BEFORE THE DISTRICT CONSUMER DISPUTES
REDRESSAL FORUM, JALANDHAR.
Complaint No.256 of 2014
Date of Instt. 04.08.2014
Date of Decision :24.02.2015
M/s Bilga General Hospital Charitable Trust(India), VPO Bilga, through Paramjit Singh Manager.
..........Complainant
Versus
1. United India Insurance Company Ltd, Regd.& Head Office Whites Road Chennai, through its Managing Director.
2. Units India Insurance Company Ltd, D.O.II, Syal House, Lajpat Nagar Market, Jalandhar through its Manager.
.........Opposite parties
Complaint Under Section 12 of the Consumer Protection Act.
Before: S. Jaspal Singh Bhatia (President)
Ms. Jyotsna Thatai (Member)
Sh.Parminder Sharma (Member)
Present: Sh.Jatinder Shamra Adv., counsel for complainant.
Sh.Raman Sharma Adv., counsel for opposite parties.
Order
J.S Bhatia (President)
1. The complainant has filed the present complaint under section 12 of the Consumer Protection Act, against the opposite parties on the averments that the complaint is being filed through Paramjit Singh, Manager of the trust, who has been authorized by the trust to file the present complaint and is well conversant with the facts of the case and can depose on behalf of the trust. The complainant trusted the opposite parties and thereby got one policy bearing No.471168 in the name of the complainant and the same was valid upto 4.4.2014. The complainant had filed claim amounting to Rs.1,68,805/- in respect of above said policy but the opposite parties have not responded till date inspite of visits made by the complainant in local branch i.e opposite party No.2 and through emails, but the official posted at local branch i.e opposite party No.2 has not dealt the complainant in a nice or official like manner and their behaviour was rude and adamant and was not congeal as expected. The alleged claim is covered under the policy and damages was caused on 15.6.2013 due to heavy rain and wind storm, which occurred in North India and boundary wall of the hospital fell down. On such like averments, complainant has prayed for directing the opposite parties to pay it the claim amount of Rs.1,68,805/- alongwith interest. He has also claimed compensation and litigation expenses.
2. Upon notice, the opposite parties appeared and filed a written reply raising preliminary objections regarding maintainability, no deficiency in service and the loss being not covered under the policy. It further pleaded that the damage to the boundary wall is not covered under the policy. The liability of the opposite parties is only with regard to the properties mentioned in the cover note and not beyond that. There is no mention of covering boundary wall in the cover note, as such the same was not covered under the policy and the claim of the complainant was repudiated after due application of mind and the complainant was informed accordingly vide letter of repudiation dated 18.12.2014, as such the complaint against the opposite parties is liable to be dismissed. They denied other material averments of the complainant.
3. In support of his complaint, learned counsel for the complainant has tendered affidavit Ex.CA alongwith copies of documents Ex.C1 to Ex.C15 and closed evidence.
4. On the other hand, learned counsel for opposite parties No.1 and 2 has tendered affidavit Ex.OA alongwith copies of documents Ex.O1 to Ex.O4 and closed evidence.
5. We have carefully gone through the record and also heard the learned counsels for the parties.
6. Ex.C2 is cover note in respect of policy obtained by the complainant trust from opposite party insurance company. The risk covered under the policy is mentioned in the cover note as " building above plinth level built of the first class construction situated at above mentioned address used as hospital including furniture etc to the extent of Rs.5 Crore". During the validity of the insurance policy, the boundary wall of the complainant hospital was damaged. Ex.C7 to Ex.C10 are photographs of the damaged boundary wall. The complainant preferred the claim with opposite party insurance company who appointed Sh.JS Khurana & Associates as surveyor and loss assessor and the surveyor and loss assessor submitted its report Ex.O1 assessing the net loss at Rs.62,428/-. However, the opposite party insurance company has repudiated the claim of the complainant vide letter dated 18.12.2013 Ex.O4 on the ground that loss reported is of the boundary wall which is not covered under the policy. Counsel for the complainant contended that only building above plinth level was covered under the policy and boundary wall was not covered under it. On the other hand, learned counsel for the complainant contended that boundary wall is an integral part of the main building of the hospital and as such was covered under the policy and opposite party insurance company has repudiated the claim without any valid reason. We have carefully considered the contentions advanced by learned counsels for both the parties. Under the policy, building of the hospital was covered. In our opinion the boundary wall is an integral part of the main building of the hospital and as such is also covered under the policy. Normally every building has boundary walls and is an integral part of the whole structure or building. In our opinion, the opposite party insurance company has wrongly rejected the claim of the complainant on the ground that boundary wall of the building was not covered under the policy. The surveyor has assessed the net loss on account of damage to the boundary wall of the building of the hospital at Rs.62,428/-.
7. In view of above discussion, the present complaint is accepted and opposite parties are directed to pay Rs.62,428/- to the complainant alongwith 9% interest from the date of repudiation of claim till payment. It is clarified that interest amount is being granted as compensation. Complainant is also awarded Rs.3000/- on account of litigation expenses. Copies of the order be sent to the parties free of costs under rules. File be consigned to the record room.
Dated Parminder Sharma Jyotsna Thatai Jaspal Singh Bhatia
24.02.2015 Member Member President
