Pritam Pal, President:
1. This appeal by opposite party i.e. National Insurance Company Ltd. (hereinafter to be referred as OP) is directed against the order dated 23.7.2009 passed by Consumer Disputes Redressal Forum-II, U.T. Chandigarh (hereinafter to be referred as District Consumer Forum) whereby complaint filed by respondent Shri Dev Raj Sharma, a senior citizen (hereinafter to be referred as complainant) was allowed in the following terms:
âThe OP shall make the following payments to the complainant:
| (i) | To pay a sum of Rs. 23,500 for the loss suffered by the complainant in respect of damage to the house building and households articles i.e. Rs. 26,000 less loss caused to the beddings (taken as 50% of the combined loss assessed for both clothes and beddings) as per the Expert Report dated 23.9.2008 given by a professional valuer. |
| (ii) | A sum of Rs. 2,000 paid by the complainant to the valuer for making fair assessment of the loss. |
| (iii) | A sum of Rs. 10,000 as compensation for mental harassment, pain and agony caused to the complainant on account of non- settlement of insurance claim. |
| (iv) | A sum of Rs. 2,500 as litigation expenses. |
2. In nutshell, the facts culminating to the commencement of this appeal may be recapitulated thus:
The complainant purchased House-holders insurance policy No. 420200/48/08/360000120 from OP in respect of residential house No. 201, Sector 8, Panchkula along with the household articles in the house. The OP charged premium of Rs. 300 for covering any damage to the building for a sum of Rs. 10 lacs and Rs. 42.9 for fire and allied perils. The policy was valid for the period from 9.7.2008 to 8.7.2009. In the month of September, 2008, the complainant and his family were away to Delhi for a few days and when they returned on 21.9.2008 they found that heavy rains had caused severe damage to the building and also to wood work and beds, bedding and cloths, etc. The complainant then approached OP on 22.9.2008 and he was advised to get the loss surveyed from a qualified valuer. The complainant on the next day engaged a highly professional valuer who assessed the actual loss at Rs. 26,000. The complainant also paid Rs. 2,000 to the valuer as his fee. The OP also appointed its own Surveyor who clicked around a score of photographs of the damaged property. The OP accepted that there was loss to the building and furniture but rejected the claim on the plea that it was not covered under âStandard Fire and Special Perils Policyâ. Alleging deficiency in service on the part of OP, complainant filed complaint before the District Consumer Forum.
3. On the other hand, the case of OP before the District Forum was that the Surveyor deputed by it had examined the building in question and assessed the loss to the tune of Rs. 6,500 but the claim of the complainant was not recommended by the Surveyor on the ground that the damage to the building was caused due to seepage of water which did not fall under any of the insurance perils and this cause of loss was not covered under the insurance policy and the same thing was communicated to the complainant vide letter dated 15.12.2008 Thus, it was pleaded that there was no deficiency in service on the part of OP.
4. The learned District Consumer Forum after taking evidence of parties on the file and hearing them, allowed the complaint as indicted in the opening part of this judgment. This is how feeling aggrieved opposite party has come up in this appeal. On the first day of admission hearing when the appeal was placed before the Bench, both parties expressed their eagerness to advance arguments which we have heard and carefully gone through the file.
5. The only noticeable point of arguments raised on behalf of OP is that the claim of complainant was rightly repudiated as the same was not covered under the terms and conditions of the policy Annexure O-1 attached with the Memorandum of Appeal. In that he made reference to Clause (k) at page-5 of the said policy under âSpecial Exceptionsâ which reads as under:
The company shall not be liable in respect of:
(a) (a) xxxxxxxx
(b) (b) xxxxxx
(k) loss, destruction or damage caused by or arising from the leakage spilling or exploding of liquid oils or materials of a like nature or articles of a dangerous or damaging nature.
6. Thus, it was argued that the findings arrived at by the District Consumer Forum regarding liability of OP are contrary to the facts and law. At the fag end of his arguments, learned Counsel for OP also made reference to the report of Surveyor and then contended that the amount of compensation awarded by the District Forum is also on the higher side.
7. On the other hand, complainant appearing in person has repelled the aforesaid points of arguments raised on behalf of OP and then submitted that in spite of his writing letters and reminders, the terms and conditions which are now being relied upon were never sent to him and that he was also not party to any such terms of the policy. He further also argued that the report of Surveyor who assessed the amount of compensation was at the instance of OP.
8. We have given our thoughtful consideration to the rival contentions put forth on behalf of the parties and find that above points raised on behalf of OP are devoid of any merit, inasmuch as here in the instant case the factual matrix of the occurrence is an admitted fact. The only issue which was to be determined is as to whether the loss caused to the building and articles of the complainant was due to heavy rains for which same were insured vide policy No. 420200/48/08/3600000120. Admittedly there are corroborative reports of the expert of complainant and that of OP that damage to the building and articles was caused due to leakage from the roof and this all had happened because of heavy rains. During the course of arguments, it was fairly admitted by Counsel for OP/appellant that terms and conditions now being relied upon by him were neither communicated nor, were signed by the complainant. Further, a perusal of the Surveyor report and other material placed on the file on behalf of the complainant goes a long way to show that there are no basis or any norms which made the Surveyor to reduce the claim of the complainant from Rs. 26,000 to Rs. 6,500. It is further apparent that damage to the house as well as other insured items of the complainant is also admitted by the Surveyor/expert appointed by OP.
9. In this view of our foregoing discussion, we find no merit in any of the pleas raised above by Counsel for OP.
10. In the result, this appeal fails and same is hereby dismissed with costs which are quantified at Rs. 2,000.
Certified copies of this order be communicated to the parties, free of charge. The file be consigned to records.