IMPORTANT POINT
Appeal – It is mandate provision that while considering the appeal grounds, the grounds which are not mentioned in repudiation letter cannot be discussed and considered at the stage of appeal.

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 17.10.2018 passed by the learned District Consumer Disputes Redressal Forum, Dehradun (hereinafter to be referred as the District Commission) in consumer complaint No. 50 of 2013 styled as M/s Negi Digital and Anr. Vs. United India Insurance Co. Ltd., wherein and whereby the complaint was allowed.

2. The facts giving rise to the present appeal, in brief, are as such that the complainant took a policy of Standard Fire and Special Perils Policy from the opposite party vide policy No. 020500/12/11/1200000044 for the year 2011-2012, but due to excessive rain flood occurred in Mohabbewala due to which boundary wall of the property of the complainant collapsed due to which one of the passerby also succumbed to injury. The complainant made a claim with the opposite party on dated 01.08.2011 and gave all the information as requested by the opposite party alongwith necessary forms required. The surveyor of the opposite party inspected the property and submitted the report on dated 11.02.2012 and in the said report of the surveyor has specifically stated that the excessive rain and over flow of water was the cause of loss to the insured property. The surveyor has submitted the loss report to the tune of Rs.4,86,340/-. Thereafter, the complainant was called upon to submit the bills for the repair of the boundary wall, therefore, the complainant submitted all the necessary documents as requested by the opposite party. But suddenly the complainant received a letter on dated 21.09.2012 from the opposite party that the claim of the complainant was rejected on the grounds that the side wall of the compound area is not covered by the policy and the cause of loss is excessive rain and water accumulation which is not an insured peril. The complainant immediately sent his reply stating that the boundary wall always is a part of the building, secondly flood is the water upon the land which is not normally covered by the water inspite of the follow up by the complainant. Again the complainant received a registered letter on 22.10.2012. Thus, the insurance company was trying to misinterpret the word water accumulation whereas the actual word used by the surveyor in his report is overflow of water and the overflow of water upon the land is caused only in the situation of floods. Another reason taken up by the opposite party for rejecting the claim is that the boundary wall does not fall within the definition of property. But in the common sense when the property is insured, it is the boundary wall in the property within the boundary wall, the walls of the property are not taken up separately for the insurance, the complete property including the boundary wall falls within the insurance policy. In such circumstances, the opposite party has no right to reject the claim of the complainant. By rejecting the claim, the opposite party has made deficiency in service and due to the act of the opposite party, the complainant has suffered the financial loss to the tune of Rs.5 Lacs alongwith mental harassment and hardship to the tune of Rs.1 Lac. Hence, the complaint should be allowed.

3. The opposite party – Insurance Company has submitted its written statement and admitted that the property in question was insured with the answering opposite party. On getting information about the loss in the insured property, the answering opposite party appointed the Surveyor, who assessed the loss at Rs.4,86,340/-, but the payment was advised to be made as per the terms and conditions of the policy. But after scrutiny of the claim, it was found that the claim is not tenable, as the boundary wall was not covered by the policy, hence the claim was rightfully repudiated. It is further submitted that the insurer has not taken extra premium from the complainant for coverage of the same. As per peril in the standard Fire