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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
C. Viswanath, Presiding Member and Ram Surat Ram Maurya, Member
National Insurance Co. Ltd. and Anr. —Appellants
versus
Roxy Color Lab and Ors. —Respondents
First Appeal No.116 of 2012 and First Appeal No.178 of 2012
Decided on 3.2.2022

Advocates:
Counsel for the Parties:
For the National Insurance Co. Ltd.:Mr. Yogesh Malhotra, Advocate
For the Roxy Color Lab:Mrs. Girija Wadhwa, Advocate

Headnote:

(A) Consumer Protection Act, 1986 – S.19 [Consumer Protection Act, 2019 – S.51] – Services – Insurance – Fire Accident – Cross Appeal against order of State Commission – Plea of maintainability of Compliant raised on the ground that the Complainant is a Company involved in commercial activities and is not a Consumer as defined under the Consumer Protection Act, 1986, if can be sustained – Insurance Policy is taken for reimbursement or for indemnity of the loss which may be suffered on account of insured perils, the services of the insurer cannot be said to have been hired or availed for a commercial purpose – Also, The validity of the Insurance Policies has not been challenged by the Opposite Parties. The incident of fire is also admitted. [Para 10].

(B) Consumer Protection Act, 1986 – S.19 [Consumer Protection Act, 2019 – S.51] – Insurance Regulatory and Development Authority (Protection of Policy Holder’s Interest) Regulations, 2002 – Services – Insurance – Fire Accident – Whether Opposite Parties had wrongly settled the claim of the Complainant, on market value basis, by deducting an amount of Rs.19,53,745/- as depreciation value (as is evident from Annexure OP-30 Addendum to Final Report) – The State Commission, therefore, held that the conversion of the Policy from reinstatement basis to market value basis without the consent of the Complainant was against clause 4 of the guidelines of Insurance Regulatory and Development Authority (Protection of Policy Holder’s Interest) Regulations, 2002 (for short IRDA) – Thus, the Opposite Parties had wrongly settled the claim of the Complainant, on market value basis, by deducting an amount of Rs.19,53,745/- as depreciation value (as is evident from Annexure OP-30 Addendum to Final Report) – The Complainant was, therefore, entitled to get amount of Rs.19,53,745/-, which was wrongly deducted by the Opposite Parties. [Para 12].

(C) Consumer Protection Act, 1986 – S.19 [Consumer Protection Act, 2019 – S.51] – Insurance Regulatory and Development Authority (Protection of Policy Holder’s Interest) Regulations, 2002 – Services – Insurance – Fire Accident – Whether State Commission was justified in holding that the Complainant was entitled to get an amount of Rs.19,53,745/-, which was wrongly deducted by the Opposite Parties – No fresh proposal form had been taken by the Opposite Parties/Insurer while renewing the Policy from 08.07.2008 making changes in the Policy from ‘Market Value Basis’ to ‘Reimbursement Basis.’ The Complainant/Insured was not made aware of the change and no evidence to this effect has been placed by the Opposite Parties – Thus, State Commission was justified in holding that the Complainant was entitled to get an amount of Rs.19,53,745/-, which was wrongly deducted by the Opposite Parties. IRDA Regulations 9(2) clearly lays down that “In no case shall a surveyor take more than six months from the date of his appointment to furnish his report”. State Commission also rightly awarded interest for the delayed payments – The interest for the delayed payment granted by the State Commission is also justified – Appeals dismissed. [Para 14].

Result: Appeals dismissed.

ORDER

C. Viswanath, Presiding Member.—Cross Appeals have been filed by the Appellants under Section 19 of the Consumer Protection Act, 1986 against the Order passed by the State Consumer Disputes Redressal Commission, U.T. Chandigarh (hereinafter referred to as the “State Commission”) in Complaint No.17/2011 dated 30.01.2012.

First Appeal No. 178 of 2012 has been filed by the Appellant/Roxy Color Lab with a delay of 30 days as per the report of the Registry. For the reasons stated in the application IA/01/2012 in the interest of justice, the delay is condoned.

2. The case of the Complainant is that the its Digital Colour Laboratory, including plant and machinery, office equipment, raw-materials, goods held in trust and trade, were covered by Standard Fire & Special Insurance Policies bearing distinct Nos.420102/11/08/3100000052 and 420102/11/08/3100000182 from 08.07.2008 to 07.07.2009 and 06.01.2009 to 05.01.2010 respectively. The total risk cover was Rs.96 lakhs. Policy No. 420102/11/08/3100000052 was earlier being serviced by another Branch Office of the Opposite Parties and was renewed by Opposite Party No.2. While renewing Policy No. 420102/11/08/3100000052, without having got the fresh Proposal Form signed from the Complainant, the nature of loss assessment for the Policy was unilaterally changed by the Opposite Parties from the earlier “Reinstatement Basis” to “Market Value Basis” without their approval or knowledge.

3. A major fire took place on 09.04.2009 at the Complainant’s premises. The Opposite Parties were duly informed by telephone on 09.04.2009 and also vide letter dated 10.04.2009. The Opposite Parties appointed Cunningham Lindsey International Private Limited, New Delhi, a loss assessment company, to assess the loss of the Complainant. All the necessary documents, as sought by the Surveyor, were supplied by the Complainant and the same was informed to the Opposite Parties on 13.08.2009. Ad-interim relief of Rs.30 lakhs was released to the Complainant, vide Inter Office Memo dated 14.10.2009 by the Opposite Parties. The Complainant sought final settlement of its Fire claim, vide letter dated 05.11.2009. The Surveyors, however, vide letter dated 17.11.2009, sought further details after about 07 months after accrual of the claim. The Surveyor submitted a final report to the Opposite Parties on 03.02.2010 and assessed the claim at Rs.48,43,268/-. After adjusting the On Account Relief of Rs.30 lakhs, paid by way of an interim measure, the balance payable was Rs.18,43,268/-. The assessment was made on Market Value Basis, instead of Reinstatement Basis clause wherein no depreciation was deductible, thus causing a loss of Rs.19,61,749/- to the Complainant. Later the Surveyors, vide Addendum dated 01.04.2010 to the Final Report dated 03.02.2010, informed the Opposite Parties that the Final Assessment of loss stood reduced to Rs.48,01,272/- and the balance payable was Rs.18,01,272/- only. This was communicated by the Opposite Parties, vide letter dated 08.06.2010 to the Complainant. After much correspondence, the Opposite Parties, vide letter dated 27.07.2010, after over 15 months issued two cheques for Rs.4,78,153/- and Rs.13,17,500/- totalling to Rs.17,95,653/- to the Complainant, short by a sum of Rs.5619/-. In view of the aforesaid acts of omissions and commissions on the part of the Opposite Parties, amounting to deficiency of service and unfair trade practice, a Complaint was filed before the State Commission with the following prayers:-

(A) Admit the present consumer complaint and issue notice thereof to the Opposite Parties;

(B) Allow the present consumer complaint and direct the Opposite Parties to make the payment of the value of loss on Reinstatement Basis to the complainant being a sum of Rs.19,61,749/-;

(C) Allow the present consumer complaint and direct the Opposite Parties to make the payment of interest @ 15% per annum on the sum of Rs.19,61,749/- w.e.f. 01.08.2009 till actual realization; amount as o

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