Per Mr.Narendra Kawde – Hon’ble Member:
(1) This complaint has been filed by Shree Shankar Sahakari Sakhar Karkhana Ltd. (‘the Complainant’ in short) a Co.operative Society registered under the Maharashtra Co-operative Registration Act, 1961 against the Opponent – The New India Assurance Co. Ltd. (“the Insurance Company” in short) alleging deficiency in service in not settling the insurance claim admissible under the Insurance Policy in respect of loss of baggasse due to fire.
(2) The salient facts giving rise to file this complaint are that the Complainant subscribed to fire insurance policy for providing insurance cover to storage of baggasse for the period from 23.01.2009 to 22.01.2010 after making payment of premium of `42,472/- with sum assured of `1,00,00,000/-. The description of the risk cover was stock of baggasse in open outside factory with add-on risk of spontaneous combustion. During the validity period of the Insurance policy fire occurred on 12.03.2009 at about 12.45 in the afternoon and the insured baled baggasse caught fire and was burnt. The complaint was lodged by the Security Officer - Shri Sudhir Khaserao Pawar of the Complainant on the same day. It was with the local police station, efforts were made to extinguish the fire with by requisitioning of the fire brigade from nearby sugar factories but the entire baggasse stored got destroyed into the fire. The Complainant informed incidence immediately to the Opponent Insurance Company. Preliminary survey of the incident was conducted by the Surveyor deputed by the Opponent Insurance Company followed by detailed survey report by another surveyor. Thereupon, the Complainant filed insurance claim payable under the policy on 17.03.2009 for `78,03,109/-. The Opponent Insurance Company repudiated the claim on the ground that the claim was not covered under the terms and conditions of the policy. Aggrieved by the repudiation of the claim Complainant has filed this consumer complaint before this Commission praying for award of claim of `95,23,336.91 together with interest and cost of the complaint.
(3) The Opponent Insurance Company has contested the Complainant’s claim by filing written version, affidavit of evidence together with copy of the proposal form, policy document, copy of detailed survey report etc. It is the contention of the Opponent Insurance Company that the “stock of baggasse in open outside factory compound” is covered under the policy. In the instant case according to survey report the entire baggasse i.e. in loose and baled form was stocked inside factory compound and the insured and out of that baled baggasse stocked spent wash tank was damaged by fire. Therefore, the loss claimed by the Complainant is outside scope of the policy and therefore, it was repudiated, since the baggasse destroyed by fire was situated inside and not outside the factory compound as specifically mentioned in the policy is not covered and held not eligible for insurance claim.
(4) Heard Ld.Advocates of the parties. It was submitted by Ld.Advocate of the Complainant that the storage of baggasse was as per the policy terms and conditions. Prior to issue of the insurance policy in the earlier year and even from the beginning the baggasse is stored in the same place since inception. The storage of baggasse site was visited and verified by the Opponent Insurance Company before issue of the policy. The total baggasse lost was worth `78,00,000/- plus and the insurance cover under the policy was for `1,00,00,000/-. The Opponent Insurance Company arbitrarily repudiated the insurance claim of the Complainant though the incident of fire destroying the entire baggasse is established beyond doubt as admitted by the Opponent Insurance Company. There is police panchanama and affidavit of the Complainant’s storekeeper supporting the incident and loss sustained by the Complainant. The Ld.Advocate of the Opponent submitted that claim was not covered under the policy and relied on the affidavit of evidence, affidavit of Surveyor and copy of the proposal form signed and submitted by the Complainant for subscribing to the Insurance Policy. The repudiation of the claim as not admissible was rightly repudiated since not covered under the policy issued by the Insurance Company.
(5) On perusal of the record and documents tendered by the parties we find that the policy document in Part-1 i.e. Waste of Category II and III materials under the description of Risk “STOCK OF BAGGASSE IN OPEN OUT SIDE FACTORY” is covered. The Ld.Advocate of Opponent Insurance Company did not come forward with explanation as to the meaning of open outside factory especially when the baggasse was stored in a conventional place as shown by the Opponent Insurance Surveyor in the diagram map (page 46) of the complaint compilation. The compound walls cover 3 sides of the factory that is east, north and west, however there is no compound wall towards south. It is an open field as can be seen from the map, much away from the sugar factory. The surveyor calculated loss of all the baggasse destroyed in the fire to the tune of `35,79,313/- as against claim filed of `78,03,109.91 by the Complainant. The affidavit on behalf of the Complainant, of one Shri Dnyandev Vishwanath Karche, working with the Complainant for the last 37 years made a mention about the visit and inspection of the Opponent Insurance Company to the site visit before the insurance policy was issued. There was no objection raised and the site was very much within the knowledge of the Opponent Insurance Company. Surprisingly, written version and the affidavit of evidence and also the affidavit of Surveyor is silent on the visit to site of the Insurance Company Officer prior to issue of the insurance policy. There is no rebuttal documentary evidence put forward by the Opponent Insurance Company. Therefore there is no reason to disbelieve the contention of the Complainant that the baggasse was stored in the open outside factory.
(6) The total claim filed by Complainant is for the tune of `95,23,336.91, which is neither fully supported nor explained properly. The detailed survey conducted in the presence of the Complainant’s representative assessed quantum of loss of baggasse to the tune of `35,79,313/- and is supported by affidavit. The survey report is held to be an important piece of evidence. We are therefore inclined to consider the survey report for settlement of claim of the Complainant.
(7) We observe that Opponent insurance company failed to appreciate the provisions of policy coverage of insurance to the baggasse in right perception and arbitrarily repudiated the claim of the Complainant rendering deficiency in service in settling the claim. We hold accordingly and pass the following order:
O R D E R
(i) Appeal is partly allowed.
(ii) Opponent Insurance Company is directed to pay an amount of `35,79,313/- with interest @9% per annum from the date of repudiation of the claim i.e. from 08.06.2010 within 45 days from the date of this order.
(iii) Rest of the claim of the Complainant stands rejected as not specifically allowed.
(iv) In the circumstances, parties to bear their own cost.
(v) Inform the parties accordingly.
Pronounced on 12th March, 2012.
