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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
C. Viswanath, Presiding Member and Subhash Chandra, Member
Gopal Dikshit – Complainant
versus
United India Insurance
Company Ltd. – Opp. Party
Consumer Case No.2287 of 2017
Decided on 7.12.2022
Consumer Protection Act, 1986 – S. 21(a)(i) – [Consumer Protection Act, 2019 – S.58(1)(a)(i)] – Services – Insurance Policy – Repudiation of Claim Justified – Heavy rains – incident occurred – seepage of water was not named in the insured perils - not mentioned / covered in policy - Complainant alleged that the Surveyor as well as the Opposite Party ignored the report of the Meteorological Department, placed on record – On facts, perusal of the Meteorological Report dated 25th August, 2016, which mentioned that at 12.00 hrs, there was 0.3 mm rain and at 15.00 hrs, there was 0.5 mm rain - The Complainant, however, in the Consumer Complaint alleged that the loss was caused during 25th to 31st August, 2016, which appears to be an afterthought – On facts, Meteorological Report dated 25th to 31st August, 2016 filed by the Complainant. Nowhere in the report is it mentioned that there was heavy rains on 25th August, 2016. The Policy covered the risk due to flood and inundation, amongst others. Meteorological Report does not show that there was such heavy rain in the area leading to flooding. Admittedly, the loss was caused due to seepage. The certificate of International Consultants and Technocrats Pvt. Ltd. dated 06.09.2016 as well as certificate issued by Unique Consulting Engineers dated 07.09.2016 make it abundantly clear that there was continuous ingress of seepage water into the foundation and basement, which corroded the reinforcement steel, making it weaker to sustain loads, especially the lateral loads. As seepage of water was not named in the insured perils, the Opposite Party rightly repudiated the claim – Complaint dismissed. [Paras 14 to 18].
Result: Complaint dismissed.
ORDER
The present Complaint is filed under Section 21(a)(1) of the Consumer Protection Act, 1986.
2. The Complainant is the owner of the premises situated at 50, Ishwar Nagar, Mathura road, New Delhi- 110065. The said premises had Basement, Ground Floor, First Floor and Second Floor. The entire building was insured with the Opposite Party, vide House Holder Insurance Policy No.2219042615P115431073 for Rs.1.50 crores.
3. The case of the Complainant is that due to the heavy downpour in New Delhi from 25.08.2016 to 31.08.2016, the house of the Complainant was flooded. The Complainant was outside Delhi from 24.08.2016 to 29.08.2016 and upon his return he found that the basement was flooded with water and the furniture, fittings, almirahs, books and other goods lying in the basement were completely damaged. The Complainant deployed booster pump on 30.08.2016 to remove water from the basement to avoid further damage. The entire flood water, however, could not be removed. The Surveyor, Shri Akash Chopra, visited the site on 03.09.2016 and inspected the basement.
4. The Complainant contacted Ms. Indu Singh, official of the Opposite Party telephonically to enquire about the survey conducted by Mr. Akash Chopra. She informed that the Survey Report was not proper and therefore, she deputed another Surveyor Mr. R.K. Singhla was deputed to visit the premises and reassess the damage. The Complainant was, however, not provided with any preliminary Survey Report. The second Surveyor, Mr. R.K. Singhla visited the premises of the Complainant and conducted the Survey. The Complainant sought opinion of two structural Engineers i.e. International Consultants & Technocrats Pvt. Ltd. dated 06.09.2016 and Unique Consultant Engineers dated 07.09.2016 regarding the safety of the premises. The opinion given by both the Structural Engineers indicated that the building was no more liveable and had become dangerous. Further, it was stated that the premises had to be vacated immediately and should be demolished and rebuilt.
5. On 10.09.2016, the Complainant again contacted Ms. Indu Singh to know the outcome of the Survey. She again informed the Complainant that the report was not proper and further asked the Complainant to visit her office on 12.09.2016 to clarify certain points. During the visit, Ms. Indu Singh informed the Complainant that due to the word “seepage” in the Survey Reports, the Complainant cannot claim benefit of the Insurance. On 23.11.2016, the Complainant received a letter from the Opposite Party repudiating the claim of the Complainant on the ground that the damage caused to the building was due to continuous seepage of water from the basement and since the seepage of water was not one of the named perils, the loss/damage was not indemnifiable under the Policy. Aggrieved by repudiation of claim of the Complainant, the Complainant approached this Commission with following prayer:—
“(a) Declare that the opposite party has committed an unfair trade practice and to direct them to discontinue the unfair trade practice;
(b) Declare that the services of the opposite parties are deficient and direct them to remove the deficiency of service;
(c) direct the opposite party to pay a sum of Rs1.5 crore as insured amount
(d) to pay interest @ 18% p.a on the amount w.e.f. 03.09.2016 till the date of realization;
(e) to pay the compensation tune to the Rs.10 Lakh for harassment, mental agony, torture as the cost of reconstruction is much more as set out in the complaint;
(f) to pay interest @ 12% p.a. on the sum of Rs.10 Lakh from 03.09.2016 till the date of realization and;
(g) may pass such other orders in the interest of justice.”
6. The Opposite Party resisted the Complaint by filing the Written Statement stating that there was no cause of action against the Opposite Party as per the Preliminary Report submitted on 06.09.2016 and the Final Survey Report dated 18.10.2016. Both the reports attributed the cause of loss to seepage of water
Repudiation - Seepage of water was not named in the insured perils, the Opposite Party rightly repudiated the claim.
Insurance – In absence of any substantive grounds to question findings of first survey, belated reassessment conducted by Insurance Company is not proper.
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