IN THE CONSUMER DISPUTES REDRESSAL FORUM, KOTTAYAM
Dated this the 30thday of March 2023
Present: Sri.Manulal.V.S, President
Smt.Bindhu.R, Member
Sri.K.M.Anto, Member
CC No. 243/2019 (Filed on 30.07.2021)
Complainant : Shaiju K.C, S/o Chellappan
Kottupadiyil House
Kumarakom South P.O
Kottayam Pin – 686 563
(St.Joseph Wood Industries
Choolabhagom, Kumarakom)
(By Adv.C.S.Ajithan Nampoothiri)
Vs
Opposite party : The Manager,
United India Insurance Company Ltd
Branch Office,
Hillson Heights 1st Floor
Pulimoodu Junction
M.C.Road, Kottayam- 686 001
(By Adv.P.G.Girija)
O R D E R
Sri.K.M.Anto
The complaint is filed under section 12 of the Consumer Protection Act 1986.
The brief of the complaint is as follows:- The complainant had availed the Standard Fire and Special Perils Insurance Policy having policy number No.1005051118P104790843 from the opposite party. The policy was for the period from 11.07.2018 to midnight of 10.07.2019. The total sum insured was Rs.18,00,000/- and the complainant remitted Rs.5,911/- as premium.
On 17.09.2018 heavy rainfall caused unpredictable heavy flood in Kerala State including Kumarakom Village. The complainant’s industry was affected by flood and the industry was completely damaged. The building, machinery and stock of woods were lost forever. The matter was informed to the opposite party in time. The opposite party appointed a surveyor and the surveyor visited the site and assessed the situation. The surveyor had taken the photos of the collapsed building and damaged machinery and other articles.The surveyor informed that he will give a proper report within one week.The petitioner started the work after making the maintenance work in the building. At the first visit the surveyor had assessed a total loss of more than Rs.20 lakhs.
The complainant approached the opposite party for getting the claim amount, then the opposite party informed that the surveyors report was missing and the surveyor will visit again for another enquiry. The surveyor visited again in the premises but at that time the complainant had restarted the works. In the said circumstances the opposite party had paid only Rs.P2 lakhs as compensation.
The opposite party did not care to take any enquiry in respect of the complainant’s grievances. The act of the opposite party amounts to deficiency in service. The complainant had estimated the loss from the negligent act as Rs.18,00,000/-, and business loss Rs.5,00,000/-.Thus, the complaint is filed for realizing an amount of Rs.19,50,000/- for the losses including the building, machinery, wooden furniture, stock, and business loss from the opposite party along with Rs.50,000/- as compensation for mental agony.
On admission of the complaint copy of the complaint was duly served to the opposite party. The opposite party appeared and filed their version.
The version of the opposite party is as follows. The complainant had availed a Standard Fire and Special Perils Insurance Policy with policy number No.1005051118P104790843 forthe period from 11.07.2018 to 10.07.2019 from the opposite party. The sum insured is under three heads via Building for Rs.10,00,000/-, Machineryfor Rs.3,00,000/- and stock for Rs.5,00,000/-. The total sum insured was Rs.18,00,000/- and premium paid was Rs.5,400/-. The policy is issued subject to the terms and conditions attached to the policy.
As per clause 10 under the head B General conditions “if the property hereby insured shall at the breaking out of any fire or at the commencement of any destruction of or damages to the property by any other peril hereby insured against be collectively of greater value than the sum insured shall be considered as being his own insurer for the difference and shall bear a ratableproportion of the loss accordingly. Everyitem, if more than one of the policies shall be separately subject to this condition”.
The averment that the surveyor had assessed a loss of more than 20 lakhs being not true. The surveyor had visited the premises only once on01/09/2018 and prepared the report. As per the survey report the stock is valued at Rs.18,40,000/- whereas the insurance availed for the same is only Rs.5,00,000/-which is an under insurance.
The loss assessed by the surveyor for the stock is Rs.2,52,000/-.Then applying the average clause,the loss assessed for the
Stock = | Loss assessed x Sum insured Present Valuation | = | 2,52,000 x 5,00,000 18,40,000 | = | Rs.68,478/- |
Loss assessed for the building = Rs.1,11,050/-
Loss assessed for themachinery= Rs.32,880/-
Loss assessed for the stock = Rs.68,478/-
The total loss assessed by the surveyor was Rs.2,01,787/- and the same was already paid to the complainant.
The opposite party had considered the complainant’s claim as per the policy conditions and guidelines for settlement of the claim. All other allegations are false and hence denied. There is no deficiency in service or unfair trade practice on the part of the opposite party.
The complainant filed proof affidavit and marked documents Exhibit A1 to A5 VigneshAnand, Assistant Manager, Kottayam of the opposite party filed proof affidavit and marked documents Exhibit B1 and B2. The insurance surveyor was examined as PW1 and VigneshAnand,Manager,Kottayam of the opposite party was examined as DW1.
On the basis of the complaint, version of the opposite party and evidence adduced, we would like to consider the following points.
- Whether there is any deficiency in service on the part of the opposite party
- If so, what are the reliefs and costs?
Points 1 and 2
On going through the complaint, version of the opposite party and evidence on record, bothparties agree that the complainant had availed a Standard Fire and Special Perils Insurance Policy with policy number No.1005051118P104790843 for the period from 11.07.2018 to 10.07.2019 from the opposite party. The total sum assured under the policy is Rs.18,00,000/-.On 17.09.2018 the complainant’s industry was affected by flood and the industry was damaged. On the basis of the insurance claim of the complainant, the opposite party deputed PW1 Insurance surveyor on 01.09.2018 and the Insurance surveyor conducted the survey on 1.09.2018 and prepared Ext B2 Survey report.
In Exhibit B2 Survey Report the loss assessed for the building is Rs.1,11,050/-and loss assessed for the plant and machinery is Rs.32,880/-.The valuation for the building is Rs.9,06,500/- and plant and machinery were Rs.2,80,000/-.Since the sum insured of building, plant and machinery is higher than the valuation amount,there is no underinsurance.
But for the stock of Wood,furniture,the loss assessed was Rs.2,52,000/- and the valuation for the stock is Rs.18,40,000/-.Since the sum insured for the stock is lower than the valuation of stock, there is underinsuranceas per clause 10 under the head B General conditions of the Exhibit A1/B1 Policy certificate.
By applying the average clause, the liability on the part of the insurance company is Rs.68,478/-only.
The opposite party had given Rs.2,01,787/- as insurance claim to the complainant. It is clear that the opposite party had processed the claim of the complainant as per the terms and conditions of the Exhibit A1/B1 Insurance Policy Certificate. On the basis of the above discussed findings,it is evident that the complainant failed to establish deficiency in service or unfair trade practice on the part of the opposite party. The complaint is liable to be dismissed. The complaint is dismissed.
Pronounced in the Open Commission on this the 30th day of March, 2023.
Sri. K.M. Anto, Member sd/-
Sri. Manulal.V.S, President sd/-
Smt.Bindhu.R, Member sd/-
Appendix
Exhibits marked from the side of complainant.
A1- Copy of standard fire and special perils policy schedule issued by United India Insurance Company Limited.
A2- Copy of receipt issued by United India Insurance Company Limited.
A3- Legal notice dated 03.04.2019
A4- Postal receipt
A5- Postal acknowledgment card
Sworn statement from the side of complainant
PW1- T.S.Biju, S/o V.K.Sekharan, Bijunivas, Kidangoor South P.O
Exhibits marked from the side of opposite party.
B1- Copy of standard fire and special perils policy schedule of United India Insurance Company Limited.
B2- Copy of survey report final – South India Floods 2018, signed by T.S.Biju, Insurance Surveyors & Loss Assessors.
Sworn statement from the side of opposite party
DW1- VigneshAnand, VAnandkumar, United India Insurance Co.Ltd, Divisional Office, Geetha Trade Centre, Nagampadom, Kottayam
By order
sd/-
Assistant Registrar
