- (1.) The complainant, M/s. Kanha Trading Company, stated to be a proprietorship concern dealing with textile fabrics, shoes and other items, obtained a standard fire and special perils policy No. 230700/11/05/00206 for the period 28.04.2005 to 27.07.2005 from the opposite party, New India Assurance Company for an assured sum of ?1,16,44,314/- for their stock-in-trade, whose description was stated as textile fabrics 1079000 mtrs. @ ?8.25/mtr. and 17,358 pairs of shoes @ ?158/-. The case of the complainant is that the stocks at their premises were damaged as a result of floods on 30.06.2005. They intimated the loss to the Insurance Company vide their letter dated 03.07.2005, following which a surveyor was appointed to assess the loss. The complainant sought payment of claim of ?1,16,44,314/- which was the sum insured in the policy. In the consumer complaint, the complainant have narrated the details of the correspondence between them and the insurance company, saying that the documents asked for by the surveyor and the insurance company were supplied to them from time to time, but they failed to adjudicate the claim within reasonable time. The complainant even approached the High Court of Gujarat at Ahemdabad by way of Special Civil Application No. 9898/2008 for relief against the OP/respondent. Vide order dated 01.08.2008, the Hon'ble High Court directed that the claim of Insurance shall be decided within a period of one month from the date of the order. The complainants were also given liberty to resort to proper proceedings as available in law, if the decision of the Insurance Company was against them.
(2.) However, the OP Insurance Company repudiated the claim on 12.09.2008 on the following grounds:- "As directed by the court in the order dated 1/8/2008, your above referred claim has been re-examined by the Competent Authority. It is observed that the claim repudiation letter dated 29.05.2008 is already sent on the policy address by Registered A.D. (copy of the said letter is enclosed) the proof of receipt of the same is available with us. On re-examination of the matter it is hereby informed that the Competent Authority has upheld the earlier decision of repudiation of liability under the said claim on the following grounds:- 1. General Condition No. 1 Mis-representation of material particulars, since the provided documents do not establish insurable interest of the policy holder on the damaged goods. 2. General Condition No. 6 (b) as no books of accounts could be produced. Further, no evidence of bills/books of accounts being lost in the flood is produced. 3. General Condition No. 8 since purchase bills of the stocks submitted by you are found to be of non-existing concerns and thus fraudulent."
(3.) The complainant have stated that they never received letter dated 29.05.2008 as stated in the above reference from the Insurance Company. Later on, they ascertained from the Department of Posts that the said letter was returned to the sender undelivered on 05.06.2008. The complainant further says that the OP Insurance Company had drawn four samples of clothes at random and sent the same to MANMADE Textile Research Association (herein referred to as 'MANTRA') Surat, whose report indicated that this was an irreversible damage and hence, a case of total loss. The action of the OP Insurance Company in repudiating the claim was, therefore, not in order.;