Chandigarh

DF-II

CC/528/2014

Sita Kashyap - Complainant(s)

Versus

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

Sh. Rajesh Pal Adv.

12 Jan 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II, U.T. CHANDIGARH

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Consumer Complaint  No	:	528 of 2014
Date  of  Institution	:	10.10.2014
Date   of   Decision	:	12.1.2017

 

 

 

 

 

Sita Kashyap wife of Krishan Kumar Kashyap c/o floriculture project, village Chamba, Tehsil Nalagarh, District Solan, residing at #148, Sector 6, Panchkula.

                …..Complainant

Versus

 

 

1.     The oriental Insurance Company Ltd. having its office at service centre: Regional Officer, Chandigarh, SCO No.109-111, Surendra Building, Sector 17D, Chandigarh through its Manager/Branch Manager.

 

2.  Pukhraj Singh Surveyor, Protech Engineers & Loss Assessors SCF-40, Phase 9, Mohali.

 

….. Opposite Parties

 

 

BEFORE:  SH.RAJAN DEWAN                 PRESIDENT

         MRS.PRITI MALHOTRA             MEMBER

         SH. RAVINDER SINGH             MEMBER

 

 

For complainant(s)      :     Sh. Rajesh Pal, Adv.

 

For OP No.1             :     Sh. Sukaam Gupta, Adv. 

 

 

For OP No.2             :     Sh. Gaurav Bhardwaj, Adv.

 

 

PER PRITI MALHOTRA, MEMBER

 

 

     As per the case, the complainant,  farmer by profession availed an insurance policy for her poly houses/green houses from OP No.1 valid for the period 24.12.2012 to 23.12.2013 by paying a sum of Rs.3597/- towards premium of the policy. It is averred that in  June 2013 there was a heavy thunder  storm followed by heavy rain shower in the area of village Chamba, Tehsil Nalagarh, District Solan, Himachal Pradesh,  which destroyed the ploy houses erected/raised at the spot on the land of the complainant and further fully damaged green houses shown at Sr. 6,7, and 17.   It is averred that the complainant intimated the OP No.1 regarding the loss under the policy in question and submitted her claim form alongwith required documents. The OP No.2 was deputed as surveyor by OP No.1 who never visited the site himself and sent some Pvt. person to assess the loss.  It  is alleged that although the complainant  provided all the necessary documents  with the OPs in time but they  intentionally delayed the issue. It is further alleged that despite submitting necessary documentation and sending numerous reminders the OP NO.1 delayed the matter and afterward  passed a claim for a meager amount of Rs.42,050/-  against the claim of Rs.13,20,220/- .  It is alleged that the OP No.2 never visited the site for assessing the loss and as such the OPs did not follow the set procedure. Alleging the said act of OPs as deficiency in service, this compliant has been filed.

 

 

2. The Opposite Party No.1 in its reply while admitting the factual facet of the case stated that the complaint is premature as the claim of the complainant is still pending with the answering OP for want of compliance of claim formalities by the complainant.  It is stated that after receiving intimation regarding the loss answering OP immediately deputed the surveyor i.e. OP No.2 who while conducting the physical inspection over the spot found that out of total green houses damage was caused to only three green houses i.e. green houses No.6,7&17. Claimed that the surveyor observed that much damage was caused to the poly sheets and damage to the pipe structure was partial in nature as only few MS pipes were found bend and except that no other damage was there and hence after considering the terms and conditions of the insurance policy the surveyor assessed the loss to the tune of Rs.2,13,852/- and after applying necessary deductions such as depreciation value, excess clause and salvage value claim was recommended for Rs.45,259.30 paise. Claimed further that an intimation to this effect was sent to the complainant  vide letter dated 5.3.2014 followed by many reminders asking the complainant to submit the necessary documents for release of the claim amount but the complainant herself remained silent and never supplied the documents as required. Pleading no deficiency in service and denying rest of the allegations, it is prayed that the complaint be dismissed.
3.     OP No.2  did not file any separate reply and counsel for OP No.2 adopted the reply of OP No.1 vide his statement dated 25.2.2015.
4.     The Complainant also filed rejoinder thereby reiterating the averments as made in complaint and controverting that of the Opposite Parties made in the reply.
5.     Parties led evidence in support of their contentions.
6.     We have heard the ld. Counsel for the parties and have also perused the record.
7.     In the realm  of admitted facts regarding the issuance of policy in question (valid from 24.12.2012 to 23.12.2013) causation of the damage to the insured poly houses during the currency of the policy and the fact  the complainant raised claim amount of Rs.13,20,220/- for her damaged poly houses  No.6,7, and 17, it is to be looked into whether the claim lodged by the complainant was rightly settled by the OPs? As the less assessment of the claim amount i.e. to the tune of Rs.42,050/- against the claim of Rs.13,20,220/- has been challenged in the present case by the complainant.

    It is the stand of the OP NO.1 that on receiving an intimation from the complainant regarding damage caused to the insured poly houses, a duly competent surveyor i.e. OP No.2 was deputed to assess  the loss. The said surveyor after thorough investigation assessed loss to the tune of Rs.42.050/-  and submitted its report. OP No.1 further took the stand that the matter in dispute is premature as the amount assessed by the surveyor could not be paid to the complainant for want of compliance of claim formalities by the complainant herself, which disabled the insurance company to release the claim amount as assessed by the surveyor.

8.       Undoubtedly, the complainant had quantified her claim for the damage caused to her insured poly houses to the tune of Rs.13,20,220/- on the basis of claimed total loss, but no justification and cogent evidence has been placed on record  by the complainant to establish the same. On the contrary the surveyor report placed on record (Annexure R1/C)reveals that no total damage had been caused to the insured poly houses of the complainant and there is only partial damage to the poly houses in question as some of the steel pipes were found bend and the poly sheets were found torn.  The surveyor assessed the loss in regards to the damage to MS pipes and poly sheets for an amount of Rs.2,13,851.93 and thereafter applying depreciation formula, average clause  and excess clause assessed the loss to the tune of Rs.45,259/-.
9.     In our considered opinion the OPs have failed to justify all the deductions made on account of depreciation, average as well as excess clause etc.. No such terms and conditions of the policy have been brought to the notice of the Forum, which justifies the deductions made on the abovesaid accounts. Even on perusal of the terms and conditions placed on record we failed to make out any of the condition which justifies the deductions made by the surveyor. Thus, we are of the view that the complainant is entitled for the amount i.e. gross loss assessed by the surveyor i.e. to the tune of Rs.2,13,852/- (mines salvage value as is assessed by the surveyor of the OPs). It is proved on record that there is deficiency on the part of the OPs for making wrongful deductions while assessing the claim of the complainant, which caused mental agony and physical harassment to the complainant.
10.     In view of the above discussion, we are of the opinion that the complaint deserves to be allowed.  Accordingly, the complaint is allowed and the Opposite Parties are  directed as under:-

        

a]  To pay the claim of the complainant to the tune of Rs.2,13,852/- as assessed by the surveyor originally(minus salvage as assessed by the surveyor of the OPs)

 

b]  To pay Rs.20,000/- as compensation for deficiency in service and  causing mental agony and physical harassment to the complainant.

C]  To pay Rs.10,000/- towards litigation expenses.

 

         The above said order shall be complied with by the Opposite Parties within 30 days of its receipt, failing which they shall be liable to pay interest @12% p.a. on the above awarded amounts at (a) from the date of claim till payment and at (b) from the date of filing the of the complaint till realization, besides paying litigation expenses.

 

         The certified copy of this order be sent to the parties free of charge, after which the file be consigned.

Announced

12.1.2017

                                                                                       Sd/-

 (RAJAN DEWAN)

PRESIDENT

 

Sd/-

(PRITI MALHOTRA)

MEMBER

 

Sd/-

(RAVINDER SINGH)

MEMBER