DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, PALAKKAD

Dated this the 5^th  day of February, 2024

Present     :   Sri. Vinay Menon V., President

                   :  Smt. Vidya A., Member              

                  :  Sri. Krishnankutty N.K., Member                                 Date of Filing: 22/07/2021    

     CC/105/2021

K.S. Surya Shyam,

S/o. K.V. Syamalan,

Blue Point, 12/657-6,

1^st Floor, M-5, Business Centre,

Head Post Office Road,

Palakkad – 678 001.                                                                -           Complainant

(By Adv.  M/s. K. Dhananjayan & S. Mujeeb Rahman)  

                                                                                                  Vs

1. United India Insurance Co. Ltd.,

Head Office, 24, Whites Road,

Chennai – 600 014,

Rep.by Authorised Signatory / MD.

2.  Authorised Signatory / MD,

United India Insurance Co. Ltd.,

Head Office, 24, Whites Road,

Chennai – 600 014.

3. Divisional Manager,

United India Insurance Co. Ltd.,      

                         PLI Branch Office, Surya Complex,

                         Mission School Junction, Palakkad – 678 014.                        -           Opposite parties  

(O.P.s by Adv. M. Krishnadas)              

O R D E R

By Sri. Vinay Menon V., President

1. Complainant’s shop was insured with the OP insurance company under compact insurance policy for Rs.1,17,50,000/-. Shop was gutted on 20/12/2019 and the complainant had to suffer a loss to the extent of Rs. 58 lakhs.  The OPs allowed a claim of only Rs.21,05,500/-. This complaint is filed seeking an order directing OPs to pay Rs. 36,94,500/- being the balance amount along with compensation and cost.
2. OPs filed version stating that the complainant was not a consumer as the insurance policy taken by the complainant was for commercial purpose, that the complainant herein is only an employee of one Mr. Vinoop, in whose name the entire business is being run.  The surveyor has assessed a net loss of Rs. 21,05,500/- towards total and final settlement and the complainant had received the said sum.  This complaint is only an attempt at unlawful enrichment and sought for dismissal of the complaint. 
3. Pleadings and counter pleadings considered, the following issues were framed for adjudication:

1. Whether the complaint is maintainable as it relates policy availed for commercial purposes?
2. Whether the complainant is a beneficiary of the policy availed?
3. Whether the complainant is entitled to be indemnified for an amount of Rs.58 lakhs?
4. Whether the partial acceptance of the insurance claim by the OP amounts to deficiency in service on their part?

5.         Cost & compensation if any?

4.      (i)          Evidence comprised of proof affidavit and Exhibits A1 to A6.  Complainant was examined as PW1.   

          (ii)           OPs filed proof affidavit. Exts. B1 series to B5 series were marked.   

            Issue No.1

5.         This issue was already considered and settled once and for all by the Hon’ble Apex Court holding that an insurance policy is availed not for resale or for making profit but for hedging losses and a complaint as against an insurance company would lie inspite of the fact that the complainant is a commercial establishment. Therefore, there is no bar on the ground that the insurance was availed for commercial purpose.

            Issue No.2

6. Even though this matter forms part of the defense of the OP, the fact that the OP had already paid the assessed losses to the complainant shows that the OP has taken this ground only for the purpose of misguiding this Commission.
7. Therefore, we are not resorting to a detailed discussion on this issue.

             Issue No. 3   

8.         Complainant’s case is that they had insured the shop for over Rs.1 crore and he had suffered a loss of Rs. 58 lakhs.  The surveyor of the OP had valued the losses suffered by the complainant and has pegged the losses at Rs.21,05,500/-. This amount was already paid by the OPs to the complainant. 

9.         It is for the balance amount of Rs. 36,94,500/- that this complaint is filed by the complainant. 

10.       Report of the surveyor was produced and marked as Ext.B5 (a) & (b). We went through Exts.B5 (a) & (b). They are detailed reports prepared after considering the documents which are produced and marked as Exts.B1 series to B4 series. Exts.B1 series to B4 series documents upon which Exts.B5(a) & (b) reports are based are the tax invoices pertaining to the transactions made by the complainant, the financial statements made by the chartered accountant of the complainant, repair orders maintained by the complainant and reports prepared and issued by Kerala Fire Force, Electrical Inspectorate and Police authorities.   The said reports, i.e. Ext.B5(a) & B5(b) were marked without any objection. Since crux of the grievance of the complainant being the inadequacy of the amounts arrived at by the surveyor, a duty was cast upon the complainant to prove that the valuation arrived at at by the expert surveyor was faulty, inaccurate, inadequate and non-representative of the actual losses suffered by the complainant.  Here the complainant has not taken any steps whatsoever to object, disprove and render nugatory the said reports of the surveyor. 

11.       Consequently, valuation of the surveyor is only to be upheld. We do so.

12.       Therefore, we hold that the complainant is not entitled to Rs.58 lakhs as claimed by him.

Issue Nos.4 &5

13.       In view of the findings in Issue No.3, Issue nos. 4 & 5 are only to be held against the complainant.  We hold that the complainant is not entitled to any of the reliefs sought for as he has failed to prove any deficiency in service on the part of the OPs.  

14.       Holding thus, this complaint is dismissed.

15.       In the facts and circumstances of the case, parties are directed to suffer their respective costs. 

Pronounced in open court on this the  5^th day of February,  2024.  

                                                                                       Sd/-                                                                                        

                                                                                             Vinay Menon V

                                                        President

                                                           Sd/-   

   Vidya.A

                       Member        

      Sd/-                                                            Krishnankutty N.K.

                                                                                                          Member

APPENDIX

Exhibits marked on the side of the complainant

Ext.A1   -  Original contact insurance policy  

Ext.A2  –  Copy of receipt dated 26/2/2019 issued from Palakkad Municipality

Ext.A3   -   Copy of receipt dated 16/2/2019 issued from Palakkad Municipality  

Ext.A4  -   Copy of  report of Kerala Fire Force

Ext.A5  –   Copy of report of Dy. Electrical Inspector   

Ext.A6 –     Copy of General Diary abstract    

Exhibits marked on the side of the opposite party:

Ext.B1 series  – A set of 16 documents maintained by OP in connection with the fire claim  

Ext.B2 series – Documents in the custody of complainant evidencing the mobile phones that

                           were destroyed in the fire.   

Ext.B3 series –  A set of 90 tax invoices  

Ext.B4  (a) –  Copy of  Tax Invoice dated 21/7/2020

       B4  (b) – Copy of closing stock on 19/12/2019

       B4  (c) –  Copy of sales & purchase details  

        B4 (d) – Original certificate issued by CA

Ext.B5  (a) –  Original of  Survey report dated 22/7/2020

       B5  (b) –  Original of addendum report dated 6/10/2020

Court Exhibit:  Nil

Third party documents:  Nil

 Witness examined on the side of the complainant

PW1 –  Surya Shyam (complainant)

Witness examined on the side of the opposite party:

 Nil   

Court Witness: Nil

NB : Parties are directed to take back all extra set of  documents submitted in the proceedings in accordance with Regulation 20(5) of the Consumer Protection (Consumer Commission Procedure) Regulations, 2020 failing which they will be weeded out.