Date of Filing:13.11.2007<br /> Date of Order:01.07.2008<br /> <br /> <br /> <br /> BEFORE THE II ADDITIONAL DISTRICT CONSUMER DISPUTES REDRESSAL FORUM SESHADRIPURAM BANGALORE-20<br /> <br /> Dated: 1ST DAY OF JULY 2008<br /> PRESENT<br /> <br /> <br /> <br /> Sri. S.S. NAGARALE, B.A, LL.B. (SPL.), President.<br /> Smt. D. LEELAVATHI, M.A.LL.B, Member.<br /> Sri. BALAKRISHNA. V. MASALI, B.A, LL.B. (SPL.), Member.<br /> <br /> <br /> <br /> <br /> COMPLAINT NO: 3057 OF 2006<br /> &<br /> COMPLAINT NO: 3058 OF 2006<br /> <br /> <br /> The Proprietor,<br /> Arun Engineering Enterprises,<br /> No.5/2, Nala Cross,<br /> Lalbagh 4th Cross Road,<br /> Bangalore 560 027. Complainant<br /> <br /> V/S<br /> <br /> The Branch Manager,<br /> The Oriental Insurance Company Limited,<br /> CBO-11, No. 12/2, Mission Road,<br /> Bangalore 560 027. Opposite Party<br /> <br /> <br /> ORDER<br /> By the President Sri. S.S. Nagarale<br /> <br /> These two complaints are clubbed together for passing common order since the facts and law points involved in these two complaints are one and the same and these two complaints are disposed off conveniently by common order.<br /> The complainant has filed a complaint under section 12 of the Consumer Protection Act stating that he had taken policy of insurance from the opposite party. The complainant has submitted documents and claim forms but he has not received any letter from opposite party either allowing or repudiating the claim. Legal notice was served on opposite party. Till date of filing of complaints it is submitted by the complainant that no settlement was forthcoming by the opposite party. Non-settlement of insurance claim is deficiency of service on the part of the opposite party. Hence, these complaints are filed before the forum. <br /> 2. Notice served to opposite party. The opposite party has put in appearance and filed defence version denying the claim of the complainant. It is submitted by the opposite party that the complainant had to submit relevant documents for scrutiny and processing. Complainant failed to submit the documents. The opposite party was unable to process or proceed further with the claim of the complainant. The surveyor has sent letter that the complainant has not obliged to forward the documents. The opposite party is unable to process the claim for want of documents and the complainant has not co-operated with the surveyor to inspect the loss or damage. The opposite party has denied any deficiency in service or negligence as on their part. Therefore, the opposite party requested to dismiss the complaint.<br /> 3. These two matters were heard by predecessor in the office. The complaints were dismissed by order dated 31.05.2007. Being aggrieved by the dismissed order the complainant preferred appeal before the Hon’ble State Commission in Appeal No. 1448/2007, 1450/2007 and these complaints were remanded back to the District Forum to dispose of afresh. After remand the matters were heard. Arguments by the learned counsels were heard. I have gone through the complaints and the defence version. It is admitted case of the complainant that the claim was neither allowed nor repudiated. Till the date of the complaint the claim submitted by the complainant was not settled by the opposite party. It is the case of the opposite party that complainant has failed to submit the details of the claim and he has failed to submit all the required documents and the surveyor was unable to proceed with the matter. The complainant had not submitted the documents in support of the claim. The surveyor who was entrusted the job of inspection was unable to process the claim for want of documents. Therefore, it is clear that the matter was not settled at the level of opposite party. The insurance claim submitted by the complainant is till pending with the opposite party. The complainant himself has stated in his complaint the matter is still pending and no settlement is forthcoming from the opposite party. So under these circumstances the only remedy now open to the complainant is to submit all the required documents as per the terms and conditions of the policy and he has to co-operate with the surveyor for assessing damage or loss. The opposite party has to settle the claim after taking into consideration of all the documents and material produced by the complainant in support of his claim. This forum cannot do the job of surveyor or Insurance Company. The complaint filed by the complainant is pre-mature one. When the claim is neither allowed nor repudiated where is the question of challenging before the District Forum. The complainant gets right to approach the forum only after repudiation of the claim by the opposite party. The function of the district forum will be to see whether the repudiation of claim is justified or not. But in this case still the claims are not settled. The matters are pending with the opposite party. The claims of the complainant are not repudiated by the opposite party. Under these circumstances there is absolutely no scope in law to decide the insurance claim of the complainant by this forum. The forum is handicap. Because before the forum there is no survey report. No original documents are produced. Without their being any relevant documents, survey report and other material how can the forum decide the claim. The district forum cannot allow or repudiate the claim. It is the duty and obligation of the opposite party to consider the claim of the complainant and either to accept the claim or repudiate the claim as per the terms and conditions of the policy. On repudiation of the claim only the complainant gets right to challenge the same and approach the District Forum for appropriate relief. Therefore, the matter required to be decided by the opposite party. At the most a direction can be issued to the opposite party to settle the claim of the complainant within a reasonable time. It is up to the opposite party either to allow the claim or repudiate the same after taking into consideration of all the documents produced by the complainant. The complainant has to co-operate with the surveyor and he should produce the relevant document material before the surveyor or opposite party within a reasonable time and co-operate with the opposite party for early settlement of the claim. With this observation I proceed to pass the following order.<br /> ORDER<br /> 4. The opposite party is directed to settle the claim of the complainant promptly either to allow the claim or repudiate the same within 4 months from the date of this order. The complainant shall produce all relevant documents as per the terms and conditions of the policy before the opposite party and co-operate with the opposite party in the early settlement of the claim. The complaints are disposed off with the above directions.<br /> <br /> 5. Keep the copy of the order in the connected complaint.<br /> <br /> 6. Send the copy of this Order to both the parties free of costs immediately. <br /> <br /> 7. Pronounced in the Open Forum on this 1ST DAY OF JULY 2008. <br /> Order accordingly,<br /> <br /> PRESIDENT<br /> We concur the above findings. <br /> <br /> MEMBER MEMBER <br /> <br /> <br /> <br /> <br />