Page 53 - Insurance Times September 2015 SAMPLE
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The complainant's TV set went out of gal gram, 2 to 4 bags of fried gram and into the shop and decamped with T.V.
order and the same was repaired (pic- cash amounting to Rs. 73,000/- were sets, music sets and other electronics
ture tube replaced) by the dealer at a alleged to have been stolen. The theft goods worth Rs. 2,47,278/-.
cost of Rs. 6820/-. The insurer rejected was informed to the insurers.
the claim saying that it was an old TV Insured complainant lodged an FIR
and the maximum life-span of the pic- Surveyor was deputed and the claim with Bhograi P.S. for this incident. The
ture tube was only 10 years. was closed, as requirements de- surveyor has assessed the loss for Rs.
manded by the insurer/surveyor were 41,558/- and insurer settled the claim
Therefore, citing the reason for dam- not furnished. The complainant con- for Rs. 41,550/-, which was duly ac-
age as aging of the TV set, the claim tended that the police authorities cepted by the financier bank without
was turned down. In the renewal of seized the account documents and any protest.
the policy in the year 2002, the TV set cheque 4books.
was insured for Rs. 8000/-. The Insured complainant being aggrieved
complainant's version was that, the The insurer was directed to send the of quantum of assessment approached
picture tube damage was related to surveyor to police authorities and pe- this forum. During hearing insured
the number of hours it was used and ruse the said documents and give his complainant admitted that he was not
not the age of the TV set. He also con- report within one month from the date able to produce to purchase, sales and
tended that a picture tube would work of hearing. The police categorically stocks register as these were stolen by
properly for more than 1 lakh hours. denied having taken the account books the burglars.
etc. The Final Investigation Report
Since the insurer had renewed the highlighted the fact that the complaint Insurance Ombudsman up hold the
policy in 2002 and the complainant had was intentionally registered on ac- decision taken by the insurer as the
really spent Rs. 6820/- as per the count of financial burden on the com- surveyor has rightly assessed the loss
Dealer's receipt and the insurer having plainant as she had taken a loan to in absence of sales, purchase and stock
been unable to prove that the damage start the factory and could not make register.
to the picture tube was only due to payment regularly.
aging of the set, the Insurance Om- Ahmedabad Ombudsman Centre
budsman allowed the complaint and The police concluded that the com- Case No. 11.002.0187
the insurer was asked to pay Rs. 6820 plaint was not genuine and manipu-
in full final settlement of the claim. lated. The insurer's version was ac- Shri Sujit J. Jain vs. The New
cepted as the insured availed cover, India Assurance Co. Ltd.
Hyderabad Ombudsman Centre only 5 days prior to the theft. Insurers'
Case No. IO (HYD)/G.11.005.239 decision was upheld. Repudiation of Claim under Burglary
Insurance Policy: The Complainant's
Smt. Padmaja Pathi vs. Orien- Bhubaneswar Ombudsman Centre Claim for Burglary was repudiated on
tal Insurance Co. Ltd. Case No. I. O. O. /BBSR / the grounds that as per the Policy Con-
14.005.0020 ditions; the policy ceases to operate if
The complainant, proprietress of M/s. the premises were left uninhabited by
Tungabhadra Agro Industries, pur- Shri Ranjan Kumar Dey vs. day and night for 7 or more consecu-
chased a burglary policy and cash in- Oriental Insurance Co. Ltd. tive days and nights.
surance policy to cover money in
locked safe for a sum insured of Rs. The Complainant, the owner of elec- Even though the burglary took place
2,50,000/- and stock-in-trade of Rs. tronic shop insured his T.V. sets, music within 7 days of reference; since the pre-
7,50,000/-. system, radio etc. with Oriental Insur- mises were uninhabited for 7 consecutive
ance Co. Ltd. under Burglary and days the decision of the Respondent to
There was an alleged burglary in the House breaking Policy for Sum Insured repudiate the claim was upheld with no
premises where 22 to 24 bags of Ben- of Rs. 2,50,000/-. Some burglars broke relief to the Complainant.
The Insurance Times, September 2015 49
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