Loss by erosion not covered in Householders Policy – Insurance Ombudsman

GUWAHATI INSURANCE OMBUDSMAN Complaint No. GUW-G-048-1314-0219 Md. Surjat Ali – Vs – National Insurance Co. Ltd.

Insurance Ombudsman Date of award: 12.12.2013

Complainant: The Complainant stated that he procured Householder’s Policy No. 200702/48/11/3600000042 insuring the house and the entire household items from the National Insurance Co. Ltd. covering the period from 10.05.2011 to 09.05.2012. While the policy was in force, his house was damaged due to erosion of Velengi River. Thereafter, he lodged a claim before the Insurer along with all supporting documents. But, the Insurer has repudiated the claim without any justified ground. Feeling aggrieved, the Complainant has approached this Authority with the above complaint. Insurer : The Insurer has stated in their “Self Contained Note” that Householder’s Policy No. 200702/48/11/3600000042 issued in the name of Md. Surjat Ali insuring his house and entire household items by us covering the period from 10.05.2011 to 09.05.2012. They received a claim intimation on 19.06.2012 stating that on 16.06.2012, due to increase of water level of Velengi River erosion effected the insured building/contents. Accordingly, they deputed their Surveyor to assess the loss and as per survey report it is confirmed that due to erosion insured suffered loss which risk is not covered under section-1 of Householder’s policy. Hence, they have repudiated the claim. Decision : I have carefully gone through the entire documents available on record including the statements of the parties. The Complainant has submitted a copy of certificate issued by the Circle Officer, Baghbar Circle Office, Mandia before this Authority which discloses that after investigation from the said Circle Office, they found that on 21.06.2012 the building of the Insured Md. Surjat Ali was damaged due to erosion of Velengi River. From the said report it is ample clear that the insured building was damaged due to erosion of Velengi River. The Survey Report discloses that the Surveyor assessed the loss at Rs. 1,29,941/-. He also mentioned in remark column that the Insured claimed that his residence building was partially damaged on 16.06.2012 at night hour. However, on scrutinizing the damaged certificate issued by respective authority / person, it is come to light that the date of damaged of the insured residence building is mentioned as 21.06.2012. In reply the Insured stated that his building was partially damaged on 16.06.2012 at night hour. Simultaneously, whole building was submersed in to river Velengi on 21.06.2012. So, while issuing certificate, the respective authority / person mentioned the exact date on which the building was totally damaged due to erosion. The Insurer has repudiated the claim on the ground that the erosion is not covered under section – 1 of the Householders’ Policy. It appears from the terms and conditions of the Householders’ Insurance Policy that the Section – 1 : Building and Contents reads as under : The Company will indemnify the Insured in respect of loss of or damage to the contents / building whilst contained in the insured premises by :-

1. Fire, Lightning, Explosion of gas in domestic appliances.
2. Bursting and overflowing of water tanks, apparatus or pipes.
3. Aircraft or articles dropped therefrom.
4. Riot, Strike or Malicious Act.
5. Earthquake Fire and / or Shock, Subsidence and Landslide (including Rockslide) damage.
6. Flood, Inundation, Storm, Tempest, Typhoon, Tornado or Cyclone.
7. Impact damage.

From the above policy condition, it is manifestly clear that only the above damages were covered under the Householders’ policy. It is clearly proved that erosion was not covered under the above policy. As per terms and conditions of the policy, the Insured / Complainant is not entitled to get the claim amount. Considering the above facts and circumstances, I have no hesitation to hold that the decision of the Insurer in repudiating the claim of the Complainant was just and reasonable. In the result, this complaint is dismissed and is treated as closed.