Insurance claims under consumer protection law require proper assessment of ownership and comprehensive loss quantification; Courts may remand for further consideration when factual disputes arise.

JUDGMENT

The petitioner is a Company engaged in the business of general insurance and this original petition is submitted challenging the orders passed by the Kerala State Consumer Disputes Redressal Commission and the National Consumer Disputes Redressal Commission, in the complaint submitted by the respondent herein and the appeal submitted by the petitioner, respectively.

2. The facts that led to the filing of this original petition are as follows: The petitioner issued a Standard Fire and Special Perils Policy, a copy of which is produced as Ext.P1, to the respondent herein, a busnesess establishment, in respect of its plywood/wood veneering factories, laminating factories, for Rupees ten crores. The said policy was valid from 01.01.2007 to 31.12.2007. Thereafter, to cover the risk of the respondent, the petitioner issued another Standard Fire and Special Perils Policy, as evidenced by Ext.P2, for a sum of Rs.9.5 Crores. The said policy was valid from 02.08.2007 to 01.08.2008. The policy was in respect of the stock held by the respondent, in its premises. The activity of the respondent was to deal with timbers and the processing of the same.

3. On 01.12.2007, at around 4.30 a.m., an incident of fire took place in the premises of the respondent company and consequently, the timber stocked in the premises was damaged substantially. The matter was immediately intimated to the petitioner and on the same day at 9.30 a.m. a spot surveyor conducted an inspection and Ext.P3 preliminary survey report relating to the fire affected building bearing No.BP/1-210, was submitted. Thereafter, a detailed survey was conducted in the matter, after referring to the documents maintained by the petitioner including stock register, purchase register and other documents etc. Ext.P4 is the survey report submitted by the surveyor deputed by the petitioner company.

4. In the survey report, it was found by the surveyor that, the building where the fire incident occurred, was possessed by M/s Kohinoor Saw Mills Ltd., which is the sister concern of the respondent and the said entity has already taken another policy for covering the risks for Rs.2,00,000/- (Ext.P5 is the policy). It was also suggested in Ext.P4 that, as per the trading account as on 30.11.2007 provided by the insured, the timber stock of the respondent was valued at Rs.57.47 lakhs, whereas, the value of the timber stocks in the affected building itself comes to Rs.1,33,28,822/-. Therefore, it was found that, the said stock was that of M/s.Kohinoor Saw Mills Ltd. only. Therefore, two options were suggested for calculating the loss; first option was by treating it as a claim in the policy issued to the respondent herein and the second option was in relation to the calculation, if the claim is considered in respect of the policy that issued to M/s.Kohinoor Saw Mills Ltd. The amount determined in respect of option one, which is applicable to the policy issued to the respondent was Rs.33,34,480.81, whereas, the amount determined as net loss, while considering the claim under the individual policy of M/s.Kohinoor Saw Mills Ltd. was Rs.2,37,047.97.

5. Based on the findings in the survey report, Ext.P6 communication was issued by the petitioner addressed to the respondent herein, wherein, the petitioner intimated that, the claim raised by the respondent cannot be entertained on the reason that, the building where the fire incident occurred, was occupied by M/s.Kohinoor Saw Mills Ltd. The finding in Ext.P6 was that, as on the 30.11.2007, the timber stock available at the premises of the respondent, which is revealed as per the stock register, was worth