Chandigarh

DF-I

CC/246/2024

ASHWANI ARORA - Complainant(s)

Versus

THE ORIENTAL INSURANCE COMPANY LIMITED - Opp.Party(s)

DEVINDER KUMAR

07 Oct 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-I,

U.T. CHANDIGARH

                               

Consumer Complaint No.	:	CC/246/2024
Date of Institution	:	17.05.2024
Date of Decision	:	07/10/2024

 

1.     Ashwani Arora, SCO No.138, Sector 5, MDC, Urban Estate, Panchkula, Haryana-134109.

2.     Dimple Arora, SCO No.138, Sector 5, MDC, Urban Estate, Panchkula, Haryana-134109.

...Complainants

Versus

The Oriental Insurance Co. Ltd., SCO No.52, Sector 42-C, Chandigarh through its Branch Manager-160036.

...Opposite Party

 

CORAM :	SHRI PAWANJIT SINGH	PRESIDENT
	MRS. SURJEET KAUR	MEMBER
	SHRI SURESH KUMAR SARDANA	MEMBER

 

                                                                                                

ARGUED BY	:	Sh.Devinder Kumar, Advocate for complainant
	:	Sh.Arjun Kundra, Advocate for OP

Per Pawanjit Singh, President

1.         The present consumer complaint has been filed by complainants against the opposite parties (hereinafter referred to as the OP).  The brief facts of the case are as under :-    
   1. It transpires from the averments as projected in the consumer complaint that the complainants are owners of the SCO No.138, Sector 5, MDC, Urban Estate, Panchkula and have been using the same for their office premises/meeting rooms (hereinafter referred to as the ‘subject premises’) and have been getting the same insured from the OP for the last 15 years on payment of the huge premium. The complainants purchased the policy valid from 10.09.2023 to 09.09.2024 on payment of the premium of ₹10,166/- (Annexure C-1)  from the OP (hereinafter referred to as the ‘subject policy’), covering the subject premises, stocks etc.  On 17.11.2023 around 7:00 P.M. the employees of the complainants working at the ground floor of the subject premises noticed the fire incident and immediately they rushed to the spot and tried to control the fire with the help of sand etc. and had also informed the fire incident to the fire brigade. A copy of the fire report dated 17.11.2023 is Annexure C-2. The intimation was also given to the OP about the fire incident who deputed the surveyor –M/s Classic Insurance Surveyor & Loss Assessors Pvt. Ltd. to assess the loss. The surveyor visited the premises to investigate the matter and the complainants submitted all the record including the details of the loss to the subject premises to the tune of ₹2,83,966/- which was spent by the complainants for the repair of the subject premises to the surveyor. The copy of the invoices are Annexure C-3 (Colly.).  However, instead of paying the entire loss amount to the complainants, the surveyor had partly  assessed the loss to the tune of ₹48,007/- which was conveyed to the complainants vide email dated 24.01.2024 (Annexure C-4).  In addition to the aforesaid amount of ₹2,83,966/-, the complainants had also spent an amount of ₹85,000/- on the tiles and provided the documents to the OP. The copies of the bills as well as voucher are Annexure C-5 (Colly.). Thereafter, the OP sent an e-mail dated 13.02.2024(Annexure C-6) directing the complainants to provide consent for the net adjusted loss of ₹61,475/- as full and final settlement of the claim. The complainants raised the objections by sending the email dated 14.02.2024(Annexure C-7) requesting the OP to reconsider the claim and to release the claim of ₹3,68,985/-.  The OP has wrongly and arbitrarily has not assessed the total loss suffered by the complainant. The aforesaid act amounts to deficiency in service and unfair trade practice on the part of OP. OP was requested several times to admit the claim, but, with no result.  Hence, the present consumer complaint.
   2. OP resisted the consumer complaint and filed its written version, inter alia, taking preliminary objections of maintainability, cause of action and concealment of facts.  However, it is admitted that the subject premises was insured under the subject policy valid from 10.09.2023 to 09.09.2024 (Annexure R-1/C-1).  The complainants had informed the OP about the fire incident by sending an email dated 20.11.2023(Annexure R-2) and accordingly the surveyor was deputed to investigate the whole case and the surveyor vide survey report dated 14.02.2024 (Annexure R-3) assessed the net loss to the tune of ₹61,475/- against the loss of ₹2,83,966/- as claimed by the complainants. It is further alleged that the approved surveyor submitted addendum to the survey report on 03.06.2024 in which the loss claimed of ₹1,65,675/- on account of false ceiling was allowed for ₹1,49,105/- and accordingly, the complainants were asked to provide the copy of the bank statement in support of the payment of ₹1,65,672/-  made to the repairers which was not provided and as such there is no deficiency in service on the part of the OP. It is further alleged that as now the net loss was revised and allowed for ₹2,09,080/- as per the addendum (Annexure R-4) to the survey report (Annexure R-3) and the complainants have not provided the bank statement in support of the payment to the repairer, the same could not be released. On merits, the facts as stated in the preliminary objections have been re-iterated. The cause of action set up by the complainant is denied.  The consumer complaint is sought to be contested.
   3. The complainant chose not to file the rejoinder.
2.         In order to prove their respective claims the parties have tendered/proved their evidence by way of respective affidavits and supporting documents.
3.         We have heard the learned counsel for the parties and also gone through the file carefully.
   1. At the very outset, it may be observed that when it is an admitted case of the parties that the subject premises along with the furniture’s, fixtures etc. were insured under the subject policy which was valid from 10.09.2023 to 09.09.2024, as is also evident from the copy of policy (Annexure C-1/R-1)  and pm 17.11.2023, the fire incident took place in the subject premises, as is also evident from the copy of the fire report (Annexure C-2) and the complainants firstly claimed the loss to the subject premises to the tune of ₹2,83,966/- and subsequently they raised another claim of ₹85000/- on account of loss to the tiles and the claim amount could not be released for want of non-submissions of the bank statement in support of the payment of ₹1,65,672/- to the repairers as asked by the OP till 18.09.2024 as the same were placed on record by the complainants in the case file on 19.09.2024, the case is reduced to a narrow compass as it is to be determined if the OP is unjustified in not releasing repudiating the claim of the complainants and the complainants are entitled to the claim as prayed for, as is the case of the complainants or if the OP is justified in not releasing the claim as the complainants have failed to submit the aforesaid documents and the complaint of the complainant, being false and frivolous, is not maintainable and is liable to be dismissed,  as is the defence of the OP.
   2. In the backdrop of the foregoing admitted and disputed facts on record, one thing is clear that the entire case of the parties is revolving around the terms and conditions of the subject policy (Annexure R-1/C-2), survey report dated 14.02.2024 (Annexure R-3) and addendum dated 03.06.2024 (Annexure R-4) and the same are required to be scanned carefully.
   3. So far as the claim of the complainants to the tune of ₹2,83,966/- is concerned, as it stands proved on record that the complainants had also included the loss to the ceiling lights which was not covered under the policy and the OP had also considered the loss to the false ceiling, which was not earlier considered by the OP as well as the surveyor, to the tune of ₹1,49,105/- and the OP has finally assessed the net adjusted loss to the tune of ₹2,09,080/- in pursuant to the addendum dated 03.06.2024 (Annexure R-4) to the survey report dated 14.02.2024 (Annexure R-3) but the aforesaid amount could not be released to the complainants for want of non-submission of the bills/invoices/bank statement, it is clear that there is no infirmity in the survey report dated 14.02.2024 (Annexure R-3) and the addendum dated 03.06.2024 (Annexure R-4) indicating that the surveyor has not assessed/considered the loss to the subject premises with material as per the terms and conditions of the insurance policy.
   4. So far as the claim of the complainants to the tune of ₹85,000/- on account of loss to the tiles is concerned as they have not intimated the OP about the loss to the tiles vide  email dated 24.01.2024 (Annexure C-4) and also during the surveyor’s inspection/investigation no loss was found to the tiles, it is unsafe to hold that the said loss to the tiles was caused due to the fire and the OP has rightly not considered the claim of the complainants to that extent.
   5. It is pertinent to mention here that surveyor report is an important piece of evidence and has to be given due weightage and can only be ignored if there is any other cogent evidence to the contrary.  Here we are strengthened by the judgment of Hon’ble Apex Court in Khatema Fibres Ltd. Vs. New India Assurance Company Ltd. & Anr., Civil Appeal No.9050 of 2018 decided on 28.9.2021 in which it was held as under:-

          “38.   A Consumer Forum which is primarily concerned with an allegation of deficiency in service cannot subject the surveyor’s report to forensic examination of its anatomy, just as a civil court could do. Once it is found that there was no inadequacy in the quality, nature and manner of performance of the duties and responsibilities of the surveyor, in a manner prescribed by the Regulations as to their code of conduct and once it is found that the report is not based on adhocism or vitiated by arbitrariness, then the jurisdiction of the Consumer Forum to go further would stop.”

 

Further, the Hon’ble National Commission in New India Assurance Company Ltd. Vs. Rabindra Narayan, I (2010) CPJ 80 (NC) held as under:-

“The Report submitted by the Surveyor is an important piece of evidence and has to be given due weight and relied upon until and unless it is proved by some cogent and reliable evidence that the Report submitted could not be relied upon.”

Further the Hon’ble National Commission in Oriental Insurance Co. Ltd vs. Arss Infrastructure Project Ltd., II (2023) CPJ 468 (NC) held as under:-

          “Insurance — Surveyors’ report — Survey and investigation are one of fundamentals in settling claim, and cannot and should not be disregarded or dismissed without cogent reasons, though it also goes concomitantly that survey or investigation should be convincing and pass test of credence in scrutiny — State Commission has not gone into contents of surveyors’ reports at all on ground that reports were filed belatedly before it — Reports were in any case available before State Commission and as such it ought to have examined their contents rather than dismissing them outright — Depending upon circumstances State Commission could have even imposed terms including cost for belatedly filing reports but to treat them as suspicious and to perfunctorily dismiss them outright merely because they were filed belatedly was not approach either justified or called for — No need to examine surveyors’ reports at this stage at any great length since both parties agree that settlement may be made on basis of respective surveyor’s assessment of actual loss in each case.”

The Hon’ble National Commission in Detco Textiles Pvt. Ltd. Vs. New India Assurance Company Ltd. & Anr., II (2023) CPJ 535 (NC) held as under:-

          “The Surveyor conducted a very detailed inspection of the premises and assessed the loss after due verification of documents. He assessed the total loss to the building, plant & machinery and furniture etc. at Rs.11,21,18,099/- after making necessary deductions of Rs.5,605,905/- towards excess clause and taking care of the process charges, debris removal, architects fee and goods held in trust arrived at the net adjusted loss of Rs.10,65,12,194/-. For every item, the Surveyor had explained the basis of arriving at the amount. The Complainant on the other hand had not placed any evidence to establish that the assessment made by the Surveyor was incorrect. The Complainant, therefore, cannot be allowed the amount beyond the assessment of the Surveyor. We see no reason not to agree with the assessment made by the Surveyor.”

 

6. In view of the aforesaid discussion, it is safe to hold that the complainant has successfully partly proved the cause of action set up in the consumer complaint and the present consumer complaint partly deserves to succeed.

4.         In the light of the aforesaid discussion, the present consumer complaint succeeds, the same is hereby partly allowed and OP is directed as under :-
   1. to pay ₹2,09,080/- to the complainant alongwith interest @ 9% per annum (simple) from 19.09.2024 onwards as the complainants submitted the requisite documents with the Commission on the said date.
   2. to pay ₹30,000/- to the complainant as compensation for causing mental agony and harassment;
   3. to pay ₹10,000/- to the complainant as costs of litigation.
5.         This order be complied with by the OP within a period of 45 days from the date of receipt of certified copy thereof, failing which the amount(s) mentioned at Sr.No.(i) & (ii) above shall carry penal interest @ 12% per annum (simple) from the date of expiry of said period of 45 days, instead of 9% [mentioned at Sr.No.(i)], till realisation, over and above payment of ligation expenses.
6.         Pending miscellaneous application(s), if any, also stands disposed off.
7.         Certified copies of this order be sent to the parties free of charge. The file be consigned.

07/10/2024			Sd/- [Pawanjit Singh] President
			Sd/-
			[Surjeet Kaur] Member
			Sd/-
			[Suresh Kumar Sardana] Member

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