IMPORTANT POINT
Insurance – In absence of requisite evidence from Complainant to support peril covered under policy, no liability can be fastened upon Insurer.

JUDGMENT

AVM J. Rajendra AVSM VSM (Retd.), Presiding Member.—This First Appeal has been filed by the Opposite Party under Section 19 of the Consumer Protection Act, 1986 (‘the Act’) against the State Consumer Disputes Redressal Commission, Himachal Pradesh (the State Commission) Order dated 26.02.2019 in CC No. 14 of 2016, wherein the Complaint was partly allowed.

2. As per the report of the Registry, there is a delay of 56 days in filing the present First Appeal. For the reasons stated in IA No. 6780/2019 is allowed and the delay is condoned.

3. For Convenience, the parties in the present case are being referred to as per the complaint before the State Commission. Ranjot Singh is identified as the Complainant and National Insurance Co. Ltd. is referred to as the Opposite Party / Insurer (OP).

4. Brief facts of the case, as per the Complainant, are that the Complainant and his brothers purchased a piece of land comprising Khasra No. 1198/1083/768/244/1, measuring 04 Biswa at Mauja Kotali, Tehsil Rajgarh, District Sirmour, Himachal Pradesh. Subsequently, based on an oral family settlement, the Complainant’s brothers relinquished their respective shares/rights in the said plot in favour of the Complainant. Following this settlement, he constructed a three-storied residential building on the aforesaid property. The Complainant obtained a Standard Fire & Special Perils Policy from the Opposite Party (OP), valid from 04.09.2008 to 03.09.2023. The original insurance policy was obtained on 04.09.2008 for sum assured of Rs.6,00,000 covering one floor of the said building. Upon completion of the construction of 2nd floor in 2014, he approached the OP for enhancement of the insurance coverage. Consequently, the insurance cover was enhanced to Rs.60,00,000 from 15.09.2014. This enhancement of the sum insured was affected after a thorough spot visit and verification by the authorized agent of the OP. On 19.01.2015 and 20.01.2015, the building in question suffered extensive damage due to heavy rainfall, vibrations caused by vehicular traffic on the adjacent road and the diversion of water from the main road. The Complainant duly notified and filed a claim with OP for the damages incurred. However, the OP failed to settle the claim and thereby committed deficiency in service, causing financial hardship and distress to the Complainant.

5. On being issued notice, the OP filed its written version before the State Commission and opposed the complaint and contended that the damage caused by heavy rainfall, vibrations from vehicular traffic on the road etc. do not fall within the ambit of the insurance policy terms and thus the coverage. OP acknowledged that the residential house insurance policy was issued to the Complainant initially for sum assured of Rs.6,00,000, which was subsequently enhanced to Rs.60,00,000 on 15.09.2014, as per the Complainant’s request. The OP, however, contended that the damage to the building was primarily caused due to use of inferior quality construction materials rather than any of the covered perils. The OP further alleged that the enhanced insurance policy amount was obtained by the Complainant through misrepresentation of facts. OP brought out that the Sub-Divisional Officer (Civil) cum Sub-Divisional Magistrate directed the Complainant to demolish the residential building in question as it posed a danger to the general public, vide order dated 29.09.2014. The OP contended further that the residential building is jointly owned by him with two other brothers, contrary to the claim of exclusive ownership. Also there was 45 days delay by the complainant in providing intimation regarding the damage to the insurance company, which constitutes a breach of policy conditions. Subsequently, OP appointed Shri Rakesh Kapoor, surveyor to assess the damages and the claim, and he submitted a comprehensive report on 09.10.2015. The surveyor cum loss assessor professionally evaluated the damages and assessed that Rs.2,09,979 as his l