Chandigarh

DF-II

CC/477/2013

Shiv Bhole Hi Tech Education Society(Regh) - Complainant(s)

Versus

The Oriental Insurance Company Limited,Service Centre(Chandigarh Ro) - Opp.Party(s)

Vikram Tandon,Adv

28 Mar 2016

ORDER

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

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Consumer Complaint  No	:	477 of 2013
Date  of  Institution	:	28.10.2013
Date   of   Decision	:	28.03.2016

 

 

 

 

 

Shiv Bhole Hi-Tech Education Society (Regd.),Plot No.994, Industrial Area, Phase-II, Chandigarh, through its President Sh.Suresh Kumar Gupta.

 

             …..Complainant

Versus

 

The Oriental Insurance Company Limited, Service Centre (Chandigarh RO), SCO # 109-111, Sector 17-D, Chandigarh- 160 017 through its Chief Manager.

 

….. Opposite Party

 

BEFORE:  SH.RAJAN DEWAN                 PRESIDENT

         SH.JASWINDER SINGH SIDHU       MEMBER

         MRS.PRITI MALHOTRA             MEMBER

        

 

Argued by:-

            Sh.Vikram Tandon, Counsel for the complainant.

Sh.Sukaam Gupta, Counsel for the Opposite Party

 

PER JASWINDER SINGH SIDHU, MEMBER

 

 

          As per the case, the complainant took an insurance policy (Ann.C-1) from the Opposite Party valid from 5.7.2008 to 4.7.2009, insuring the College Building, Furniture, Machinery, Electronic equipments etc.  It is averred that due to storm on 30.6.2009, there was a loss to the College Building (including Boundary wall), Electronic Transformers, Glass Windows etc.  On reporting it to the Opposite Party, the Opposite Party appointed a Surveyor, who visited the site and gave first report on 10.7.2009 (Ann.C-2).  Thereafter, on 25.11.2010, the Surveyor again submitted a report that the cover note is not clear about the insurance of the building, damaged in the storm whether both buildings are covered or only one (Ann.C-3). It is also averred that though the Opposite Party had also passed a claim earlier on 2.2.2009, in respect of the same building, yet it raised irrelevant query about the ownership of the building involved in the storm.  Ultimately, the Opposite Party rejected the claim of the complainant on the ground that there is no specific mention of the boundary wall in the risk coverage.  The matter was again brought to the notice of Opposite Party, but to no avail.  Thereafter, a consumer complaint No.4 of 2012 was filed on 3.1.2012, which was decided by the Hon’ble District Forum-I, UT, Chandigarh vide order dated 26.6.2012 with direction to the Opposite Party to settle the claim within 45 days from the date of order (Ann.C-10).  It is pleaded that however, the Opposite Party very clandestinely passed the claim only to the tune of Rs.6557/- excluding boundary walls, which is neither proper nor as per the terms & conditions of the policy and the complainant did not accept it as improper and insufficient (Ann.C-11). Hence, this complaint has been filed alleging the said act of the Opposite Party as gross deficiency in service.

 

2]       The Opposite Party has filed its reply and admitted the issuance of the insurance of the policy, receipt of intimation of loss, appointment of surveyor, assessment as well as settlement of the loss to the tune of Rs.6558/-.  It is stated that the Surveyor in its report Ann.R-1 gave specific remarks to the effect  “that inspect of our repeated request to insurer to kindly send the copy of proposal form but no proper response was received.  Hence we have assessed the loss to the boundary wall of both the buildings and loss of building no.2 which is 400 mtrs ahead from the building no.1.  There is a private land in between two buildings.  So while settling the claim insurer may look into the aspect for coverage of boundary wall of both the buildings and shall settle the claim in accordance to terms and conditions of insurance policy”.  It is pleaded that the boundary wall of the said trust/society was not covered under the scope of the policy.  It is also pleaded that as per the directions of the Hon’ble DCDRF-I, UT, Chandigarh in Complaint NO.4 of 2012, decided on 26.6.2012, the answering Opposite Party reconsidered the claim file and after re-scrutinizing the claim papers, approved the claim to the tune of Rs.6558/- only, however, due to typographical mistake in calculations, it was mentioned as Rs.6557/- and intimation about the said approval was also sent to the complainant and it was specifically mentioned in the said letter (Ann.R-5) that ‘since no wherein the cover note and policy coverage for the boundary wall has been mentioned, therefore, the same has been excluded and the claim has been settled for rest of the building.’  Pleading no deficiency in service and denying rest of the allegations, it is prayed that the complaint be dismissed.

 

3]       Parties led evidence in support of their contention.         

 

4]       We have heard the ld.Counsel for the parties and have also perused the record.

 

5]       The complainant has preferred the present complaint on the score that the constructed building, along with fixtures, fitting, furniture etc., of the Education Institute being run by it, was insured against damages from the Opposite Party by making a payment of premium of Rs.17,708/- vide insurance policy cover dated 30.6.2008, which was effective from 5.7.2008 to 4.7.2009. 

 

6]       That due to unfortunate happening of storm on 30.6.2009, the building of Opposite Party suffered extensive damage, which was duly reported to the Opposite Party, but it preferred not to settle the claim, but kept the same pending, giving rise to the dispute, resulting in filing of the consumer complaint dated 03.01.2012 with District Forum-I, UT, Chandigarh. The said consumer complaint was decided vide orders of the Forum dated 26.6.2012 giving directions to the Opposite Party in terms of Para No.9 of the said order, reproduced herein below:-

“9] Admittedly, the insurance company had made a mention in the repudiation letter dated 18.1.2011 – Annexure R-5 regarding loss of boundary wall and building, whereas, the claim has been repudiated qua loss to the boundary wall and with regard to the loss of the building, the repudiation letter is silent.  Thus, we are of the opinion that directions is required to be issued to the Insurance Company to settle the claim with regard to the building also.”

 

7]       The complainant was given liberty to contest the settlement offered by the Opposite Party after the passing of the orders dated 26.6.2012.  The complainant on being offered Rs.6557/- vide letter dated 20.7.2012 (Ann.R-5), preferred the present complaint contesting that it was entitled to the entire amount of loss, which included loss to the building as well as to the boundary walls of the institute. 

 

8]       The Opposite Party while defending its assessment of the loss has placed on record the Surveyor’s Report (Ann.R-1), dated 5.5.2010, wherein the Surveyor while quantifying the loss to the building along with the boundary wall, glass fixtures, furniture etc. has assessed the same to the tune of Rs.1,37,950/-, mentioning the same as the liabilities of the insurance company towards the complainant. 

 

9]       The Opposite Party while claiming that the amount payable to the complainant towards the loss, suffered by it, has quoted the contents of the letter dated 20.7.2012 (Ann.R-5), claiming that the amount of loss quantified as Rs.1,20,400/- was not payable as the boundary wall of the institute of the Opposite Party was not covered under the said insurance policy.  Interestingly, the Manager under whose signature the letter dated 20.7.2012 (Ann.R-5) was issued has failed to differentiate as to how the officer concerned has concluded that the claim for the loss of the boundary wall was not payable when the Surveyor in his report dated 5.5.2010 (Ann.R-1), has not opined any such differentiation while quantifying the loss of the complainant nor had quoted any clause of the terms & conditions of the policy in question, so that such assessment of the Surveyor could be ignored while releasing the payment of Rs.6557/- to the complainant through letter dated 20.7.2012. 

 

10]      It is settled preposition that any competent authority while exercising its powers must authenticate its assessment or opinion on the basis of the evidence available with it.  The affidavit of Sh.V.K.Bhoocher, Manager of Opposite Party, dated 28.2.2014, filed along with the reply of the Opposite Party does not disclose any such evidence on the basis of which the Opposite Party preferred to modify the assessment of the Surveyor, dated 5.5.2010 which was submitted with the Opposite Party for the settlement of the claim of the complainant.  Furthermore, even the letter dated 20.7.2012 (Ann.R-5) does not disclose the name of the Officer or his Designation under whose signatures the same was issued while offering pittance of the claim amounting to Rs.6557/-.  Thus, the offer letter dated 20.7.2012 (Annexure R-5), which ignored the assessed amount of Rs.1,20,400/- towards the loss of boundary wall is nothing but an act of the Opposite Party in denying the duly assessed rightful claim of the complainant without any logic, which amounts to deficiency in service on its part. 

 

11]     In the light of above observations, we are of the concerted view that the Opposite Party is found deficient in rendering proper service to the complainant. Hence, the present complaint of the Complainant is allowed against Opposite Party. The Opposite party is directed as under:-

 

[a]      To release the assessed amount of Rs.1,20,190/- as per Surveyor’s Report (Ann.R-5 at Page No.12), along with interest at the rate of 9% per annum from the date of assessment i.e. 5.5.2010 till its payment;  

 

[b]      To pay Rs.20,000/- to the complainant as consolidated amount of compensation for causing mental agony and harassment on account of deficiency in service.

 

[c]     To pay Rs.10,000/- towards litigation expenses to the complainant. 

 

         The above said order shall be complied within 45 days of its receipt by the Opposite party; thereafter, it shall be liable to pay an interest @18% per annum on the amount of Rs.1,20,190/- as per Surveyor’s Report (Ann.R-5 at Page No.12), instead of 9% per annum, from the date of assessment i.e. 5.5.2010 till its payment and also on the compensation amount of Rs.20,000/- from the date of filing this complaint till its payment, apart from paying litigation expenses.

 

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

 

Announced

28^th March, 2016                                                         

                                                                        Sd/-

 (RAJAN DEWAN)

PRESIDENT

 

Sd/-

 

(JASWINDER SINGH SIDHU)

MEMBER

 

 

Sd/-

(PRITI MALHOTRA)

MEMBER