The District Consumer Disputes Redressal Commission, Kupwara, has directed Bajaj Allianz General Insurance Co. Ltd. to pay ₹5 lakh to a shop owner after finding that the company failed to provide sufficient evidence to support its allegation that the bills submitted with an insurance claim were forged.
The Commission also awarded 6% annual interest, ₹50,000 for mental agony and harassment, and ₹20,000 towards litigation expenses.
Dispute over fire insurance claim
The case arose after a fire broke out at Ghulam Mohammad Shah’s readymade garments and cosmetics shop in Kupwara on 22 July 2017.
Shah had an insurance policy covering the shop’s stock for ₹10 lakh. Following the fire, he submitted a claim along with bills and other documents supporting the loss.
The company rejected the claim, alleging that the bills submitted by Shah were fake and forged. Shah challenged the rejection before the District Consumer Commission, alleging deficiency in service and seeking compensation for the loss.
Commission questions evidence behind claim rejection
The Commission examined the documents and evidence placed before it. One issue was a contradiction in the survey report.
The FIR and the report of the Fire and Emergency Services department recorded the incident as a fire. However, the survey report described the incident as a burglary.
The Commission found the survey report unreliable in view of this contradiction. It also examined the allegation that the bills were forged. The Commission noted that the company had not produced cogent evidence to establish that the bills were fake.
The order records that the company’s verification team had checked the bills. The shopkeepers who had issued the bills had also confirmed them by putting their seals and signatures on the documents.
The Commission therefore found that the company had failed to establish its allegation against the policyholder.
Company directed to pay compensation
The Commission held Bajaj Allianz liable for deficiency in service and unfair trade practice.
It directed the company to pay ₹5 lakh towards the loss suffered by Shah, along with 6% annual interest from the date of filing of the complaint until payment.
The company was also directed to pay ₹50,000 for mental agony and harassment and ₹20,000 towards litigation expenses. The order was to be complied within 30 days.
What does this mean for you?
The order highlights the importance of evidence when an insurance claim is rejected on allegations of fraud or forged documents.
For you, maintaining original bills, claim documents, survey reports and communication with the company can help establish the basis of a claim if a dispute arises.
Case: Ghulam Mohammad Shah v. Bajaj Allianz General Insurance Co. Ltd. & Ors.
Forum: District Consumer Disputes Redressal Commission, Kupwara, Jammu & Kashmir
