The District Consumer Disputes Redressal Commission, Thrissur, comprising President Sri C.T. Sabu, Member Smt. Sreeja S. and Member Sri Ram Mohan R., has partly allowed a complaint filed by Rama Wilson against United India Insurance Co. Ltd., holding that the insurer's repudiation of the claim was unjustified and amounted to deficiency in service.

The Commission observed that the insurance policy was valid when the damage occurred and that the insurer failed to prove that the damage fell within the policy's exclusion clause.

Facts:

The complainant, Rama Wilson, was the owner of a residential flat insured with United India Insurance Co. Ltd. under a Standard Fire and Special Perils Policy. During the currency of the policy, the floor tiles of the flat were damaged, allegedly due to heat. The complainant claimed ₹56,245 towards reimbursement of the loss.

The complainant challenged the repudiation, maintaining that the damage had occurred during the validity of the insurance policy and that the insurer had wrongly refused to indemnify her. She also issued a lawyer's notice to the insurer, but received no satisfactory resolution.

Aggrieved by the repudiation, the complainant approached the Consumer Commission alleging deficiency in service and seeking reimbursement of the claimed amount along with compensation and costs.

The insurer contended that the damage was not caused by any insured peril. Relying on the Surveyor's report, it argued that the damage resulted from over-heating and defective workmanship, which were not covered under the policy. The Surveyor assessed the maximum loss at ₹35,260.

Observation and decision:

The Commission observed that the insurance policy was valid and subsisting when the damage occurred, and the damage to the floor tiles was not disputed. It held that the insurer's reliance on the exclusion relating to “natural heating”was misplaced, as floor tiles cannot generate heat by themselves.

The Commission also noted that the Surveyor's report was never proved in evidence, as the Surveyor was not examined. Therefore, the insurer's allegations regarding overheating, defective workmanship and the assessment of ₹35,260remained unsubstantiated. The repudiation was consequently held to be unjustified and amounting to deficiency in service.

However, the complainant failed to produce sufficient documents to establish the exact repair or replacement cost.

Since the complainant failed to establish the precise extent of her pecuniary loss, the Commission declined to award the claimed ₹56,245. It nevertheless partly allowed the complaint and directed the insurer to pay ₹10,000 as lump-sum compensation and ₹10,000 towards costs, both carrying 9% annual interest from the date of filing until realisation.

Case Title: Rama Wilson v. Manager, United India Insurance Co. Ltd.

Case No.: CC 452/18

Appearances:

For Complainant: Adv. A.D. Benny,

For the Opposite party: Adv. Joshy Jose

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