AI Structured Summary
Not yet generated for this judgment
Judgment
According to the Respondents/Complainants, they purchased a Householders Insurance Policy No.350100/48/08/32/0000287 from the Petitioner/Insurance Company by paying a premium amount of Rs.3,153/-, valid for the period 17.11.2008 to 16.11.2009. The Policy, besides other risks, also covered risk of loss under Section 2- burglary and housebreaking including larceny and theft and under Section 3- all risks (jewellery and valuables). The insured value of the items covered as per Section 2 was Rs.1,52,000/- and under Section 3 Rs.1,25,000/-, totalling to Rs.2,77,000/-. Their house 3018, Sector 35-D, Chandigarh was burgled on the night of 15.07.2009. They informed the Police about the theft and an FIR No.188 dated 15.07.2009 was registered. On receiving information, the Insurance Company appointed M/s Surya Surveyors who visited the premises on 15.07.2009. According to the Complainants, they extended all cooperation and handed over necessary documents to the Surveyor on his visit to the house. The Police, after due investigation reported the burglary as "Untraced" on 07.12.2009. The Judicial Magistrate also passed an order on 15.04.2010 declaring the items as "Untraced." The Complainants alleged that no action was taken by the Petitioner/Insurance Company on the indifferent attitude of the Surveyor and their employees. Their claim of Rs.2,01,000/- was reduced by the Surveyor and the Insurance Company to a paltry sum of Rs.25,200/-, without assigning any reasons. The Petitioner Company insisted on either accepting the amount or else close the file. The Complainants, therefore, filed a case in the District Forum to direct the Respondent/Insurance Company to
"(i) Release the claim amount of Rs.2,01,000/-
(ii) Interest at the rate of 12% from the date of incident of theft i.e. 15/07/2009 Compensation amounting to Rs.20,000/- for the harassment and mental agony suffered at the hands of the Respondents and
The cost of litigation amounting to Rs.10,000/- being incurred bythe complainants."
The Petitioner/Opposite Party contested the case. They contended that on receipt intimation, M/s Surya Surveyor was deputed by them for assessment of loss caused due to theft. The Surveyor visited the Complainants' house and took necessary photographs and requested the Complainants to submit the claim form, FIR and details of articles stolen. The Opposite Party contended that the Complainants sought compensation for gold articles which were not even insured under the Policy. Most of the gold items were kept by the insured in the safe of HDFC Bank. Only gold articles of daily use which were kept in the house were insured. As per Section 3 of the Policy, jewellery amounting to Rs.1,25,000/- was covered, whereas the Complainants claimed Rs.2,01,000/-. The Opposite Party, vide letter dated 16.12.2010, informed the Complainants about the settlement of the claim for Rs.25,200/- as per the Surveyor's report and therefore sought dismissal of the Complaint.
The District Forum, after hearing Complainant No.1 in person and learned Counsel for Opposite Party and perusing the record, relying on the Surveyor's report, partly accepted the Complaint. The Opposite Party was directed to pay the Complainants Rs.25,200/- as assessed by the Surveyor, within one month from the date of receipt of the certified copy of the order, failing which pay the awarded amount alongwith 9% p.a. interest from the date of filing of the present Complaint i.e. 07.02.2011, till the date of realization. In view of the peculiar circumstances of the case, the respective parties shall bear their own cost.
Aggrieved by the order of the District Forum, the Complainants filed an Appeal before the State Commission. The State Commission was of the considered opinion that the loss assessed by the Surveyor to the tune of Rs.25,200/- was without any justification, as he failed to establish that the stolen jewellery was not the same as was insured. The Surveyor had also not given any reasons as to how he came to the conclusion that the insured had kept the jewellery in the locker. The Surveyor failed to prove that the Complainants did not cooperate in the verification/inspection of the locker. The Opposite Party declined the claim of the Complainants by wrongly placing reliance on the Surveyor's report, which had reduced the claim on flimsy grounds without any proper justification. The Opposite Party was, therefore, held to be deficient in rendering service and the Appeal was allowed with cost. The order of the District Forum was modified in the following manner: -
"i) The Opposite Party shall pay to the appellants/complainants Rs.1,25,000/- towards settlement of his claim, by way of indemnification.
The Opposite Party shall also pay Rs.10,000/- ascompensation to the appellants/complainants, towards mental agony and physical harassment.
The Opposite Party is further directed to pay Rs.5,000/- as costs of litigation to the appellants/complainants."
Not satisfied with the order of the State Commission, the Petitioner/Insurance Company filed the present Revision Petition before this Commission.
Heard the learned Counsels for the Parties and carefully perused the record. Brief facts of the case are that the Complainants purchased a Householders Insurance Policy from the Opposite Party/Insurance Company on payment of Rs.3,153/- towards premium amount, valid from 17.11.2008 to 16.11.2009. Burglary took place in the house of the Complainants on the night of 15.07.2009. The Complainants immediately informed the Police about the incident and an FIR No.188 dated 15.07.2009 was registered. The Opposite Party/Insurance Company was also informed of the same. The Petitioner/Insurance Company deputed M/s Surya Surveyors for inspection and assessment of loss. Representatives of the Surveyor inspected the burgled house and the Complainants handed over all the necessary records/documents. The items claimed to have been stolen were declared untraced by both the Police and the Judicial Magistrate. Having provided all the documents sought by the Opposite Party/Insurance Company, the Complainants filed a claim for Rs.2,01,000/-, which was reduced by the Insurance Company to Rs.25,200/- based on the report of the Surveyor. The Complainants having not got the required relief, filed a Complaint before the District Forum. The District Forum partly allowed the Complaint and the State Commission allowed the Appeal with cost and modified the order of the District Forum.
Learned Counsel for the Petitioner/Insurance Company submitted that the claim of the Complainants was settled for Rs.25,200/- based on the survey report, vide letter dated 16.12.2010. It was submitted that according to Section 3 of the insurance policy, jewellery amounting to Rs.1,25,000/- was covered under the Policy, whereas the Complainants had claimed an amount of Rs.2,01,000/-, which was not admissible. It was further submitted that the Complainants claimed the loss of five gold chains, whereas only two gold chains were covered under the 'Policy.
Learned Counsel for the Respondents/Complainants contended that the Surveyor had reduced the claim to Rs.25,200/- without any proper justification. Surveyor had wrongly reduced the claim on the ground that the Complainants failed to produce receipts/bills of the stolen items, whereas all information regarding the value and weight of the insured items had already been given at the time of issuance of the Policy.
As per the report of the Surveyor dated 20.10.2010, theft did take place in the insured premises of the Complainants. The Police as well as the Petitioner/Insurance Company were duly informed. The Police after investigation recorded the items as untraced as also confirmed by the Judicial Magistrate. The Complainants had taken an insurance policy for all risks of jewellery and valuables to the tune of Rs.1,25,000/-. The report of the Surveyor formed the basis of settlement of the claim. The District Forum held that Surveyor's report was an important document and could not be brushed aside while the State Commission held that the Surveyor wrongly reduced the claim of the Complainants on flimsy grounds without any proper justification.
The Opposite Party/Insurance Company on the basis of the report of the Surveyor reduced the claim of the Respondents/Complainants from Rs.2,01,000/- to Rs.25,000/- only. The Insurance Company as well as the District Forum heavily relied on the report of the Surveyor. We have carefully gone through the Surveyor's report. Surveyor in his report had mentioned that Mr. Kuldip Singh was a retired government servant. He purchased the house 30 years back and had been taking insurance regularly. There was theft at the residence of the Complainants on 15.07.2009 and Surveyor confirmed it to be a genuine case. There was sufficient evidence to confirm that the miscreants entered the house with the purpose of theft. The Police authorities have also registered the incident under Section 380 of the IPC. According to the Surveyor, the incident fell within the term of risk "All risks for jewellery and valuables" as per insurance policy.
The Surveyor noted that proper support and complete information was not provided by the Complainants. However, in the same report, the Surveyor also stated that the insured did submit the documents and information, though on a piecemeal basis. As and when the Surveyor sought additional information, the Complainants did provide the same. The Surveyor also mentioned that the Complainants also filed reply to the detailed questionnaire sent by him. The Surveyor in his report had also stated that the Insurance Policy was taken only for the articles of jewellery which were in daily use or kept in the house. If the insured items related only to those kept in the house, why was the Surveyor harping on the issue of non-opening of locker. The State Commission also observed that the Surveyor had not given any reason as to how he came to the conclusion that the Complainants had kept the insured jewellery in the locker. Furthermore, he failed to establish that he had asked the Complainants for the verification/inspection of the locker and the same was not agreed to. The Complainants filed an FIR with the Police and also submitted their claim for 8 jewellery items apart from cash. Most of the items claimed to have been lost had not been allowed by the Surveyor on one pretext or the other. The State Commission observed "Furthermore the Surveyor disallowed the claim, on the ground, that the loss did not fall within the scope of subject matter 'insured.' The insured had other uninsured jewellery items kept in the locker. Thus the Surveyor was wrong in coming to the conclusion that all the articles mentioned, in the FIR, were not stolen." The State Commission further observed that "the Surveyor wrongly reduced the claim of the complainants on the ground that they had failed to produce receipts/bills of the stolen items, whereas, all the information regarding the value and weight of the insured items had already been given at the time of issuance of policy."
From the above it is seen that the survey report seems to be a bundle of contradictions. Though information was provided to the Surveyor as and when sought, the Surveyor wrongly concluded lack of cooperation and non-furnishing of certain documents by the Complainants. He also recorded their non-cooperation in opening of the locker, which he could not substantiate with cogent evidence. The Surveyor in his report gave skewed reasoning to deny compensation for loss on several items.
The State Commission rightly held "that the Opposite Party declined the claim of the complainants by wrongly placing reliance on the Surveyor report, who had reduced the claim on flimsy grounds without any proper justification. However, this fact cannot be denied that the number of stolen items, mentioned in the FIR, was more than the number of insured items and the complainants wrongly claimed a sum of Rs.2,01,000/-, whereas as per the policy he was only entitled to a sum of Rs.1,25,000/-, (the insured amount) by way of indemnification for the loss."
In view of the above, the Revision Petition is dismissed and Petitioner/Insurance Company is directed to pay to the Respondents/Complainants Rs.1,25,000/- towards settlement of claim alongwith interest @ 6% p.a. from the date of filing the Complaint before the District Forum till realization, within eight weeks from the date of passing of this order. There shall be no order as to cost.