The court emphasized the significance of a survey report in insurance claim disputes and affirmed that claims must align with properly assessed loss evaluations.

ORDER

PER BHARATKUMAR PA ND YA. MEMBER

1.The present appeal has been filed by the appellant/complainant against the order dated 15.12.2021 passed by the State Commission whereby State Commission partly allowed the consumer complaint allegedly without considering the important facts of the case. The brief facts of the case are that the appellant obtained a credit limit of Rs.40 lakhs from R-2/State Bank of India. In order to secure this loan amount, R-2 purchased insurance policy in the name of the appellant from R-1 SBI General Insurance Company for the period 05.12.2018 to 04.12.2019. Stocks of hosiery goods of the appellant covering the risk of Rs.54 lakhs was insured for which appellant paid a premium of Rs.13,383/-. On 06.02.2019 proprietor of the appellant company, when he had gone to his native village, came to know that at about 4.00 AM a fire had taken place in the factory premises. Two fire brigades IHGFEDCBA were used to douse the fire. The incident of fire was reported to the PS Meharban. Stock worth Rs.58,74,600/- was lying in the factory premises at the time of incident. Copy of purchase stock report, sale stock report and pending stock report for the period from 01.04.2019 to 05.02.2019 was supplied, along with claim form, to R-1 insurance company. Stock statement was regularly supplied by the appellant to the R-2 bank and from the latest stock statement it was clear that at the time of fire incident, stock was more than the insurance amount i.e. Rs.54 lakhs. A surveyor was appointed by R-1 insurer to assess the loss and all the requisite documents as required by the surveyor were supplied by the appellant. Surveyor also visited the site of incident on a number of occasions. No copy of survey report was supplied to the appellant and finally on 02.05.2019 an amount of Rs.18,61,699/- was transferred to the loan account of the appellant as full and final settlement of the claim. The transferred amount was short of Rs.35,38,301/- as was claimed by the appellant and no reason was provided for transfer of such reduced amount. Appellant wrote a letter to the R-1 objecting on the amount received as claim but no response was received from R-1 insurer.

2. Being aggrieved, appellant filed a complaint before the State Commission, Punjab against respondent no. 1/insurer and respondent no. 2/bank praying for payment of remaining balance amount of Rs.35,38,301/- along with cost of litigation and other expenses. The relevant portion of the order dated 15.12.2021 of the State Commission is reproduced below:DCBA 13 On the basis of assessment of surveyor the opposite party No. 1-Insurance Company credited Rs.18,61,699/- into loan account of the complainant out of net assessed loss to Rs. 18,64,489/- and communicated to the complainant vide email dated 27.04.2019, Ex.OP-1/4. However, the complainant vide his letter dated 06.05.2019 and again vide Ex.OP-1/6 received on dated 24.07.2019 requested to pay the balance claim. The opposite party No.1-lnsurance Company vide their letter dated 01.08.2019, Ex. OP-1/7 stated "that said claim was surveyed by IRDA licensed surveyor and claim was settled based on survey alongwith physical verification & survey report issued by them." However, vide e-mail dated 22.04.2019, the opposite party directed the complainant to submit Discharge Voucher duly signed and stamped. Neither the copy of the survey report was sent to the complainant nor any assessed amount was mentioned in the said email. Therefore, the plea of the opposite party No. 1/lnsurance Company that the complainant has signed the discharge voucher as full and final is not tenable. As per IRDAI guidelines, the opposite party No. 1/lnsurance Company was required to send a copy of survey repo