M.J. SURGICALS Vs. NATIONAL INSURANCE COMPANY LTD.

JUDGEMENT

(1.) This first appeal has been filed under Sec. 22 (A) of the Consumer Protection Act, 1986 (in short, 'the Act') impugning the order dtd. 11/6/2019 of the Uttar Pradesh State Consumer Disputes Redressal Commission, Lucknow, (in short, 'the State Commission') in Complaint no.547 of 2017. The State Commission has allowed the complaint filed by the present appellant partly and directed the respondent to appoint another surveyor within one month to assess the loss on account of a fire accident. Appellant has prayed that the claim amount assessed by the chartered accountant be considered and allowed.

(2.) In brief, the facts, as stated by the appellant, are that she is the proprietor of M/s M J Surgical located at Baij Nath Dham, Nunhai, Agra dealing in pharmaceuticals/ consumables. She had obtained a Standard Fire and Special Peril Policy (in short, 'the policy') for a sum of Rs.1,20,00,000.00 from the respondent covering stocks for a value of Rs.62.00 lakhs, plant and machinery for Rs.18.00 lakhs and building for Rs.40.00 lakh by way of two policies. Premia of Rs.21,000.00 and Rs.10,500.00 respectively were also paid. The Policy was valid between 31/10/2015 to 30/10/2016. On 27/6/2016, at about 07.00 p m, a fire accident occurred in the factory premise, which was put out by the fire brigade. Local police were also informed about the fire on 28/6/2016. The fire brigade assessed the loss at more than Rs.65.00 lakhs. The opposite party deputed a spot surveyor, Ms Amita Garg, who prepared the preliminary survey report and noted the loss assessed by insured to be Rs.70,00,000.00. Thereafter the final surveyor, Mr Ram Gopal Verma, Insurance Surveyor and Loss Assessors, New Delhi was deputed on 29/6/2016. Information sought by the surveyor was provided by the appellant from time to time. The surveyor has estimated the loss at Rs.1,93,978.00 vide his report dtd. 28/9/2016. The appellant has alleged that [the surveyor made illegal demands] about which she has complained to the respondent. The State Commission, vide impugned order, partly allowed the complaint and directed the opposite party to appoint another surveyor within a month from the date of order to correctly assess the actual loss by examining and considering all facts and grounds of the accident and documents such as bank statement, VAT return, sale purchase receipts, weight of burnt stock, trading account, balance sheet and other documents submitted by the complainant. The opposite party was directed to finalize its decision within a period of one month, if felt necessary with the help of the Chartered Accountant, in the assessment of loss.

(3.) It is averred by the appellant that the State Commission has erred in directing the respondent to reassess the claim by appointing another surveyor since as per IRDA guidelines a claim has to be decided within three months. It is stated that the incident of fire in the storeroom is not disputed where the stock of medicines, raw materials and finished surgical goods were stored contrary to the report of the surveyor that the items burnt in the fire were bought from outside to inflate the claim which is against the photographic evidence produced. As per record, the weight of the burnt items had been correctly recorded in the presence of the representative of the surveyor on 28/7/2016. The surveyor has not considered the consumable raw material, packing material, surgical goods manufactured and stock of surgical goods for trading but have only assessed bottles with collar, urine bags and urine meter and have wrongly concluded that 15,000 urine bags were verified from the burnt materials as it was not possible to count and separate the items which were burnt as claimed by the surveyor. As regards the medicines, the surveyor, according to the appellant, only considered the stock which was not burnt and did not consider the medicines held in stock based upon bills of purchase and confirmation from suppliers. The surveyor is also alleged to have wrongly held that the bill for medicines shows the residential address of the appellant and has wrongly concluded that the medicines were not on the premises at the time of fire. It has also been stated in the surveyor's assessment that the factory premises did not have adequate storage capacity to store the items. The conclusion of the surveyor that the IV fluids which were safe from the fire, be the basis of rejecting the claim against the loss of medicines, is incorrect and has been rejected by the State Commission.