Delhi

North East

CC/70/2021

Kala Sales Agency - Complainant(s)

Versus

United India Insurance Company Ltd. - Opp.Party(s)

28 Aug 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION: NORTH-EAST

GOVT. OF NCT OF DELHI

D.C. OFFICE COMPLEX, BUNKAR VIHAR, NAND NAGRI, DELHI-93

 

Complaint Case No.70/21

 

 

In the matter of:

 

	Kala Sales Agency, Through its Proprietor Mrs. Anita Sharma W/o Sh. Raj Kumar Sharma, 1/2246, Shop No. 1, East Ramnagar, SubhashMarg, Shahdara Delhi	Complainant
	Versus
	United India Insurance Company Ltd., Through the Manager H-611ST  Floor, Gobind Mansion Indra Palace, Behind Plaza Cinema Connaught Place, New Delhi 110001	Opposite Party

 

DATE OF INSTITUTION:         JUDGMENT RESERVED ON:                         DATE OF ORDER  :

09.04.2021 17.07.2023 28.08.2023

 

 

CORAM:

Surinder Kumar Sharma, President

Anil Kumar Bamba, Member

 

ORDER

 

Anil Kumar Bamba, Member

The Complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019.

Case of the Complainant

1. The case of the Complainant as revealed from the record is that the Complainant was having OD account bearing account no. 6140162912 with Indian Bank. While opining the account the Complainant was asked to insure her shop with Opposite Party.The Complainant has insured her shop M/s Kala Sales Agency from Opposite Party for a total sum of Rs. 7,50,000/-. The period of policy was 27.07.2018 to 26.07.2019. On late evening of 06.04.2019 at 09.26 p.m her godown has caught fire due to short circuit. The fire brigade was called by the neighbour of the Complainant and fire was extinguished by fire brigade. Due to the fire most of the goods and stocks lying in godown got burnt. The surveyor took photographs of the place/shop of incidence. The Complainant suffered a loss of Rs. 6,82,621/- due to fire incident. The Complainant filed claim with the Opposite Party. The Opposite Party appointed a surveyor. The surveyor visited the site on 1.04.2019. The surveyor vide letter dated 11.04.2019 and 27.05.2019 Opposite Party asked the Complainant to furnish documents. The Complainant duly supplied all the documents to the Opposite Party as well as surveyor. Complainant stated that some documents got burnt inside the godown. The Complainant supplied all the documents except few documents. The accountant who was handling the books of accounts and all legal requirements of the Complainant firm, unfortunately died during this period and hence the certified balance sheet could not be submitted. All available documents were supplied to the Opposite Party. The Opposite Party again sent a letter dated 28.06.2019 informing to provide documents. The Complainant provided auditeddocuments, GST return certificate, purchase invoice. ITR, provisional balance sheet and stock statement and list of goods saved form fire and list of goods burnt in the fire and requested to settle the claim. The Opposite Party had wrongly assumed that “Basis of calculating the quantity of stocks of intact/saved after fire and quantity of stocks destroyed during fire showing name of item, item code quantity, rate and value supported with proof of rates, at affected premise, because the photographs arranged by us indicated large quantities of saved stocks for Rs. 86,860/-. In reply to this it is being submitted that “the surveyor surveying the remaining stock considered all the stocks in the godown as the stock of Kala Sales Agency whereas the godown contained the stocks for Kala Sales Agency as well as for Sri SatyaSai Agency both the above stated entities were registered under GST on the same address and both are also insured by the same insurer. The Complainant served demand notice on 09.02.2021 to the Opposite Party and in response Opposite Party stated that we are apprise that the subject claim may not be settled, on the basis of available documents which had been received by us, up to the date of issuance of our survey report. Complainant stated that the claim is closed as NO CLAIM due to non submission of required documents. Complainant has prayed to direct the Opposite Party to pay Rs. 6,82,621/- along with interest @ 18 %, Rs. 1,00,000/- on account of mental harassment and Rs. 25,000/- on account of litigation expenses.

Case of the Opposite Party

2. Opposite Party contested the case and filed its written statement. It is stated that the present complaint is not maintainable as the Opposite Party has not caused any deficiency of service essentially required for filing a complaint under a Consumer Protection Act, 2019. Opposite Party further stated that the Opposite Party has duly intimated the Complainant to comply the terms and conditions of the policy and for submission of relevant documents to process the claim but the Complainant has failed to submit the relevant documents. Opposite Party further stated that upon the intimation of the claim, Rohit Kumar & Company, an independent and licensed surveyor was duly deputed by the insurance company to assess and survey the loss. Said surveyor submitted his final report vide reference No. 23/2019-2020 dated 03.09.2019 with remarks “No Claim”. It is submitted that Surveyor asked several times for the relevant documents for the assessment of actual loss but Complainant neither submitted said relevant document nor replied to the Surveyor. It is further submitted that non-submission of the relevant documents by the Complainant is a violation of the condition no. 6 of insurance policy, which is read as under:-

“Insured shall also at all times at his own expense produce, procure and give to the company all such further particular, plans, specification, books vouchers, invoices, duplicates, or couples thereof, documents, investigation reports (internal/external) proofs, and information with respect to the claim and the origin and cause of the loss and the circumstances under which the loss or damage occurred, and any matter touching the liability or the amount of the liability of the company as may be reasonably required by or on behalf of the company together with the declaration on oath or in other legal form of the truth of the claim and of any matter connected therewith. No claim under this policy shall be payable unless the terms of this condition have been complied with.”

 

3. Opposite Party further stated that on 08.11.2019, the Opposite Party sent a detailed letter to the Complainant and informed him about the closure of the claim due to non-submission of documents. It is pertinent to mention herein that said letter clearly mentioned the details of the required documents. But, the Complainant did not bother to provide the sought documents. Subsequently, again on dated 18.02.2021, the Opposite Party asked the documents necessary for the assessment of the alleged loss. It is stated that the Opposite Party and the Surveyor asked several times and sent many reminders requesting the Complainant to submit the documents necessary for the assessment of the alleged loss but, the Complainant failed to provide those documents.Ultimately, the Opposite Party closed the claim as “No Claim” and same was informed to the Complainant again vide letter dated 11.03.2021.It is further denied that the Complainant provided all the genuine purchase bills prior to incident to the surveyor along with list of goods which have been burnt. It is submitted that list of articles mentioned in the annexure G and H of the said complaint were not supported by purchase invoice and the Surveyor did not properly assess the alleged loss. It is submitted that whatever document submitted by the complaint to the surveyor, that was not relevant and proper for the assessment of the loss and said document were not relevant to the said alleged loss. The surveyor specifically mentioned in his final roper that he asked for several times the relevant documents and even sent list of those documents but the Complainant neither provided such documents nor replied to the letter of the Surveyor.

Evidence of the Complainant

4. The Complainant in support of his case filed his affidavit wherein he has supported the assertions made in the complaint.

Arguments & Conclusion

5. We have heard theLd. Counsel for the Complainant and Ld. Counsel for the Opposite Party.  We have also perused the file and written arguments filed by the Complainant and Opposite Party. The case of the Complainant is that at the time opening of OD account with Indian Bank she was asked to insure her shop with the Opposite Party. The Complainant insured her shop from the Opposite Party for the sum of Rs. 7,50,000/-. During the validity period of the policy with the Opposite Party her godown caught fire due to short circuit. Due to the fire most of the goods and stocks lying in the godown got burnt. It is stated by the Complainant that she suffered loss of Rs. 6,82,621/- due to fire incident. She filed a claim with the Opposite Party. Opposite Party appointed a surveyor and after surveying the incident site surveyor asked for certain documents from the Complainant which she had duly supplied to the Opposite Party as well as surveyor. It is further stated by the Complainant that she had supplied all the documents except few documents as her accountant died during this period. Hence, the certified balance sheet could not be submitted. As per the Complainant the claim is closed by the Opposite Party as no claim due to non submission of the required documents. Hence, there is deficiency of service on the part of Opposite Party.
6. The case of the Opposite Party is that after the incident of fire, Opposite Party appointed a surveyor who surveyed the premises and asked for required documents time and again which was not supplied by the Complainant. Hence, the claim was closed with remarks “No Claim”. Since, the Complainant neither submitted the relevant documents nor reply to the surveyor which is a violation of condition No. 6 of insurance policy. Hence, there is no deficiency of service on the part of the Opposite Party.
7. It is clear from the record of the case that the Complainant failed to provide the required documents to the Opposite Party for considering her claim. Even in her evidence file in the Commission, para no. 11 left blank by the Complainant which is reproduced as under:

“I say that the accountant namely....................... who was handling the books of accounts and all legal requirements of the ct firm, unfortunately died on.............. and hence the certified balance could not be submitted.”

8.  In view of the above facts, in our considered opinion, there is no deficiency of service on the part of Opposite Party. Therefore, the complaint is dismissed.
9. Order announced on 28.08.2023.

Copy of this order be given to the parties free of cost

File be consigned to Record Room.

(Anil Kumar Bamba)		(Surinder Kumar Sharma)
(Member)		(President)