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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Dr. S.M. Kantikar, Presiding Member
Bajaj Allianz Insurance Co. Ltd. —Petitioner
versus
Ketan Vira & Anr. —Respondents
Revision Petition No.1357 of 2012
(Against the Order dated 25/01/2012 in Appeal No. 807/2009 of the State Commission Maharashtra)
Decided on 18.10.2016
Result: Revision Petition dismissed.
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Based on the provided legal document, the key points are as follows:
The case involves a property insurance claim under a Standard Fire and Special Perils Policy issued to Ketan Vira and Madhukant Vira for damage caused to stocks due to heavy rains and storm during the policy period (!) .
The insured filed a claim for damages caused between 19.9.2005 and 21.9.2005, which was initially allowed by the District Forum, directing the insurer to pay the claimed amount along with interest, mental agony compensation, and litigation costs (!) (!) .
The insurer appealed to the State Commission, which dismissed the appeal and upheld the District Forum’s order. The insurer then filed a revision petition, which was also dismissed (!) .
The insurer argued that there was a discrepancy between the storm and heavy rains, suggesting that the damage was not caused by a storm but possibly by other factors such as moss growth and porous roof sheets, and that the claim was repudiated before the final survey report was available (!) (!) (!) .
The insurer relied on a meteorological report indicating heavy rainfall on relevant dates and contended that the damage was due to inundation caused by heavy rains, which falls under the policy’s coverage for damage caused by flood and inundation (!) (!) .
The insured and their counsel argued that the damage was due to inundation from heavy rainfall and storm, which are covered per the policy’s clauses. They also emphasized that the insurer inspected the premises before issuing the policy and that the damage was consistent with inundation rather than other causes (!) (!) .
The court noted that the insurer repudiated the claim prior to the final survey report and that the surveyor’s report contained inconsistencies, such as conflicting observations about the roof damage (!) .
The court considered the definitions of ‘flood,’ ‘thunderstorm,’ and ‘inundation’ from authoritative sources, supporting the conclusion that the damage was caused by inundation due to heavy rains or thunderstorms (!) .
The court also reviewed relevant principles, including that survey reports are not sacrosanct and that decisions should be based on evidence and proper interpretation of the facts and policy clauses (!) (!) .
The court concluded that the evidence supported the finding that the damage resulted from inundation caused by heavy rainfall and thunderstorms, which falls within the coverage of the policy, and that the insurer’s repudiation was premature and unjustified (!) .
The revision petition was dismissed, affirming the earlier orders, and no material irregularity or jurisdictional error was found in the impugned orders (!) (!) .
Overall, the judgment emphasizes that claim repudiation should not occur before final survey reports and that consistent, evidence-based evaluation is essential in insurance disputes.
Dr. S.M. Kantikar, Presiding Member—The brief facts relevant to dispose of this revision petition are that, Mr. Ketan Vira and Mr. Madhukant Vira, complainants had taken Standard Fire and Special Perils Policy for a sum of Rs.3,43,50,000.00 from Bajaj Allianz Insurance Co. Ltd./OP covering the risk of building, machinery, furniture fittings and fixture stocks and others in their M/s K. P. Packing Konark Udyog. The policy was valid for 1 year i.e. from 18.07.2005 to 17.07.2006. During the subsistence of policy, between 19.9.2005 to 21.9.2005, there was damage to stock lying in the insured premises due to sudden storm, gusty winds and heavy rains. The complainants informed the OP on 21.9.2005 because, 20.9.2005 was being a staggering holiday and claimed total Rs.12,67,481/- from the OP. The petitioner appointed Mr. P. D. Desai, as a Surveyor and also obtained report from metrological department of Surat. Survey was conducted on 23.9.2005, but the copy of survey report was not furnished to complainant. On the basis of Surveyor’s report, the complainant claim towards reimbursement of loss was repudiated by OP. Therefore, aggrieved by unlawful repudiation, on 28.09.2006, the complainants filed a complaint before District Forum at Central Mumbai.
2. The District Forum after considering the pleadings and evidence, allowed the complaint and directed the OP to pay Rs.12,67,481.93 towards loss sustained due to storm with interest @ 10% from 21.9.2005, alongwith Rs. 20,000/- towards mental agony plus Rs.10,000/- as costs of litigation.
3. Aggrieved by the order of District Forum, the petitioner filed first appeal before the State Commission on 2.6.2009. The State Commission dismissed the appeal and confirmed the order of District Forum. Hence, against the impugned order of State Commission, this instant revision petition arose.
4. Learned counsel for both the parties present. Arguments heard at length. Learned counsel Mr. Nandwani, for the petitioner submitted that there is a difference between thunderstorm and storm. As such, there was no storm or heavy rains between 19.9.2005 to 21.9.2005. The OP had element of suspicion that, how the only part of roof of godown was affected and not the entire roof during the storm. Counsel brought my attention towards the condition of the policy under clause ‘VI’ of the policy, which are reproduced as under:-
“Clause VI
Storm, Cyclone, Typhoon, Tempest, Hurricane, Tornado, Flood And Inundation.
Loss destruction or damage directly caused by storm, cyclone, typhoon, tempest, hurricane, flood and inundation, excluding those resulting from earthquate, volcanic eruption or other convulsions of nature.”
5. About metrological report, the counsel submitted that the observation made by District Forum and the findings recorded by the Surveyor are more relevant that the date and time of loss or damage was noticed on 21.9.2005 at 9.00 hrs. Further, there was growth of moss on inner surface of the roofsheet, therefore, the sheets became porous. The repair/sealing was carried out on the joint prior to the occurrence. Such sealing becomes necessary only when gap is wider and leakage through the said roof. He brought my attention towards photographs of roof sheets. Learned counsel squarely relied upon the survey report and the observation of District Forum which is reproduced hereunder:
“The contentions of surveyor appears to be absurd as at one end the surveyor says that on inspection of the roof no sign or symptoms or displacement of the roof sheets could be seen and on the other hand the surveyor says that photographs also do not reflect the same. It appears that what the surveyor saw he is not sure hence he wants to confirm the same in the photographs. It is astonishing that what cannot be seen by the person inspecting the spot of the incident as displacement of roof as rightly contended by the Surveyor & Opponent Company is not a small event which goes unnoticed.”
Therefore, the counsel submitted that both t
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