A consumer complaint alleging deficiency in service regarding insurance claim deductions lacks merit when the claimant fails to disclose signed discharge vouchers in original pleadings and the insurer’s deductions are found to be contractually justified per the surveyor’s report and policy terms.

ORDER

JUSTICE SUDIP AHLUWALIA, MEMBER

The present Complaint has been filed under the Consumer Protection Act, 1986 alleging deficiency in service on the part of the Opposite Parties in relation to settlement of Insurance Claim arising out of fire loss suffered by the Complainant in its insured business premises.

2. The factual background, in brief, is that the Complainant is stated to be engaged in business of electronic goods and had obtained Standard Fire and Special Perils Policy bearing No. 51230011140100000067 from Opposite Party No.1 for the period 24.06.2014 to 23.06.2015 covering stock for an insured sum of Rs.1,75,00,000/-. During the intervening night of 17.04.2015 and 18.04.2015, a fire occurred in the insured premises resulting in damage, allegedly, to the entire stock. Immediate intimation thereof was furnished to the Insurer, whereafter claim processing was undertaken through appointment of Surveyors.

3. The grievance of the Complainant is that despite full cooperation and submission of all requisite records including Stock Statements, Invoices and Books of Account, the Insurer ultimately released only Rs.1,40,14,523/- after effecting deductions which, according to the Complainant, were unjustified and arbitrary. Aggrieved by the same, the present Complaint was filed in which directions against the Opposite Parties for payment of the Outstanding Claim Amount of Rs. 34,85,477/- along with interest including pendent lite interest @18% per annum from 13.04.2016 till realisation along with ancillary reliefs.

4. Notice was issued upon Opposite Party Nos. 1 and 2 who have filed their Written Statement and resisted the Complaint. They have denied all the material averments made by the Complainant. The Opposite Parties, in their Written Statement, have raised preliminary objections regarding maintainability of the Complaint and have denied any deficiency in service, contending that the claim of the Complainant was processed strictly in accordance with the terms and conditions of the Insurance Policy and on the basis of the assessment made by duly appointed licensed Surveyors. It is averred that immediately upon receipt of the intimation of fire, survey proceedings were initiated and necessary documents were called for from the Complainant, whereafter detailed scrutiny of stock records, invoices and other financial documents was undertaken before determining the admissible loss. The Opposite Parties have relied upon two levels of assessment - primary final survey by McLarens Insurance Surveyors & Loss Assessors India Pvt. Ltd. and then a review by a CA Assessor. They claim that the deduction was not arbitrary but mathematically structured. The Opposite Parties averred that the Surveyor assessment is binding unless rebutted.

5. The Opposite Parties submitted that after considering the survey findings and reassessment, the net payable amount was correctly quantified at Rs. 1,40,14,523/- after lawful deductions towards dead stock @ 5%, salvage, under-insurance @ 1.84% and Policy excess @ 5%, all of which, according to them, were contractually permissible and technically justified. It was averred that the Complainant has not technically rebutted why any specific deduction is illegal. It is further averred that the Complainant accepted the said amount without protest at the relevant stage and executed Discharge Vouchers in full and final settlement, thereby bringing the contractual claim to a complete closure. The Opposite Pa