Punjab

Sangrur

CC/49/2019

Prem Singh - Complainant(s)

Versus

The Oriental Insurance Company Limited - Opp.Party(s)

Sh.G.S.Shergill

01 Feb 2021

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SANGRUR .

 

                                                                         Complaint No. 49

 Instituted on:   07.02.2019

                                                                        Decided on:     01.02.2021

Prem Singh son of Sh. Jaswant Singh, resident of Village Nelowal, Tehsil Sunam, District Sangrur.

                                                          …. Complainant.     

                                                 Versus

The Oriental Insurance Company Limited, Branch Office: SCO 126, 1^st Floor, Chhoti Baradari, Patiala through its Branch Manager.

             ….Opposite party. 

For the complainant:             :Shri  G.S.Shergill, Adv.              

For the OP                          :Shri  Ashish Grover, Adv.

 

Quorum:    Shri Jasjit Singh Bhinder, President

                Shri V.K.Gulati, Member   

ORDER:   

Shri Jasjit Singh Bhinder, President

1.             Shri Prem Singh,  complainant has filed this complaint pleading that the complainant has a Green House/Poly house at village Nelowal and he is running the Green house for his daily livelihood and got insured the said Green House/Poly House from the OP vide policy number 233503/11/2019/44 for the period from 11.5.2018 to 10.5.2019 for Rs.40,00,000/- and paid the premium of Rs.7258/- to the OP.  Further it is stated that if Green house/poly house is damaged in any manner, then the OP will release the entire amount without any deduction. Further it is stated that the OP only issued the policy and except that no terms and conditions were supplied by the OP. 

2.             Further case of the complainant is that on 1.6.2018 due to heavy storm the said green house/poly house was damaged and the complainant immediately intimated the OP about the loss, who appointed the surveyor.  The surveyor visited the premises of the complainant and told to get it repaired and to submit bills to the OP.  Further it is averred that the complainant got repaired the damaged green house/poly house and spent an amount of Rs.28,750.20 on the repair of the same. Further the complainant submitted the bills and other documents to the OP for release of the claim amount, but the OP vide letter dated 17.09.2018 stated that the  liability of the claim is under excess clause as per the terms and conditions of the policy, the claim is not payable and the claim file has been closed as ‘No Claim’. Further case of the complainant is that the complainant requested the OP a number of times to release the amount of Rs.28,750/-, but all in vain.   Thus, alleging deficiency in service on the part of the OP, the complainant has prayed that the Opposite party be directed to pay to the complainant the claim amount of Rs.28,750/- along with interest @ 18% per annum from the date of loss till realization and further to pay Rs.50,000/- as compensation on account of mental agony, tension and harassment and an amount of Rs.11,000/- on account of litigation expenses.

3.             In reply filed by the OP preliminary objections are taken up on the grounds that the complaint is not maintainable, that the complainant has no cause of action to file the present complaint and that the complainant is not a  consumer of the OP. On merits,  it is admitted that the said poly house was insured with the OP.  It is further averred that after receiving the intimation from the complainant, the OP appointed Mr. Deepak Malhotra surveyor and loss assessor to investigate the matter and to assess the loss. The said surveyor sent letters to the complainant for providing the relevant documents but the complainant failed to comply with the same.  After detailed investigation, the said surveyor submitted his report dated 19.7.2018 vide which he recommended the opposite party to close the file because the liability of the claim is under excess clause.  Further it is averred that as per the report of surveyor, the loss assessed is Rs.15,800/- depreciation @ 75% was applied i.e. Rs.11,880/- and excess clause i.e. Rs.10000/- as per terms and conditions of the policy.  It is denied that the complainant submitted all the bills to the OP and has stated that the claim has rightly been repudiated.

4.             The learned counsel for the parties produced their respective evidence.

5.             The learned counsel for the complainant has argued that that the complainant has a Green House/Poly house at village Gharachon and the same was got insured from the OP vide policy number 233503/11/2019/44 for the period from 11.5.2018 to 10.5.2019 for Rs.40,00,000/- and paid the premium of Rs.7258/- to the OP.  The learned counsel for the complainant has further argued that that on 1.6.2018 due to heavy storm the said green house/poly house was damaged and the complainant got it repaired by spending an amount of Rs.28,750/-. The learned counsel for the complainant further argued that the complainant submitted all the bills to the OP, but the OP closed the file as No Claim. As such, the complainant has prayed for acceptance of the complaint.

6.             On the other hand, the learned counsel for the OP has argued that upon receiving intimation from the complainant, the OP appointed  Mr. Deepak Malhotra surveyor and loss assessor to investigate the matter and to assess the loss. The surveyor submitted the  survey report and recommended the opposite party to close the file because the liability of the claim is under the excess clause. The learned counsel for the OP further argued that the surveyor assessed the loss at Rs.15,800/-,  depreciation applied was @ 75% and excess clause is Rs.10,000/-as per the terms and conditions of the policy, as such the learned counsel has prayed that the complaint be dismissed.

7.             The complainant has tendered Ex.C-1 is affidavit to support the claim in the complaint. Ex.C-2 is  invoice of Empower Evergreen Pvt. Ltd. dated 20.8.2018 for Rs.18750/- spent by the complainant for repair of the poly house, Ex.C-3 is the voucher of Rs.10,000/- received by Ramchandan Chohan from the complainant and  Ex.C-4 is the policy and this policy was for a sum of Rs.40,00,000/-.

8.             On the other hand, the learned counsel for the OP has tendered the affidavit of Mukesh Malhotra Ex.OP/1 and he has deposed as per the written statement.   Ex.OP/2 to Ex.OP/4 are the letters sent to the complainant by Shri Deepak Malhotra.  It is mentioned that the poly house was destroyed due to storm. It is mentioned further that he recommended to the opposite party to close the file because the liability of the claim is under excess clause. Strangely enough, the depreciation has been shown as 75% and this depreciation is illegal and as per the policy the depreciation can only be 5%.  It is clear cut illegality committed by the insurance company and the depreciation has been deducted at 75%.

9.             Admittedly, as per the insurance policy which is Ex.C-4, the complainant got insured his poly house for Rs.40,00,000/- and maximum deduction can only be 5% upto the sum insured of Rs.10 Crore.  So, as per the conditions, the maximum deduction was 5% and they have illegally deducted 75% of the bill.  It is also admitted fact that there was storm and the poly house was destroyed.  The complainant has attached the bills on the file as Ex.C-2 and Ex.C-3 vide which he got repaired his poly house.  Ops have not challenged the veracity of these bills in the affidavit and it seems that the Ops have wrongly repudiated the rightful claim of the complainant.

10.            As per the policy, the OP can deduct 5% of the total amount of Rs.28,750-. Accordingly, we direct the OP to pay to the complainant the amount of Rs.28,750/- after deducting 5% of the amount of Rs.28,750/-. We further direct the OP to pay to the complainant an amount of Rs.5,000/- on account of litigation expenses.  This order be complied with by the opposite parties within 60 days from the date of receipt of certified copy of this order. A certified copy of this order be issued to the parties free of cost as per rules. File be consigned to records.

Pronounced.

                        February 1, 2021.

 

(Vinod Kumar Gulati)  (Jasjit Singh Bhinder) 

           Member                  President