NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
AVM J. Rajendra, AVSM VSM (Retd.), Presiding Member
National Insurance Co. Ltd. – Appellant
versus
Geekay International Co. – Respondent
First Appeal No.870 of 2021
(Against the Order dated 13/10/2021 in Complaint No. 390/2015 of the State Commission Maharashtra)
Decided on 16.8.2024
Consumer Protection Act, 2019 – Section 51 – Insurance Claim – Loss of stock due to inundation due to heavy rains – Deficiency in service unfair trade practice – Inundation is covered as a risk under the Standard Fire & Special Perils Policy – No reason to interfere with order of State Commission – OP is directed to pay complainant Rs. 46,48,565- with interest @ 9% p.a. from date of loss & damage – Cost to be paid @ Rs. 25,000/- by OP to complainant. (Paras 6, 12, 15 and 16)
Result: FA Dismissed.
ORDER
The present First Appeal has been filed under Section 51 of the Consumer Protection Act, 2019 (“the Act”) against the Order dated 13.10.2021 passed by the State Consumer Disputes Redressal Commission, Maharashra, Mumbai (the State Commission), in Consumer Complaint No.390 of 2015, wherein the Complaint filed by the Complainant (Respondent herein) was partly allowed.
2. As per report of the Registry, there is a delay of 6 days in filing the present First Appeal. As the delay was during the suspended period of limitation by the Hon’ble Supreme Court due to Covid-19, the First Appeal is treated to have been filed within limitation.
3. For the sake of Convenience, the
parties in the present matter are being
referred to as mentioned in the complaint before the State Commission. M/s. Geekay International Co. is identified as the Complainant and M/s. National Insurance Co. Ltd. is referred to as the Opposite Party / Insurer (OP).
4. Brief relevant facts of the case, as per the Complainant, are that the complainant is Geekay International Co. Ltd., a partnership firm based in Andheri, Mumbai, engaged in the business of cloth and garments. The OP is the National Insurance Company Limited, from whom the complainant purchased a Standard Fire and Special Perils insurance policy No. 261600/11/11/3100000292. The policy was intended to cover the stock of the complainant stored in rented premises. The business was being conducted from these premises, which were taken on rent under a leave and license agreement, for the period 2011 to 2012. On 18.07.2011, heavy rains led to the outpouring of rainwater, causing a partial collapse to the building where the complainant’s stock was stored. As a result, the stock was spoiled due to the water damage. The complainant promptly informed the OP, National Insurance Company, via email about the damage. The OP appointed a surveyor to assess the damage and provide a report on the valuation of the loss. Despite the surveyor’s report, the OP repudiated the insurance claim, stating that the Standard Fire and Special Perils policy covers flood and inundation, but does not cover damage caused by heavy rains. Aggrieved by the claim repudiation, the complainant approached the State Commission by filing a consumer complaint, alleging deficiency in service on the part of the insurance company sought a declaration that the OP is guilty of deficiency in service and a direction for the opposite party to pay the complainant the sum of Rs.48,93,226/-, which represents the actual loss incurred, along with interest at the rate of 18% per annum from the date of the incident along with compensation of Rs.25 Lakhs for mental harassment.
5. In its written statement before the State Commission, the OP opposed the complaint and contended that the Standard Fire and Special Perils policy purchased by the complainant does not cover losses caused by heavy rains and the insurance company’s assessment, as determined by the surveyor, does not fall under the covered perils of the policy. Therefore, the repudiation of the claim is justified and in accordance with the policy terms.
6. The learned State Commission, vide the Impugned Order dated 13.10.2021 passed the following order:
“Order
i. The consumer complaint is partly allowed with costs quantified to Rs.25,000/- to be paid by the opposite party to the complainant.
ii. It is declared that the opposite party is guilty of deficiency in service/ unfair trade practice.
iii. The opposite party is directed to pay the complainant, Rs.46,48,565/- (Rs. Forty-Six Lakh Forty-Eight Thousand Five Hundred and Sixty-Five only) with an interest at the rate of 9% per annum from the date of loss and damage, i.e. 18th July 2011, within the period of one month from the date of this order, failing which, it will carry interest at the rate of 12% till realization of the order.
iv. The opposite party is also directed to pay Rs. 1 Lakh towards compensation for mental harassment of the compla
Suraj Mal Ram Niwas Oil Mills Pvt. Ltd. vs. United India Insurance Co. Ltd., (2010) 10 SCC 567
Insurance policy – Exclusion clause – Burden of proof is on the insurer to show that case falls within the purview of exclusion clause – In case of ambiguity, benefit goes to insured.
Appeal – It is mandate provision that while considering the appeal grounds, the grounds which are not mentioned in repudiation letter cannot be discussed and considered at the stage of appeal.
(1) Terms and Conditions – The terms and conditions of the Insurance Policies require the Insured to take all reasonable steps to safeguard the property under insurance.(2) Policy – Examination of th....
Insurance – In absence of requisite evidence from Complainant to support peril covered under policy, no liability can be fastened upon Insurer.
1. Investigated and determined - Merely because recording of evidence is required, or some questions of fact and law arise which would need to be investigated and determined, cannot be a ground for s....
IMPORATNT POINT Appointment of Surveyor – Insured can also appoint a Surveyor or loss accessor.
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