Miscellaneous Policy (General) - Gbic.co.in

Chennai Ombudsman CentreCase No. 11.03.1166 / 2004 - 2005Mr. C. Saji DavidVs.National Insurance Co. Ltd.Award Dated 29.10.2004Mr. Saji David insured his household articles since 1993 onwards. The Insurer sent arenewal notice for the premium amount of Rs. 2,483/- towards of the policy for the period25.01.2003 to 24.1.2004. Accordingly the premium was paid. The Insurer sent the policyaltering the sum insured under different sections and sent a refund voucher for Rs. 407/-.The Insurers also gave the cheque towards refund.On 31.5.2003, when the insured was abroad, some culprits had broken the door and stolenthe jewellery, dresses, cash, etc. The matter was reported to Police by the neighbours.After returning to India, the insured made a supplementary complaint to the Police on6.6.2003 as per which the value of jewels lost was Rs. 74,400/-. The surveyor released hisreport on 3.3.2004 recommending settlement of the jewellery claim for Rs. 17,000/-, as thesum insured for jewellery was Rs. 17,000/- under the policy.A joint hearing was conducted. The insured said that the reduction of sum insured underjewellery section to different sections under the policy was done without his knowledge. Hefurther stated that in the year 1995 - 1996, when the sum insured was increased from Rs.80,000/- to Rs. 1,12,000/-, item wise valuation was done by the valuer. To the question bythis Forum as to why he did not study the policy on receipt, he stated that he did not noticethe same till the claim arose. He alleged that some items covered under Section I havebeen changed to Section V and VI without his consent and premium was adjusted. Sincethe refund cheque did not contain any covering letter, he presumed that the Insurer isrefunding the premium under the provision of no claim bonus.The Insurer said that they have decided to restrict the sum insured to Rs. 17,000/- as therewas no valuation report in the underwriting file. To the question as to whether the Companycalled for the valuation certificate from the insured in writing, the Insurer had answered innegative. At the time of sending the refund cheque also, the Insurer did not send anycovering letter. When the Insurer added new items like plate glass, etc., under the policy,the Insurer could not give any answer under whose advice these were included. They alsoclarfied that no separate proposal was taken for inclusion of new items. When asked aboutthe calculation sheet, the Insurer stated that they did not have it in file.The series of events showed how the events would have taken place. The basisresponsibility lied with the Insurance Company to directly write to the insured calling forrequirements and communication in writing would be the correct and acceptable practice. Itis not clear how the Insurer distributed the sum insured under one section to other sectionsBy all the above actions, the Company had acted in a unilateral manner. This case wasreferred to the Vigilance Department of the Insurer for further investigation. As the policy inquestion was issued for Rs. 17,000/- for jewellery value, it is not appropriate to pass anaward more than the sum insured under the policy by this Forum and accordingly the casewas dismissed.Chennai Ombudsman CentreCase No. 11.02.1193 / 2004 - 2005M/s. Ambika JewellersVs.The New India Assurance Co. Ltd.Award Dated 16.11.2004Shri R. Mohanlal, the sole proprietor of M/s. Ambika Jewellers insured his jewellery shopwith The New India Assurance Company Limited for the period 12.08.2002 to 11.08.2003