NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Subhash Chandra, Presiding Member and AVM J. Rajendra, AVSM VSM (Retd.), Member
Oriental Insurance Company Ltd. – Appellant
versus
M/s. Duroflex Private Ltd. – Respondent
First Appeal No.105 of 2015
(Against the Order dated 10/12/2014 in Complaint No. 57/2012 of the State Commission Tamil Nadu)
Decided on 12.1.2024
Consumer Protection Act, 1986 – Section 19 [Consumer Protection Act, 2019 – Section 51] – Services – Insurance – Repudiation of Claim – Plant and Machinery – Reduction of Deprecation – Not proper – the insured party is entitled to the reinstatement value rather than the depreciated value in such situations – In the given situation, the assessment made by the Surveyor, after following necessary site visits and thorough scrutiny of records, is deemed to carry more weight than the claims put forth by the Complainant. This stance is in alignment with numerous judgments of the Hon’ble Supreme Court, which emphasize the pivotal role of the Surveyor’s assessment as a foundation for settlement. Rejecting the Surveyor’s assessment requires substantial and valid reasons, and such justifications must be clear and cogent, which is not evident in this case. Further, the State Commission did not provide the rationale for altering the depreciation value of the machines from 80% to 40% – The settlement of the claim, amount under protest, was based on the Surveyor’s report, which employed a systematic and logical calculation on a machine admittedly procured as a second hand machine and used for 20 years. The vintage of the machine is also evident from the fact that such machines are not available in the market and thus its reasonable market value could not be ascertained. Having inspected and considered the vintage of the second hand machine which has already been utilised for about 20 years, the surveyor assessed its depreciation as 80%, which is considered fair and reasonable. Therefore, learned State Commission erred in arbitrarily reducing the depreciation value of the machines duly determined by the surveyor, from 80% to 40%, that too without assigning any reasons for such consideration – Appeal allowed, impugned order set aside. [Paras 10 to 25].
Result: Appeal allowed.
ORDER
AVM J. Rajendra, AVSM, VSM (Retd.), Member—The present First Appeal has been filed under Section 19 of the Consumer Protection Act, 1986 (“the Act”) against the Order dated 10.12.2014 passed by the learned Tamil Nadu State Consumer Disputes Redressal Commission Chennai (hereinafter referred to as “the State Commission”), in Consumer Complaint No. 57 of 2012, wherein the Complaint filed by the Respondent was partly allowed.
2. For the sake of convenience, the parties in the present matter being referred to as mentioned in the Complaint before the State Commission. “M/s. Duroflex Private Ltd” is identified as Complainant/ Respondent and “The Oriental Insurance Company Ltd.” is referred to as the Appellant/Opposite Parties/Insurer.
3. Brief facts of the case are that on 19.10.2009 at about 03.20 AM Fire broke out at the Complainant’s manufacturing unit situated at Kumaranapalli Village, Denkanikottal Taluk, Krishnagiri District, TN during Deepavali festival and the cause of fire was bursting of crackers in vicinity and the splinters falling on the roof of the factory. The complainant covered the establishment under the Standard Fire and Special Perils Insurance Policy Nos.441901/11/2009/406 and 441901/11/2009/466.
4. The policy pertains to Plant and Machinery and Building, and the total sum insured was Rs.9,88,00,000/- towards plant, Machinery and Building. The annual premium of Rs.3,67,019/- was paid. The Plant, Machinery and Building is insured on market Value basis. The stocks in process were insured for Rs.4,50,00,000/- and the premium paid is Rs.1,86,827/-. Total premium paid was is Rs.5,53,846/- for both the policies, for insuring the property at Market value. The List of machineries annexed to the insurance policies and insurance surveyor report reveals that the plant and Machinery and Building were insured at Market value. Consequent to the Fire Accident, the OP had deputed an insurance Surveyor from Coimbatore to assess the loss and submit a Report. Though the Surveyor immediately visited the premises, he submitted his Report dated 16.06.2010 after a lapse of nine months. After the fire accident, to confirm the adequacy of sum insured for the buildings, the OP had also appointed a government approved valuer, who valued the building assets at Rs.4,29,97,345/- excluding the quilting section building. As regards the buildings destroyed in fire, the Govt approved valuer has taken depreciation at 13.5% in his report dated 01.11.2009. Whereas, the insurance surveyor in his report dated 16.06.2010 has taken 27% depreciation for buildings, which exposes the anomalies in the depreciation norms adopted by the OP and their double standards.
5. After the Fire accident the OP did not settle the insurance claim for over 12 months and only after repeated follow-ups and personal liaison, they came forward and belatedly settled about 24% of the originally claimed amount. The Fire Accident completely destroyed the buildings in the quilting Section and gutted the electrical fittings and machinery which had to be completely scraped. Consequently, production in quilting Department stopped and the semi-finished Mattresses had to be sent outside for quilting. There was no choice except to rebuild the Quilting Dept and replace it with new machinery, without delay. However, this process of reconstruction and production took three months. Cost of Civil work alone was Rs.32,82,178/-. Consequent to the fire accident they submitted claim on 04.11.2009 for Rs.1,57,26,600/- of which Rs.41,49,027/- was for Quilting building; Rs.91,41,180/- towards Plant & machinery; Rs.6,23,397/- for electrical erections; and Rs.18,12,996/- towards stock. Whereas, the OP belatedly settled a part of the insurance claim for Rs.37,37,853/-, while there is a shortfall of Rs.1,19,88,747/-. The cost of new Quilting machine is Rs.82,93,275/-. However the said quilting machine was insured at Rs.85 lakhs towards replacement cost of the machine. The OP had settled part cla
Depreciation – State Commission erred in arbitrarily reducing the depreciation value of the machines duly determined by the surveyor, from 80% to 40%, that too without assigning any reasons for such ....
In case Insurance Company is unable to reinstate or repair property insured, insurance company shall be liable to pay such sum as would be requisite to reinstate or repair such property if same could....
(1) Hearsay – No documentary evidence in regard to financial stress of the insured has been brought on record and this assertion is merely a hearsay.(2) Sampling – A mere sampling of some bills canno....
(1) Fresh Survey – if for any reason, the insurer is of the view that certain material facts ought to have been taken into consideration while framing a report by the surveyor and if it is not done, ....
Insurance – In absence of any ambiguity no scope for applying doctrine of contra proferentem – Insurer can write letter to Surveyor to re-assess settlement amount.
Approved Surveyor’s report may be foundation for settlement of claim by Insurer but such report is neither binding upon insurer or insured.
Insurance companies cannot avoid liability by citing external compensations, and second surveyors must be appointed with regulatory oversight.
Insurers must appoint qualified surveyors and provide just compensation based on thorough assessments; arbitrary alteration of surveyor findings by consumer commissions is impermissible.
Surveyor report The surveyor report is not based on legally justiciable reasons and facts and cannot be relied upon, being arbitrary and perverse.
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