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UTTARAKHAND STATE CONSUMER DISPUTES REDRESSAL COMMISSION, DEHRADUN
Kumkum Rani, Judicial Member-II and B.S. Manral, Member
Trilok Singh – Appellant
versus
The Branch Manager, National
Insurance Co. Ltd. and Anr. – Respondents
First Appeal No.174 of 2015
Decided on 2.1.2023
Consumer Protection Act, 1986 – Section 15[Consumer Protection Act, 2019 – Section 41] – Appeal – Services – Insurance – Repudiation of Claim – Justified – Consumer case not maintainable – against privity of the contract between the consumer and service provider - It is true that in absence of statement regarding sale and purchase during that financial year, it could not be presumed that what items had already been sold and what items in the shop were kept in the stock, which were burnt in the said fire occurrence. No G.S.T./VAT statement / returns and sales tax statement have been filed on behalf of the insured in order to show as to what items were actually kept in stock - Mere stock statement provided to the bank for loan purpose is not sufficient to access the actual loss – thus, the insured had not submitted any objection before the District Commission regarding the surveyor report stating on what ground it is not admissible in evidence and what is the cogent and reliable evidence contrary to the surveyor report – therefore, proper weightage should be given to the report of surveyor unless and until there is some facts to disprove it - It is also not proved that the appellant-complainant has ever informed the Bank about such change of his address for further correspondence - The appellant-complainant has neither clearly stated in the complaint nor in his appeal that on what date, he got the knowledge or when he demanded the account statement of his account on monthly basis from the Bank, nor filed any such documentary evidence to this effect. There is nothing on record to show that the petitioner was compelled by the respondent No. 1 or any official of the respondent No. 1 at any stage to settle the claim at lesser amount than made by him - It is also well settled that provisions of Consumer Protection Act, 1986 are not applicable as the appellant-complainant ceases as per the Act and the privity of the contract between the consumer and service provider, came at an end, the moment when the appellant-complainant has accepted the amount unconditionally – On facts, the appellant-complainant has not come with clean hands before the District Commission. There is also no deficiency in service on the part of the respondent No. 1, i.e. the insurance company – Appeal dismissed. [Paras 14 to 37]
Result: Appeal dismissed.
ORDER
Kumkum Rani, Judicial Member-II—This appeal under Section 15 of The Consumer Protection Act, 1986 has been directed against the judgment and order dated 14.07.2015 passed by the learned District Consumer Disputes Redressal Forum, Dehradun (hereinafter to be referred as the District Commission) in consumer complaint No. 456 of 2013 styled as Sh. Trilok Singh Vs. National Appeal No. 174 of 2015 Sh. Trilok Singh Vs. The Branch Manager, National Insurance Co. Ltd. and Anr. 02.01.2023 Insurance Co. Ltd. and others, wherein and whereby the complaint case was dismissed.
2. The facts giving rise to the appeal in hand, in brief, are as such that the shop of the complainant situated at Tuini, Dehradun was insured with the opposite party No. 1 for the period from 20.12.2011 o 19.12.2012. As per the complaint case, an electrical short circuiting took place in the insured shop in the midnight of dated 24/25.03.2012 at about 2:30 hours due to which fire spread and damaged all the contents lying in the insured’s shop. An intimation about fire loss was given to Naib Tehsildar by the insured; as there was no Fire Brigade Office in that area, the fire was extinguished by the local residents. The information about the incident was given to Police Station Tuini on dated 25.03.2012 as well as to the insurer immediately. It is also pleaded in the complaint that as per the assessment of Patwari / Naib Tehsildar, the total loss was of Rs. 5,71,000/-, copy thereof was given to the Branch Manager, National Insurance Co. Ld. After completing all the formalities, the insurer had quietly without informing deponent deposited only Rs. 1,55,835/- in deponent’s account and this fact was subsequently brought to the notice of the deponent by the State Bank of India, Tuini, Dehradun. It is further stated that the store was insured for Rs. Five Lakhs and instead of making the payment of Rs. Five Laksh, the company / insurer have paid only Rs. 1,55,835/- which is less by Rs. 3,44,165/-. The complainant approached the opposite party No. 1 for detail of the amount paid with the request to release the additional amount due the complainant but no satisfactory answer has been given to the complainant, hence, the complaint was filed with the prayer to pay the balance of the amount of Rs. 3,44,165/- alongwith legal expenses incurred in the notice / complaint case.
3. The Opposite Party No. 1 (the insurer) has averred in its written statement alleging that the store in question was insured with the answering Appeal No. 174 of 2015 Sh. Trilok Singh Vs. The Branch Manager, National Insurance Co. Ltd. and Anr. 02.01.2023 opposite party. The occurrence was also admitted by the insurer alleging there is no such documentary evidence filed in support of the assessment made by the Naib Tehsildar to the tune of Rs. 5,71,000/- in regard to the said incident; such assessment is the hearsay evidence which cannot be taken as authentic evidence; they are also not technically qualified to assess the losses, whereas the surveyor assessed the losses on the basis of documents, who is duly approved by IRDA. It is also admitted that the answering opposite party has deposited a sum of Rs. 1,55,835/- with the State Bank of India, Tuini Branch, Dehradun as per the terms and conditions of the policy on the basis of surveyor report, who is an independent authority to assess the losses. It is also pleaded that there exists no cause of action against the answering opposite party as the company has settled the claim of the complainant as per terms and conditions of the policy and as well as on the basis of survey report; as such there is no deficiency on the part of the answering opposite party and the complainant has not mentioned anywhere in his complaint that there is any deficiency on the part of the answering opposite party; the company has settled the claim of the complainant as per the report of the surveyor as full and final satisfaction of the loss and the company is not liable for an
(1) Privity of contract - It is also well settled that provisions of Consumer Protection Act, 1986 are not applicable as the appellant-complainant ceases as per the Act and the privity of the contrac....
Approved Surveyor’s assessment is necessary for a claim – There is no reason to reject Report of Surveyor Target Surveyor which inspire confidence of Bench.
Report of Surveyor which inspires confidence of Bench, cannot be rejected.
Insurance claims must be assessed justly, with surveyor reports not being conclusive and subject to scrutiny.
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