IMPORTANT POINT
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.

JUDGMENT

The Appellants/OPs filed the instant Appeal under Section 19 of the Consumer Protection Act, 1986 (“the Act”), against State Consumer Disputes Redressal Commission, Lucknow (“State Commission”) Order dated 30.04.2010 in CC No. 01/2006 allowing the Complaint.

2. As per the Registry report, there is 76 days delay in filing this Appeal. For the reasons stated in IA/02/2010, the delay is condoned.

3. For convenience, the parties in the present matter are being referred to as per position held in the Consumer Complaint.

4. Brief facts of the case, as per the Complainant, are that the Complainant is the owner of Motor Vessel “MIRAJ” utilized for self-employment in the shipping business, transporting materials between locations as per customer requirements. The Complainant adhered to the pre-requisite terms of Opposite Party (OP) Insurer by obtaining a valuation report for the vessel prior to obtaining insurance. Thus, M/s JB Boda Surveyors Pvt. Ltd. issued a report determining the market value at Rs.1,15,00,000 on 07.02.1996. Upon consideration of this valuation, OP Insurer issued policy No. 300506/22/08/4102748 for Rs.1,05,00,000 covering the period from 08.02.1997 to 07.02.1998 collecting the premium of Rs.70,705 from the Complainant.

5. On 11.05.1997, as reported in Khalij Times newspaper on 12.05.1997, the Complainant’s vessel keeled over on its left side at the Deira side of Dubai creek, settling in the mud shortly after 09.00 AM. The Complainant, upon receipt of this information, promptly notified the OP Insurance Company and subsequently submitted all requisite documentation. The OP Insurer registered the claim under Marine Hull Claim No.300506/41/97/98/04. The Complainant submitted a claim for Dhs. 7.56 Lakhs (equivalent to approx. Rs.73,00,000), but after about five years of correspondence, the OP offered only Rs.21,44,000 vide DD dated 31.10.2002, representing this as full and final settlement. The Complainant, having previously requested an on-account payment of Rs. 21 lakhs on 08.08.2002, and later reminding the OP on 01.10.2002, accepted the belated payment under explicit protest. On 31.10.2002, the Complainant transmitted a fax to the OP Insurance Company acknowledging receipt under protest and requesting detailed calculations justifying the substantial reduction of the claimed Rs.73,00,000 to the offered Rs.21,44,500. OP-2, responding by letter dated 03.01.2003, provided cursory claim consideration details but omitted justification for disallowed items and failed to provide copies of the survey report or claim note. Following this inadequate response, the Complainant issued reminders via fax on 08.12.2003, and subsequently on 11.07.2004, requesting settlement of the balance claim amount. OP-1, responding on 02.09.2004, asserted that they had re-examined the claim file, concluding that settlement had been processed in accordance with surveyor assessments and that full and final payment had been made, precluding further action or review. The Complainant promptly contested this position vide letter dated 16.10.2004, registering strong protest against the purported reexamination, asserting that the claim had not been settled according to policy terms and conditions, emphasizing the under-protest acceptance, and demanding the balance of Rs.52,86,475 as calculated per documentation submitted during claim lodgement. Due to continuing silence and delay from both OPs, the Complainant, through legal counsel, issued notices dated 04.06.2005, 01.07.2005, and 02.08.2005. OP-1’s Regional Manager finally responded on 05.08.2005, providing detailed calculations for considered and disallowed claim components, asserting that arbitration proceedings were unnecessary and inviting the Complainant to seek further clarification with prior notice. Upon receipt of this delayed explanation, the Complainant, through counsel, responded on 10.08.2005, countering the calculations and asserting wrongful deductions contrary to policy terms