Chandigarh

DF-I

CC/265/2015

Ram Kumar Gupta - Complainant(s)

Versus

The Oriental Insurance Company - Opp.Party(s)

Neeraj Sharma

04 Dec 2015

ORDER

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

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Consumer Complaint  No	:	CC/265 /2015
Date  of  Institution	:	30/04 /2015
Date   of   Decision	:	04/12/2015

 

 

 

 

 

Ram Kumar Gupta son of late Sh. Sawan Ram resident of House No. 1257, Sector 26, Panchkula.

 

….Complainant

Vs.

 

[1] The Oriental Insurance Company, SCO No. 109-111, IIIrd floor, Sector 17D, Chandigarh, through its Manager.

 

[2] The Oriental Insurance Company, SCO 325, IInd floor, Sector 9, Panchkula, through its Manager.

…… Opposite Parties 

 

 

BEFORE:  SH. P.L. AHUJA                              PRESIDENT

                   MRS.SURJEET KAUR                            MEMBER

                  

 

For Complainant	:	Sh.  Neeraj Sharma, Advocate
For Opposite Party	:	Sh. Sukaam Gupta, Advocate

 

PER SURJEET KAUR, MEMBER

 

 

 

                The facts, in brief, are that the complainant purchased householders package policy from Opposite Party No.1 for the period from 6.11.2013 to 5.11.2014 for Rs.5,10,000/- whereby household goods were insured.  On 14.11.2013 the complainant alongwith his wife went out of station and when they returned back to their house on 20.1.2014 they found that from back side some thief had entered the house after breaking the grills and the household goods were lying scattered here and there.  The bolts and windows were also broken and some of the goods were stolen.  Then complainant on 21.1.2014  vide   Annexure- A  lodged  FIR  of   theft   with the  police.   The complainant also intimated the Opposite
Parties regarding the theft. Accordingly a surveyor was appointed. Thereafter the complainant received a letter dated 25.7.2014 from the Opposite Parties demanding reasons for delay in  reporting the matter to police and also copy of the FIR in original and final untraceable report.  The said letter was duly replied by the complainant vide letter dated 7.8.2014. The complainant also handed over the Opposite Parties copy of untraceable report accepted by the court of ACJM Panchkula vide order dated 19.11.2014.  It has been alleged that the Opposite Parties vide letter dated 19.1.2015 sanctioned claim of Rs.5490/- against the claim of Rs.1,77,500/-, which was not accepted by the complainant.  Alleging the aforesaid act of the Opposite Parties deficiency in rendering service, the instant complaint has been filed.

 

2.          Notice of the complaint was sent to Opposite Parties, seeking their version of the case.

 

3.          Opposite Parties in their joint reply admitted issuance of the policy in question.  It has been averred that after receiving report regarding theft, a surveyor was appointed who after thorough verification submitted his report and on the basis of survey report and documents the claim was approved to the tune of Rs.5940/-. The surveyor assessed the loss on the basis of articles mentioned in proposal form and out of the said articles number of items were not stolen by the thieves as same were not even mentioned in the FIR. Moreover,  the list of items mentioned in FIR were not covered under the policy and as such the Opposite Parties  were not liable to indemnify the complainant for those articles which were not covered under the policy. Denying all other allegations and stating that there is no deficiency in service or unfair trade practice on their part, Opposite Parties have prayed for dismissal of the complaint.

 

4.          The complainant has filed a rejoinder, wherein he has reiterated all the averments, contained in the complaint, and repudiated those, contained in the written version of Opposite Parties.

 

 

5.          Parties were permitted to place their respective evidence on record, in support of their contentions.

 

6.          We have heard the learned counsel for the parties and have perused the record, along with the written arguments filed on behalf of the complainant.

 

7.          It is an admitted fact that the complainant purchased householders package policy. The   policy evidently covered the risk of loss of clothing, kitchenware/crockery/cutlery, furniture, miscellaneous items, electrical mechanical appliances, jewellary, TV set Sony, Home Theatre Sony 3000 and baggage cover.  As per the complainant on 20.1.2014 he realized  that a theft took place in his premises in his absence when he visited his sons place at Sikandarabad and Singapore respectively. Accordingly FIR Annexure A-9 was duly lodged with the police on 21.1.2014. Intimation to this effect was also given to the Opposite Parties.  The Opposite Parties appointed surveyor to assess the loss. The surveyor assessed the loss to the tune of Rs.5,490/- against the actual claim of the complainant i.e. Rs.1,77,500/-.

 

8.          The stand taken by the Opposite Parties is that the surveyor assessed the loss on the basis of articles mentioned in proposal form Annexure A-2.  Even few items, which were claimed to be stolen were   not mentioned in the FIR and moreover few items were not covered under the policy. Therefore, the Opposite Parties are not liable to indemnify the complainant for those articles, which were not covered under the policy.

 

9.          After going through the facts of the case, it is evident that as per Annexure A-2 the complainant has taken the policy for covering all the risks of households i.e. jewellary and other miscellaneous/electrical valuables etc. with sum insured value as Rs.5,10,000/-. Further the surveyor assessed the loss for the stolen items only for Rs.5,490/- on the ground that few  items were not mentioned in the FIR  lodged by the complainant. The surveyor disallowed the claim on the ground that the loss did not fall within the scope of the policy. We feel that the surveyor was wrong in coming to the conclusion that most of the stolen items were not covered under the policy. In our view the loss assessed by the surveyor to the extent of Rs.5,490/- was without any justification as the surveyor failed to establish the authentic reason/purpose for the same. Moreover, the surveyor had not given any reason as to how he came to the conclusion to reduce the claim to a meager amount of Rs.5,490/- only. Thus the surveyor wrongly reduced the claim of the complainant on the flimsy ground despite the fact that all the information regarding the value of insured households items  were given to the Opposite Parties at the time of issuance of policy.

 

10.          It has been argued by the ld. Counsel for the Opposite Parties that the complaint is premature as few requisite documents were not filed by the complainant himself. We do not find any merit in these arguments of the ld. Counsel for the Opposite Parties.  It is evident from Annexure A-20 dated 19.1.2015 that the Opposite Parties approved the claim of the complainant to the tune of Rs.5,490/-, which itself proves that the complainant had completed all the formalities..  Had the complainant not completed the requisite formalities the Opposite Parties would not have even approved the said claim. As far as the documents required by the Opposite Parties in the aforesaid letter dated 19.1.2015 are concerned, those were to be submitted by the complainant for
 

release of the amount but as stated by the complainant in Para No.11 the said amount was not acceptable to him, therefore, question of submission of such documents does not arise at all. Hence the Opposite Parties deliberately raised these arguments with a view to nullify/frustrate the case of the complainant. Therefore, this argument of the Opposite Parties is rejected being devoid of merit.

 

11.          We are of the considered view that the Opposite Parties declined the claim of the complainant by wrongly placing reliance on the surveyor’s report that reduced the claim of the complainant on flimsy ground without any proper justification. It is also noteworthy that the household valuables of the complainants were insured to the extent of Rs.5,10,000/- and he was claiming only Rs.1,70,500/-. Hence, for the reasons stated above, we are of the firm view that the Opposite Parties are deficient in rendering service and wrongly settled the claim of the complainant due to which he had to undergo a lot of mental agony and physical harassment. Hence the complaint deserves to be allowed.

 

12.          In the light of above observations, we are of the concerted view that the Opposite Parties are found deficient in giving proper service to the complainant and having indulged in unfair trade practice. Hence, the present complaint of the Complainant deserves to succeed against the Opposite Parties, and the same is allowed, qua them. The Opposite Parties are, jointly and severally, directed:-

 

[a]     To pay Rs.1,77,500/ to the complainant towards his claim.

 

[b]     To make payment of Rs.25,000/- to the complainant towards compensation for causing mental and physical harassment.

 

[c]      To make payment of Rs.10,000/- to the complainant as litigation expenses.

 

 

13.          The above said order be complied with by the Opposite Parties, within 30 days from the date of receipt of its certified copy, failing which the amounts at Sr. No.[a] & [b] shall carry interest @12% per annum from the date of filing of the present Complaint, till actual payment, besides payment of litigation costs.

 

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

 

 

Announced

4 December, 2015                                                                              sd/-

 (P.L. AHUJA)

PRESIDENT

 

Sd/-

 (SURJEET KAUR)

MEMBER

R SARDANA)

 

MEMBER