Insurance Ombudsman rejects Flood Insurance Claim on account of fraud

Case No: CHD-G-005-1516-0515
In the matter of Mr Bashir Ahmad
Bajaj Allianz Insurance Co. Lt.

Insurance Ombudsman Date  –  12.02.2016

FACTS: Mr Bashir Ahmad complained to this office on 06.10.2015 that his claim on account of damage to the stock due to floods has not been paid. His karyana shop which was known as M/S K C Mart was insured by Bajaj Allianz General Insurance Company under their Policy No. OG-14-1205-4092-00045253 for the period from 07.03.2014 to 06.03.2015 for a sum insured of Rs.20 lacs. There were floods in the Srinagar in September 2014. Insured claimed that stock of shop was damaged and was thrown away as it had started giving foul smell. Insurer deputed an investigator to verify the facts. During investigation it was found that the insured had already handed over the possession of the shop to the landlord. Since building was already handed over to the landlord, there is no question of any damages to any stock.

FINDINGS: The complainant has produced a photocopy of an agreement with the landlord which stated that physical possession of the building was handed over to landlord in October 2014. Document produced was only copy of the front page which does not prove when the stamp papers were actually purchased. On the other hand insurance company has produced original letter no. CRB/flood/2014/3257-58 dated 11.12.2014 from Sub Divisional Police Office, Kothibagh to Superintendent of Police, City East Zone Srinagar in which it has been stated that Mr Bashir Ahmed (complainant)”was running a shop from 2012- till July 2014 on monthly rental basis. He had already handed over the possession of the shop to landlord Haji Mohmmad Amin. Therefore, he was not in possession of the shop in question at the time of floods”.

DECISION: In view of the finding of the police and complainant having no rebuttal, it was concluded that complainant was not in possession of shop at the time of floods in September 2014 and consequently no damage to the stock. Therefore, complaint was dismissed.