Miscellaneous Policy (General) - Gbic.co.in

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expressed his inability to produce the same from the police authorities. The Insurer finallyrepudiated the claim on the ground that the loss of diamond stone was due to normal wearand tear.A joint hearing was conducted. Indian Penal Code defines the theft as whoever intending totake dishonestly any movable property out of the possession of any person without thatperson’s consent, moves that property in order to such taking, is said to commit theft.During the time of hearing, a specific question was put forth to the complainant about whenand where the diamond stone was lost for which the reply given was that he did not knowabout the same when it happened exactly. Even though there is no direct evidence to provethat the stone was lost due to wear and tear as alleged by the Insurer, it is also to be notedthat it has been proved that the loss had occurred due of operation of an insured peril. Thepolicy conditions stipulate that the insured must produce documents / explanation andevidence to substantiate the claim as the Company may reasonably require. Under thesecircumstances, this Forum could not find fault with the Insurer.Delhi Ombudsman CentreCase No. GI / 309 / UII / 04Shri. Ravinder Kumar AggarwalVs.United India Insurance Company LimitedAward Dated 17.12.2004The complainant was aggrieved by the inadequate settlement of his claim.It was held that after already receiving payment of his claim from the Insurance Companyand discharging the insurance company form any further liability by signing the dischargevoucher (clean), he cannot now rake up old issues. If he thought that the compensationoffered by the insurance Company was inadequate or that the Insurance Company hadbeen unfair to him by not allowing certain expenses legitimately incurred by him, then heought not to have accepted the payment of his claim. He should have come straight to thisForum with his grievance.Delhi Ombudsman CentreCase No. GI / 280 / UII / 04Smt. Shilpa VigVs.United India Insurance Company LimitedAward Dated 09.11.2004Mobile phone set was insured for Rs. 13,300/-. The mobile was stolen. The InsuranceCompany settled the claim for Rs. 6,750/-, whereas, the complainant wanted the full suminsured, namely Rs. 13,300/-. The Insurance Company had settled the claim on the basis ofreport of the loss assessor.The stand of the Insurance Company was upheld. The contact of the insurance is contractof the indemnity and the insured is entitled to compensation only to the extent of financialloss. The financial loss has to be assured on the basis of the market price of the same typeof mobile at the time of theft. If the same type is no longer available in the market on thebasis of more or less comparable model which is available. The complainant cannotdemand the full sum insured as compensation. The full sum insured is only a maximum limitto the indemnity to be provided. The Insurance Company is justified to pay the claim paidas per the report of the loss assessor.Guwahati Ombudsman CentreCase No. NL / NIC / 11 / 126 / 03 - 04 / 2004Mrs. Manju Rajkhowa
Vs.National Insurance Co. Ltd.Award Dated 29.11.2004FACTS : The contention of the complainant that the insured computer and the printer alongwith all accessories and continues to pay the renewal premium which was charged on theoriginal value of the computer. That the computer being damaged she, on advice of thecompany, got it repaired on 6.6.03 at an expense of Rs. 19,250.00 through the dealer. Thatthere was delay in settlement of the claim and finally they offered an amount of Rs. 6,000/-which she refused to accept.Contention of the Opposite party on the other hand is that the claimant is a trained agent ofthe company and she insured her computer at Rs. 1 lakh w. e. f. 27.11.98 to 26.11.99. Thatshe continued to renew the policy sometime at short and some times at long intervals andthe insured / complainant, at her own choice, kept the sum insured at Rs. 1 lakh. That onthe alleged report of the loss, in - house verifier was deputed who assessed the loss at Rs.6,525.00 after application of 50 % depreciation and deduction of compulsory policy excessof Rs. 2,500.00.DISCUSSIONS : It is undisputed that the damage was due to voltage fluctuation as perinspection report of the in-house verifier confirmed by the engineer of the repairer M/sModular peripherals (India) Pvt. Ltd. Notwithstanding, the fact that all the parts replacedwere parts with limited lives, it has not been mentioned anywhere when these parts werepurchased or what was the life of the damaged parts at the time of damage. But factsremain that the cause of damage was voltage fluctuation not the age of the parts. It wasalso not stated in the statement of the opposite party whether at the time of damage of thecomputer the parts with limited life were repaired only or replaced by suprerior one.Therefore, I find the application of 50 % depreciation is not logical and appropriate.Therefore, in my opinion 10 % depreciation will meet the ends of justice instead of 50 %depreciation, on the particular circumstances of the case.DECISION : It is therefore directed that the opposite party will settle the claim by deductionof 10 % depreciation and pay interest as ordered.Guwahati Ombudsman CentreCase No. 11 / 002 / 0026Shri Apurba BarmanVs.New India Assurance Co. Ltd.Award Dated 01.03.2005FACTS : An employee of Oriental Insurance Co. Ltd. namely, Shri Apurba Barman lodgedthis complaint against New India Assurance Co. Ltd. stating that on 01.06.2001 rain - waterinundated / flooded the dwelling house of the complainant and he lodged a claim of Rs.29,150/- on the basis of report of the surveyor. An amount of Rs. 6,678/- was paid on01.08.03 which he received under protest.The insurer / opposite party would submit that on getting the report of the damage, Mr.Pranjal Bhagawati was appointed as surveyor to assess the loss. The surveyor submittedhis report assessing the loss at Rs. 6,678/- and discharge voucher was signed by theinsured as full and final settlement and accordingly cheque no 2685 was issued on31.07.03.There is no dispute regarding the flood, insurance cover and about the receipt of the sumassessed by the surveyor. The only objection is that the quantum assesed was not proper(Evidence discussed)It is difficult under the facts and circumstances of the particular claim to assess the actualamount of loss. But then, in view of the fact that goods / articles remained under the water
Page 1 and 2: Miscellaneous Policy (General)Ahmed
Page 4 and 5: Complainant failed to submit the af
Page 6 and 7: Bhubaneswar Ombudsman CentreCase No
Page 8 and 9: insurance cover was given on the ba
Page 10: conditions of the policy were not f
Page 14 and 15: Chennai Ombudsman CentreCase No. IO
Page 16 and 17: the loss at Rs. 5,03,120/- which in
Page 20 and 21: only for a day or two and the exten
Page 22 and 23: Taking into consideration all the r
Page 24 and 25: Vs.Oriental Insurance Co.Ltd.Award
Page 26 and 27: Kochi Ombudsman CentreCase No. IO/K
Page 28 and 29: the Company repudiated the claim on
Page 30 and 31: Not getting any response from the C
Page 32 and 33: Award Dated 14.12.2004Shri Bahadur

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