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TAMIL NADU STATE CONSUMER DISPUTES
REDRESSAL COMMISSION, MADRAS
Honble Thiru Justices S.A. Kader,
President; Thiru R.N. Manickam & Dr. Tmt. Ramani Mathuranayagam, Members
M. KESAWAN—Complainant
versus
ORIENTAL INSURANCE CO. LTD.—Opp. Party
O.P. No. 544 of 1992—Decided on 1.9.1993
Counsel for the Parties :
For the Complainant :Tr. Calvin Jacob, Advocate.
For the Opp. Party:Tr. V. Jambunathan, Advocate.
An insurance company is liable to settle a claim made by the insured under a policy of insurance, even if the insured is unable to produce records and particulars due to a fire accident that has reduced the insured property to ashes.
Headnote:
CONSUMER PROTECTION ACT - SECTION 17 AND 12 - INSURANCE POLICY - FIRE ACCIDENT - CLAIM SETTLEMENT - DEFICIENCY OF SERVICE - QUANTUM OF COMPENSATION - INTERPRETATION OF POLICY CONDITIONS AND ASSESSMENT OF LOSS - CONSUMER ENTITLED TO COMPENSATION FOR LOSS SUFFERED DUE TO FIRE ACCIDENT.
Fact of the Case:
The complainant, a tailor, insured his shop and its contents against fire and burglary with the opposite party insurance company. On 29.12.89, a fire accident occurred, causing extensive damage to the shop and its contents. The complainant filed a claim with the insurance company, but the claim was not settled. The complainant then filed a complaint under Section 17 read with Section 12 of the Consumer Protection Act, alleging deficiency of service and negligence on the part of the insurance company.
Finding of the Court:
The court found that there was a fire accident on the night of 29/30.12.89 and the entire building of the complainant was reduced to ashes. The court held that the insurance company was liable to settle the claim made by the complainant under the policy of insurance, as there was no evidence to show that the fire was anything but accidental. The court also held that the insurance company was negligent in not settling the claim on the ground of the non-production of records and particulars, as the fire had reduced the shop to ashes and it was not possible for the complainant to produce records.
Issues: 1. Whether there was any deficiency of service or negligence on the part of the insurance company? 2. To what compensation, if any, is the complainant entitled?
Ratio Decidendi: The court held that the insurance company was liable to settle the claim made by the complainant under the policy of insurance, as there was no evidence to show that the fire was anything but accidental. The court also held that the insurance company was negligent in not settling the claim on the ground of the non-production of records and particulars, as the fire had reduced the shop to ashes and it was not possible for the complainant to produce records.
Final Decision: The court ordered the insurance company to pay to the complainant the sum of Rs. 1,25,902/- with interest thereon at 12% p.a. from 3.12.90 till payment. The insurance company was also ordered to pay to the complainant costs of Rs.1,000/-.
Mr. Justice S.A. Kader, President—This is a complaint under Section 17 read with Section 12 of the Consumer Protection Act.
2. The complainant is the proprietor of M/s. Kesavan Tailor's shop at No. 14, Mount Road, Coonoor. His son was running a Video Library in a portion of the same building. The complainant has taken a policy of insurance against fire and Burglary with the opposite party for a sum of Rs. 2,31,300/- for the period from 26.12.89 to 25.12.90. On 29.12.89 at about 11.58 p.m. there was a fire accident in which the entire building was gutted. A reoprt was given to the police and a claim was made to the opposite party. The claim has not been settled. Hence this complaint.
3. The claim is resisted by the opposite party. It is admitted that the complainant has taken up a Fire Insurance Policy with the opposite party for Rs. 2,31,300/- for the period 26.12.89 to 25.12.90. The value of the articles mentioned in the policy were not tested at the time of the policy. As per the conditions of the policy, it is the duty of the insured to establish the value of the goods, machinery etc., destroyed by fire by producing all vouchers invoices and documents to substantiate the claim. It is denied that there was an accidental fire in the premises on 29.12.89 at about 11.58 p.m. Mr. Devanathan was appointed as Surveyor to conduct the preliminery survey and M/s. Asawas & Co., was appointed to conduct the final survey. The Surveyor has requested the complainant to furnish various particulars and documents, but the complainant failed to furnish them and hence the loss could not be ascertained. The investigation of the police is also not over. In the circumstances of the case it is not possible of decide about the claim pending the final decision by the police. The claim is not genuine one. It is only to cheat the insurer.
4. Exhs. A1 to A12 and B1 to B6 are marked by consent. Proof affidavits are filed. No oral evidence has been let in.
5. The points that arise for determinations are:
(1) Whether there has been any deficiency of service or negligence on the part of the opposite party?
(2) To what compensation if any is the complainant entitled.
6. Point No. 1 : The complainant is running a Tailor's shop at Door No.14, Mount Road, Coonoor. He has insured the materials in the shop against fire and burglary with the opposite party for Rs. 2,31,300/- for the period from 26.12.89 to 25.12.90. Exh. B2 is the proposal form and Exh. B3 is the policy. On 29.12.89 at about 11.58 p.m. there has been a fire accident in which the entire shop of the complainant was gutted. Exh. Al is the First Information Report given by complainant's son Prem Anand who is running a Video Library in a portion of the same building and who has filed O.P. 560/92 against the same opposite party for claiming compensation in respect of loss sustained by him on account of the same fire accident. The said son Prem Anand and his brother Muruganandam and another person Monord sustained burn injuries in that accident. Exhs. A3, A4 and A5 are wound certificates issued to these persons by an Assistant Surgeon, Government Hospital, Coonoor. Exh. B5 is the preliminary survey report of R. Devanathan, Surveyor who was appointed by the opposite party. He has found debris all over and there was no trace of the building since the entire ground floor and the first floor of the building were razed to the ground. There is therefore no doubt that there had been a fire accident on the night of 29/ 30.12.89 and the entire building of the complainant has been reduced to ashes.
7. The cause of the accident is not known and the police investigation is still pending. It is averred in the counter statement filed by the opposite party that it is not an accidental fire and that in view of the fact that the police has not been completed their investigation, the claim could not be settled. The policy covers fire, burglary explosion etc., there is nothing to show that the fire was anything but acciden
