IMPORTANT POINT
Estoppel - Once the Complainant accepted the claim in full & final settlement, the Complainant by application of estoppel cannot go back on its act of acceptance of claim full & final settlement, they are stopped from claiming any further amount.

ORDER

Padma Pandey, Member—In brief, the facts necessary for the disposal of the instant Consumer Complaint are the Complainant works for the livelihood by virtue of being engaged in Export business and for the said purpose, had taken insurance cover from the Opposite Parties from time to time. The present case relates to ECGC Policy No. SCR 0320000171 for the period 01.09.2015 to 31.08.2016 for a cover of upto Rs.12 crores issued by the Chandigarh office of ECGC Ltd. (Policy Annexure C-1). It has been alleged that during the ordinary course of business, the Complainant developed business of export of ladies Suits, Sarees, Shoes and artificial jewellery with a Buyer M/s Diya By RFL Ltd., U.K (earlier known as M/s Rani Fashion). The volume of the business touched to the height of crores of rupees every year. The complainant effected shipments as per buyers order, but the last shipments went into default for which the claim was raised. Several emails were sent to the Buyer reminding/requesting for payments, but no reply was received nor was any payment received. In this manner, a default occurred giving rise to a claim under the Policy issued by the Opposite Party No.1 (details of the default Annexure C-2). This led to Claims being filed with the Opposite Parties on 28.07.2016, as per policy terms and conditions (Claim Form Annexure C-3). The said claim was processed by the Opposite Parties, at their highest levels and ultimately, were numbered as Claim No. 22350 (Bank of India) and Claim No. 22351 (Axis Bank). After a long and protracted investigation/ queries, the two claims were partially allowed as per communications dated 31.03.2017 from the Opposite Party No.1. Since the claim was partly settled, less than the full claimed amount, the complainant wrote to the Opposite Parties vide e -mail date d 22.4.2017 (Annexure C-6), which was replied by the Opposite Parties vide their e-mail dated 24.4.2017 (Annexure C-7) intimating that they had deducted Rs.52,25,800/- (GBP 53000) by giving a narration “Less further Advance received-1st subsequent advance received, from buyer”. According to the Complainant, such a deduction was not as per the policy terms and conditions. Alleging that the aforesaid acts amount to deficiency in service and unfair trade practice on the part of the Opposite Parties, the Complainant has preferred the instant Consumer Complaint.

2. Notice of the complaint was sent to Opposite Parties seeking their version of the case.

3. Opposite Parties No.1 to 3 filed their joint reply, inter alia, admitting the basic facts of the case. It has been pleaded that that Complainant had obtained Shipment Comprehensive Risks Policy (for short, “SCR Policy”) from them for covering its export credit risk against insured buyers subject to strict compliance of the terms and conditions of the SCR Policy & Policy Bond, unless especially excused in writing by the Opposite Parties. It has been further pleaded that the claim amounting to Rs.3,63,17,589/- was paid to the Complainant as a special case by condoning special lapses and deficiencies in complying with the policy conditions and which was accepted as full & final settlement by the Complainant on 30.03.2017. Therefore, the deduction made was reviewed on representations of the Complainant and it was found that the additional amount is not at all payable as the Complainant failed to initiate legal action against the Buyer in violation of Clause 7 and 23 of the Policy Bond despite repeated reminders vide various letters from the answering Opposite Parties. It has been submitted that the claim was settled in good faith that the Complainant would comply with the terms and conditions of the policy bond, but the Complainant after receipt of claim failed to adhere the same by not taking legal action against the buyer. Pleading that there was no deficiency in service or unfair trade practice on their part, a prayer has been made for dismissal of the complaint.

4. Opposite Party No.4 in