IN THE CONSUMER DISPUTES REDRESSAL FORUM, PATHANAMTHITTA,
Dated this the 16th day of October, 2012.
Present : Sri. Jacob Stephen (President)
Sri. N. Premkumar (Member)
Smt. K.P. Padmasree (Member)
C.C. No. 76/2012 (Filed on 09.04.2012)
Between:
George Puthoor,
Puthoor House,
Maramon.P.O.,
Thiruvalla Taluk,
Pathanamthitta Dist.
(By Adv. Anzil Zachariah) …. Complainant
And:
New India Assurance Co. Ltd.,
Kunnithottathil Towers,
Ring Road, Pathanamthitta,
Rep. by its Manager.
(By P.D. Varghese) …. Opposite party
O R D E R
Smt. K.P. Padmasree (Member):
Complainant filed this complaint against the opposite party for getting a relief from the Forum.
2. Facts of the case is brief as follows: Complainant had taken a Standard Fire and Special Peril Policy from the opposite party in respect of his family and properties from 12.02.2002 to 11.02.2012 for an assured sum of 20 lakhs. On 07.12.2011 due to wind blow, a coconut tree fall on the house of the complainant where car shed was situated. The car shed got demolished, thereby the car shed and the car parked inside got damaged. The incident was intimated to the opposite party. The surveyor of the opposite party assessed the loss. Complainant submitted the claim form along with details of estimate to repair the damages and bills incurred to renovate the shed. But the opposite party repudiated the claim vide communication dated 01.02.2012 informing that his claim is not covered under specified perils mentioned in the policy. The act of the opposite party amounts to deficiency of service. Hence the complainant filed this complaint for getting insurance claim along with cost and compensation of a total amount of ` 74,510 under various heads.
3. Opposite party entered appearance and filed their version with the following contentions. Opposite party admit the issuance of a Standard Fire and Special Peril Policy to the complainant. As per the policy issued in this case if the insured property is destroyed or damaged by any of the perils mentioned in the policy such as fire, riot, strike and malicious damage, storm, cyclone, subsidence and landslide including Rock Slide, bursting and overflowing of water tanks, apparatus and pipes. Missile testing operation, leakage from automatic sprinkler installations and bush fire. The damage occurred in this case will not come under any of the perils and mentioned in the policy. Hence the claim lodged by the complainant is repudiated by the opposite party and the matter was intimated to the complainant. Moreover, no claim can be allowed for the damage sustained to the car, as the car is not covered under the policy. Opposite party prays for the dismissal of the complaint with their cost.
4. On the basis of the pleadings of the parties, the only point to be considered is whether this complaint can be allowed or not?
5. The evidence of this complaint consists of the oral evidence of PW1, PW2, DW1 and Exts.A1 to A5 and B1 to B3. After closure of evidence, both sides were heard.
6. The Point:- The complainant filed this complaint for getting insurance claim from the opposite party for the damage sustained to the car shed and car which was insured with the opposite party. But the opposite party repudiated the claim by stating that the damage sustained to the case will not come under any of the perils mentioned in the policy. According to the complainant, the reason for the repudiation is baseless and illegal and hence opposite party is liable to the complainant.
7. In order to prove the complainant’s case, complainant filed proof affidavit in lieu of his chief examination along with 5 documents. On the basis of the proof affidavit, complainant was examined as PW1 and the documents were marked as Exts.A1 to A5. One witness was also examined as PW2 for the complainant. Ext.A1 is the policy certificate issued by opposite party. Ext.A2 is the estimate for repairing cost. Ext.A3 is the receipt for materials purchased for repairing work. Ext.A4 is the invoice from Royal Automobiles. Ext.A4(a) is the cash bill issued by Sivan Spray Painting Works. Ext.A5 is the repudiation letter issued by opposite party.
8. On the other hand, the contention of the opposite party is that the repudiation is genuine and legal. According to the opposite party, they have issued an insurance policy to the complainant. As per the policy if the insured property is destroyed or damaged by any of the perils mentioned in the policy the insurance company is liable. But the damage occurred in this case will not come under any of the perils mentioned in the policy. Hence the claim lodged by the complainant is repudiated by the insurer and the matter was intimated to the complainant.
9. In order to prove the contention of the opposite party, the surveyor was examined as DW1 and three documents produced were marked as Exts.B1 to B3 series. Ext.B1 is the survey report. Ext.B2 is the Fire Insurance Claim Form. Ext.B2(a) is the estimate of materials. Ext.B3 series (6 in number) are the photographs of the damaged car shed.
10. 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 party 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 the policy benefits whereas the contention of the opposite party is that the complainant is not entitled to get the benefits as the policy in question didn’t cover the alleged incident. In the light of the rival contention of the parties, we have examined Ext.A1 policy and found that the car shed is insured as the 6th item of Ext.A1 policy certificate and the assured amount is ` 20,000. So in that aspect we found that the complainant’s car shed is covered under Ext.A1 policy. At the same time, the contention of the opposite party is that the alleged incident is not covered under the policy conditions. Though they have raised such a contention they have not adduced any evidence to substantiate their contentions, and they have also no case that the alleged incident is a manmade incident for getting money from the opposite party’s. So we further find the incident occurred in this case is unexpected and is beyond the control of the complainant. The complainant took the policy for covering the unexpected damages beyond the control of the complainant. So the complainant is entitled to get the policy benefits as per Ext.A1 policy. However, the sum assured in the Ext.A1 policy is ` 20,000. So the complainant is not entitled to get any amount more than the assured amount of ` 20,000, even if he had incurred any amount more than the assured amount. Therefore, the opposite party is liable to pay the assured amount subjected to the policy conditions. So the non-payment of the policy amount is a clear deficiency of service from the part of the opposite parties. Therefore, this complaint is allowable in part.
11. In the result, this complaint is allowed in part, thereby the opposite party is directed to pay the assured amount of ` 20,000 less the statutory deductions to the complainant within 15 days from the receipt of this order with interest at the rate of 9% from the date of filing of this complaint along with cost of ` 1,500 (Rupees One thousand five hundred only), failing which complainant is allowed to realize ` 20,000 and cost ordered with 10% from the date of filing of this complaint till the realization of the whole amount. Since interest is allowed, no orders for separate compensation.
Declared in the Open Forum on this the 16th day of October, 2012.
(Sd/-)
K.P. Padmasree,
(Member)
Sri. Jacob Stephen (President) : (Sd/-)
Sri. N. Premkumar (Member) : (Sd/-)
Appendix:
Witness examined on the side of the complainant:
PW1 : George Puthoor.
PW2 : Ency. M. Kosh.
Exhibits marked on the side of the complainant:
A1 : Policy certificate issued by opposite party.
A2 : Estimate for repairing cost.
A3 : Receipt for materials purchased for repairing work.
A4 : Invoice for ` 5,070 dated 20.12.2011 issued from Royal
Automobiles, Maramon.
A4(a): Cash bill dated 22.12.2011 for ` 17,500 issued by Sivan
Spray Painting Works, Changannur.
A5 : Copy of repudiation letter dated 01.02.2012 issued by
opposite party to the complainant..
Witness examined on the side of the opposite party:
DW1 : Sampath. G.
Exhibits marked on the side of the opposite party:
B1 : Final survey report.
B2 : Fire Insurance Claim Form.
B2(a): Estimate of materials.
Ext. B3, B3(a), B3(b), B3(c), B3(d) & B3(e) : photographs of the
damaged car shed (6 in number).
(By Order)
(Sd/-)
Senior Superintendent
Copy to:- (1) George Puthoor, Puthoor House, Maramon.P.O.,
Thiruvalla Taluk, Pathanamthitta Dist.
(2) The Manager, New India Assurance Co. Ltd.,
Kunnithottathil Towers, Ring Road, Pathanamthitta.
(3) The Stock File.
