filed the copy of Income-Tax Return for the Assessment Year 2017-18.

Considering all we are of the view that the Complainant has been able to prove its case to the effectthat fire was broken out in the shop of the Complainant and for which Complainant sustained monetary loss. From the record we are also of the view that the O.P. has admitted the breaking out fire in the shop of the Complainant and that’s why the O.P. intends to settle the claim amount.

From the documents submitted by the Complainant it is proved that the O.P. prepared one Loss Voucher where the O.P. Insurance Company as if settle the claim with the Complainant @ Rs. 95,000/- (Rupees Ninety Five Thousand) Only. But from the four corner of the record we did not find any documents submitted by the O.P. to substantiate the fact as on the basis of which documents they fixed the amount of Rs. 95,000/- (Rupees Ninety Five Thousand) Only. The O.P. neither filed any surveyor report regarding assessment of damage nor they filed any Written Evidence in the form of an Affidavit to prove the quantum of damage @ Rs. 95,000/- (Rupees Ninety Five Thousand) Only. On the other hand the Complainant has filed the copy of FIR dated 10.02.2018 where the Complainant alleged that, he sustained loss of Rs. 7,00,000/- towards damage of stock, Rs. 50,000/- towards furniture and Rs. 60,000/- towards Computer, printer. In support of the Complaint the Complainant has also annexed one application dated 10.02.2018 addressed to the officer-in-Charge of Mal Fire Station, Mal, Jalpaiguri in which the Complainant has also claimed that, due to breaking out fire in his shop he sustained loss ofRs. 8,10,000/-.

The Complainant has also annexed the application dated 06.12.2019 addressed to the O.P. for reconsideration of the Loss Voucher dated 26.11.2019. But the O.P. did not state anything about the said application and the OP neither allowed nor rejected the said application of the Complainant .

From the In-come Tax Return of the Complainant for the Assessment Year 2017-18 it reveals from the Balance Sheet as at 31.03.2017 the capital & Liabilities as well as assets and properties of the Complainant was having of Rs. 12,80,793/-.

From the record it further reveals that, the Complainant has annexed three Invoice dated 25.01.2018, 05.02.2018 and 07.02.2018 which proves that immediately prior to the said incident of fire the Complainant had purchased goods of Rs, 82,249/- + Rs. 1,03,244 /- + Rs. 80,288 /- = Rs. 2,65,771/-.

On the other hand the O.P. did not produce any documents to substantiate the quantum of damage sustained by the Complainant due to fire.

Considering all we are of the view that, the Complainant has been able to prove his case to the effect that there was deficiency in service on the part of the O.P. who did not settle the claim application of the Complainant by appointing their Surveyor for assessment of loss / damage due to fire though the O.P. has specifically admits the incident of fire as well as existence of the Insurance Policy of the Complainant.

Hence, it is therefore,

                                                     O R D E R E D

That the instant Consumer Case being in No. 39/2021 is hereby allowed on contest but in part. The O.P. is directed to pay a sum of Rs. 4,05,000/- (Rupees Four Lakhs Five Thousand) Only which is 50% of the claim amount to the Complainant along with interest @ 5% per annum with effect from 10.02.2018 till making payment of the entire amount. The O.P. is further directed to pay a sum of Rs. 30,000/- (Rupees Thirty Thousand) Only to the Complainant towards Compensation for deficiency in service and for causing mental pain, agony to the Complainant and towards cost of Legal Proceedings. The O.P. is further directed to pay a sum of Rs, 10,000/- (Rupees Ten Thousand) only in the Consumer Legal Aid Account of this Commission. Compensation paid if any to the Complainant by the O.P. be adjusted.

The O.P. is directed to pay the entire amount within 45 days from this day failing which the O.P. will have to pay interest @ 5% per annum with effect from this day till making payment of the entire amount.

Let a copy of Judgement be given to the parties free of cost.