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UTTARAKHAND STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Mr. D.K. Tyagi, H.J.S. and Mrs. Veena Sharma, Members
UNITED INDIA INSURANCE CO. LTD. - Appellant
Versus
MODERN HOSIERY STORE - Respondent
First Appeal No. 161 of 2010
Decided on : 02-08-2017
Consumer Protection Act - Insurance Claim - 1986 - [SHOPKEEPER'S INSURANCE POLICY, REPUDIATION OF CLAIM, SURVEYOR'S ASSESSMENT] - The court discussed the repudiation of the claim by the insurance company based on the failure of the insured to provide required documents and the surveyor's assessment that the insured did not incur any loss. The court found that the insurance company rightly repudiated the claim as the insured failed to provide the necessary documents and failed to prove the loss. The court set aside the previous judgments and dismissed the consumer complaint.
Fact of the Case:
The complainant suffered a loss due to flood damage to his shop and filed a consumer complaint against the insurance company for repudiating his claim. The District Forum allowed the complaint, directing the insurance company to pay the insured amount and damages. The insurance company appealed against the decision.
Finding of the Court:
The court found that the insurance company rightly repudiated the claim as the insured failed to provide the necessary documents and failed to prove the loss. The court set aside the previous judgments and dismissed the consumer complaint.
Issues: The main issues were the repudiation of the claim by the insurance company and the failure of the insured to provide required documents and prove the loss.
Ratio Decidendi: The court held that the insurance company rightly repudiated the claim as the insured failed to provide the necessary documents and failed to prove the loss.
Final Decision: The court allowed the appeal, set aside the previous judgments, and dismissed the consumer complaint.
ORDER
Veena Sharma, Member. - This appeal, under section 15 of the Consumer Protection Act, 1986, has been preferred by the appellant-opposite party against the order dated 07.04.2010 in consumer complaint No. 46 of 2009 passed by the Members of the District Forum, Haridwar whereby the Members allowed the consumer complaint and directed the opposite party to pay a sum of Rs. 3,50,000/- insured amount along with Rs. 5,000/- as damages to the complainant within a month from the date of order and also against the judgment and order dated 07.04.2010, in the same complaint, passed by the Chairman, District Forum, Haridwar, whereby the Chairman allowed the consumer complaint and directed the opposite party to pay an amount of Rs. 75,000/- to the complainant, within a month from the date of order.
2. Briefly stated the facts of the case, as mentioned in the consumer complaint are that the complainant Sh. Pranay Kumar had taken a Shopkeepers Insurance Policy from the opposite party-United India Insurance Co. Ltd. for the period from 19.02.2007 to 18.02.2008 with a policy No. 081500/48/06/34/00000331 and paid Rs. 3,440/- as premium. On 14.08.2007, flood water entered into complainant's shop and damaged the entire stock. Due to mud and sand, ready made garments, which were stored in complainant's shop, were damaged in the said flood. Due to which the complainant suffered a loss of Rs. 3,50,000/-. Local administration had inspected the spot and prepared a report about the loss of the complainant. After informing to the local administration, the complainant informed the opposite party. The opposite party appointed a Surveyor, Sh. Rajeev Gupta, who inspected/surveyed the complainant's shop and asked some documents/papers from the complainant, also made assessment and the complainant has provided all the required documents related to his compensation/business to the Surveyor. After fulfilling all the formalities by the complainant, the opposite party-Insurance Company did not settle the complainant's claim and repudiated the complainant's claim vide letter dated 26.12.2007. Thereafter, the complainant sent a registered notice dated 26.11.2008 through his counsel to the opposite party, which was replied by the opposite party vide letter dated 07.12.2008. Aggrieved by the repudiation of the claim, the complainant has filed a consumer complaint before the District Forum, Haridwar.
3. The opposite party-Insurance Company has filed written statement before the District Forum and has pleaded that the complainant had taken a Shopkeeper's Insurance Policy from the answering opposite party. It is denied that due to the said flood on 14.08.2007, the complainant suffered a loss of Rs. 3,50,000/-. The fact is that the complainant vide letter dated 27.08.2007 informed the answering opposite party about the incident. The answering opposite party appointed a Surveyor Sh. Rajeev Kumar Gupta for survey, who inspected and evaluate the loss and submitted his report with the answering opposite party on 18.11.2007 with the conclusion that the complainant did not get inspected his shop according to the terms and conditions of the policy. Insured has to inform the insurance company immediately, which was not done by the complainant. The damaged stock was not found in the said shop and the complainant was running his shop successfully. He has no loss due to any flood, as the proprietor Sh. Pranay Kumar accepted himself and stated in written that the damaged stock was stored in another safest place. The complainant has not filed any evidence about his loss, therefore, the complainant's claim was repudiated as per the norms and conditions of the insurance policy as "No Claim" on 26.12.2007. The consumer complaint is liable to be dismissed.
4. Learned Members of the District Forum, Haridwar on an appreciation of the material on record, allowed the consumer complaint vide impugned order dated 07.04.2010 in the above terms, whereas the Learned Chairman of the District F
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