2021 Supreme(Online)(Del) 4366
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
D. K. Jain, J
United India Insurance Co. Ltd. – Appellant
Versus
Raman Chandrakant Govitrikar & Anr. – Respondent
Revision Petition No. 3409 of 2013 | Revision Petition No. 3410 of 2013
Insurance policy interpretation includes coverage for plants under greenhouse; compensation must reflect correct assessment.
Headnote:(A) Consumer Protection Act, 1986 - Insurance claims - The complainants insured a greenhouse for an agricultural business; insurance claims were made following damages from storms. The insurer disputed coverage for flowers and plants, claiming their destruction wasn't covered. The District Forum awarded compensation, but appellate tribunals remanded for reassessment. The Supreme Court ordered merits consideration. (Paras 1-26)
(B) Insurance - Coverage interpretation - The commission affirmed the lower Fora's findings that the policy provided coverage for plants therein; therefore, claims for plant losses were valid. (Paras 3-19)
(C) Delay in filing appeals - A delay of 59 days in filing revision petitions was condoned based on justifiable reasons from the insurer. (Paras 12-15)
| Table of Content |
|---|
| 1. insurance policy covering greenhouse includes risks related to its contents. (Para 1 , 2) |
| 2. disputes arise from coverage interpretations of insurance policies regarding agricultural losses. (Para 3 , 4 , 5 , 6 , 7 , 8) |
| 3. insurance assessments must consider all relevant evidence, including surveyor reports. (Para 9 , 10 , 11) |
| 4. delays in filing appeals can be condoned based on justifiable reasons. (Para 12 , 16 , 18 , 19 , 20) |
| 5. final compensation amounts must reflect claims substantiated by evidence and assessments. (Para 21 , 22 , 23 , 26) |
1. The brief facts of the cases are that complainant / respondent Nos. 1 and 2 had an agricultural business of growing carnation flowers for which they had erected a greenhouse under loan of Rs.41,15,000 from OP No. 2 / respondent No. 3 - Bank of Maharashtra, Raigad at village - Shendurmalai, Waki Budruk, Taluka Mahad, District Raigad. The complainants also got insured the green house with the opponent / petitioner - Insurance Company for Rs.41,15,000 and the policy was operative from 20.7.2007 till 19.7.2008. On 7.12.2007, because of rain and storm there was a damage to the greenhouse which resulted in destroying of flowers seedlings and other articles of the greenhouse which the complainants reported to the Insurance Company as well to local Revenue Officer and to the Bank and raised a claim of Rs.7,34,654 for reimbursement with the Insurance Company. The Insurance Company appointed a surveyor and based on the survey report tried to settle the claim at Rs.21,725 vide their letter dated 15.5.2008 which the complainants refused to accept and after due notice filed a complaint before the District Forum, Raigad, bearing No. 115/2009 agitating for appropriate settling of their claim. Meanwhile, the surveyor revised its assessment of loss from Rs.21,725 to Rs.97,701 and this amount was again offered by the Insurance Company vide their letter dated 13.6.2008 but it was also not accepted. When the above complaint was being processed, there was a second storm with heavy rains on 21st and 22nd March, 2008 which destroyed all greenhouse, UV films and about 50,000 carnation flowers seedlings. The complainants promptly informed everyone including the opponent Insurance Company. Again the opponent Insurance Company appointed a surveyor to survey and assess the loss. The complainant filed claim of Rs.18,01,401 with the opponent Insurance Company. In the second case, the surveyor assessed the loss to the tune of Rs.1,28,870 and the Insurance Company offered this amount to the complainants but the same was also refused and filed an independent complaint No. 114/2009 before the District Consumer Disputes Redressal Forum, Raigad. OP No. 1 resisted both the complaints and submitted that after reassessment of loss, amount was offered to the complainant which was not accepted by the complainant. It was further submitted that greenhouse of complainant was for commercial purposes; so, dispute was not covered under the Consumer Protection Act. It was further submitted that insurance coverage did not cover the flowers, seedlings and the plants and rightly offered amount of compensation. Denying any deficiency on their part, prayed for dismissal of the complaints. OP No. 2 was proceeded ex parte. District Forum after hearing both the parties, allowed complaints and directed OP to pay Rs.5,00,000 in first complaint and Rs.15,00,000 in second complaint along with compensation of Rs.50,000 and cost of Rs.10,000 in each complaint. OP No. 1 filed appeals before the State Commission and the State Commission vide order dated 19.4.2010 allowed appeals partly and remanded the matter back to District Forum to give opportunity to the parties to lead evidence pertaining to quantum of compensation and decide compensation afresh. District Forum again allowed complaints and awarded same compensation, but deleted compensation of Rs.50,000 for mental torture and reduced cost to Rs.5,000 in both the complaints and




