(Per Shri Narendra Kawde, Hon’ble Member)
(1) Complainant, who is a partnership firm, has filed this consumer complaint alleging deficiency in service against the opponent, Oriental Insurance Co.Ltd. (for the sake of brevity ‘opponent insurance company) as the claim on account of damage due to fire has been repudiated under the insurance policy subscribed by the complainant covering insurance to stock of raw material, finished goods, dies, tools & accessories etc.
(2) Salient facts giving rise to this complaint are that
The complainant firm has purchased insurance policy to provide insurance cover to the stock of material and other finished goods more particularly description of risk in the list accompanied the proposal form submitted by the complainant Firm. During validity of this insurance policy, fire broke out on 03/01/1997 in the insured premises incurring loss of `14,60,616/-. Opponent insurance company on intimation appointed an surveyor and submitted their report estimating loss payable to the extent of `7,49,253.83. However, the opponent insurance company repudiated the claim stating that no claim was payable as the ground floor of the insured premises was not covered under the insurance policy from where the loss to the goods occurred. Further, it is contended that the complainant company bought another policy of insurance from The New India Assurance Co.Ltd. for the same goods and The New India Assurance Co.Ltd. repudiated the claim which was preferred by the complainant company on the ground that “further the Surveyor of M/s.New India Assurance Co.Ltd. has confirmed that stocks and furniture, fixture and fittings lying in the Basement were not damaged by fire hence we are not liable for the loss and please treat this claim as closed by us.” This letter is dated 04/09/2000 was issued by the opponent insurance company on the strength of survey conducted by the surveyor of The New India Assurance Co.Ltd. and not considered the very report of the authorized surveyor appointed by the opponent insurance company. Since the repudiation of the claim is on wrong ground, the complainant filed complaint claiming an amount of `14,60,616/- together with interest @17.5% p.a. effective from 14/06/1999 and additional `3 lacs towards mental agony and cost of `25,000/- on account of litigation.
(3) Opponent insurance company appeared and filed written version and affidavit evidence denying the contention of the complainant company on the ground that the loss due to fire was not covered under the insurance policy. It was submitted further that the complainant had purchased two insurance policies one from the opponent insurance company and other from The New India Assurance Co.Ltd. for sum assured `9,68,000/- under each policy precisely for providing insurance cover to the same goods as identified in the list accompanied proposal form. The total goods insured under each policy were for `9,68,000/-. The complainant firm preferred the claim under policy issued by The New India Assurance Co.Ltd. (Policy No.11/112000/25661). The said company repudiated the claim on the ground that the stocks, furniture and fixures & fittings from the basement of the insured premises were not damaged by fire. The contention of the opponent insurance company is that ground floor from where the insured’s stock was lost to fire was not covered under the policy issued by them. Therefore, relying upon the repudiation report of The New India Assurance Co.Ltd., they have rightly rejected insurance claim preferred under their policy No.121800/11/99/1000. Opponent insurance company tried to justify the repudiated on this ground.
(4) Admitted facts are that the complainant company bought two different policies for providing insurance cover to the same stock and material one from the opponent insurance company and other from The India Assurance Co.Ltd. The learned advocate of the complainant submitted that the policy issued by the opponent insurance company covers entire stock and raw material and stock in godown as it is found from the description of risk in the proposal form which reads as under:-
Description of Risk as in Proposal Form
Stock in godown consisting of `7,00,000/-, stock of raw material such as goods plywood hazardous polishing material, furnace oil and such other material `65,000/-, finished goods `85,000/- on semi finished goods and packing materials. `34,000/- on dies tools and accessories. `12,000/- on sewing machine, cabinets, finished &/or unfinished goods. `72,000/- on furniture fixture and fitting and elec.fittings incl. elec. Instn. Main switch and cable. Subject to form ‘F 97’ 1, 2, 4 (Cl.1) E & G. Form ‘D1’
Further it was submitted by the learned advocate for the Complainant that though the same stock, the list of which is available along with proposal form amounting `9,68,000/- was insured under two different policies, the complainant has not availed insurance benefits under the insurance policy issued by The New India Assurance Co.Ltd. and they have not preferred any appeal against the repudiation of the claim as such. The learned advocate for the opponent insurance company submitted that the proposal form does not speak of entire insurance coverage to the insured premises where the stock insured was stored. However, this submission does not warrant any merit as the policy issued by the opponent insurance company covers the risk as narrated on the facing sheet of the policy which provides insurance cover to “stock in godown, stock of raw material, plywood hazardous polishing material, furnace oil and such other material, finished goods, semi finished goods, packing materials, dies, tools & accessories, sewing machine, cabinets, finished &/or unfinished goods, furniture, fixtures & fittings with electric fitting.” This endorsement on the policy does not speak of ground floor, basement, first floor etc of the insured premises. It is not the case of the complainant that the stock from basement was lost. It is pleaded on behalf of the complainant that the authorized surveyor while conducted the survey thoroughly and considered the loss of the insured goods only on the ground floor in exclusion to the damage sustained to the first and second floor which were not insured. The submission of the learned advocate for the complainant is sustainable as the authorized survey report excludes the premises of first and second floor of the building as there was no insurance cover provided to these floors. There was no damage to the foundry section and the basement, it is precisely the report of the loss sustained to the goods stored on first floor of the building which was insured. As such the loss has been worked out to `7,49,253.83/- and also the surveyor recommended this amount stating that it is payable to the insured Complainant Firm. Further stating that all the terms & conditions of the policy has been observed by the insured which means there is no violence of terms & conditions of the policy by the complainant.
(5) This is an old matter placed on board for hearing and disposal from the sine-die list. Both the parties appeared and submitted their contentions/arguments. We have considered this case in its entirety. Repudiation of the claim on the basis of survey conducted by The New India Assurance Co.Ltd., the terms & conditions are not before us of the insurance policy issued by that company. Admitted facts are that the insurance policy was issued by the opponent insurance company to cover goods with sum assured `9,68,000/-. There was no loss to the goods stored on the basement and it was confined to the stock of goods on first floor which was insured under the insurance policy. Survey report is an important peace of documents. The surveyor has assessed the loss limited to the first floor of the premise and also recommended for payment to the complainant. In spite of these facts on record, the opponent insurance company unjusticely and arbitrarily repudiated insurance claim under the policy. All these facts of record lead us to infer that action of the opponent insurance company to repudiate the claim arbitrarily renders to deficiency in service. There is substantive merit in the complaint. Therefore, we are allowing the complaint partly and pass the order accordingly.
ORDER
(1) Complaint is partly allowed.
(2) Opponent insurance company is directed to pay `7,49,253.83 together with interest @ 12% p.a. effective from 04/09/2000 i.e. the date of repudiation of the claim within the period of 45 days from the date of this order, failing which the opponent insurance company will have to pay additional interest @6% p.a.
(3) Rest of the claim of the complainant stands rejected as specifically not admitted.
Pronounced on 26th July, 2012
