Rajeev Traders - Appellant
Versus
United India Insurance Co. Ltd. and another - Respondent
Decided On : 09/28/1991
Complaint Case No. 31/90
.
Result: Complaint dismissed.
IMPORTANT POINT
Where the Insurance Company after making investigations has reasonable grounds to doubt the genuineness of the claim, the non-payment of insurance amount under policy cannot be deemed.
S.K.M. Lodha, President• This complaint has been filed by M/s. Rajeev Traders through its Proprietor Mrs. Sobha Lodha having shop at Bajaj Khana, Kota against United India Insurance Co. and another(insurer) for recovery of Rs. 6,07,150/-. It is alleged by the complainant that insurance policy wasobt1ined by it for the period 6.11.1988to 5.11.1989. The risk coverage for the loss of goods was upto Rs. 4 lacs and the coverage for loss of money in safe/steel cupboard was upto Rs. 8,000/-. The complainant submitted photostat copy of the insurance policy No. 140604/57/1/ 137/89.
2. The communal riots broke out in Kota on 14.9.1989. The complainant's entire shop was burnt totally on 14.9.1989 at about 7.30 P.M. by miscreants. The loss was total which included all the records of the complainant. Thereafter curfew was imposed. The complainant informed the Sr. Divisional Manager(Opposite Party No.2) about the losses caused to the complainant in the riots where her entire shop was burnt to ashes. She lodged F.I.R. No. 195/89 on 19.9.1989. The complainant lodged a claim before the insurers. The documents and the information required by the insurers were submitted. Reminders were given by the complainant for early disposal of the claim. As the claim was not settled and the amount was not paid despite correspondence, she filed the complaint before the State Commission on 3.2.1990. Page 27 of the complaint is as under:-
"27. That the complainant submits the present claim as under:
(1) Loss of goods in riots Rs.4,00,000/-
(2) Loss of cash from cash box Rs.1,150/-
(3) Loss of business and turn
over on account of nonpayment
of the insurance amount@ Rs. 14,000/-
per month(Rs. 6.000/- for Interest.
Rs. 3,000/- for home expenditure) Rs.56000/-
(4) Compensation caused due to
(a) harassment of the complainant
in running from pillar to post for
the settlement of dues Rs.50,000
(b) mental agony caused due to
failure to make the payment Rs.50.000
(c) non-payment of insurance dues Rs. 50,000/-
Total Rs.6,07,150/-
It is, therefore, prayed that the claim of the complainant to the tune of Rs. 6,07,150/- may be allowed and the opposite parties may be directed to forthwith make the payment of the aforesaid amount in pursuance of the policy No. 140604/57/1/37/87 agency No. 301/SS. It is further prayed that till the claim is settled finally, the opposite parties may be directed to make the interim payment of the insurance amount to such extent this Hon'ble Commission thinks just and proper."
3. The opposite parties submitted an application under Section 34 of the Arbitration Act. The complainant submitted its reply. The State Commission dismissed the application under Section 34 of the Arbitration Act vide its order passed on 13.6.1990. The opposite parties(insurers) thereafter filed version of the case on 18.7,1990 contesting the claim. Various pleas were raised in it. Para 7 of the version of the case is as under:-
"7. That in para No.7 it is not disputed that the communal riots broke out in Kota on 14.9,1989. It may be stated that as admitted there is one shop. In this shop Shri Rajendra Lodha styling himself as proprietor of M/s. Sanjay Textiles and Smt. Sobha Lodha styling herself as proprietor of M/s. Rajeev Traders alleged to carry out business and got separate insurance policies' through Rajasthan Bank Ltd. Kota. This fact that both husband and wife were carrying business in separate names in the same shop(accommodation) was never disclosed to the Insurance Company, in the proposal form as well as in the claim form of the policy nor any proof of any tenancy of the shop has been furnished to the opposite parties. But it is not admitted that there has been a total loss including all the records of the complainant. Had the complete record of the complainant been burnt in the fire, he could not have been able to submit the bills obtained from various traders regarding purchase of the goods, many of them bear the seal of octroi authorities also, whic
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