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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Dr. Inder Jit Singh, Presiding Member
Inland World Logistics Pvt. Ltd. – Complainant
versus
Oriental Insurance Co. Ltd. – Opp. Party
Consumer Case No. 2556 of 2017
Decided on 25.1.2023
Consumer Protection Act, 1986 – S. 21(a)(i) – [Consumer Protection Act, 2019 – S.58(1)(a)(i)] – Services – Insurance – Repudiation of Claim – if justified – Factum of fire accident not justified - for repudiation viz; cause of fire not established, OP could not show any clause in the policy which would permit the OP to repudiate the claim if the cause of fire is not established. In this case, even the expert/competent authority like FSL report, fire Deptt. etc. have not been able to come to a definite finding after detailed investigation about the cause of fire. Loss due to fire is not in dispute. There is no allegation that the fire was caused deliberately - Further, it is admitted that the same fire incident also engulfed a few other establishments adjoining to the complainant and the same OP has admitted and paid the claim of two other establishments who suffered loss in the same fire incident. Hence, the reasoning to repudiate the claim on this ground is not valid – Therefore, reasons given by the OP in their repudiation letter dated 22.9.2015 are not valid and hence the said repudiation letter is set aside. OPs are directed to consider and pay the claim of the complainant on merits as per the report and assessment dated 31.07.2012 of the surveyor appointed by them; subject to standard deductions as per policy conditions - Consumer Complaint is allowed. [Para 14 to 19].
Result: Complaint allowed.
ORDER
The present Consumer Complaint (CC) has been filed by the Complainant against the opposite party as detailed above, inter aila praying for directing the Opposite Party (OP) to:—
(i) grant Rs.17,41,94,520/- alongwith interest @18% p.a. towards the loss of goods due to the accident (Rs.7,75,00,000/- towards principal, and interest Rs.9,66,94,520/-, calculated @18% from 14.09.2010 to 15.07.2017);
(ii) grant pendentelite and future interest @ 18% per annum till realization;
(iii) grant an amount of Rs.50,00,000/- towards damages;
(iv) grant cost of litigation of Rs.10,00,000/-.
2. Notice was issued to the opposite party on 20.09.2017 giving them 30 days’ time to file their written statement.
3. It is averred/stated in the complaint that:—
(i) That the complainant is a company incorporated under the Companies Act, 1956 and is engaged in transportation of consignments across India for various customers. The complainant is a logistic company which is globally respected as one of the industry leaders in offering point to point services for transportation of goods and storage facilities and has over 350 locations, fleet of vehicles and a nation-wide network. The complainant, so as to secure the goods, which would be stored in its various warehouses across India, has always been taking insurance policies with the OP. As per regular practice, OP had issued many policies including the relevant Standard Fire and Special Perils Policies for the year 2009-2010.
(ii) The complainant obtained the policies from the OP (a) Standard Fire & Special Perils Policy No. 311700/11/2010/201, Policy period from 04.09.2009 to 03.09.2010, sum insured Rs.27,66,00,000/- covering 32 premises. The goods covered were “Stock (GNL Merchandise Non Hazardous Goods on A/c of various clients, Goods held on trust, Cloths, Yarns, Mach”, (b) Standard Fire & Special Perils Policy No. 311700/11/2010/202, Policy period 04.09.2009 to 03.09.2010, sum insured was Rs.59,19,00,000/- covering 110 premises. The goods covered were “Stock (GNL Merchandise Hazardous and Non-Hazardous Goods on A/c of various clients, Goods held on Trust”.
(iii) During the pendency of the Insurance Policies, unfortunately a fire broke out on the intervening night of 13.02.2010 and 14.02.2010 in a few of the premises covered under the above two policies. The affected premises were covered under Sr.No. 8, 9 and 10 under Policy No. 201 and Sr.No.24, 29 and 31 under Policy No.202. The complainant informed the OP about the fire accident immediately on 15.02.2010 by way of letter informing that Sr.Nos. 8,9 and 10 covered under Policy No. 201 and vide another letter of the same date had informed that Sr.Nos. 24 and 31 covered under Policy No. 202 have been badly affected due to fire. The complainant vide another letter dated 16.02.2010 informed the OP about the loss at premises mentioned in Sr.No. 29 also under policy No.202.
(iv) The OP vide its letter dated 18.02.2010 replied that the Surveyors and Loss Assessors have been deputed and requested the Complainant to fill up the claim form attached with the letter. The OP had appointed Absolute Surveyors Pvt. Ltd. as the Surveyor for the present claim. The complainant vide letter dated 19.02.2010 specifically described the affected locations by providing the list and details of those godowns and buildings in which the damage occurred. Vide letter dated 20.02.2010, the complainant also informed the OP that all the records, books, documents and papers got burnt and there is no access to any paper. However, the complainant explained that they are trying to organise the records through the help of various branch offices and provided a provisional stock sheet as on 13.02.2010. The complainant vide letter dated 24.02.2010 informed the OP that there was no casualty in godown No.4,6,7,9 ground floor and mezzanine floor and platform at Strand warehouse. The complainant vide its mail dated 12.03.2010 had forwarded a comprehensive list of goods stor
SupremeToday
Repudiation - For repudiation viz; cause of fire not established, OP could not show any clause in the policy which would permit the OP to repudiate the claim if the cause of fire is not established.
Insurance companies must provide substantial proof when denying claims; unjust repudiation leads to enforceable obligations to pay agreed amounts.
The insurer must settle valid insurance claims timely, and failure to substantiate claims can lead to repudiation; however, claimants must provide adequate documentation to support their claims.
(1) Adverse Claim – The law mandates that a party confronted with an adverse claim must voice its opposition; failure to do so results in a deemed acceptance of the allegations or facts asserted agai....
(1) Contract of Insurance – It is well settled that a contract of Insurance is to be honoured strictly in terms of the conditions specified in the Policy without making any alteration in the words us....
The court established that a consumer can claim under the Consumer Protection Act for insurance disputes, even with commercial intent, emphasizing assessment fairness by the appointed Surveyor.
Assessment - The Complainant, therefore, cannot be allowed the amount beyond the assessment of the Surveyor.
The insurer's repudiation of a claim must adhere to statutory timelines; arbitrary and unfounded repudiation constitutes deficiency in service.
(1) Constructive approach - A constructive approach, not one that is based on assumptions and surmises with an intention to negate the claim by categorizing it fraudulent is desirable.(2) Industry Ap....
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