O R D E R

Smt. K.P. Padmasree (Member):

                    Complainant filed this complaint against the opposite parties for getting a relief from the Forum.

                    2. Brief facts of the case is as follows:  Complainant had taken a standard Fire and Special Peril Policy of the 1^st opposite party and the said policy is valid from 30.03.2013 to 29.03.2014.  As per the policy the building, furniture, fittings etc. were insured for Rs.63,00,000/- and the compound wall was insured for Rs. 4 lakhs.  While so on 28.11.2013 at about the rear side of the complainant’s house collapsed due to heavy rainfall and subsequent water flow.  The matter was properly intimated to the opposite parties and placed a claim form to the 1^st opposite party on 04.12.2013.

                    3. The estimated loss and the amount required for the re-construction of the said compound wall was assessed as Rs.74,217/- and the contractor completed the reconstruction of the wall on payment of Rs.74,217/-.  On 25.04.2014 the 1^st opposite party informed the complainant that the insurance company is liable to pay only Rs.10,000/- as compensation in this regard.  But the complainant is not ready to accept Rs.10,000/- as compensation in this regard.  But the complainant is not ready to accept Rs.10,000/- because the same is very meager when compared with the actual loss of the complainant.  The above said acts of the opposite party amounts to deficiency of service.  Hence the complainant filed this complaint for getting an insurance claim of Rs.74,217/- with interest along with cost and compensation.

                    4. Opposite parties entered appearance and filed joint version with the following contentions:  Opposite parties admitted that they have issued a Standard Fire and Special Peril policy to the complainant.  On getting the claim form, opposite parties deputed a surveyor for assessing the actual loss suffered by the complainant.  Surveyor filed report and assessed Rs.10,128/- as the net loss.

                    5. Thereafter the 1^st opposite party requested the complainant vide letter dated 15.04.2014 to produce the final bill for the claim.  But the complainant did not submit the final bill.  Therefore, the claim of the complainant is pending for want of the final bill.

                    6. Moreover, complainant has no cause of action to file this complaint as opposite parties so far did not repudiate the claim of the complainant and therefore there is no deficiency in service on the part of the opposite parties.  With the above contentions, opposite parties prays for the dismissal of the complaint with their cost.

                    7. On the basis of the pleadings of the parties, the only point to be considered is whether this complaint can be allowed or not?

                    8. The evidence of this complaint consists of the oral evidence of PW1, DW1, Exts.A1 to A4,  Ext.B1and B2.  After closure of evidence both sides were heard.

         9. The point :-  The complainant filed this complaint for getting the insurance claim from the opposite parties for the damage caused to the compound wall which was insured with the opposite parties.  Due to the heavy rainfall compound wall collapsed and for the re-construction complainant has to spent Rs.74,217/-.  Complainant submitted the claim form but the opposite parties offered Rs.10,000/- only.  According to the complainant it is a meager amount when compared with the actual loss of the complainant.  Hence opposite parties are liable to the complainant.

                    10. In order to prove the complainants case, complainant filed proof affidavit in lieu of his chief examination along with 6 documents.  On the basis of the proof affidavit, complainant was examined as PW1 and the documents were marked as Ext.A1 to A4.  Ext.A1 is the policy certificate issued by the 1^st opposite party dated 30.03.2013.  Ext.A2 is the statement of account of reconstruction dated 02.12.2013.  Ext.A3 is the fire insurance claim form dated 4.12.2013.  Ext.A4 is the copy of the letter sent by the complainant to the opposite parties dated 12.12.2013.  Ext.A5 is the invoice for Rs.74,217/- dated 05.01.2014.  Ext.A6 is the copy of the letter dated 31.03.2014 issued by the complainant to the opposite parties.

                    11. On the other hand, the contention of the opposite parties is that they have not repudiated the claim so far.  On getting the claim form and the surveyors report they requested the complainant to submit the final bill.  But the complainant did not submitted the final bill.  Therefore, there is no deficiency in service from the opposite parties.

                    12. In order to prove the contentions of the opposite parties 1^st opposite party filed proof affidavit along with 2 documents.  On the basis of the proof affidavit 1^st opposite party was examined as DW1 and documents were marked as Ext.B1 and B2.  Ext.B1 is the survey report dated 07.03.2014 prepared by Mr. Abraham Cherian.  Ext.B2 is the copy of the letter issued by the 1^st opposite party to the complainant dated 15.04.2014.

                    13. On the basis of the contentions and arguments of the parties, we have perused the entire materials on record and found that the complainant is a policy holder of the opposite parties under  ‘Standard Fire and Special Perils’ and it is valid as on the date of the incident.  In the circumstances, the only point to be considered is whether the complainant is entitled to the insurance benefit as claimed by him.  According to the complainant he is entitled to get Rs.74,217/-, which he spent for reinstating the collapsed wall.  But the contention of the opposite party is that the claim of the complainant is pending for want of the final bill.  In the light o the rival contentions of the parties, we have examined Ext.A1 policy and found that the compound wall is insured as the 7^th item of Ext.A1 policy certificate and the assured amount is Rs.4 lakhs.  So we found that the complainant’s compound wall is covered under Ext.A1 policy.  On going through Ext.A3 insurance claim form we can see that complainant has submitted the claim form timely.  But the only contention of the opposite party is that even though they have issued a notice to the complainant requesting the final bill, complainant is not wiling to submit the same so far. 

                    14. In order to prove the contention, opposite parties stick on Ext.B2 document, which is a letter dated 15.04.2014 issued by the Branch Manager to the complainant requesting the final bill.  Even though the complainant submitted the claim form on 04.12.2013, the Ex.B2 document sent by the opposite parties is on 15.04.2014 and hence there is 4 ½ month delay on the part of the opposite parties.  As per Ext.A2 and A5, it is seen that the complainant had spent an amount of Rs.74,217/- for the reconstruction.  Opposite parties are relying on Ext.B1 for allowing Rs.10,128/- as their assessment.  But Ext.B1 is not proved properly.  At the same time, opposite parties has not made any attempt to disprove Ext.A2 and A5.  In the circumstances, Ext.A2 and A5 can be accepted.  Therefore, this complaint can be allowed. 

                    15. In the result, this complaint is allowed thereby the opposite parties are directed to pay an amount of Rs.74,217/- (Rupees Seventy Four Thousand two hundred and seventeen only) spent by the complainant to reinstate the collapsed wall along with 9% interest from the date of filing of this complaint along with cost of Rs.2,000/- (Rupees Two Thousand only) within 15 days from the date of receipt of this order, failing which the complainant is allowed to realize the whole amount ordered hereinabove with 12% interest from today till the realization of the whole amount.  Since interest is allowed there is no separate order for compensation. 

                    Declared in the Open Forum on this the 18^th day of December, 2014.

                                                                                                       (Sd/-)

                                                                                            K.P. Padmasree,                    

                                                                                                 (Member -I)

Sri. Jacob Stephen (President)               :      (Sd/-)

Smt. Sheela Jacob (Member – II)            :     (Sd/-)

Appendix:

Witness examined on the side of the complainant:

PW1  :  Abraham Varghese 

Exhibits marked on the side of the complainant:

A1 :  Policy certificate issued by the 1^st opposite party dated 30.03.2013.  A2 :  Statement of account of reconstruction dated 02.12.2013. 

A3 :  Fire insurance claim form dated 4.12.2013. 

A4 :  Copy of the letter dated 12.12.2013 sent by the complainant to the  

         opposite parties. 

A5 :  Invoice dated 05.01.2014 for Rs.74,217/-. 

A6 :  Copy of the letter dated 31.03.2014 sent by the complainant to the  

        1^st opposite party.

Witness examined on the side of the opposite parties:

DW1  :  P.I. Habeeb Muhammad

Exhibits marked on the side of the opposite parties:

B1 :  Survey report dated 07.03.2014 prepared by Mr. Abraham Cherian.  B2 : Copy of the letter dated 15.04.2014 issued by the 1^st opposite party  

        to the complainant. 

                                                                                                 (By Order)

                                                                                                       (Sd/-)

                                                                                      Senior Superintendent.

Copy to:- (1) Abraham Varghese, Thondutharayil, Thekkemala.P.O.,

                      Kozhencherry, Pin – 689 654.

1.  Branch Manager, The New India Assurance Co. Ltd.,   

      Kunnithottathil House, St. Peter’s Junctioin, Ring Road,  

      Pathanamthitta.P.O., Pin – 689 645,

1.  Divisional Manager, New India Assurance Co. Ltd., Divisional Office, Khaife   

      Building, Beach Road, Chinnakkada, Kollam, Pin – 673 307.

(4)  The Stock File.