[Resolved]  The Oriental Insurance Company Ltd - Veraval Branch — Partial Claim Settlement

Address:

Junagadh, Gujarat

Dear Sir/Mada,

I state hereunder the fact of my complaint.

Dwarka B. Kundlani











[protected]
To,
The Manager,
The Oriental Insurance Company Ltd.,
Near Public Library,
Bunder Road,
Veraval – 362 265.

Dear Sir,

Sub : 142803/11/2010/152 Exp.[protected].
Claim No.142803/11/2010/000002
Ref : Your Discharge Voucher dated[protected]

Please refer to my loss/damage Intimation letter dated[protected] in
which estimate of loss/damaged claimed by me is of Rs.6,10,000/-
(Rupees Six Lac Ten Thousand Only).

In consideration of disapproval of my claim, I hereby deny from the
Oriental Insurance Company Limited the sum of Rs.9355/- in full and
final settlement of my claim for the loss of property which occurred
on[protected] and[protected] covered under the above policy number.

I hereby bind the company for the full & final settlement of my claim
of Rs.6,10,000/- in respect of the said loss. I hereby do not
transfer any of my rights and remedies to the Oriental Insurance
Company Ltd who has indemnified me in respect of the loss till the
claim is settled.

Thank you,

Yours faithfully,



Dwarka Balchand Kundlani
The insured.












To,
The Manager, [protected]
The Oriental Insurance Company Ltd.,
Near Public Library,
Bunder Road,
Veraval – 362 265.

Dear Sir,

Sub : Policy No.142803/11/2010/152 Exp.[protected].
Claim No.142803/11/2010/000002

It has been considerable length of time since I had intimated the
loss/damage to your office through my letter dated 16.07.2009. The
claim of Rs.6,10,000/- is not yet settled by you. It is far from my
capacity to understand the reason behind so much delay that has taken
in settling the claim. Please let me know if any document is required
by you other than what I have duly provided to you as per the letter
received from the surveyor.

The loss has made me handicapped financially. I am facing great
financial hardship. Your early settlement of claim will restore me in
the same financial position as I was before. However, I am unable to
wait for unnecessary long time as it will lead me further damage and
put me financially from bad to worse situation so I request you to
please settle the claim at the earliest and do not oblige me to take
the help of third party mediation like insurance ombudsman.

Thank you,



(Dwarka Balchand Kundlani)
The Insured

To,
The Manager, [protected]
The Oriental Insurance Company Ltd.,
Near Public Library,
Bunder Road,
Veraval – 362 265.

Dear Sir,

Sub : Policy No.142803/11/2010/152 Exp.[protected].
Claim No.142803/11/2010/000002

The discharge voucher of Rs.9355/- issued by you is partial (short)
payment and is underestimated settlement of the claim so I have not
signed it and is not correct arriving at the settlement of the case
according to the actual loss incurred to my property.

It is now after receiving my letter through registered ad that
clarifications are issued. Yes, I have received a letter of
20/07/2009 from the surveyor about the claim related papers but it
does not mean that I have not sent the detailed estimate alongwith
required building papers duly signed by me. I have not received any
reminders over phone that the same have not been received by him. It
is only after I rang him over the phone that I have received partial
(short) discharge voucher from the insurance company then he told me
that papers have not been received by him. I am sending herewith 2nd
copy of all the required documents. Before issuing the survey report,
if he had asked me to provide 2nd copy of all the documents, I would
have sent at the earliest because documents are in order with me.

I have insured my property as under :-

1) Building Rs.3,50,000/-
2) FFF Rs. 50,000/-
3) Contents Rs.2,10,000/-

According to photographs taken by the surveyor, my house is not
totally destroyed. I agree with you that my house is not totally
destroyed but I will never agree that my house has not been washed
out. Only the building has not fallen to the ground, otherwise
everything is done to the house. You would consider for Rs.3,50,000/-
only if the building is totally damaged and if not nothing, no one
would take the policy from you. I have estimated the repairing cost
of the building to Rs.3,50,000/-. The total cost of the building is
greater the amount than what I have insured. Each and everything in
the house has been destroyed. I have also taken the photographs. If
you base your report solely on the photographs and rely on your survey
report is partial, unjustified and not fair.

P.T.O
If you consider the entry level of water of 2 feet only to my house
then it will make all the newspapers, the people living the area, the
Mamalatdar report and survey of Municipality wrong in their estimate
of level of water entered in the houses of our society. The muddy and
sandy water entered in my house is upto 4 ½ to 5 feet and not 2 feet.
I have kept the evidence to prove that. The Furniture items and most
of the contents do lie to this level and these items are destroyed and
some are washed away with the water.

The surveyor did not even called me up to say that he required the 2nd
copy of the documents, the question of all the facts explained by him
does not arise.

Since, my claim is not settled which amounts to Rs.6,10,000/- and
since the discharge voucher is of short payment, I cannot sign it
until full & final claim is settled.

Thank you,

Yours faithfully,



Dwarka Balchand Kundlani
The insured.


From:
Dwarka Balchand Kundlani
Dabhor Road, Nr. Gayatri Mandir,
Veraval – 362 266.
(Junagadh)


To,
Shri Amitabh,
Insurance Ombudsman
2nd Floor, Ambica House
Nr. C. U. Shah College
Ashram Road,
Ahmedabad – 380 014.
[protected] / 27546142
e-mail : ins.[protected]@rediffmail.com

Sub : Policy No.142803/11/2010/152 Exp.[protected].
Claim No.142803/11/2010/000002

Dear Sir,

I have taken the Fire & other perils Policy for my house located at
Dabhore Road, Nr. Gayatri Mandir, Veraval from The Oriental Insurance
Co., Ltd., Veraval Branch as per the details mentioned above. After
the flood, furniture, goods and house are damaged. I have intimated
on time of the damage/loss to my property to the insurance company.
The survey of my house is conducted. The house is extensively damaged
and goods and furniture in the house are completely destroyed. I have
provided them a copy of all the documents asked by them as per their
letter. I have put the claim of Rs.6,10,000/- (sum assured) though
the estimate of damage/loss is more than that. In response to my
claim, they have issued me a discharge voucher of Rs.9,355/- which is
partial, unfair and unjustified settlement of the claim.

I have registered my complaint with them about the partial settlement
of the claim and requested them to settle the claim of Rs.6,10,000/-
as full & final settlement of my claim. But they have not responded
to my letters.

I enclose herewith the policy and other documents corresponded with
the company till now.

I kindly request you to register my complaint and do the needful in
this matter so that my claim of Rs.6,10,000/- is settled.

Thank you, cc to : (1)The Manager, The Oriental Insurance Co. Ltd. VRL
(2)Mr. Manoj Shukla, Surveyor, Junagadh.
Yours faithfully,


Dwarka Balchand Kundlani
The Insured

[protected]
To,
The Regional Manager,
The Oriental Insurance Co. Ltd.,
3rd Floor, Navjivan Trust Building,
B/h Gujarat Vidyapith, Off. Ashram Road,
Ahmedabad – 380 014.

Dear Sir,

Sub : Policy No.142803/11/2010/152 Exp.[protected].
Claim No.142803/11/2010/000002

I had taken Fire & other perils Policy for my house located at Dabhore
Road, Nr. Gayatri Mandir, Veraval from The Oriental Insurance Co.,
Ltd., Veraval Branch as per the details mentioned above. After the
flood, furniture, goods and house are damaged. I have intimated on
time of the damage/loss to my property to the insurance company. The
survey of my house is conducted. The house is extensively damaged and
goods and furniture in the house are completely destroyed. I have
provided them a copy of all the documents asked by them as per their
letter. I have put the claim of Rs.6,10,000/- (sum assured) though
the estimate of damage/loss is more than that. In response to my
claim, they have issued me a discharge voucher of Rs.9,355/- which is
partial, unfair and unjustified settlement of the claim.

I have registered my complaint with the Branch office about the
partial settlement of the claim and requested them to settle the claim
of Rs.6,10,000/- as full & final settlement of my claim.

I had also registered my complaint with Insurance Ombudsman, Ahmedabad
and requested him to do the needful in this matter. He has directed
me to approach you for my grievance. He has instructed me to approach
his office if the matter is not settled within one month. I request
you to look into the matter seriously. Because of the extensive
delay, I am incurring much more financial loss than the claim of
Rs.6,10,000/- is settled with interest since the lodging of the claim.

Thank you, cc to : (1)The Manager, The Oriental Insurance Co. Ltd. VRL
(2)Mr. Manoj Shukla, Surveyor, Junagadh.
Yours faithfully,


Dwarka Balchand Kundlani
The Insured

[protected]

Insurance Ombudsman
2nd Floor, Ambica House
Nr. C. U. Shah College
Ashram Road,
Ahmedabad – 380 014.
[protected] / 27546142
e-mail : ins.[protected]@rediffmail.com

Dear Sir,

Sub : Policy No.142803/11/2010/152 Exp.[protected].
Claim No.142803/11/2010/000002

Ref : A letter dated _______________ sent to you.

In response to my letter dated ______________ sent to you, you had
directed me to first register my complaint with Regional Office of the
insurance company. If I do not get response from the office in one
month, I should write a letter to you.

I have to state that I have not received any letter from the Regional
office of the company. But I have received a letter from branch
office, Veraval. I state hereunder the points that they have
mentioned in their letter:

(1) That Discharge voucher was “full and Final Payment. It was not partial.

Please refer to my loss/damage Intimation letter dated[protected] in
which estimate of loss/damage claimed by me is of Rs.6,10,000/-
(Rupees Six Lac Ten Thousand Only). Though the damage/loss is more
than Rs.6,10,000/-, I have not claimed more than Rs.6,10,000/- because
I had indemnified my property against loss to the amount of
Rs.6,10,000/-. I have paid full premium to cover the loss of amount
of Rs.6,10,000/-. Even if I have not paid less premium and the
loss/damage intimated by me is Rs.6,10,000/-. I have received
discharge voucher of Rs.9355/-. The Discharge voucher is not full and
Final Payment and is partial because against the loss/damage of more
than Rs.6,10,000/-, an amount of Rs.9355/- is issued. This is
partial, unfair and unjustified in any sense of the term. In fact, I
have incurred more loss than what I have indemnified. I have not
claimed any penny over and above what I have indemnified. In fact, I
have incurred more loss than what I have indemnified. I have not
claimed any penny over and above what I have indemnified.

(2) That they have sent a letter to the concerned surveyor in response
to my letter. The surveyor has responded that discharge voucher is
all right and no change is required.

(2) Damage to my property was done on 15.07.2009. Reporting of damage
was intimated on 16.07.2009 and the survey was carried out on
17.07.2009 when the water was receded. The amount of loss surveyed by
the surveyor is unjust, unfair, unreasonable, imbalanced and partial.

The photographs are taken on 17.07.2009. According to photographs
taken by the surveyor on 17.07.2009, my house is not totally
destroyed. I agree with you that my house has not fallen to the
ground. But I will never agree that my house has not damaged due to
flood water. Only the building has not fallen to the ground,
otherwise everything is done to the house. I have estimated the
repairing cost of the building to Rs.3,50,000/-. The total cost of
the building is greater the amount what I have insured.

Contents and FFF are totally destroyed. Some are also washed away
with flow of the flood water.

Each and everything in the house has been destroyed. If you base your
report solely on the photographs and rely on your survey report is
partial, unjustified and not fair.

The house has received the impact of the flood water. The flood water
had made a way through the floor tiles. All the tiles of the all the
floor are cracked and the flood water had seeped through these tiles
made damage to the foundation resulting the cracking of the walls of
the rooms. It has also destroyed the lighting system. There had also
been short circuit in the house which had destroyed the lighting
system of the house which has been replaced. It had cost around
Rs.35000/-. The iron net set in the window has completely been rusted
due to water and needs to be replaced. The windows, doors, the
setties, Palangs, the beds, the pillows, the household goods, kitchen
wares, the china items are broken and rest of the household items are
washed away with the flow of the water, the iron-sheet cup boards,
bags, clothes, chairs, fans, tube lights, bulbs, are damaged not
direct with the touch of the water but when the water entered inside
the lighting system, it caused the short circuit and because of the
short circuit, all the electrical items are short circuited and
destroyed.

(3) That the details of the insurance taken is as under:
(1) Building Rs.3,50,000/-
(2) FFF Rs. 50,000/-
(3) Contents Rs.2,10,000/-

(4) That according to the survey report and the photographs taken, my
building is not totally damaged, washed away with water, fell down nor
met with the ground. Whatever damage has been done to my building by
2 to 2.5’ of flood water has been surveyed and the payment is made
accordingly. Damage to the building is not done to the amount of
Rs.3,50,000/- so it is not payable.

(5) In the same way, contents and FFF which are damaged up to level of
2 to 2.5’ of flood water has been surveyed and also included in the
discharge voucher.

(6) That there could be many things above 2.5’ level of the house such
as Fan, Tube lights, furniture on the wall etc. which could not be
damaged.

(7) That surveyor has carried out survey according to the terms and
conditions laid out in the policy.

(8) That I have not proved that my house and the contents of the house
have been washed away with the flood water or are totally destroyed
and that this house is not being used now.

Whatever damage to my house, contents and FFF has been done upto the
water level has been surveyed and discharge voucher issued according
to the survey is correct

Now, I state hereunder my points of complaint :

Please refer to my loss/damage Intimation letter dated[protected] in
which estimate of loss/damage claimed by me is of Rs.6,10,000/-
(Rupees Six Lac Ten Thousand Only). How could it be final payment and
not partial? Have I not paid the full premium to cover the amount of
Rs.6,10,000/- to indemnify my property against the loss? Against the
claim of Rs.6,10,000/-, I was issued a Discharge voucher of Rs.9355/-.
If it is not called partial then what could be called. In fact, I
have incurred more loss than what I have indemnified. I have not
claimed any penny over and above what I have indemnified.

Damage to my property was done on 15.07.2009. Reporting of damage was
intimated on 16.07.2009 and the survey was carried out on 17.07.2009
when the water was receded. I doubt the cent percent reliability of
the survey report made after the damage/loss to my property. The
amount of loss surveyed by the surveyor is unjustified, unfair and
partial.

According to photographs taken by the surveyor, my house is not
totally destroyed. I agree with you that my house is not totally
destroyed but I will never agree that my house has not been washed
out. Only the building has not fallen to the ground, otherwise
everything is done to the house. I have estimated the repairing cost
of the building to Rs.3,50,000/-. The total cost of the building is
greater the amount what I have insured.

Contents and FFF are totally destroyed. Some are also washed away
with flow of the flood water.

Each and everything in the house has been destroyed. If you base your
report solely on the photographs and rely on your survey report is
partial, unjustified and not fair.

The house has received the impact of the flood water. The flood water
had made a way through the floor tiles. All the tiles of the all the
floor are cracked and the flood water had seeped through these tiles,
made damage to the foundation resulting the cracking of the walls of
the rooms. It has also destroyed the lighting system. There had also
been short circuit in the house which had destroyed the lighting
system of the house which has been replaced. The water has entered in
the safety tank. All the walls of the safety tank are broken. They
need to be reconstructed. The Otlo has detached from the house and
washed away by the water and needs to be reconstructed. The house has
tilted to the side and has received maximum impact of the flood water.
The tiles have separated to each other and need to be set after
filling in the Manchad. The plaster and colour of the wall has been
peeled out and needs to be replastered and coloured. The iron net of
the windows are completed rusted by the water and the windows and
doors are not workable. The plywood of setties, Palang, chairs,
tables have come off. There is no way out but to replace them. The
clothes, beds, bed sheets, shawls, are completely washed away in
water. They are giving stinking smell. The iron net set in the
window has completely been rusted and needs to be replaced. The
windows, doors, the setties, Palangs, the beds, the pillows, the china
items are broken and rest of the household items are washed away with
the flow of the water, the iron-sheet cup boards, bags, clothes,
chairs, fans, tube lights, bulbs, are damaged not direct with the
touch of the water but when the water entered inside the lighting
system, it caused the short circuit and because of the short circuit,
all the electrical items are short circuited and destroyed.

We left the house to save our lives when the water level in our house
was 4 feet. The water gushed into our house which made us unable to
shut the doors and windows. When we returned to house, most of the
items were washed away with flow of the water after the water receded.
The rest of the goods in the house were completed damaged and
destroyed. We have carried out the estimate of repairing work of the
house which has cost us more than Rs.3,50,000/-. FFF and Contents are
completely destroyed. Because the walls have become weak the slab has
tilted to one side. The whole structure needs to be rebuilt.

As of now, we are not residing in this house because of the fear of
poor structure caused by the flood water and may fall at any time.
Even if we live in this structure, we are not getting the facilities
that we used to get. The toilet water is choked. It does not enter
in the safety tank because all the walls of the safety tank are broken
and have come to the ground. We cannot sit on the Otlo which has
detached with the house and completely decomposed. The choktha have
separated from the walls. The doors, windows have separated from the
walls and are hanging on the floor. Because the water has seeped
through the tiles, it has done maximum damage to the walls and because
of it the slab may give way. The whole structure may give way and
fall to the ground at any time. One part of the house is sloped
towards the other so it is not residentiable.

If it is surveyed the entry level of water of 2 feet only to my house
then it will make all the newspapers, the people living the area, the
Mamalatdar report and survey of Municipality wrong in their estimate
of level of water entered in the houses of our society. The muddy and
sandy water entered in my house is upto 4 ½ to 5 feet and not 2 feet.
The Furniture items and most of the contents do lie to this level
and these items are destroyed and some are washed away with the water.





Documents enclosed:
(1) Intimation Letter of Damage/loss dated[protected].
(2) Policy copy
(3) Claim Form
(4) Estimate of Claim
(5) Newspaper cuttings
(6) Blueprint of House
(7) Dastavej of House (and power of attorney of my father in my favour)
(8) Light Bill