BRANCH MANAGER ORIENTAL INSURANCE CO. LTD. Vs. YASHOWANTA

JUDGEMENT

(1.) This First Appeal has been filed by Oriental Insurance Co. Ltd., Opposite Party before the Orissa State Consumer Disputes Redressal Commission (hereinafter referred to as the State Commission) and Appellant herein being aggrieved by the order of that Commission which had allowed the complaint of deficiency in service filed against it in not settling the claim as per the insurance policy and unjustifiably offering a lesser amount which was not acceptable to Yashowanta Narayan Dixit, Complainant before the State Commission and Respondent herein.

(2.) Facts of the case as per the Respondent/Complainant are that he was engaged in the business of oil extraction in the name and style of Dixit Oil Industries for self-employment and had taken an insurance policy from the Appellant/Insurance Company to cover loss or damage to his unit for a sum of Rs.33 lakhs by paying a premium of Rs.5280/- and Rs.2475/- for special peril of Floods for the period 04.09.1999 to 03.09.2000 vide Policy No. 2000/192 dated 06.09.1999. On 29.10.1999 during the validity of this policy, there was a super cyclone followed by heavy torrential rain in the entire coastal area of Orissa, including Bhadrak town where the Respondent/Complainant's business was located. Because of the cyclone and heavy rains and due to overflowing of the river Salandi the entire business premises of the Respondent/Complainant was flooded and remained under 4 to 6 feet of water for about four days and as a result raw material (mustard seeds), mustard oil in tanks and it's by-product i.e. Khal (de-oiled cakes) were washed away or spoiled. The entire stock became unfit for human consumption. When the situation improved after some days, Respondent/Complainant vide letter dated 02.11.1999 informed the Appellant/Insurance Company giving a brief picture of the damage which was roughly estimated to be Rs.27.21 Lakhs. It was contended that four Surveyors were appointed one after the other, namely, M/s R.P. More And Associates, who visited the Respondent/Complainant's premises and also asked him to send some oil for laboratory tests. Thereafter another Surveyor - M/s D.S. Consolt & Network Pvt. Ltd., Bhubaneswar was appointed who confirmed that the water had entered into the godown causing damage to the mustard seeds etc. but instead of settling the claim, Appellant/Insurance Company appointed yet another Surveyor - M/s S. Soni & Co. who again inspected the premises and sought certain clarifications which were supplied. However, even after this, instead of settling the claim Appellant/Insurance Company appointed a fourth Surveyor - M/s Sanjeeb Kumar Mohanty And Associates. As per the assessment of this Surveyor which was based on the survey reports of the three earlier Surveyors, Appellant/Insurance Company offered the Respondent/Complainant a sum of Rs.2,98,145/- in settlement of the insurance claim which was not accepted since it was well below the actual loss caused due to damaged goods. Being aggrieved by the deficiency in service on the part of Appellant/Insurance Company, Respondent/Complainant filed a complaint before the State Commission and requested that Insurance Company be directed to settle the claim for a total amount of Rs.69,06,685/- as per the following break up : <FRM>JUDGEMENT_620_NCDRC_2013_1.html</FRM>

(3.) Appellant/Insurance Company on being served filed a written rejoinder refuting the allegations made by the Respondent/Complainant. It was contended that in order to settle the claim of the Respondent/Complainant, with his knowledge and consent three Surveyors were appointed and based on the report of the final Surveyor, whose assessment was based on the earlier three survey reports as also examination of relevant documents, the insurable loss was rightly assessed at Rs.3,74,167/-. In fact, Respondent/Complainant had highly inflated his loss by placing reliance on various purchase bills stating that there was extensive damage to not only raw material but to the finished goods, including those stored in the oil tanks. However, this extensive damage was not backed by credible evidence. The contention of the Respondent/Complainant regarding the loss and also seeking an insurance claim amount which was much higher than the amount insured as per the insurance policy itself indicates that the Respondent/Complainant's complaint/allegation lacks credibility.