NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
C. Viswanath, Presiding Member and Ram Surat Ram Maurya, Member
Biswajit Guha and Anr. – Appellants
versus
Branch Manager, New India
Assurance Co. Ltd. and Anr. – Respondents
First Appeal Nos.835 and 875 of 2013
Decided on 1.7.2022
Consumer Protection Act, 1986 – S.19 [Consumer Protection Act, 2019 – S.51] – Appeal against order of State Commission – Services – Insurance –“Contractor’s All Risk Insurance Policy” - Repudiation of Claim – “Rains” – Compelling to sign – Assessment of Loss – Justification for loss - Discharge voucher – Coercive practise – Duress - The Opposite Party submitted that on receipt of the Survey report, the claim was processed and the Complainant was paid a sum of Rs.27,63,782/-, subject to deduction of reinstatement premium, vide voucher dated 27.10.2008, towards full and final settlement against the claim of the Complainant - The Complainant had accepted the assessed amount without any pressure, coercion or undue influence. The claim was settled based on the report and assessment of the Surveyor. The Survey Report is an important document and cannot be ignored while settling claims. The Complainant had accepted the amount as assessed by the Surveyor and by signing the Discharge Voucher towards full and final settlement of claim - In the present case, the Complainant had written to the Opposite Party about the severe financial crisis being faced by him and the urgent needs to clear the pending payments of his staff in view of the ensuing Durga Puja and requested release of the claim amount – Thus, the Appellant was under severe financial crisis, he was compelled to receive Rs.27,83,782/- on protest to the Opposite Party, vide letter dated 29.10.2008, wherein again the Opposite Party was requested to review the reasons put forth by the Surveyor for deducting certain amount from the total amount payable - Complainant has not issued the Discharge Voucher of his own free will and volition but was executed under economic duress. Issuing Discharge Voucher in full and final settlement of the claim received by the Complainant in the facts and circumstances of the case, in the of the National Commission is a coercive practice. It is very essential that the justification for assessment of loss provided by the Surveyor needs to be properly examined before rejecting any claim made by the Complainant - Nowhere in the Surveyor Report any reason has been given nor elaboration made as to the sudden exclusion of certain items of works which is totally unjustified - The Opposite Party is directed to pay the difference in amount of Rs.50,17,699/- and the payment made, alongwith 6% interest from the date/payment/part claim was paid till realization within eight weeks from the date of this order - Appeals disposed off. [Paras 13 to 16].
Result: Appeal disposed off.
ORDER
Cross Appeals have been filed by the Appellants under Section 19 of the Consumer Protection Act, 1986 against the Order passed by the West Bengal State Consumer Disputes Redressal Commission, Kolkata (hereinafter referred to as the “State Commission”) in Complaint No.58/2010 dated 04.11.2013.
2. The Complainant is sole proprietor of M/s Vida Engineering Company which was awarded construction contract for road works at South Tripura by NBCC Ltd. According to the Complainant he took ‘Contractor’s All Risk Insurance Policy’ with the Respondent on payment of premium of Rs.3,48,316/- on 15.11.2007 and further two additional premia of Rs.1,03,987/- and Rs.1,13,076/- were realized. In the middle of July 2008, during the subsistence of the insurance contract, there was a heavy rainfall at the construction site which led to flash floods. This caused heavy damage to the project work. Thereupon, he infirmed the Insurance Company who deputed Surveyor Mr. S.R. Das to assess the loss. The Surveyor visited the site from 21.07.2008 to 24.07.2008 and undertook detailed inspection of the site. While at the site, he arrived at a loss figure of Rs.60,15,232/- for two affected road segments and the statement was signed both by the Complainant and the Surveyor. Based on this, the Complainant submitted a Claim Form with the Opposite Party recording the loss as Rs.60,15,232/- alongwith a photocopy of loss estimate prepared jointly the Surveyor during the inspection.
3. On his return to Kolkata, the Surveyor submitted a contradictory Survey Report dated 15.09.2008 in which he deviated from his earlier assessment of loss of Rs.60,15,232/-. In his detailed analysis of loss, the Surveyor assessed the total loss at Rs.58,58,644/-. He further deducted 10% contractor’s profit to which the Complainant protested, vide letter dated 29.10.2008. After deducting 10% Contractor’s Profit, the Surveyor arrived at a figure of Rs.52,81,788.60/- from which he deducted 5% policy excess amounting to Rs.2,64,089/- and thereby the total amount payable was shown as Rs.50,17,699/-. The Surveyor further deducted some items of the assessed damage to be ‘outside the scope of policy purview’ without any explanation and fixed the liability of the Insurance Company at Rs.27,63,787/-. In pursuance to the final Survey Report, the Complainant was sent a cheque amounting to Rs.27,62,174/-. The Complainant had on earlier occasion written to the Opposite Party about the severe financial crisis that he was facing and had to clear the pending payments of his staff, especially since Durga Puja was nearby and hence requested release of his claim amount. Since the Appellant was under severe financial crisis, he was compelled to receive Rs.27,83,782/- on protest with a letter dated 29.10.2008 to the Opposite Party wherein they were requested to review the reasons put forward by the Surveyor for deducting Rs.23,72,544/- from the total payable amount.
4. Aggrieved by the actions of the Surveyor and the Opposite Party, the Complainant filed a Consumer Complaint No.58 of 2010 before the West Bengal State Consumer Disputes Redressal Commission with the following prayer:—
“(a) direct the Insurance Company to pay to the Complainant the balance of compensation assessed by its Surveyor, amounting Rs.32,31,450.00;
(b) along with 18% interest over Rs.32,31,450.00 from 16.9.2008, the next date of submitting Survey Report, till the date of disposal;
(c) direct the Insurance Company to pay Rs.1,00,000.00 by way of compensation for harassment, suffering, mental agony to the Complainant caused by repudiating part of the survey’s total loss assessed.
(d) to pass such other order for public interest against the Insurance Company, as the Hon’ble Commission may deem fit and proper.”
5. During the course of hearing, the Complainant with the permission of the State Commission produced a report by an Expert which brought forth the inaccuracies in the Survey Report and independently assessed the loss payabl
(1) Survey Report - The Survey Report is an important document and cannot be ignored while settling claims.(2) Coercive practice - Complainant has not issued the Discharge Voucher of his own free wil....
The acceptance of an insurance settlement under protest does not forfeit the right to pursue further claims, affirming the consumer's right amid shortcomings in service.
Insurers must appoint qualified surveyors and provide just compensation based on thorough assessments; arbitrary alteration of surveyor findings by consumer commissions is impermissible.
The court emphasized the significance of a survey report in insurance claim disputes and affirmed that claims must align with properly assessed loss evaluations.
Insurance companies cannot avoid liability by citing external compensations, and second surveyors must be appointed with regulatory oversight.
The insurance company’s coercive practices in settling claims amount to deficiency in service under consumer law.
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