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A. P. SAHI
Okaya Fujikawa Power Pvt. Ltd. – Appellant
Versus
National Insurance Company Ltd. – Respondent
ORDER
This is a complaint alleging deficiency in service against the National Insurance Company Ltd. contending that once the loss assessment made by the Surveyor had been finalized, and accepted by the Complainant, then successive reductions by the surveyor at the instance of the Insurance Company are unjustified in the circumstances of the present case. This action is alleged as an unfair trade practice and deficiency in service.
2. The undisputed facts are that the Complainant acquired a Fire & Special Perils Insurance Policy, the duration whereof was from 13.05.2011 to 12.05.2012. The total sum insured was Rs.29,00,00,000/- covering the risk of stocks, buildings, furniture, fixtures and fittings of the unit.
3. The Complainant is a manufacturer of batteries and unfortunately, in the night of 17th November 2011, a fire occurred in the unit that is insured which spread to a large extent causing severe damage to the building, machinery, electrical installations, stocks as well as the furniture and fixtures. The intimation was immediately given to the Insurance Company on the date of the incident itself and the Surveyor appointed by the Insurance Company visited the affected premises
(1) Unfair Trade Practice – Successive Reductions indicates trend of unfair treatment that does deserve to be encouraged.(2) Insurance company is also regulated by IRDA regulations & reasonable perio....
The insurance company’s coercive practices in settling claims amount to deficiency in service under consumer law.
Insurance companies must provide substantial proof when denying claims; unjust repudiation leads to enforceable obligations to pay agreed amounts.
(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....
Insurance claims must be assessed based on fair and contractual standards, avoiding arbitrary deductions.
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.
Insurance companies cannot avoid liability by citing external compensations, and second surveyors must be appointed with regulatory oversight.
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