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2009 DIGILAW 314 (JK)

Ab. Aziz Lone v. United India Insurance Co. Ltd.

2009-06-23

G.D.Sharma, Rifat Aijaz

body2009
G.D. Sharma, J. 1. The Complainant herein owned two houses and they were constructed over survey No. 1367 situated in village Aloosa Patli Binglipora, Tehsil Bandipora. He had obtained Fire Insurance Policy bearing no. 2444 which came in operation on 9-9-99 and was valid upto 8-9-2000. The policy covered the fire risk of the above stated houses. One house was insured under the said policy for a sum of Rs. 5.00 lakhs and the household articles lying therein were insured for risk of Rs. 1.00 lakh. The other house was insured under the said policy for a risk of Rs. 3.00 lakhs and the household articles for (sic) above said insured buildings alongwith household articles lying therein caught fire and everything was reduced to ashes. The complainant at that time was living in Srinagar and when he got information, he reported the incident in the Police Station Bandipore on 2-4-2000. The claim was raised with OP No. 2 who registered it on 20-4-2000 and sought information of the incident from Addl., S.P. Sopore. The latter informed that the cause of fire was due to electric short circuit. OP No. 2 had also sought information from Asstt. Director, Fire Services Sopore who too corroborated the version of the Addl. S.P. The case of the complainant is that from the year 2000, he had been approaching the OPs for the settlement of his claims but dilly dallying tactics were adopted. The complainant was compelled to approach the Commission and ultimately on 28-02-2001, the complaint was filed seeking, interalia, the following reliefs: - (i) Indemnification of the assured loss to the tune of Rs. 9.50 lakhs alongwith interest @ 18% P.A. from the date of loss till final settlement is made. (ii) Compensation for mental agony and physical torture amounting to Rs. 3.00 lakhs. (iii) Litigation charges in the sum of Rs. 50,000/-. 2. The claim has been resisted by the OPs and in their written version it is pleaded that false and frivolous claims have been raised regarding the alleged loss caused to the insured houses. That because of the onset of militancy the complainant had abandoned his residence from the insured houses and shifted to Srinagar by taking all the household articles with him. As the houses were lying vacant, so they were occupied by the security forces. That because of the onset of militancy the complainant had abandoned his residence from the insured houses and shifted to Srinagar by taking all the household articles with him. As the houses were lying vacant, so they were occupied by the security forces. The complainant had migrated to Srinagar in the year 1995 and did not return till May 2000. During the year 1994-95, the said houses were raised by the security forces several times and search operations were conducted for effecting the recovery of arms and ammunitions. The raids had caused complete collapse of the buildings in the year 1994-95. In the month of November 1999, debris of the wooden items were set on fire by some miscreants. This fact had been supported by the reports of SSP Baramulla and a certificate was also issued by the Asstt. Director, Fire Services Sopore. It is emphatically denied that any fire incident had occurred which destroyed the structures of the complainant was being projected by him. The investigator appointed by the OPs had recommended no claim case of the complainant and as a matter of prudence and caution the loss was got assessed from the surveyor Mr. Waris Sheikh. That on the basis of investigation reports and observations of the surveyor it was found that the claims were frivolous and vexatious, so repudiation was made. 3. In support of the complaint, the complainant appeared as his own witness as well as examined Mohd. Shafi Beig, Mohd. Shaban Lone, Bashir Ahmed Khan Fayaz Ahmed Lone, Abdul Ahad Lone and Abdul Hamid Shoda. The OPs have produced Mr. A.R. Makroo, Sr. Manager and P.R. Chalkoo as witnesses. 4. The complainant in his deposition has corroborated the allegations made by him in the complaint and further stated that the surveyor had assessed the loss to the tune of Rs. 362774/-. All the witnesses produced by the complainant have stated that the houses in question were not occupied by the armed forces as well as they had never damaged them in any way and they got destroyed in fire caused by electric short circuit. Mr. 362774/-. All the witnesses produced by the complainant have stated that the houses in question were not occupied by the armed forces as well as they had never damaged them in any way and they got destroyed in fire caused by electric short circuit. Mr. Abdul Hamid Shoda who is an expert witness of the complainant being a Draftsman of Srinagar Municipality, has deposed that at the request of the complainant he visited the spot in the month of April 2000 and found the houses, alongwith godowns gutted due to fire which occurred during the intervening night of 25-03-2000 and estimated the loss to the tune of Rs. 6,30,401/-. He has placed on record all his estimates. In his cross-examination, he admits that he has no licence to assess the loss in his favour from the Controller of Insurance and that only a surveyor is competent person to assess the loss. However, he says that he has been permitted by the authorities to prepare the site plans and drawings of private parties residing in Kashmir Valley. He had charged Rs. 10,000/- as his fee for visiting the spot and preparing the estimates in question. 5. Heard the arguments. 6. The plea taken by the OPs is that these are fake and fraudulent claims raised by the complainant in order to enrich himself from the money of the depositors lying in trust with the OPs because during the year 1994-95 frequent raids were conducted by the security forces to unearth the concealed arms and ammunitions in these houses because of the suspicion as his one son had become a militant. The houses were lying vacant and they were occupied by the security forces. The digging of the houses because of frequent raids had caused their complete collapse during the year 1994-95. The complainant had migrated to Srinagar and in the month of Nov. 1999, the debris of wooden items of the said houses were set on fire by some miscreants. The learned counsel appearing for the OPs has placed great reliance on the letter written by Sr. Superintendent of Police, Baramulla to M/s Jhelum Investigating Services Pt. Ltd. under his no. The complainant had migrated to Srinagar and in the month of Nov. 1999, the debris of wooden items of the said houses were set on fire by some miscreants. The learned counsel appearing for the OPs has placed great reliance on the letter written by Sr. Superintendent of Police, Baramulla to M/s Jhelum Investigating Services Pt. Ltd. under his no. Conf-Insur/2000/6613 dated 14-09-2000 wherein it is stated that report of SDPO Bandipura had revealed that houses were dismantled by the security forces because of the reason that one son of the complainant had become a militant and after the demolition of the house/houses, the complainant alongwith other family members had migrated from his native village. "It was found that in the year 1999 some unknown persons set on fire the debris of dismantled house." However, the case had been registered in the concerned police station. He has also placed reliance on the letter written by Asstt. Director, J&K Fire Services, Sopore to M/S Jhelum Investigating Services Pvt. Ltd. under his no. 2527/FRC dated 6-12-2000 which also recites that one son of the complainant was a militant and he had left his residence for Srinagar. The houses were damaged by the security forces and they were set on fire by unknown persons. The counsel has laid stress that in this letter it is also written, "Moreover, the fire Station Bandipora was not informed about the said fire." 7. It is admitted fact that incident had taken place during the intervening night of March 25th, 2000 when the insurance policy was in currency. The Development Officer of the OPs Mr. Sultan had insured the houses in question and he had told M/S Jhelum Investigating Services Pvt. Ltd. that he had done the insurance without inspection and in good faith because that is the procedure adopted by the insurance company. It is also an admitted fact that the houses were initially insured in the year 1994-95 and policy was being renewed year wise. The Incharge Officer, Fire Station Bandipora after spot verification had written to the Asstt. Director, Fire Services Sopore that during the night of 25-03-2000, the houses in question were gutted in fire. Those houses alongwith household articles were destroyed. The letter written by Asstt. The Incharge Officer, Fire Station Bandipora after spot verification had written to the Asstt. Director, Fire Services Sopore that during the night of 25-03-2000, the houses in question were gutted in fire. Those houses alongwith household articles were destroyed. The letter written by Asstt. Director, Fire Services Sopore to M/S Jhelum Investigating Services Pvt. Ltd. dated 16-12-2000 as referred above gets nullified because of the letter written to him by the Incharge Officer, Fire Station Bandipora which is placed on record and shows that information had been laid before him about the incident. Similarly, the letter dated 14-09-2000 written by the SSP Baramulla to M/S Jhelum Investigating Services Pvt. Ltd. also loses its significance when SDPO Bandipora vide annexure CI marked EXP-3 had written on 08-05-2000 to the Additional Superintendent of Police, Sopore and stated that the insured houses and the household articles lying therein were gutted in fire on 25-03-2000 and the cause of fire had been reported due to electric short circuit. The Additional Superintendent of Police, Sopore vide annexure `C2' which is a letter bearing no. Conf/46/2K-690 dated 15-05-2000 written by him to the Branch Manager, United India Insurance Co. Ltd. Sopore had stated that report called by him from SHO Police Station Bandipora stated that in the fire that broke out during the night of 25-03-2000, it had completely destroyed the insured houses alongwith household articles and the cause of fire was reported due to electric short circuit. Even the contents of M/S Jhelum Investigating Services Pvt. Ltd. prove the fact that Development Officer Mohd. Sultan Chopan of the OPs who had insured the houses in question had insured them without any inspection and he had failed to assign any reason for adopting that procedure except a lame excuse that it was done so in good faith. The incident of fire stated in the said investigation report pertains to the month of Nov. 1999 which statement runs contrary to the official police record because in the police Daily Diary Report EXP-2, the incident stands registered on 25-03-2000. Mr. A.R. Makroo who is the Branch Manager of the OPs had admitted that the information about the alleged loss was received by him on 10-04-2000 and the company had deputed Mr. 1999 which statement runs contrary to the official police record because in the police Daily Diary Report EXP-2, the incident stands registered on 25-03-2000. Mr. A.R. Makroo who is the Branch Manager of the OPs had admitted that the information about the alleged loss was received by him on 10-04-2000 and the company had deputed Mr. P.R. Chalkoo to conduct the preliminary survey who vide his report dated 08.05.2000 had recommended for getting the claim investigated because of the reasons given in his report. On his recommendation, M/S Jhelum Investigating Services Pvt. Ltd. were deputed Mr. Waris Sheikh for making the final assessment of the loss by way of precautionary measures and loss assessed by him was to the tune of Rs. 362744/-. That report was not in consonance with the observations made by the preliminary surveyor Mr. Chalkoo and report submitted by M/S Jhelum Investigating Services Pvt. Ltd. that they had found the claim as fake is also not credible. The said manager Mr. A.R. Makroo in his cross-examination has admitted that the insured houses were being insured for the last 4 years before the occurrence and there was no complaint about the fakeness of the polices or non-existence of the houses in question. The company had been receiving the premiums of all the insurance. He also stated that no action has been taken by the OPs against the Development Officer who had issued the policy in question without inspection. He is categorical is stating that Mr. Waris Sheikh had assessed the loss after physical inspection of the houses in question to the extent of Rs. 362784/-. Mr. P.R. Chalkoo, surveyor and loss assessor in para no. 3 of his affidavit has stated that the insured houses were damaged and dismantled a few years before the alleged date of occurrence which took place on 25-03-2000. In cross-examination, he has admitted that he visited the spot all alone and he did not exactly remember who assisted him is making the assessment on the spot. He could not name any person from whom he had made the enquiry. He also admits that he had not recommended any action against the agent or against the Development Officer who had issued the insurance policy, when according to his estimate the property had been damaged much earlier to the date of its issuance. He could not name any person from whom he had made the enquiry. He also admits that he had not recommended any action against the agent or against the Development Officer who had issued the insurance policy, when according to his estimate the property had been damaged much earlier to the date of its issuance. His estimate was only of tentative nature regarding the loss of the property. 8. After considering the respective contentions of the counsel of the parties and going through the record, we find that there is not even an iota of evidence that security forces had digged the insured houses to such an extent that they had collapsed and at the time of the alleged incident there were only wooden debris which had been burnt. On the contrary, the record reveals that the houses in question were regularly being insured by the OPs. This fact finds support from the admission of the witness of the OPs Mr. A.R. Makroo who had been working as Branch Manager for the last 4-5 years coupled with the conclusion arrived at by M/S Jhelum Investigating Services Pvt. Ltd. It cannot be held in the absence of any evidence that these houses were not in existence and had been dismantled from the year 1994-95. The statement of Mr. A.R. Makroo, Branch Manager is only a figment of his imagination because it is self-contradictory and not based on any credible evidence. The concerned officers of the OPs are answerable to their higher officers to explain how the insurance policy was being issued regularly year-wise without any verification. It is found from the written version that in the year 1996-97 residential building alongwith household goods were insured for Rs. 3.50 lakhs under policy no. 28/54 and under policy no. 2853 commercial building and stocks were insured for Rs. 1.50 lakh. During the year 1997-98, the residential building alongwith the household goods under policy no. 2119/97 were insured for Rs. 4.00 lakhs. For the year 1998-99, the building with attached cowshed and household goods were insured under policy no. 2271/98 for Rs. 7.00 lakhs. For the year 1999-2000 under policy no. 2444/99 one residential building was insured for Rs. 5.00 lakhs and household goods for Rs. 1.00 lakh. Second building was insured for Rs. 3.00 lakhs and household goods were insured for Rs. 50,000/-. 2271/98 for Rs. 7.00 lakhs. For the year 1999-2000 under policy no. 2444/99 one residential building was insured for Rs. 5.00 lakhs and household goods for Rs. 1.00 lakh. Second building was insured for Rs. 3.00 lakhs and household goods were insured for Rs. 50,000/-. These are the insured building in question which have a insurance cover of Rs. 9.50 lakhs and the plea taken by the OPs is that the buildings already stood dismantled in the year 1994-95. It has also come in the evidence that the concerned. Development Officer Mohd. Sultan Chopan had insured the buildings in question without any verification but purely while acting in good faith when according to the defence version of the OP the buildings were not in existence. On the contrary the complainant in his deposition as well as in the evidence of his witnesses Mohd. Shafi Beig, Mohd. Shaban Lone, Bashir Ahmed Khan, Fayaz Ahmed Lone, Abdul Ahad Lone and Abdul Hamid Shoda have stated in one voice that the houses were existing and army had not caused any damage to them. By preponderance of evidence it is thus established that the buildings were in existence when the insurance policy was issued. It is for the OPs to fix the responsibility in case according to them, the policy in question was of fake and fraudulent nature. The law cited at bar by the learned counsel of the OPs laid down by the Hon'ble National Consumer Disputes Redressal Commission in the case of "SHREE COLD STORAGE PVT. LTD. V/S NEW INDIA ASSURANCE CO. LTD." has no bearing with the facts and circumstances of the case in hand and need not to be discussed. 9. The OPs have got the loss assessed from their surveyor namely, Mr. Waris Sheikh who has not been examined as a witness in support of his assessment being made at Rs. 362784/-. Moreover, this assessment made from Mr. Abdul Hamid Shoda who was a draftsman. Mr. Abdul Hamid Shoda is not a licensed surveyor and loss assessor under the Insurance Act and his assessment carries no legal weight and as such has to be discarded. However, when it is a proved case of total loss then there is no option for the OPs but to reimburse the complainant of the assured value of the buildings and the household goods which amount is in the sum of Rs. 9.50 lakhs. However, when it is a proved case of total loss then there is no option for the OPs but to reimburse the complainant of the assured value of the buildings and the household goods which amount is in the sum of Rs. 9.50 lakhs. However, taking into consideration the attending facts and the circumstances which are of suspicious nature as to how the insurance policies in question were being obtained, by constantly increasing their insured value and without verification of the insured property by the responsible officer/officials of the OP, we in our considered opinion, indemnify the complainant to the extent of the assured amount of Rs. 9.50 lakhs (Rupees nine lakhs fifty thousand only) from today and direct the OPs to make the payment to the complainant within two months, failing which interest shall become payable at the rate of 6% per annum on the awarded amount till the final payment is made. The litigation charges are quantified at Rs. 5000/- to be paid by the OPs. We direct the higher echelons in the hierarchy of the OPs to hold enquiry about the issuance of the alleged fake and fraudulent insurance policies in question. In case the departmental enquiry fixes responsibility on some delinquent official/officials, then the awarded amount be recovered from his/their pay/pension as the case may be, but at present the OPs shall reimburse the loss to the complainant in the manner as stated above. The complaint be consigned to records.