This is an application u/s.12 of the C.P. Act, 1986.

          Complainant by filing this complaint has submitted that complainant is running small scale industrial unit in the name and style of Diamond Box & Company and he has no other source of income other than running the said SSI Unit by means of self employment and it is a proprietorship business of the complainant and for the purpose of protection of the said unit complainant under the OP insured the said unit and paid for insurance coverage a premium of Rs.8,366/- and that insurance coverage was including boundary wall, factory shed etc of the building along with super structure of the building and stock, stock in process office equipments furniture, fittings, plants & machinery under standard fire and special perils policy and on receipt of the premium OP issued insurance policy being policy no.51040011100100200162 and the period of insurance was 27-02-2011 to 26-02-2012. 

          Fact remains due to heavy rain for deep depression and cyclone as an act of nature on 22-06-2011 in Kolkata and the surrounding due to the devastating natural calamity huge los has been sustained by the complainant for falling northern side of the building and the stock of materials kept inside the northern portion of the building was damaged and destroyed for which the roof of the building and main gate were all totally damaged which is required to be replaced by way of new construction and the news of natural calamity was duly covered under the source of the newspapers also stating the entire facts and as such on 22-06-2011 the complainant intimated the facts to the OPs in writing. 

          On receipt of the letter dated 22-06-2011 the OPs appointed a surveyor to survey the incident and accordingly the surveyor visited the place of occurrence on 28-06-20-11 and on 11-07-2011 and the said surveyor Kalyan Bhattacharya issued a letter by asking complainant to submit some papers and also intimated for compliance of necessary formalities and the complainant vide letter dated 23-09-2011 intimated the OPs regarding the compliance and furnished the required papers and documents to the said surveyor and the same were duly received on 26-09-2011 by the surveyor and also submitted stock of draft paper on and from 01-04-2011 to 21-06-2014 showing closing balance on 21-06-2014 and in fact complainant’s loss was estimated by an Engineer of the complainant and it was Rs.4,65,000/- but peculiar factor is that OP by a letter dated 30-09-2011 settled the claim only by releasing a sum of Rs.38,629/- without assigning any reason and calculated settled the claim of the complainant for such amount in place of Rs.4,65,000/-.  Complainant subsequent to that appointed LBS at his own cost for the estimation for cost of repair made by the C.E. Consultants, Architect Engineer and Licentiate Building Surveyor being Registration No.1100(1) K.M.C. Registered (L.B.S.) of the Kolkata Municipal Corporation and as per his report it is found that his loss was to the extent of Rs.4 lakhs and above.  The matter was reported to the OP but OP did not consider the same but fact remains that the total insured amount is Rs.60 lakhs and complainant claimed the amount of Rs.4,65,000/- only and loss against building was calculated for an amount of Rs.2,62,780/- and rest of the amount was against loss of the stock in trade as well as in process and as such the Surveyor Report was not acceptable by the complainant and in the above circumstances complainant prayed for redressal for baseless assessment of loss in such a situation.

          On the contrary Insurance Company by filing written statement admitted the fact of the insurance of the said necessary unit of the complainant and validity of the policy etc.

          Insurance Company OP also admitted that complainant wrote a letter on 22-06-2011 stating inter alia that the building was damaged due to continuous rain and cyclone resulting to collapse of northern wall of the factory of the insured and the said loss is estimated by the complainant to the extent of Rs.2 lakh and thereafter, as per standard norms the insurer appointed a licensed surveyor Kalyan Bhattacharya who inspected the place and he submitted his report and issued a letter to the insured asking him to submit Claim form, relevant bills etc. and repair work of damaged wall in as much as for declaring the cost of salvage of bricks after the incident of loss but OP did not receive any intimation from the insured but surveyor send a reminder on 20-09-2011.  After that this claim was settled and complainant was asked to supply bank account.  Subsequently, insured on 04-11-2011 wrote a letter stating that he is not willing accept such settlement amount of Rs.38,592/- but claimed for reassessing his claim on proper merit and ultimately insurance company did not reconsider the same in view of the fact that the matter is adjudicated with proper reasoning and in the application form complainant did not claim compensation with valid documents.  So, there is no scope to reconsider the claim of the complainant further and there was no deficiency and negligence on their part and they prayed for dismissal of the case.

Decision with Reasons

On proper consideration of the complainant, written version and also relying upon the documents as filed by the parties and further copy of application for claim it is clear that complainant claimed Rs.20,000/- as his claim initially when it was reported to the OP.  but subsequently, at the time of filing application form complainant claimed Rs.4,65,000/- by such loss but as because initially the complainant reported that only about the loss of damage etc. OP decided the same after appointing surveyor when OP finally settled the matter by fixing a sum of Rs.38,629/-.

          Moot question is whether the damage sustained by the complainant was due to Sunami or heavy rainfall on the date of incident prior to that and whether the complainant factory was fully damaged and the articles were damaged due to said natural calamity and the factory premises of the complainant was water-logged and due to said heavy rainfall the building was damaged.  Fact remains complainant paid premium of Rs.8,366/- and as per insurance policy sum insured is Rs.60 lakhs complainant claimed Rs.4,65,000/- and insurance company released Rs.38,629/- considering that fact it is clear that insurance company are borne with their right to take premium but not to release the claim amount.  No prudent man shall believe that with the help of such Rs.38,629/- the entire building can be repaired.  It is fact that complainant does not maintain his daily account by verifying it by Chartered Accountant and there is no doubt banking loan but that has not been disclosed, bank report has also not been submitted by the complainant and at the same time repairing cost of the building as mentioned by the complainant through their LVS is no doubt is personal act of the complainant but even then after considering the entire facts and material and further considering the natural calamity of that date we find that insurance company ought to have consider his prayer and to release some more money to some extent to save the present SSI Unit but practically the approach of the insurance company is not always social and moral though insurance act was promulgated with a hope that it is a social legislation and concerned authority shall have to show their social obligation but in the present case that is not shown.  After proper consideration of the materials as produced by the parties it is found complainant initially reported that he sustained a loss of Rs.2 lakhs it is fact.  When application Form was filed by the complainant it became Rs.4,65,000/- but he has failed to produce any audited account of his stock prior to date of incident at the same time he has failed to show his stock verified by the Bank wherefrom he has taken loan.  Whatever it may be without wasting time and also considering the entire fact and materials and further considering the release of Rs.38,629/- by the OP and claim of the complainant initially made by the complainant in respect of Rs.2 lakhs we are granting a sum of Rs.2,39,000/- in favour opf the complainant treating the entire dispute as settled finally by this Forum and OP shall have to pay the same to the complainant and this order is passed only with a view to giving a prime relief to the consumer to present SSI Unit without referring the matter for further investigation because it will somehow or otherwise waste time and may be complainant may not get such relief if it is referred to the OP. 

In the result, the case succeeds.

Hence,

Ordered

That the case be and the same is allowed on contest against OPs1,2 and 3 with a cost of Rs.2,000/- and dismissed against other OPs.

          OPs 1,2 and 3 are jointly and severally hereby directed to pay a sum of Rs.2,39,000/- to the complainant treating his claim as finally settled and it must be paid within one month from the date of this order to the complainant and if OP fails to comply in that case for non-compliance and disobeyance of the Forum’s order OPs shall have to pay penal interest  at the rateRs.250/- per day till full satisfaction of the decree and if it is collected it shall be deposited to this Forum.         

          Even if OPs are found reluctant to comply the order in that case penal action shall be started against them u/s.27 of the C.P. Act, for which they shall be further imposed penalty and fine.