Complainant by filing this complainant submitted that complainant is carrying on proprietorship business under the name and style of M/s New International Chemical Concern for manufacturing Micronutrient Fertilizer and trading of the same within the state of West Bengal for the purpose of earning his livelihood by means of self employment after obtaining licence and necessary registration certificates from the Govt. of West Bengal for carrying fertilizer business as per Fertilizer Control Order, 1985.

          For getting benefit of the insurance services of the op nos. 1 & 2 he availed of Standard Fire & Special Peril Policy from the op nos. 1 & 2 on payment of premium of the said policy and the complainant began to expand his business and approached the Bank op no.3 for financial assistance and obtained a Cash Credit Facility with a credit limit of Rs.3 lakhs from the op no.3 and considering the goodwill and reputation and past recovery history of the complainant, op no.3 enhanced the credit limit of the said loan from Rs. 3 lakhs to Rs. 5 lakhs and thereafter it was increased up to Rs.10 lakhs in the year 2008.

          To cover the uncertain risk in the business complainant insured his business against accident due to fire, flood and special peril by obtaining an Insurance Policy from the op nos. 1 & 2 being the policy No. 311500/112012/265 having period from 11.07.2011 to 10.07.2012.

          Further complainant has alleged that on 13.08.2011 complainant after carrying out production activity in his factory returned to his home early because it was raining heavily and on the said night  at about 11:00 P.M. the complainant was informed over his telephone by one of his staff that the flood water entered into the factory premises and spread all over the processing unit and also into the godown and after hearing the said incident the complainant immediately rushed to the factory and found that the entire area and the factory premises was inundated and the water level increased up to 2 inches to 6 inches inside the factory premises and the raw materials kept on the floor of the process unit was almost washed out, the flood water also already damaged almost entire raw material and to remove stocks of raw material to higher place the complainant with the assistance of the staffs hurriedly tried to remove stocks of raw materials to higher place in the factory but he could not remove the same because no place was left unaffected by the flood and the complainant came to know from the local people that due to lock gates of the drainage and sewage canals connected to the river canals were opened in some places for which the excess water entered Sonarpur and flooded certain areas.

          In the above situation complainant wrote a letter on 17.08.2011 informing about the incident to the Branch Manager, Dena Bank and also the present op Insurance Company and further requested the insurance company for deputing a surveyor for assessment of the loss sustained by the complainant and in the mean time Branch Manager of the Dena Bank mentioned that approximate amount of loss was for about Rs.7 lakhs.

          But despite the letter written by the op no.3 Bank, op nos. 1 & 2 did not send any surveyor and complainant repeatedly visited the office of the op no.2 to know the fate of his claim but on all occasion the complainant returned with empty hand.  Thereafter op no.3, Bank requested op no.2 to send certificate to inspect the loss but no surveyor was appointed.  After that 07.02.2012 along with claim bill dated 13.08.2011 statement of account etc and thereafter op no.2 without settling the claim vide its letter dated 07.02.2012, asked the complainant to bring a metrological report for the respective  period in order to proceed further for settlement of the claim and after obtaining  the said Metrological Report from the Regional Metrological Department, Alipore in respect of Rainfall of Alipore from 07.08.2011 to 15.08.2011, the complainant send the said report to the op no.2 along with a letter dated 15.03.2012.

          Thereafter all on a sudden the complainant was asked to receive the claim amount when the complainant approached the op no.3 at its office, the complainant was asked to sign a Discharge Voucher Form, wherefrom it appears that the claim of the complainant had already been settled by the op without conducting any survey regarding assessment of loss sustained by the complainant and for which the final settlement bill was found of Rs.1,83,918/- and the said amount transferred to the account of the Bank with the permission of the complainant.  But anyhow complainant asked the op nos. 1 & 2 to produce such document and also to consider the same but that was turned down for which for relief the complainant appeared before this Forum for directing the op nos. 1 & 2 to pay a sum of Rs.6,42,629/- as further claim amount.

          On the other hand op nos. 1 & 2 by filing written statement submitted that the entire allegation of the complainant is false and fabricated and have denied it and fact remains the surveyor visited the spot on 18.08.2011, 20.08.2011 and 02.09.2011 respectively carried out investigation to assess the quantum of loss.  So, the entire allegation of the complainant is false and fabricated and the story of settling the claim without surveyor report is also baseless and without any foundation.  Another factor is that the insurance was issued covering the godown only.  So, at the time of settlement, loss occurred in process unit has not been considered by the Surveyor and further complainant at first claimed Rs.13,35,000/- dated 17.08.2011 to Dena Bank op no.3, then the claim intimation of O.I.C. Ltd for Rs.7,00,000/- and finally the complainant submitted claim form claiming Rs.6,49,629/- without any basis and inconsistent with the nature of loss complying with policy coverage and in this regard the entire claim of the complainant should be dismissed on contest with cost.

                                                    Decision with reasons

          On overall study of the complaint including written version and particularly the argument as advanced by the Ld. Lawyers of both the parties including the vital insurance policy and on proper application of mind and reading the said Insurance Policy it is found that M/s New International Chemical Concern’s entire property was not insured.  But particular insurance was in respect of period from 11.07.2011 to 10.07.2012 wherefrom it is found that the risk covered only in respect of material stored in godown but no other article.  But it is specifically noted that good listed in category nos. 2 & 3 Copir Fibre carries are not settled therein.  So, other than the godown in respect of other damages this insurance policy does not cover that package.  So, we must have to see what was loss assessed by the assessor in respect of the articles/goods of the godown and invariably on the first date it was under lock and key when he left the factory and there was no chance to check the articles in that godown due to such rain water logging.  So, in this regard we have gathered from the document that surveyor assessed and Prabal Biswas the surveyor submitted a very lengthy report and the loss assessor visited the godown on 18.08.2011, 20.08.2011 and 02.09.2011 and we find that said area premises was inundated and found the water level was around 1 ft. and 6 inches all around of factory premises and different type of raw materials stocks were soaked and dissolved leaving the empty sealed bag and due to continued/prolong water the chemicals were destroyed but on inspection of the entire bags it was found that entire area of raw material from cotton process section for production of 2.5 M/T process section intavate super soil and 1 M/T Intavate Chelated Zinc Edta for that these raw materials were found lying in the process section floor ready to be mixed manually proportionately in open heaps. The flood water also washed away most of the materials but he found that mixed residue weighing 1.5 M/T was lying in the process section floor after the flood water had drained out.  It was found that house keeping inside the factory cum godown was poor and storage of Spent Sulphuric acid in Silos was done in the open space and it was also found that factory was below the floor level to the extent of 10 inches and the article which are outside the godown were not considered as per contract.  Loss assessor also prepared a schedule –A, B & C and specifically mentioned that schedule reflected cost of raw materials washed by flood water which are laying at different locations at the time of inspection.  But actual loss is noted in schedule- A which was in the said godown that is serial No.1, 2 & 3.  But B- schedule materials were in laboratory and C-schedule materials was lying in the process section and he prepared loss of different schedule.  But complainant is entitled to only loss in respect of the godown which was insured and said loss was assessed to the extent of Rs.1,32,097/- and submitted final report but in his report he submitted entire loss of different areas including godown separately.

          Further considering of the entire matter, the loss assessor Prabal Biswas submitted very exhaustive report and submitted that complainant was entitled to Rs.2,15,810/- not only that the loss assessor prepared a hand sketch map of the entire area and also took some snaps of that area and thereafter op insurance company disposed of the claim and sent a cheque of Rs.1,83,918/- that was received by the bankers of complainant.

          No doubt the question is whether the complainant has been able to prove that entire factory was covered by that insurance policy or not.  But after thorough scrutiny of the policy certificate we find that entire factory was not covered under the present policy but only the godown and fact remains loss assessor visited the said factory premises forthwith because loss assessor visited the said premises on 18.01.2011 when it was partially under water on 24.01.2011 then on 02.09.2011 and carried out physical inspection thereafter submitted report when the op insurance company considered and released a sum of Rs.1,83,918/- but complainant has suppressed this fact invariably for some ill purpose he did it.  Another factor is that in the complaint has stated very specifically even after knowing everything about business transaction including the purchased policy status that the entire factory was covered under the policy but that is false story, only factory godown is insured and no doubt inspection was not only held several times but snaps were taken and entire factory picture during inspection was duly ventilated and no doubt the loss assessor assessed the loss to the extent of Rs.2,15,810/- but insurance company granted Rs.1,83,918/-.  Then question is for what reason the complainant suppressed the said fact that loss assessor did not visit the said premises that means he realized the loss assessor’s report will not give him full claim for which he brought allegation against the insurance company but that allegation is proved false.

          In this context we are well aware of the fact that the surveyor’s report was taken into account at the time of considering any claim of any insurance and most interesting factor is that about loss assessor report there is no allegation and no such allegation is made in the complaint also.  But it is the case of the complainant that no inspection was held but it is truly false because he submitted claim along with papers along with material report and at the same time it is fact that the on 13.08.2011 the said incident took place due to rain water and complainant informed this matter to the op on 17.08.2011 and inspection started on 18.08.2011.  So, there was no latches on the part of the op insurance company and there was no lapse of investigation authority of who hold inspection submitted report and in respect of Schedule-A of the report, complainant is entitled to claim and no doubt in respect of Schedule- B & C complainant is not entitled to get any compensation for loss or damages due to rain water because it was not covered by the insurance policy.  Anyhow after considering the loss assessor amount we find that loss assessor assessed Rs.2,15,810/- whereas insurance company released Rs.1,83,918/-.  So, it is found that op did not pay Rs.31,892/- as per loss assessor statement.  Invariably some other matter was considered by the insurance authority.  But we are confirmed that at best we may release Rs.31,892/- more but not more than that.  In view of the above fact the present complainant presented the complaint suppressing all facts of this insurance policy and also the coverage of his business and factory when the insurance policy does not support that entire factory was covered by the policy so it is proved that complainant is found suppressed the truth and tried to take away huge amount.  But any how we have gathered that insurance company did everything after receiving his complaint for payment to survey on 17.08.2011 and inspection started on and from 18.08.2011.  Fact remains inspection report was submitted on 19.01.2012 and the amount of Rs.1,83,918/- was released then and there.  So, there was no latches on the part of the ops insurance company and practically present complainant has failed to prove that by this insurance policy his entire factory was covered for the risk of flood or fire or any other peril for which we are accepting final report of the surveyor and we are considering and are giving Rs.32,000/- as per report of loss assessor to the complainant but not more that that because deficiency in service and negligence on the part of the op insurance company is not at all proved. 

          In the result, the complaint succeeds in part as we are giving some relief.

          Hence, it is

                                                       ORDERED

          That the complaint be and the same is allowed in part on contest with cost of Rs.2,000/- against op nos. 1 & 2 and same is dismissed against op no.3 but without any cost.

          Op nos. 1 & 2 are directed to pay a sum of Rs.32,000/- to the complainant within one month from the date of this order positively.

          But no compensation is awarded in this case in view of the fact complainant suppressed the truth in his complaint and on proper evaluation of the material and evidence of the parties and documents we are confirmed that there was no fault on the part of the op insurance company and complainant has failed to prove any negligence and deficiency in service of the op nos. 1 & 2 by any means whatsoever.