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MADHYA PRADESH STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BHOPAL
S.D. AGARWAL, J.
Shree Balaji Borewells – Appellant
Versus
Oriental Insurance Co. Ltd. and Others – Respondents
Consumer Complaint No. 30 of 2013
Decided On : 17-07-2018
Advocate Appeared:
For the Appellant : Mr. Yash Vidyarthi.
For the Respondent: Mr. Mohan Chouksey.
The insurance company was found guilty of deficiency in service for not mentioning 'BINA' in the policy, but the insured amount could not be awarded due to the policy not covering 'BINA'. The complainant was compensated with a sum of Rs. 20,00,000.
Headnote:
Insurance Claim - Deficiency in Service - Consumer Protection Act - [FACT OF THE CASE] The complainant filed a complaint alleging deficiency in service by the insurance company for repudiating the claim of his Hydraulic Crawler seeking an insurance claim. The insurance company repudiated the claim on the ground that the incident occurred at a place not covered under the policy. [FINDING OF THE COURT] The court found that the insurance company committed deficiency in service by not mentioning the place 'BINA' in the policy, but since the policy did not cover 'BINA', the insured amount could not be awarded. The court ordered the insurance company to compensate the complainant with a sum of Rs. 20,00,000. [ISSUES] Jurisdiction of the Commission, Deficiency in service, Relief. [RATIO DECIDENDI] The insurance company was found guilty of deficiency in service for not mentioning 'BINA' in the policy, but the insured amount could not be awarded due to the policy not covering 'BINA'. The complainant was compensated with a sum of Rs. 20,00,000. [FINAL DECISION] The court ordered the insurance company to compensate the complainant with a sum of Rs. 20,00,000 and pay Rs. 5,000 as costs of the proceedings.
ORDER :
1. This is a complaint filed by the complainant alleging deficiency in service on the part of the opposite party repudiating the claim of his Hydraulic Crawler seeking a sum of Rs. 54,86,651 as insurance claim, with Rs. 23,86,695 as interest, Rs. 2,00,000 compensation along with litigation expenses and any other relief which the Commission deems fit.
2. Brief facts of the case as narrated by the complainant are that the complainant is engaged in the business of Earth work and Excavation job as a contractor and for that he purchased an Atlas Copco Hydraulic Crawler Drilling Machine (hereinafter referred as ‘machine’) in the year 2008. For the purpose of insurance of said machine complainant contacted Mr. Santosh Jothe, an authorized and licensed non-life insurance agent of the opposite party Insurance Company engaged in the business of providing insurance cover, who took all the information required for Risk Management & Risk Analysis and then suggested to cover the said machine under Contractor Plant & Machinery Policy. Thereafter he filled the proposal form, on the basis of proposal form, opposite party No. 3 quoted premium rate and the same was paid by the complainant. The opposite party No. 3 issued the policy namely “Contractor Plant and Machinery Floater Policy”. It is alleged that though the opposite party No. 3 issued the policy mentioning therein as per the terms, conditions, warranties and endorsements attached herewith but the opposite parties did not attach any documents relating to terms, conditions, warranties and endorsements. Only computerized policy schedule was delivered. It is further stated that, the said machine was working at Bina Power Plant of M/s. Jaiprakash Associates Ltd. While working on 14.1.2011, due to short circuit, said machine caught fire and got burnt completely. The incident was immediately reported to police and the opposite parties-Insurance Company. On receipt of intimation, the opposite party No. 3 deputed Mr. Deepak Pathak for spot/preliminary inspection, who inspected the machine. Subsequently, the complainant submitted claim form with estimate of loss and other necessary documents. On receipt of claim and documents, the opposite party appointed M/s. R. L. Agrawal Surveyors Pvt. Ltd. for final survey/inspection and assessment of loss. Surveyor Shri O. P. Agrawal visited the site and inspected the damaged machine, thereafter the complainant was asked to submit few more documents.” On receipt of documents Shri O.P. Agrawal sent an e-mail with an attachment mentioning therein the provisional assessment of loss for Rs. 49,52,462 and requested the complainant to give their consent. That on receipt of e-mail, the complainant did not agree with the proposal and requested that calculation of depreciation is on higher side and gave his calculation of depreciation with supporting documents, which was accepted by Shri O.P. Agrawal and he submitted his final report dated 25.6.2011 assessing the loss to the tune of Rs. 54,86,651 as full and final settlement.
3. After final survey report, again opposite party No. 3 wanted few documents vide their letter dated 14.7.2011, thereafter on various correspondences and approaches, the complainant was asked to wait for positive response. Thereafter the opposite party No. 3 vide their letter dated 28.3.2013 repudiated the claim. On receipt of repudiation letter, complainant provided one more chance to opposite parties to reconsider the claim by giving legal notices dated 22.4.2013 and 25.4.2013 through Advocate, which were replied by the opposite parties through their Advocate on 18.5.2013. The incorrect facts were stated in the reply by the opposite party which were contrary to the documents available in their file. It is alleged that Surveyor submitted his report on 25.6.2011 and till 28.3.2013 there was no response from any of the opposite parties, in spite of so many reminders in writing, telephonic conversations and personal visits. This shows non-pr
