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J & K STATE CONSUMER DISPUTES
REDRESSAL COMMISSION, JAMMU
Hon’ble Mr. Justice Malik Sharief-ud-Din, President &
Mrs. Misra Maryum, Member
FAYAZ AHMED KAPTA—Complainant
versus
UNITED INDIA INSURANCE CO. LTD.—Opposite Party
Decided on 1.8.1995

Advocates:
Counsel for the Parties :
For the Complainant :Mr. Mumtaz Ahmed Kapta, Advocate.
For the Opp. Party :Mr. N.A. Kharoo, Advocate.

An insurance company is liable for negligence in dealing with a claim, and may be ordered to pay compensation for loss and injury suffered by the insured as a result of such negligence.

Headnote:

CONSUMER PROTECTION ACT - SECTION 21 - INSURANCE POLICY - DELAY IN SETTLEMENT OF CLAIM - NEGLIGENCE OF INSURANCE COMPANY - AWARD OF COMPENSATION FOR LOSS AND INJURY SUFFERED BY THE INSURED.

Fact of the Case:

The complainant, a policyholder with the opposite party insurance company, filed a complaint alleging that his shop and electronic goods were damaged due to seepage of water caused by heavy rains and that the insurance company failed to settle his claim despite repeated representations.

Finding of the Court:

The court found that the insurance company had been negligent in dealing with the complainant's claim, as it had failed to obtain a survey report from the surveyor initially appointed, and had subsequently deputed two more surveyors who had not conducted a proper survey. The court also found that the insurance company had fabricated its defense and had attempted to defeat the just claim of the complainant.

Issues: 1. Whether the insurance company was negligent in dealing with the complainant's claim? 2. Whether the complainant had suffered any loss or injury as a result of the negligence of the insurance company?

Ratio Decidendi: The court held that the insurance company had been negligent in dealing with the complainant's claim, as it had failed to obtain a survey report from the surveyor initially appointed, and had subsequently deputed two more surveyors who had not conducted a proper survey. The court also found that the insurance company had fabricated its defense and had attempted to defeat the just claim of the complainant.

Final Decision: The court allowed the complaint and directed the insurance company to pay the complainant a sum of Rs. 40,000/- with interest at the rate of 18% from the date of incident till the date of final realization, and a further sum of Rs. 15,000/- on account of the loss suffered by him as a result of the neglect of the insurance company.

ORDER

Mr. Justice Malik Sharief-ud-Din, President—The complaint is based on an Insurance Policy No.11402/57/1/1238/89 issued in favour of the complainant on payment of premium of Rs. 1,925/- in respect of insurance of his shop and electronic goods covering the period 8th of August, 1989 till 7th August, 1990 for a sum of Rs. 4.00 lacs. In the month of August, 1989 due to heavy rains the deep drain falling in front of his shop overflowed resulting in seepage of water into the shop causing damage to various goods lying on the floor of this shop. He lodged a report about the same with the police on 1.9.1989 and also informed the Insurance Company. According to the complainant one Mr. Ramesh Sazawal, Chartered Accountant, was deputed to conduct the survey and assess the loss and that the said Surveyor assessed the loss at Rs. 40,000/-. His contention further is that for a period of 10 months he kept the damaged goods in the same conditions and did not repair his shop but the Insurance Company failed to settle his claim. Consequently a notice was served on the Insurance Company after a lapse of time but even then it failed to settle the claim. He has now filed this complaint.

2. The version of the Opposite Party in short is that this complaint is barred by limitation . That Mr. Sazawal Surveyor had to flee the Velley due to unavoidable circumstances and has not submitted his Survey Report. That the Company has no knowledge about the amount of damage suffered. It is also stated that after the failure of Mr. Sazawal to submit his Survey Report and pursuant to a representation by the complainant Mr. G.M. Pir another Surveyor was deputed to assess the loss but he could not do so due to the failure of the complainant to cooperate and furnish the requisite documentary evidence and the Surveyor has reported that the claim of the complainant is fabricated. It is also stated that on another representation yet another Surveyor was deputed who also due to non-cooperation of the complainant reported no claim. Yet another plea of the Opposite Party is that keeping in view the features of the locality in which the shop is situated the area is not prone to floods and the case is fabricated. It is also stated that the drains in the locality never get flooded much less to cause any damage.

3. Now after hearing learned Counsels of the parties and after addressing ourselves to the circumstances and facts of the case and the respective stand of parties we may at once state that the last plea of the Opposite Party is based on assumption and presumptions. We are not concerned with the fact as to what are the local features. All that we are concerned with in as to whether on the date of incident the deep drain flowing in front of the shop got blocked resulting in seepage of water into the shop and whether as a result of this some of the goods lying in the shop got damaged.

4. Now to begin with we may point out that the stand of the Opposite Party is somehow curious. The incident has taken place in the last week of August, 1989 and Mr. Sazawal has been deputed immediately to conduct the survey. The case of the Opposite Party is not that Mr. Sazawal for some reason or other was not able to visit the spot nor is it the case of the Opposite Party that he did not conduct the survey. All that is stated is that he had to flee from the Valley and his present whereabouts are not known. We would like to take a notice of this fact that there has been no migration from the Valley in the year 1989. The migration most probably took place in the middle of 1990. We were therefore entitled to know form the Opposite Party as the what it was doing since August, 1989 till the middle of 1990 and why it failed to procure the Sourvery Report from Mr. Sazawal. One doesn’t under the circumstances know as to whether he has actually submitted the report and if it has been suppressed by the Insurance Company. In any case there is no justification for the plea that Mr. Sazawal has faile







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