Miscellaneous Policy (General) - Gbic.co.in

operation. of any insured peril. During the hearing the complainant contended that impactdamage is one of the perils covered under Sec-I of the policy and damages having beencaused due to impact of collapsing roof. Insurer contended that impact damage does notinclude destruction caused to insured property by hitting of debris of a collapsing roof. Asper lexical meaning of the term “Impact Damage” means the damage caused by force withwhich one object hit another. In this case the debris of collapsed roof and wateraccumulated on the roof hit the insured properties kept in shop. The definition of impactdamage given in All India Fire Tariff can not be imported to the contract of Shop Keeper’sInsurance. Insurer is directed to pay Rs. 25,000/- within fifteen days of consent given byinsured complainant.Bhubaneswar Ombudsman CentreCase No. I.O.O. / BBSR / 11 - 460Shri Sitaram PandaVs.The Oriental Insurance Co. Ltd.Award Dated 16.02.2005Insured complainant has filed this complaint under Rule 12(1)(b) for partial repudiation ofhis claim by Oriental Insurance Co. Ltd. Insured complainant insured his cloth shop underShop Keeper’s policy for sum insured of Rs. 10,00,000/- On 8-4-2002 fire broke out due toelectrical short circuit and damaged the stocks worth Rs. 12,79,480/- as claimed bycomplainant. The surveyor has assessed the loss for Rs. 477095/- where as the insurer hassettled the loss forRs. 3,52,998/-. Though the complaint had received the amount due to financial constraintsbut preferred the complaint in this forum.During the Hearing the complainant has stated that surveyor ignored the documents shownby him in order to reduce the assessment which was further reduced by the insurer andpointed out the lacunae in the loss assessment.In presence of surveyor, complainant and Insurer the loss has been worked for Rs.4,63,072/- On negotiation both the parties confirmed their satisfaction regardingassessment. Hon’ble Ombudsman directed the Insurer to pay balance of Rs. 1,10,000/-within 15 days of receipt of consent letter from the complainant.Chandigarh Ombudsman CentreCase No. GIC/63/OIC/11/05Shri Suraj BhanVs.Oriental Insurance Co. ltd.Award dated: 3.12.2004FACTS : The complainant purchased two buffalos for Rs. 16000 each on 28.10.02 byraising loan from PNB branch Jalbera, and were insured from DO Ambala w.e.f. 29.11.02.One of the buffalos died in the night intervening between 16/17th Dec., 2002 afterswallowing a sharp edged nail. The complainant immediately informed the Branch Managerof the bank and pursued the matter with the insurer regarding settlement of claim but it wasof no avail. The claim was repudiated on the ground that the buffalo had died due to a preexistingdisease. The complainant contended that the buffalo was not sick at the time itwas purchased and was duly medically examined.FINDINGS : M/s Royal Associates (Investigators) deputed to ascertain the cause of deathreported that as the buffalo was sick for 20-25 days prior to its death, the buffalo may havebeen sick at the time the insurance cover was taken. It was contended that the claim wasrightly repudiated under exclusion clause 7-B which reads “death or loss due to accidentor disease contracted prior to risk is not covered under the policy”. It was noted that the