The assessment of loss under an insurance policy must be supported by credible evidence, and the regulatory provisions must be considered in reaching a decision.

ORDER

Mrs. Rekha Gupta, Member—Facts of the case as per the Respondent/Complainant are that Respondent/Complainant was the owner of a medicine shop in the name of New Shubam Medical Store in Raipur City. The respondent obtained fire insurance policy No. 321000/11/05/3100001335 from the Petitioner/Opposite Party valid for the period from 30.1.2006 to 29.1.2007. In the said policy medicines worth Rs. 7,50,000 covering all kinds of medicines boxes, loose and covered and also furniture and fixtures such as inverter, fridge, meter glass for Rs. 1,75,000 were covered.

2. Respondent stated that there was a sudden fire in his shop on 16.11.2006 and information was reported to Police Station, Lal Bagh. In his report to the police respondent alleged to have suffered a loss of Rs. 10,00,000 in his shop. He also informed the agent and office of the petitioner telephonically as well as in writing about the fire incident in medical store on 16.11.2006. The petitioner deputed Mr. R.K. Jain surveyor who inspected the spot and gathered information from the respondent. The petitioner appointed another surveyor Mr. Radhey Shyam Gupta, Chartered Account.

3. Respondent further stated that he was income tax as well as sales tax payer and in this regard Sh. Dashore, Consultant handles his accounts, which the latter on maintains on his computer. The insurance policy was issued only after the insurance agent and an officer had carried out an extensive inspection of the goods, furniture and other items which were to insured. The information about fire in the shop of the respondent was give by his neighbour Kishore Chaudhry. The police prepared the panchnama about the damage caused to the medical store and assessed the loss of Rs. 9,34,000. In the said incident, the entire stock of medicines and furniture was destroyed and panes of the show case were broken. Packets and strips of medicines, bottles, injections, sales bill books and envelopes, etc. were totally destroyed. The documents supplied by the petitioner to the respondent were those lying with the tax consultant Mr. Kishoreji for accounting purposes. The respondent had also informed the fire brigade of Municipality about the fire and they had issued a certificate in this regard.

4. The petitioner's surveyor Mr. R.K. Jain asked the respondent to pull down the broken glass from the frame but his neighbour Kishore Chaudhry raised objection and the surveyor took the photographs of the site as such. The earlier photographs taken by the surveyor were wrong. Surveyor took the respondent's signature on blank papers. The respondent demanded documents from the petitioner but the survey report and other documents were not supplied by the petitioner and by the surveyor Mr. Jain. The petitioner appointed another surveyor Mr. Radhey Shayam Gupta, C.A. without informing the respondent and without any reason. Mr. Gupta made enquiries on 17.1.2007 in presence of Rajesh Savle and Rama Bhai about the incident. The respondent supplied all the documents and information to the said surveyor.

5. Respondent further stated that there was epidemic of bird flu and chikungunya in District Burhanpur during January to November, 2006 and for this reason the respondent had kept a stock of related medicines. His monthly sale and purchase amounted to Rs. 1,00,000. Between 1.4.2006 and 15.11.2006 medical store of the respondent purchase medicines worth Rs. 8,76,941 and had sales to the tune of Rs. 7,65,698. Respondent had filed the quarterly returns with the tax department from 1.4.2006 to 30.6.2006 and 1.7.2006 to 30.9.2006. He had also filed a copy of trading profit and loss account. The surveyor demanded certain documents from the respondent which were destroyed in the fire and as such he was unable to furnish the same. The details about the purchases made by the respondent and payments to the concerned parties was maintained in the sales-purchase register which had been supplied to the surveyor. He remained unemployed from the date