MR. PRAVAT KUMAR PADHI, PRESIDENT :-
Complainant has filed C.C.Case No. 100/2023 U/s-35 of C.P.Act seeking the following relief:-
Hon’ble Commission may graciously be pleased to admit this case, issue notice to the Ops and after hearing allow the same and direct the Ops to pay Rs.35,00,000.00 (Rupees thirty five lakshs) only towards full and final settlement of claim and mental and physical harassment and litigation expenses and loss sustained by the complainant to his business.
Brief fact of the case of the complaint is that:-
The Complainant being Proprietor of Micro Enterprise in the name and Style of M/s Pinku Electrical shop deals with procurement and supply of electrical items/goods as a wholesaler in the district of Kendrapara. His shop-cum-go-down was insured under the Op No.1 bearing standard fire and special perils policy No.PG-21-2403-4008-00005454 for the period 21.10.2020 to 20.10.2021 for a sum of Rs.30,00,000/- (thirty lakhs). On 22/23.02.21 mid night around 3 A.M. due to fire break out because of short circuit in the shop, the Petitioner los all his articles, including other official accessories therein, the same was intimated to Garadapur fire station vide case No.144 of DGPFC dtd.23.02.21.Upon intimation by the petitioner to the Op No. No.1 Insurer. Surveyor was deputed for assessment of loss, where in the surveyor assessed the net loss of fife damage only at Rs.8,24,500/-.. Complainant has submitted the GST returns copies and the stock summary maintained by him along with Bank statement for the recent year before the surveyor. Due to short circuit fire, all documents including electrical items have burnt but the surveyor without taking into account the same unilaterally arrived at a point that the stocks was of Rs.30,04,313.And further taking into average stocks of 3 months amounting to Rs.9,14,313/- after deduction towards salvage of Rs.597/- dead stock. Policy excess finally on 20.06.2021 the liability was assessed at Rs.8,24,600/- by the Insurer. The said amount is much less than the actual loss incurred by the Complainant, more so when assured amount was Rs.30,00,000/- surprisingly on 30.06.2021 the Op No.1 /Insurer closed the claim.The Petitioner had lost Rs.50,00,000/- including other accessories. As all the files/documents kept inside the premises which was entirely burnt he had submitted whatever papers available with him to the concerned surveyor deputed by Ops. The very assessment of Rs.8,24,000/- is much less compared to loss suffered by him for which the complainant is entitled for sum insured of Rs.30,00,000/-(Rupees thirty lakhs) at least.
Being aggrieved by assessment of surveyor the Petitioner approached Insurance ombudsman vide claim BHU-G-005-2122-0132-2849.Upon hearing the parties, considering the size of shop and circumstances vis-s-vis the assessment made by the surveyor dtd.21.12.2021 the Insurance Ombudsman directed the Insurer to pay only Rs.15,00,000/-(Fifteen Lakhs) towards full and final settlement of claim. The complainant-Petitioner being insured under Standard Fire and Special Perils Policy of Op No.2 has sustained huge amount of loss due to short circuit fire dtd.21/22.02.21. As the Complainant had lost all the documents only Bank transaction were available. Therefore the Ombudsman ought to have settle the claim at assured amount. Instead of settling the claim at Rs.30,00,000/- (Rupees thirty lakhs) the Ombudsman directed the Insurer/Opp. Party to pay only Rs.15,00,000/- (Rupees fifteen lakhs) which is also much less than the loss sustained by complainant and sum insured. Therefore, order of Ld.Ombudaman being illegal and non-application of judicial mind is liable to be interfered with by this Forum as per law.
In the case at hand the Complainant seeks for kind direction of the Commission to Op No.1/Insurer to pay the amount assured along with the mental agony and loss sustained to the business of Complainant and the Complainant is residing within the territorial jurisdiction of this Hon’ble Commission and so also his business stock go-down was carried on with the fire accident.The action of Ops/Insurance Company has caused tremendous tension to the complainant suffering mental and physical harassment, hence being aggrieved by arbitrary action of the Opp.Party the complaint petition is filed and the cause of action for this proceeding on the date of Fire accident to the Complainant’s go-down on 22/23.02.2021 (mid-night)and the Opp. Parties only assessed as the liability on dtd.20.06.2021 at Rs.8,24,600/- only and lastly the Insurance Ombudsman assessed only Rs.15,00,000/- (Rupees fifteen lakhs) on 21.12.2021.
Complainant has relied on the decision of Hon’ble SCDRC in the case of Jahagir Alam vs Branch Manager SBI Life & submit that the present C.C. against case the order of Ombudsman is maintainable before this Commission and NCDRC Judgment in the case of V.P. Padmakumar Vs Insurance Ombudsman & another where the order of Ombudsman was under challenge before Honbl’e SCDRC on being questioned the counsel for complainant submitted that since the pecuniary jurisdiction is upto Rs. 50 Lakhs the complainant has filed the C.C. before this Commission instead of SCDRC. We are of the view that even oif the pecuniary jurisdiction of Hon’ble SCDRC is above Rs. 50 Lakhs . The order of Ombudsman cannot be adjudicated by DCDRC as we have no appellate Jurisdiction. The Complainant has also relied on the decision of Hon’ble NCDRC in F.A. No. 401/2013 and Hon’ble Apex Court Judgement in the case of New Delhi Assurance Co. Ltd. Vs Paradeep Kumar which are nor relevant to the case at hand.
The Ops have filed their Written Version stating that the order passed by the Learned Ombudsman, State of Odisha is under challenge before Hon’ble High Court of Orissa in W.P.(C) No.13307/22, which is pending. The DCDRC is not empowered to adjudicate any order passed by the Learned Ombudsman. After repudiation of claim by the Insurance Company, the door of Consumer Commission as well as Ombudsman are open but Complainant has to choose either of the two, cannot be allowed to approach other Forum. The order passed by the DCDRC is challengeable before Hon’ble SCDRC and order passed by the learned Ombudsman can be challenged before Hon’ble High Court which is the present case, the Complainant has already availed. When Hon’ble High Court of Orissa is in the session of the matter, we being the sub-ordinate to SCDRC and Hon’ble High Court are not empowered to adjudicate the matter. Hence the C.C.Case No. 100/2023 is devoid of merit .No order as to cost & which parting with the case we give liberty to complainant to approach appropriate Forum for redress of his grievance and consider the Banking transaction while considering the case for settlement of claim.
With the aforesaid observation the C.C.Case No.100/23 is accordingly disposed off.
Issue extract of the order to the parties for compliance.
Pronounced in the open Commission, on this the 31st day of July,2024
I, agree.
Sd/- Sd/-
MEMBER PRESIDENT
