HARSH RANTA S/o. lat... v. THE ORIENTAL INSURAN...

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2. Briefly, the facts of the case are that the complainant is consumer and OPs are service provider because the complainant being a owner in possession of the house consisting of 30 rooms constructed over land comprised in khasra No.186 abadi deh situated in Mohal Daroti, Tehsil Tikkar, District Shimla, HP has insured the said house with OPs w.e.f. 09.12.2022 to 08.12.2027 under policy No.263100/11/2023/782 for a sum of ₹1.25 crores after making the payment of premium amount of ₹19,999/- and the said policy was to be commenced from 09.12.2022. It is also stated that the said policy was purchased by the complainant from the OPs to insure his house under the Oriental Insurance Bharat Griha Raksha Dwelling Policy. It is further stated that the complainant agreed to purchase the insurance policy as the same was disclosed by the OPs to the complainant. It is further stated that on 02.09.2023 at about 11.45 PM a major fire incident took place in village Daroti, in which, the house of complainant and all valuable items kept in the house gutted in fire completely along with houses of other villagers. It is also stated that the incident of fire was reported to the police and in this regard a rapat was lodged in the concerned police station. It is further stated that the matter regarding incident of fire was reported in the local newspaper and intimation about the said incident and damage to the house of complainant was also given by the complainant to the OPs and OPs deputed a surveyor-cum-loss assessor, who inspected the spot and assessed the loss. It is also stated that the surveyor suggested the complainant to obtain certain documents and record from the government departments for completing codal formalities. It is further stated that the complainant got assessed the loss from Proprietor of Sharma Consultancy, Neri, Hira Nagar, Shimla-5, who assessed the loss to the tune of ₹2,70,35,800/- and the said report was submitted to the OPs by the complainant. It is further stated that later on, the OPs got verified the incident of fire and damage caused to the house of

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complainant from the concerned Naib-Tehsildar and the complainant was also asked by the surveyor to get the fresh valuation of the loss and accordingly, the complainant got assessed the loss again, which comes to ₹2,93,63,200/- and the said report also submitted by the complainant to the OPs. It is also stated that as the loss was assessed by the surveyor of complainant to the tune of ₹2,93,63,200/- and the insured amount was ₹1,25,00,000/-. However, the surveyor of OPs assessed the loss only to the tune of ₹1,84,34,636/- and from this amount also depreciation amount @ 50% was deducted, which appears to be without any basis and arbitrary. It is further stated that the house in question was about 60-70 years old and this fact has been verified by the Naib-Tehsildar, Tikkar as well as by the Fire Department. It is also stated that the complainant has completed all the codal formalities, but even then the genuine claim of complainant was not settled by the OPs on one or the other pretext due to which reason, the complainant issued a legal notice dated 16.12.2024, which was of no avail and as such, the complainant was compelled to file this complaint against OPs before this Commission on the grounds of deficiency in service and unfair trade practice on their part. Hence, this complaint. It is prayed that the complaint may be allowed as prayed for.

3. After admission of complaint, notices were issued to the OPs and they (OPs) filed their joint reply on 02.12.2025, but the learned counsel for the complainant objected that the said reply has not been filed by the OPs within stipulated period and prayed that the defence of OPs may be struck off.

4. After hearing the submissions made by Ld. Counsels for the parties and perusing the entire record carefully, the defence of OPs was struck off vide order dated 19.01.2026 when it was found that the OPs have failed to file their reply within stipulated period after receiving the notices of complaint from this Commission. However, the stand of OPs in their joint reply is that the insured value of the house in question is

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₹1,25,00,000/-, whereas, the complainant has submitted an exaggerated estimate to the tune of ₹2,93,63,200/-. It is further stated that the complainant was asked by the OPs number of time to supply the requisite documents, but the complainant has failed to do so and due to that reason, the claim of complainant could not be processed and settled. It is also stated that the house in question was an ancestral property and there were found 9 co- owners of the same including the complainant and the complainant is only entitled for 1/9 share in the same. It is further stated that after receiving intimation of fire and loss to the house of complainant, the OPs immediately deputed a surveyor, who assessed the loss and submitted his report and as per his report, the reinstatement value was assessed to the tune of ₹1,84,34,636/-, to which, 50% less depreciation along with less salvage value of material to the tune of ₹12,00,000/- was applied and net loss of ₹80,17,318/- was recommended by the surveyor to be paid by the OPs to the complainant. It is also stated that as the complainant has failed to supply the requisite documents and due to that reason, the claim could not be settled, however, if this Commission comes to the conclusion that OPs have wrongly withheld the claim of complainant, then the complainant is only entitled for 1/9 share from gross amount of ₹80,17,318/-, which comes to ₹8,90,813/-. It is further stated that neither there is any deficiency in service nor any unfair trade practice on the part of replying OPs. Hence, prayer is made to dismiss the complaint in the interest of justice.

5. The complainant has adduced evidence in support of his contentions. On behalf of complainant, affidavit of complainant Mr. Harsh Ranta was tendered in evidence. The complainant has also filed documents Annexure C-1 to Annexure C-16 in support of his contentions. No evidence has been led on behalf of OPs as the defence of OPs was struck off by this Commission vide order dated 19.01.2026. However, some

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documents Annexure OP-1 and Annexure OP-2 have been placed on record in support of their contentions.

6. We have heard learned counsel(s) for the parties and also gone through the entire record carefully.

7. After hearing the submissions made by Ld. Counsel(s) for the parties and perusing the entire record carefully including pleadings and evidence on record, it is very much clear that the house in question was got insured by the complainant with the OPs as per policy document Annexure C-2 w.e.f. 09.12.2022 to 08.12.2027 and the incident of fire, in which, the house was completely gutted in fire, took place on 02.09.2023 i.e. within the currency of insurance policy and also before completion of one year of policy. The plea of complainant is that he has completed all the codal formalities, but even then his genuine claim was not settled by the OPs and so has been asserted in the affidavit tendered in evidence.

8. The plea of OPs, on the other hand, is that the OPs after receiving intimation of loss to the house of complainant in fire, they (OPs) immediately appointed a surveyor, who assessed the loss and submitted his report Annexure OP-2, wherein, the gross loss has been assessed on reinstatement value basis to the tune of ₹1,84,34,636/- and after applying depreciation @ 50% and less salvage value of material to the tune of ₹12,00,000/-, the net liability of OPs was recommended by the surveyor to the tune of ₹80,17,318/-, but the same was payable by the OPs to the complainant only as per terms and conditions of the policy. It is also the plea of OPs that there were found 9 co-owners in the house along with the complainant being ancestral property and, therefore, the complainant is entitled only for 1/9 share, which comes to ₹8,90,813/-. It is further the plea of OPs that they (OPs) have written number of letters to the complainant to provide requisite documents so that the claim could be settled, but the same were not supplied by the complainant to the OPs and only due to that reason, the claim could not be settled.

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9. In this regard, perusal of record goes to show that the OPs were demanding estimate of loss and drawing details, copy of latest jamabandi, copy of tatima, copy of lease deed/sale deed, copy of sanctioned plan, certificate of loss from concerned Tehsildar, copy of FIR, copy of fire brigade report, copies of electricity and water bills and copy of newspaper cutting. The perusal of record also goes to show that there are copy of FIR, copy of jamabandi, copy of report of Tehsildar, copy of fire brigade report, copy of tatima, copy of water bill and copy of electricity bill on record. Perusal of the said documents clearly goes to show that Tehsildar and Fire Officer have clearly mentioned that the house of complainant was completely gutted in fire of incident, which took place on 02.09.2023. Hence, the demand of OPs from the complainant regarding said documents is not justified for settlement of claim and appears to be just delay tactics because all the said documents were made available by the complainant to the surveyor-cum-loss assessor as find mentioned in his report Annexure OP-2. However, there was found no breach of terms and conditions of the policy on the part of complainant. Moreover, as per terms and conditions of the policy, when there was found no breach of terms and conditions of the policy, then the OPs were under legal obligation to settle the claim of complainant because in this regard, the Insurance Regulatory and Development Authority (IRDA) has issued the guidelines and emphasized that insurance companies should not close the genuine claim on technical grounds including of delay in giving intimation or in submission of documents due to unavoidable circumstances and the insurer's decision to reject a claim should be based on sound logic and valid grounds and one needs to see the merits and good spirit of the clause, without compromising on bad claims. The Hon'ble Apex Court in case titled Gurmel Singh Versus Branch Manager, NIC, has also taken a similar view and held that while settling the claims, the insurance company should not be too technical and ask for

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documents, which were beyond the control of the insured to procure and furnish. It is very much clear from the foregoing discussion that the demand of documents by OPs from the complainant for processing the claim is not justified. Moreover, it is not a regular Court where minor contradictions make a big difference in the fate of the case. The Consumer Protection Act is a beneficial legislation and has been enacted to protect the interest of the consumers. Hence, it is clear that there is no breach of terms and conditions of the policy on behalf of the complainant and OPs have adopted delaying tactics not to settle the genuine claim of complainant by demanding documents, which were already supplied by him to the surveyor-cum-loss assessor.

10. The another reason for which, the claim was not settled by the OPs is that the complainant has submitted an exaggerated estimate to the tune of ₹2,93,63,200/-, though, the sum insured is ₹1,25,00,000/-. In this regard, the record clearly goes to show that the OPs have admitted the value of house of the complainant worth ₹1,25,00,000/- when the same was insured by the complainant with the OPs and this fact has been admitted by the OPs in its letter dated 14.02.2024 written to the complainant. Further, the OPs on the basis of joint affidavit of alleged to be of other co-owners in the house in question placed on record are saying that the said house was ancestral property and the complainant has only 1/9 share in it. Perusal of said joint affidavit of other alleged co-owners clearly goes to show that deponents have clearly stated in the said affidavit that the house in question has come into possession of the complainant after family partition and the same was insured by the complainant with the OPs and if the insurance claim is settled in favour of the complainant, then they have no objection in this regard. Hence, the OPs have tried to use the said affidavit otherwise just to delay the claim by saying that the persons, who have executed the affidavit, are co-owners and they are also

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entitled for the claim amount along with the complainant. However, the situation is otherwise because they have stated on oath that the house in question came into the possession of complainant in family partition and if the claim is settled in his favour, then they have no objection. Moreover, it is not the job of OPs to see whether the house is joint property or not because the OPs have entered into contract of insurance with the complainant and the OPs are under obligation to honour the same and cannot ask for division of the house. Otherwise also the division of the house is complex issue and not so simple. Hence the complainant alone is entitled to receive the indemnification amount from the OPs. As stated above, the defence of OPs has been struck off, but even then the stand of OPs has been discussed so as to set the controversy at rest and the report of surveyor is a valuable piece of evidence to settle the claim.

11. It is clear from the foregoing discussion that the house in question was insured by the complainant with the OPs for a sum of ₹1,25,00,000/- after making the payment of premium amount of ₹19,999/- and the premium amount is relevant so far the pecuniary jurisdiction of this Commission is concerned because the pecuniary jurisdiction is to be determined on the basis of value of goods or services paid as consideration. It is further clear from the foregoing discussion that the loss to the house in question was caused during the currency of policy and OPs were under obligation to settle the claim of complainant when the complainant has completed all the codal formalities and further the incident of fire and loss to the house has been established from report of Patwari, Tehsildar, Fire Officer along with other material on record. The OPs have withheld the claim of complainant on the grounds that the complainant has not supplied the requisite documents and the complainant is entitled only for 1/9 share as discussed herein above in details. Said action of the OPs not to settle the genuine claim of the complainant is no way found justified as per IRDA guidelines

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and decision of Hon'ble Apex Court as discussed hereinabove. Rather, it was obligatory upon the OPs to settle the claim of complainant where there was found no breach of terms and conditions of the policy. Meaning thereby that the action of OPs not to settle the genuine claim of complainant is found unjustified and the same amounts to deficiency in service and unfair trade practice on the part of OPs. The net conclusion of our foregoing discussion is that the complainant through evidence on record has been able to prove his case against the OPs so far deficiency in service and unfair trade practice are concerned and the OPs are under legal obligation to indemnify the loss caused of the house of complainant in fire incident. Accordingly, the present complaint deserves to be allowed. The complainant is also entitled for compensation on account of mental harassment and agony along with litigation charges.

12. Now comes the question of quantum of compensation. It is clear from record that the sum insured is ₹1,25,00,000/-. However, the complainant has submitted two estimates to OPs one is of ₹2,70,35,800/- and another is of ₹2,93,63,200/- and the OPs after receiving intimation of loss to the house of complainant in fire, the OPs as per their plea, immediately deputed a surveyor-cum-loss assessor, who inspected the spot and assessed the loss and submitted his report as Annexure OP-2. As per surveyor report, the surveyor has assessed the gross loss to the tune of ₹1,84,34,636/-, however, the surveyor has recommended the net liability of OPs to the tune of ₹80,17,318/- after carrying out deduction @ 50% on account of depreciation and ₹12,00,000/- on account of salvage value of the wreck material. We are well aware of the legal position so far value of the report of surveyor-cum-loss assessor is concerned, wherein, it has been held that the surveyor report has to be given due importance while awarding the compensation and the same cannot be ignored easily (United India Insurance

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Co. Ltd. vs. Deen Dayal, II (2009) CPJ 45 (NC),

Venkateshwar Syndicate versus Oriental Insurance Company Ltd. & another, II (2010)CPJ 1 (SC) and Khimji Bhai and sons vs. NIA, IV (2011) CPJ 458 (NC). However, the law is also to the effect that, although, the assessment of loss by the approved surveyor is a pre-requisite for payment or settlement of claim, if the amount exceeds twenty thousand rupees, but the surveyor's report is not the last and final word. It is not that sacrosanct that it cannot be departed from; because it is not conclusive. The approved surveyor's report may be the basis or foundation for settlement of a claim by the insurer in respect of loss suffered by insured but surely such report is neither binding upon the insurer nor insured" (New India Assurance Company Limited Vs. Pradeep Kumar (2009) 7 SCC 787 and National Insurance Company Ltd. Vs. M/s Hareshwar Enterprises (P) Ltd. & Ors. Civil Appeal No.7033 of 2009 followed).

13. Hence, in the light of settled position of law as laid down by Hon'ble Supreme Court of India in judgments cited (supra), it is to be seen whether the report of surveyor Annexure OP-2 is to be considered for awarding compensation to the complainant or not. Perusal of report clearly goes to show that the surveyor has discussed each and every detail in his report and mentioned the relevant clause of insurance policy, wherein, it has been mentioned that there was automatically increased to 10% per annum for policy on policy anniversary date, without additional premium and at the time of loss, the sum insured under ₹1,32,70,548/-. It is also mentioned in the report that the assessment has been made as per H.P.P.W.D. SCHEDULE OF RATES-2020 being latest. Hence, no escalation or cost index has been added. The assessment was made by the surveyor in the item mentioned in the report as per the prevailing local market rates. However, at the conclusion of report, the surveyor

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has recommended depreciation @ 50% straightway without assigning any reason. Not only this, the surveyor has also recommended less salvage value to the tune of ₹12,00,000/- again without assigning valid reasons and has recommended the liability of insurer towards the insured to the tune of ₹80,17,318/-. As mentioned above, as per policy, the insured sum so far value of property was concerned, is ₹1,25,00,000/- and as per surveyor-cum-loss assessor report, the sum insured at the time of loss was ₹1,32,70,548/-. Hence, it is not understandable that how the surveyor has recommended the depreciation @ 50% when he is mentioning in the report that insured value of the property at the time of insurance was ₹1,25,00,000/- and at the time of loss was ₹1,32,70,548/-. Meaning thereby that the value of property cannot be less than ₹1,25,00,000/- in any manner. Hence, the report of surveyor appears to be self contradictory and can be easily discarded for the reason mentioned above and the case law cited (supra) that although the report of surveyor is a relevant piece of evidence, but it is neither final word nor conclusive one. The complainant has submitted two estimates and the amount mentioned in the said estimates is definitely more than the insured amount and the report of surveyor is held to be self contradictory and the same cannot be relied upon for settlement of claim of complainant. As it has been established on record that it is a case of total loss, therefore, the complainant is entitled for the insured sum from the insurer i.e. ₹1,25,00,000/-, reason being that this is agreed amount between insurer and insured and there is no dispute in this regard between the parties. Further, as already held hereinabove that the alleged co-owners have no right in the claim amount and it is only the complainant, who is entitled to receive the entire compensation amount from the insurer for the loss of his house in fire incident. Hence, the insurer has to make the payment of indemnification amount to the complainant only.

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14. In view of the foregoing discussion and reasons assigned therein the complaint is ordered to be allowed and the OPs are directed to pay the sum insured amount of ₹1,25,00,000/- to the complainant along with interest @ 9% per annum from the date of filing of complaint till its payment. The OPs are also directed to pay a sum of ₹75,000/- as compensation for mental harassment and agony and sum of ₹25,000/- as litigation charges to the complainant. The OPs are also directed to comply this order within 45 days from the date of receipt of copy of the order. Pending application(s), if any, also stands disposed of. Copy of this order be supplied to the parties free of cost as per rule. The file after its due completion be consigned to the Record Room.

Announced on this the 2^ndday of July, 2026.

(Dr. Baldev Singh)

President

(Nidhi Sharma)

Member

*Ramesh*