PER SHRI. S.S.PATIL - HON’BLE MEMBER :
1) This is the complaint regarding the deficiency in service on the part of Opposite Parties as they have partly repudiated the claim of the Complainant and only meager amount was sanctioned.
2) The facts of the complaint as stated by the Complainant are that the Complainant has been availing the insurance facility from the Opposite Parties since 1999. It is further stated that, the Complainant is manufacturing and storing Ayurvedic Medicines at the address given in the title. He has two godowns one for storing a raw material and other is for finished goods (Ayurvedic medicines). The godown for finished goods is at 1/13, Shastri Nagar, J.R. Boricha Marg, Mumbai -11, and other, for storing raw material is at G.S.M./114/Adarsh Nagar, J.R. Boricha Marg (2nd Godown). The godowns are situated in a low lying areas. In rainy reason, there is water logging problem in this area. The above said both the godowns were insured with the Opposite Parties vide two policies. In the 1st policy the sum insured was Rs.2 Lac and 2nd policy the sum insured was Rs.1,25,000/-. The 1st Policy No. was 120/00/11/13/16/20/004/02592/99 and 2nd PolicyNo.120/00/11/13/16/20/0004/02591/ 99.
3) The Complainant has further stated that in the year 2000, he had sent a letter dtd.26/09/2000 to Opposite Party requesting to transfer Policy No.120/00/11/13/16/20 /0004/02592/99 (Rs.2 Lacs) for 1st godown situated at C.S.M./114 Adarsh Nagar to 2nd godown situated at 1/13 Shastri Nagar and similarly transfer the 2nd policy of Rs.1,25,000/- from 2nd godown to 1st godown at G.S.M./114 Aadarsh Nagar.
4) In the year, 2005, there was heavy rain on 26/07/2005. The second godown situated at 1/13 Shatri Nagar was totally submerged due to heavy rain. Entire raw material and other finished goods were destroyed and the Complainant suffered a loss of Rs.1,90,842.25
5) The Complainant has, by amendment added to the complaint that after filing the complaint the Complainant has filed Policy No.120100/11/04/01999 and Policy No.120100/11/04/01998 which were valid at the time of incident (when the loss occurred).
6) The Complainant has further stated that the material stored in 2nd godown i.e. at Adarsh Nagar was insured under policy No.120/100/11/04/01998 for a sum of Rs.2 Lacs.
7) The representative of Opposite Party No.1 surveyed the loss occurred at 2nd godown. Surveyors B.M. Darji & Associates, vide letter undated asked the Complainant to submit documents. The Complainant furnished the necessary documents. After submitting the claim to the Opposite Party No.1, the Complainant also sent reminders for sanction of his claim. Then the Opposite Party No.1, by its letter dtd.29/11/06 informed the Complainant that the claim of only Rs.26,956/- was settled by the Opposite Party as against claim of Rs.1,90,842.45. Thus, the Opposite Party is deficient in rejecting the remaining legitimate claim of the Complainant without any reason. Thereafter, the Complainant requested the Opposite Party to sanction his entire claim vide letter dtd.16/06/2007 but in vain.
8) The Complainant has lastly prayed that Opposite Parties be directed to pay Rs.1,90,842.45 to the Complainant with interest towards the loss caused, Rs.1 Lac compensation for other loss suffered by the Complainant, Rs.50,000/- compensation for mental agony and cost of this complaint.
9) The Complainant has attached the following documents in support of his complaint -
a) Policy No.120/100/11/04/01998.
b) Policy No.120/100/11/04/01999.
c) Letter dtd.26/09/2000.
d) Undated letter addressed by Surveyor to Complainant.
e) Letter dtd.10/11/2005.
f) Letter dtd.09/01/2006.
g) Documents sent by the Complainant to Opposite Party
h) Reminder by the Complainant.
i) Letter dtd.29/11/2006 of Opposite Party.
j) Notice dtd.16/06/2007.
10) The complaint was admitted and notices were served on the Opposite Parties. Opposite Parties filed their written statement and denied the allegations of deficiency in service. It was brought to the notice of this Forum that the policy numbers quoted in the complaint are not admitted by the Opposite Party. The policies quoted were expired on the dates of incident of loss. Therefore, the Opposite Parties deny their liability. It is also clarified that the letter dtd.26/09/2000 has no validity.
11) It is also submitted that the Complainant has not followed the requirements of law such as getting the policies transferred etc. However, the Opposite Parties have admitted of para 6 of the complaint as the entire Mumbai city & neighbouring places were flooded due to the deluge but the efforts to safeguard the material were not admitted by the Opposite Party.
12) The Opposite Party has further submitted that it is ready to pay Rs.29,956/- as assessed by the loss assessor and surveyor as it is admissible under the policy.
13) Finally the Opposite Party has averred that there are no merits in the complaint therefore, it may be dismissed with cost.
14) The Opposite Party then filed its reply to the rejoinder of the complaint wherein it reiterated the points mentioned in its written statement and annexed the policy documents bearing Nos.120110/11/04/01998 for the period 26/09/04 to 25/09/08 and Policy No.120110/11/04/01999 valid for 26/09/04 to 25/09/05. These are the correct numbers under which the loss of the Complainant was covered and not the policies mentioned in the complaint.
15) Thereafter, the Opposite Party produced the survey report of Surveyor B.M. Dargi & Associates.
16) The Complainant then filed its affidavit of evidence and written argument. The Opposite Party also filed their written argument. We heard the Ld.Advocates of both the parties and perused the papers submitted by them and our findings are as follows.
17) The Complainant is a Proprietor of M/s. S.P. Drug Company which manufactures Ayurvedic Medicine at the address in the above said title. The Complainant is having two godowns for storing the raw material as well as finished products of his company. One is at G.S.M./114 Aadarsh Nagar, J.R. Bhoricha Marg, Mumbai and 2nd is at 1/13, Shastri Nagar, J.R. Bhoricha Marg, Mumbai. Both the godowns are covered under insurance policies viz; Bearing No.120100/11/04/01998 and 120100/11/04/01999. The validity of both the policies being from 26/09/04 to 25/09/05. The sum insured in 1st policy was Rs.2 Lacs and sum insured for 2nd policy was Rs.1,25,000/-.
18) During the validity of the above said policies, there was a heavy rainfall and deluge on 26/07/05 in Mumbai City and surrounding area. The insured godowns being at low lying area were submerged under water because of the flood water. The Complainant has himself stated in para 6 that the second godown situated at 1/13, Shastri Nagar, J.R. Boricha Marg, Mumbai was totally submerged in the water. Due to water logging in 2nd godown, the entire raw material and other finished goods stored in second godown has been “(destroyed)” damaged and the Complainant suffered the loss of Rs.1,90,842.45. However, the Complainant has failed to explain how he assessed this loss and came to the conclusion that the loss was of Rs.1,90,842.45. The Complainant has not mentioned as to who assessed the loss. How the loss was assessed, etc.
19) In this respect we have minutely scrutinized the papers. The Complainant himself has created a confusion regarding the policies under which the 2nd godown which was submerged under water was insured. The papers on record clearly show that the godown at 1/13 Shashri Nagar in which the material was damaged was insured vide policy number 120100/11/04/01999. The sum insured was Rs.1,25,000/- and not 2 Lacs as claimed by the Complainant. In the insurance matter the policy document is very important. The policy has been issued on or about 26/09/04. The contents show it covered the godown at Shastri Nagar and the sum insured Rs.1,25,000/-. But the Complainant did not bother to bring any discrepancy to the notice of the Opposite Party if there was any as per his claim and now he is taking shelter of letter dtd.26/09/2000 in which he had requested the Opposite Party No.1 to transfer the 1st policy of Rs.2 Lac from 1st godown to 2nd godown. Thereafter he has not bothered to see whether his request was granted or otherwise.
20) On 26/07/20005, when there was a loss, the said loss would be indemnified as per the existing insurance policy. On 26/07/05, the relevant policy covering the damage was Policy No.120100/11/04/01999. But the Complainant has also created a confusion in this respect also. From the papers the correct policy covering the loss on 26/07/05 was policy bearing No.120100/11/04/1999 valid from 26/09/04 to 25/09/05. The sum assured was Rs.1,25,000/-.
21) As per the insurance law and procedure, on receipt of the information of damage/loss due to deluge, the Opposite Party had appointed a surveyor to assess the loss, the surveyor being one B.M. Darji & Associates. The Opposite Party has filed his survey report dtd.03/03/06. We perused this report. The surveyor has observed in his report that the closing stock on 25/07/05 i.e. one day before the deluge was of Rs.1,9804/- as against the sum insured of Rs.85,000/- only. Hence, the stock was under insured by 57%. Therefore, based on the documents the surveyor assessed the loss as under -
Gross loss - Rs.48,768.25
Less – under insurance 57% - Rs.27,797.00
Net loss assessed` - Rs.20,970.35
At work negative positive block - Rs.18,000.00 allowed
Less excess - Rs.10,000.00
The total net adjusted - Rs.28,970.00
22) In our view, the Surveyor who is a an authorized licensed assessor, has assessed the loss after actual visit to the sight and the assessment is based on the documents supplied by the Complainant. From the stock register, as per the stock of 25/07/05, i.e. on day earlier to the loss, the stock is more than what is insured and consequently it is underinsurance. Therefore, the loss assessed by the Surveyor appears to be as per the documents and the terms and conditions of the insurance policy.
23) At the same time, the Complainant has not filed any document to establish that the loss of Rs.1,90,842.45 was caused. Only averment without any assessing report cannot be relied upon. Hence, the amount of reimbursement claimed by the Complainant is not substantiated. Therefore, from the above observation we find no merit in the complaint ad hence, the complaint deserves to be dismissed. Hence, the order –
O R D E R
1. Complaint No.08/2008 is hereby dismissed for want of merit.
2. There is no order as to cost.
6. Certified copies of this order be furnished to the parties.
