PER SHRI. S.M. RATNAKAR – HON’BLE
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2) According to the Complainant, the Opposite Party cannot deny the claim on the basis of the survey report which is baseless and unfair assessment.
3) written statement. written statement. The Surveyor had submitted the detailed report on 27/04/06 and though assessed net loss of Rs.30,682/- however, came to the conclusion that the insured claim has not been substantiated and the documents submitted by the insured would definitely formed a base for repudiation of the claim. According to the Opposite Party there is no deficiency and unfair trade practice on the part of the Opposite Party.
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2) In the first instance you are not cooperated with the Surveyor initially to access the loss on 02/08/05 for reasons best known to you.
3) You have failed in your obligation to discharge your duty as a Insured since the Surveyor has specifically in his report dtd.27/04/06
4) You are further failed to discharge your obligation as a prudent insured to produce the records relating to plant & machinery, stocks,
5) You have failed to establish the loss in toto, since due to the delay caused on your side to cooperate with the Investigator, the
6) You have provided in appropriate documents to the Investigator all of which do not hold any veracity to justify your claim.
7) The balance-sheet provided by yourself is questionable on your face of it since, on verification it has been found that you are not filed
8) You have failed to give proper justification since the statement signed by your Auditors is itself questionable.
9) You have failed to justify your basis of loss to the Surveyor since the documents made available by you do not even correspond with the
data and the claim made by you.
We as a matter of utmost regret informed you that we are now repudiating your claim in toto in view of the above.The said communication sets out in detail the reasonswhich have weighed the Insurance Company for repudiating the claim of the Complainant. The question therefore, arises whether the reasons stated are right or wrong and on which the Commission/Forum can express any opinion is required to be taken into consideration.
“The Insurance Company has by it’s order dtd.21st
relied the authorities in the following cases –
1) National Insurance Co. Ltd. V/s. Govind Chandra Nayak, 2009 CTJ 62 (CP)(NCDRC).
2) Pradeep Kumar Sharma V/s. National Insurance Co. Ltd., 2009 CTJ 170 (SP) (NCDRC).
3) Karnataka Power Transmission V/s. Ashok Iron Works (P) Ltd., 2009 CTJ 233, Supreme Court (CP).
The said authorities are not applicable to the facts of this case.
We therefore, hold that the complaint is liable to be dismissed on the ground that this is not a case where deficiency in service on the part of the Opposite Party is made out so as to entitle the Insured Company to seek any relief under the Consumer Protection Act. In the result the complaint is dismissed by observing that such dismissal will not operate to the prejudice of the Complainant Insured Company in the matter of it’s pursuing other remedies.
O R D E R
i. Complaint No.256/2008 is dismissed with no order as to cost with the observation that the dismissal of the complaint will not operate to prejudice of the Complainant in the matter of it’s pursuing other remedies.
ii. Certified copies of this order be furnished to the parties.
