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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Ram Surat Ram Maurya, Presiding Member and Bharatkumar Pandya, Member
Sri Pathy Assoceates Private Limited – Complainant
versus
Branch Manager, National Insurance
Co. Ltd. and Ors. – Opp. Parties
Consumer Case No.33 of 2013
Decided on 16.5.2024
Insurance Policy – Deficiency in service – Repudiation of two insurance claims under Contractors All Risk Insurance Policy issued by OP – No error on part of insurer in repudiating both the claims within the policy terms as originally issued – Complainant is Contractor Firm which was awarded contract for construction of breakwater and its approaches for fishing harbor by Government of Tamil Nadu – In view of adverse factual findings in Surveyor’s report, it was incumbent upon insured-complainant to bring on record cogent evidence to establish fallacy or untenability in surveyor’s factual findings – No such serious attempt has been made by complainant – Complaint raises issues of other wrongful actions of insurer with regard to mid-term cancellation of policy and revival thereof and adverse unilateral amendment of policy coverage with regard to excess clause – These issues would require consideration or adjudication in the event claim itself is found tenable in terms of policy as was originally issued – State Commission should decide complaint absolutely on the basis of material placed before State Commission without getting influenced by any of the observations contained in present order.(Paras 21 and 24)
Result: Complaint dismissed.
ORDER
Bharatkumar Pandya, Member.—This complaint involves allegation of deficiency in service of insurance company with regard to repudiation of two insurance claims under Contractors All Risk Insurance Policy issued by OP M/s National Insurance Co.
2. The complainant is a contractor firm which was awarded contract for construction of breakwater and its approaches for fishing harbor by Government of Tamil Nadu at Thengapattinam at Kanyakumari for a total contractor value of Rs.27,62,60,930/-. The contract involved construction/erection of breakwater having, broadly, a ‘core’ to be fortified by primary armor of specially shaped and patented technology ‘CORE-LOC’ units, and, secondary armor of specified shape, size and weights of specified sourced stones and with laying of ‘berm’ at the base. As a part of the contract work, the complainant was also required to use CORE-LOC, a patented product of M/s Concrete Layer Innovations (CLI). As per agreement, the project was to be executed as per the design, terms and conditions and to be monitored by the Fisheries Department of Government of Tamil Nadu and under technical assistance from CLI. The design for the breakwater project was made by the Fisheries Department after technical study of the site and as per the recommendation of the Indian National Centre for Ocean Information Service. The complainant entered into agreement with the Fisheries Department as also with the CLI for execution of the work which commenced on 03.04.2010. The complainant invited for quotation from the insurer after submitting all requisite documents, design papers and agreements for grant of appropriate Contractors All Risk Insurance policy (CARP). Accordingly, the National Insurance Co. (OP) issued the policy for the policy period 12.05.2010 to 11.08.2013 for sum assured of Rs.27,62,60,930/- for which the premium was to be paid in eight instalments of Rs.95,643/-. As per the risk coverage in the policy, the Contractors All Risk insurance was covered for the period 12.05.2010 to 11.08.2012. The maintenance work was covered for the period 12.08.2012 to 11.08.2013.
3. The first instance of damage/loss intimated by the insured was due to “heavy storm accompanied by very high waves” which occurred between 11.08.2010 to 19.08.2010 and which as per the insured’s communication to the insurer dated 19.08.2010, was to the tune of Rs.75 lakhs. That particular claim however, is not the subject matter of the present complaint. The second damage and third damage and claims are subject matter of the present complaint. The second damage “due to heavy storm accompanied by very high waves” occurred on 25.02.2011 as a consequence of which, the contract work was totally stopped. (page 145-146 of the complaint). As per communication to the insurance company dated 26.02.2011, the construction of main breakwater had reached upto 480 meter on 25.02.2011. Because of the damage caused by the heavy storm, the breakwater beyond 325 mtrs.(i.e. about 155 meter) got damaged /dislocated resulting into loss to the tune of Rs.1,09,98,690/-. Similarly, the third loss of around Rs.75 lakhs occurred due to heavy storm/waves during the period of 20.06.2011 to 30.06.2011. The intimation dated 04.07.2011 sent to the insurer (page 166), however, does not contain the description of the nature or the exact extent/location of the damage.
4. As regard the first claim, Surveyor M/s Mehta & Padamsey Surveyors Ltd. was appointed who submitted their report dt. 16/12/2010 and recommended the settlement of claim in full. But no communication regarding the said report was sent to the complainant by the Insurer. Intimation of the Second damage on/from 25.02.2011 was immediately sent to the insurer vide letter dated 26.02.2011. On 04.03.2011, Surveyor Mr. Ananda Padmanaban visited the spot and advised the complainant firm to carry out the repairing/restoration work which was also duly communicated to the insurance company. The said surveyor submitted his report dt.
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