NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Subhash Chandra, Presiding Member and AVM J. Rajendra, AVSM VSM (Retd.), Member
M/s. Surya Lakshmi
Cotton Mills Ltd. – Complainant
versus
M/s. United India Insurance
Co. Ltd. and Ors. – Opp. Parties
Consumer Complaint No.85 of 2010 with
IA/ 5313/2017 (Placing Addl. documents)
Decided on 21.5.2025
Consumer Protection Act, 1986 – Section 21[Consumer Protection Act, 2019 – Section 58] – Services – Insurance – Repudiation of Claim – Surveyor Report – The surveyor has gone into detailed examination of scope of each policy with respect to the claim under each head preferred by the complainant and made detailed evaluation of amounts applicable under each head of each policy separately as well as the amounts admissible and the amounts beyond the scope of the policies as well as detailed justification. The surveyor report is detailed and comprehensive encompassing all the material issues that need to be considered and determined as per the terms of the policies in question – After due consideration of the survey report in question as well as the clarifications he provided in the supplementary reports, evidently the report is appropriate and as per the terms of the policies. It is also undisputed that, the OP insurer accepted the survey report and the liability and decided to settle the amount payable by the OP as Rs.25,18,44,899, Of this amount payable, considering the fact that the OP had already released Rs.8,00,00,000 to the complainant as interim payment and after deducting the Reinstatement of Sum Insured Rs.66,714, released the balance payable Rs.17,17,78,185 to the complainant on 25.08.2009. Thus, of the total claim of Rs.31,07,08,219 filed on 14.04.2009 the OPs settled the claim up to Rs.25,18,44,899 – On facts, complaint dismissed. [Paras 10 to 20]
Result:Complaint dismissed.
JUDGMENT
AVM J. Rajendra, AVSM VSM (Retd.), Member—The present Consumer Complaint has been filed under Section 21 of the Consumer Protection Act, 1986 (for short “the Act”) against the Opposite Parties seeking to direct the OPs:—
“For the reasons stated hereinabove it is most humbly prayed that this Hon’ble Forum may be pleased to pass an Order directing the Respondents to pay a sum of R$ 8,97,68,900/- with interest at the rate of 12% p.a.; and be pleased to pass
Such other Order or Orders as this Hon’ble Commission may deem fit and necessary in the facts and circumstances of the case.”
2. Brief facts of the case, as per the Complainants, are that Complainant had obtained four insurance policies from the Opposite Parties (OPs) to cover various assets of its industrial establishment. The first policy No. 050405/11/06/11/00000452, provided coverage for the Building, Plant and Machinery, and Electrical Installations for a total sum insured of Rs. 260,00,00,000, valid from 28.03.2007 to 27.03.2008. The second policy, No. 050405/11/06/11/00000435, covered Stock in Process for Rs.13,50,00,000, valid from 08.03.2007 to 07.03.2008. The third policy, No. 050405/11/07/12/00000061, covered Stocks of Finished Goods to the extent of Rs.30,00,00,000, valid from 01.05.2007 to 30.04.2008. The fourth policy, No. 050405/11/07/11/00000293, covered stock of Denim Fabric and Finished Goods worth Rs. 5,00,00,000 and was valid from 03.10.2007 to 02.03.2008; however, no claim was preferred under this policy.
3. While all these policies were in force, a major fire broke out at the insured premises on 27.01.2008 at about 06:00 AM, resulting in extensive damage to the insured property including the building, plant and machinery, electrical installations, stock in process, and finished goods. The complainant initially lodged a total claim of Rs.38,70,32,797. Since the policies carried a reinstatement value clause and the complainant opted for reinstatement, an interim payment of Rs.8,00,00,000 was recommended. Thereafter, on 03.01.2009, the complainant submitted a revised claim of Rs.31,07,08,218.66, providing a detailed breakdown of the loss incurred under the respective policy heads. The OPs appointed M/s. N. Velayudham& Company as surveyors to assess the loss, who submitted their final report on 11.05.2009. However, despite repeated requests, the report was not furnished to the complainant until the fourth week of September 2009. In the meantime, the OPs called upon the complainant to sign a discharge voucher for full and final settlement of the claim, without disclosing the particulars or basis of the assessment. Under financial duress and unaware of the printed endorsement “full and final” in the voucher, the complainant signed and returned the same. On 25.08.2009, the complainant received a cheque bearing No. 761037 for Rs.17,17,78,185 from the OPs. The very next day, the complainant protested and informed the OPs that a balance amount of approximately Rs.23.14 Cr. was still due, and that no details or calculations had been shared to justify the payment made. Despite further communications requesting the surveyor’s report and a joint discussion to clarify the assessment, no meeting was arranged. When the report was finally received, the complainant found numerous discrepancies, arbitrary exclusions, and excessive deductions, including those relating to depreciation, excise duty, VAT, and costs associated with reinstatement and loan interest. It is the case of the complainant that the claim was settled unilaterally and in an unfair manner, amounting to deficiency in service on the part of both the OPs and the appointed surveyor. Thus, complainant filed the present complaint.
4. Upon notice, the complaint was resisted by the OPs by filing their Written Statement, wherein, the OPs contended that the complaint was not maintainable and deserved dismissal, as the complainant had not approached with clean hands and deliberately suppressed material facts
Texco Marketing Pvt. Ltd. vs. Tata AIG General Insurance Co. Ltd. (2023) 1 SCC 428. (Para 8)
Bharat Watch Co. vs. National Insurance Co. (2019) 6 SCC 212. (Para 8)
Modern Insulators Ltd. vs. Oriental Insurance Co. AIR 2000 SC 1014. (Para 8)
General Assurance Society Ltd. v. Chandumull Jain (AIR 1966 SC 1644). (Para 8)
National Insurance Co. Ltd. v. Hareshwar Enterprises (P) Ltd. [(2021) 17 SCC 682.(Para 8)
United India Insurance Co. Ltd
Polymat India Pvt. Ltd. vs. National Insurance Co. Ltd. [(2005) 9 SCC 174. (Para 8)
National Insurance Co. Ltd. vs. Shetia Shoes (2008) 5 SCC 400. (Para 8)
Sri Venkateshwara Syndicate vs. Oriental Insurance Company Limited (2009) 8 SCC 507. (Para 14)
Surveyor – The assessment made by a surveyor holds significant importance.
The insurance company’s coercive practices in settling claims amount to deficiency in service under consumer law.
(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....
Delay – The delay in settling the claim for the incident occasioned on 11.05.1997 after the lapse of over 5 years and 5 months verges to deficiency in service.
The acceptance of an insurance settlement under protest does not forfeit the right to pursue further claims, affirming the consumer's right amid shortcomings in service.
(1) Survey Report - The Survey Report is an important document and cannot be ignored while settling claims.(2) Coercive practice - Complainant has not issued the Discharge Voucher of his own free wil....
Second Surveyor – In the present case, there no valid reasons are stated for the appointment of the second surveyor. There is nothing to suggest that the first surveyor’s report to be arbitrary or th....
Approved Surveyor’s assessment is necessary for a claim – There is no reason to reject Report of Surveyor Target Surveyor which inspire confidence of Bench.
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