NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Ram Surat Ram Maurya, Presiding Member and Dr. Inder Jit Singh, Member
M/s. Jodhpur Industries and Anr. – Complainant
versus
New India Assurance
Co. Ltd. and Anr. – Opp. Party
Consumer Case No.3231 of 2017
Decided on 13.2.2023
Consumer Protection Act, 1986 – Section 21[Consumer Protection Act, 2019 – Section 58] - Services – Insurance – Repudiation of Claim – Exaggeration of claim – proved - the claim in respect of machinery was exaggerated inasmuch as the Insured had claimed purchase price for the machinery which were not damaged. The surveyor assessed the loss for Machinery to Rs. 1961400/-, after deduction of 20% to 25% in different matters. Exaggeration of the claim is proved - The Insured informed that his factory was closed since 16.08.2016. On the date of incident, it was closed. The surveyor again and again asked the Insured to produce the technical staff and labourers, engaged in manufacture, for recording their statement. But the Insured did not produce any staff engaged in manufacture - During the course of survey the undersigned advised the claimant to arrange segregation of burnt/damaged & arranged weighment of the smoke but inspite of regular follow-up & through various reminders the claimant failed to segregate the stock & thrown the same without ascertaining the quantum so the loss is considered on the basis of physical estimated inventory enlisted on dated 3.9.2016 – On facts, the complaint is dismissed. [Para 7 to 13].
Result: Complaint dismissed.
ORDER
Heard Ms. Sonia Sharma, Advocate, for the complainants and Mr. R.B. Sami, Advocate, for the opposite parties.
2. M/s. Jodhpur Industries and Ms. Nisha (the Insured) have filed above complaint for directing The New India Assurance Company Limited (the Insurer) to pay (i) Rs.11681327/- with interest @18% per annum, from 01.09.2016 till actual payment, as the insurance claim; (ii) Rs.10/- lacs, as compensation for mental agony and harassment; (iii) Rs.10/- lacs, as business loss; (iv) costs of litigation; and (v) any other relief which is deemed fit and proper, in the facts and circumstances of the case.
3. The facts as stated in the complaint and emerged from the documents attached with the complaint are as follows:—
(a) M/s. Jodhpur Industries (the Insured) was a proprietorship firm and engaged in manufacture and sale of bread and biscuit. Ms. Nisha (complainant-2) was proprietor of the Insured. The Insured took a shed at B-24-A, RIICO Industrial Area, Rajgarh, Rajasthan, on rent through lease deed dated 22.03.2014 from Prem Kumar Bansal and installed manufacturing unit in it. The Insured was registered as “Small Scale Industry” with District Industries Centre, Churu, Rajasthan on 24.04.2014. The Insured was also registered with Commercial Tax Office, Churu, Rajasthan. The Insured installed its manufacturing unit and started manufacture at the said location since January, 2015.
(b) The New India Assurance Company Limited (the Insurer) was a public sector insurance company and engaged in the business of providing different types of insurance services. The Insured obtained “Standard Fire & Special Peril Policy” No.331500 1115011140 100000268, for the period of 03.03.2015 to 02.03.2016, from the Insurer, for sum insured of Rs.95/- lacs (i.e. Rs.5/- lacs for Furniture, Fixtures, Fitting & other contents, Rs.15/- lacs for Stock and Stock in process, Rs.70/- lacs for Plant & Machinery and Rs.5/- lacs for Building-superstructure). The Insured obtained renewal “Standard Fire & Special Peril Policy” No. 33150046150100000107, for the period of 03.03.2016 to 02.03.2017, from the Insurer, for sum insured of Rs.95/- lacs (i.e. Rs.5/- lacs for Furniture, Fixtures, Fitting & other contents, Rs.15/- lacs for Stock and Stock in process, Rs.70/- lacs for Plant & Machinery and Rs.5/- lacs for Building-superstructure). Sum Insured for Plant & Machinery was increased by Rs.65/- lacs, through Endorsement No. 33150011160183000001 w.e.f. 24.04.2016.
(c) The factory of the Insured was closed due to ‘Amavasya’ holiday on 01.09.2016. Vikas Goyal, owner of adjoining factory noticed smoke emanating from the factory of the Insured at 15:30 hours on 01.09.2016. He immediately informed Surjeet Singh, husband of complainant-2 and also intimated Police Station, Rajgarh, who in term intimated Fire Service Station, Churu, in this respect. The police personal and the people collected at the site and managed a water tanker and broke out window of the factory and started throwing water inside it. Fire Brigade also arrived at about 17:30 hours and doused the fire. Incident was registered in General Diary on 01.09.2016 at 19:00 hours at police station on the complaint of Surjeet Singh.
(d) The Insured informed the Insurer on 02.09.2016 about the fire incident and loss caused due it. The Insurer appointed B.K. Modi, Surveyor & Loss Assessors, Bikaner, as the surveyor on 02.09.2016, for survey and assessment of loss. The surveyor inspected the factory premises on 03.09.2016, took photographs and made inventories. The surveyor, vide letter dated 03.09.2016, advised the Insured to segregate burnt/damaged stock, submit statement of damaged part of Plant & Machinery, with details of its serial number/configuration/ manufacture year, estimate of loss of buildings and stock, claim form and documents i.e. Books of Accounts, Purchases & Sales Record, Stock Regi
Insurers must substantiate their claim settlements and cannot rely on acceptance of prior inadequate offers without fully disclosing material information.
Insurance claims must be assessed justly, with surveyor reports not being conclusive and subject to scrutiny.
Corroboration of Evidence – The surveyor is an expert and its report stands on the footing of expert evidence and has to be corroborated with other evidence on record, in order to examine bonafide / ....
Underinsurance assessed by Surveyor is arbitrary.
Approved Surveyor’s report may be foundation for settlement of claim by Insurer but such report is neither binding upon insurer or insured.
The court established that prior acceptance of an insurance settlement does not bar legitimate further claims, adhering to the principles of indemnity outlined in the insurance contract.
Insurance companies must provide substantial proof when denying claims; unjust repudiation leads to enforceable obligations to pay agreed amounts.
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