NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Binoy Kumar, Presiding Member and
Saroj Yadav, Member
Kamla Devi – Petitioner
versus
Iffco Tokyo General
Insurance Company Ltd. – Respondent
Revision Petition No.763 of 2019
(Against the Order dated 2nd January 2019 in Appeal 177/2017 of the State Consumer Disputes Redressal Commission Himachal Pradesh)
Decided on 7.5.2025
Consumer Protection Act, 1986 – Section 21(b) [Consumer Protection Act, 2019 – Section 58(1)(b)] – Revision against order of State Commission – Services – Insurance – Repudiation of Claim – It is an established fact that the insured vehicle met with an accident during the currency of the policy and that the Respondent/Opposite Party, through its surveyor, assessed the loss at Rs.95,000/-, conditional upon the submission of requisite documents by the Complainant/Petitioner. The report submitted by a duly appointed surveyor is an important piece of evidence that must be given due weight, though it is not sacrosanct and may be disregarded if there is cogent evidence to the contrary. In the present case, the complainant has not produced any reliable evidence disproving the surveyor’s report submitted by the respondent/opposite party. In the absence of such contrary evidence, the assessment made by the insurance company’s surveyor must be accepted. Therefore, when the surveyor has assessed the value of the loss, the respondent/opposite party cannot be directed to pay more than the amount assessed unless the complainant successfully disproves the assessment by providing convincing evidence showing the surveyor’s assessment was incorrect – On facts, the surveyor assessed the loss at Rs.95,000/-, this Commission cannot direct the Respondent/Opposite party to pay the entire amount as claimed by the Complainant/Petitioner without cogent evidence rebutting the surveyor’s findings. The Complainant/Petitioner has failed to provide such evidence, and mere reliance on a repair invoice which is itself inadequately stamped and unverified is insufficient to justify the claimed amount. The Discharge Voucher, which the Complainant/Petitioner contends was signed under protest for Rs.3,00,000/-, was never placed on record by either side, and no enforceable settlement was proven. [Paras 6 to 11]
Result: Petition dismissed.
ORDER
Saroj Yadav, Member—The present Revision Petition has been filed under Section 21(b) of the Consumer Protection Act, 1986 (for short the Act) by Kamla Devi (hereinafter referred to as Petitioner/Complainant) against IFFCO TOKYO General Insurance Company Ltd., through Its G.M. (hereinafter referred as Respondent/Opposite Party/Insurance Company), assailing the Judgment and Order dated 02.01.2019 passed by the learned Himachal Pradesh State Consumer Disputes Redressal Commission, Shimla (hereinafter referred to as the State Commission) in F.A No. 177/2017, wherein the learned State Commission partly allowed the appeal and modified the judgment and order dated 14.03.2017 passed by the learned District Consumer Disputes Redressal Forum, Shimla (hereinafter referred to as the District Forum) in CC/58/2014.
2. Brief facts of the case are that the Complainant is the owner of a vehicle bearing no HP-63A-1350, insured with the Respondent under policy no.80874481 for Rs.5,38,118/- from 08.08.2012 to 07.08.2013. The vehicle was involved in an accident on 05.08.2013 and was extensively damaged. An FIR was filed, and the Complainant submitted a claim to the Respondent for the loss, with an estimated claim amount of Rs.3,50,000/. The complainant submitted all necessary documents and was assured by the Respondent that her claim would be settled within one to two months. Later, the Respondent requested the complainant’s consent to settle her claim for Rs.300,000/-, which she rejected, as the vehicle was a total loss and she was entitled to Rs.3,50,000/-. After waiting for a week, she issued a legal notice to the Respondent demanding settlement of her claim for Rs.3,50,000/-, but the Respondent did not respond to the above said notice. Aggrieved by the act of Respondent, the Complainant has filed the present complaint before the learned District Forum, seeking the following reliefs:—
(i) That the O.P may be directed to pay a sum of Rs.3,50,000/- with interest @ 9% since 01.01.2014, till the date of actual payment;
(ii) That the O.P may be directed to pay a sum of Rs.25,000/- as punitive damages & compensation for the unnecessary mental, financial & physical harassment;
(iii) That the O.P. may be burdened with costs;
(iv) Any other order which this Hon’ble Commission may deem fit in the ends of law & justice.
3. The Respondent/Opposite Party resisted the Complaint by stating that the complainant is not a consumer under Section 2(1)(d) of the Act, as the vehicle was purchased for commercial purposes. The vehicle was insured for Rs.5,38,118/- on an Insured Declared Value (IDV) basis, with coverage from 08.8.2012 to 07.8.2013. The Respondent/Opposite Party was notified of the incident 12 days late, which violated the policy terms and deprived the insurer of the right to investigate. The Respondent/Opposite Party appointed a surveyor, Sh. Sandeep Sharma and Associates, to inspect the vehicle, and requested additional documents from the Complainant, which were not provided. Due to the lack of required documents, the surveyor submitted a report based on physical inspection, assessing the repair cost at Rs.95,000/-. The Respondent closed the claim as “No Claim”, when the Complainant failed to provide the requested documents.
4. The learned District Forum after appreciation of the facts of the case and perusal of record vide order dated 14.03.2017 has allowed the complaint against the Respondent/Opposite Party with the following directions:—
“Without going into the question whether the complainant was justified in withholding the original bills or the OP was justified in closing her claim case as ‘No Claim’ and the surveyor was justified in making assessment merely on the basis of physical inspection and final survey without taking into consideration the original bills we are of the considered view that it would be just and reasonable if the OP is directed to settle the claim of the complainant as follows:
The complainant shall furnish
Khatema Fibres Ltd. vs. New India Assurance Co. Ltd. and Anr.
Surveyor – The report submitted by a duly appointed surveyor is an important piece of evidence that must be given due weight, though it is not sacrosanct and may be disregarded if there is cogent evi....
The insurance company's surveyor's assessment governs the claim under the Consumer Protection Act in instances of dispute over damages.
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Report of surveyor has to be accepted.
Court upheld the significance of a surveyor's report in assessing insurance claims, emphasizing adherence to policy conditions regarding total loss determinations.
(1) No cause is forthcoming to disregard or dismiss the self-contained self-speaking survey Report.(2) Insurance Co. settled the claim in consonance with its Surveyor’s Report.
(1) Surveyor Report - When licensed surveyors are appointed under the Insurance Act, their report cannot be pushed aside contending that there are no credible evidence supporting to Surveyor Report s....
Report of Surveyor cannot be simply brushed aside.
The assessment of damages in insurance claims must provide clear reasoning, and failure to do so invalidates reliance on a surveyor's findings.
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