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2023 Supreme(Online)(Del) 18026
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Ram Surat Ram Maurya, MEMBER
M/s. Goyal and Company – Appellant
Versus
United India Insurance Company Ltd. – Respondent
Consumer Complaint No. 25 of 2010
Insured must substantiate claims with reliable evidence; surveyor's report, though significant, is not sacrosanct and cannot solely determine liability.
Headnote:(A) Consumer Protection Act, 1986 - Insurance - Scope of insurer's liability and assessment of loss - Claim of Rs.86,22,123 due to fire - Insurer appointed surveyor to assess loss but did not consider all damages - Assessment based on partially burnt stock deemed unjust - Burden of proof rests on the insured to substantiate loss - State Commission's findings improperly assessed hence overturned. (Paras 1-16)
(B) Report of surveyor - Not sacrosanct, must be corroborated with evidence - Challenges to the report necessitate examination of evidence on record. (Paras 9-11)
Facts of the case:
Appeal against State Commission's order for compensation regarding fire loss under insurance policy. Insured claimed damages failed to properly substantiate with adequate evidence against insurer’s assessment.
Findings of Court:
State Commission improperly assessed evidence and did not take into account all damages, leading to reversal of its order.
Issues: Correct assessment of loss and reliance on surveyor’s report in determining insurer's liability.
Ratio Decidendi: The court noted the necessity of reliable evidence to support claims and the limitations of surveyor reports, indicating that adequacy in terms of substantiation is crucial.
Result: Appeals adjudicated leading to dismissal of the complaint and reversal of earlier compensation awarded.
| Table of Content |
|---|
| 1. consumer complaint regarding insurance claim (Para 2 , 3) |
| 2. insurer's response and failure to challenge all facts (Para 4 , 5) |
| 3. dispute over surveyor's assessment and necessary substantiation (Para 6 , 10 , 11) |
| 4. final judgment reversing earlier compensation awarded (Para 7 , 16) |
| 5. burden of proof lies with the insured (Para 8 , 12) |
1. Heard Mr. Aman Preet Singh Rahi, Advocate, for M/s. Goyal and Company and Mr. Rajesh K. Gupta, Advocate, for United India Insurance Company Ltd. and Mr. Himanshu Munshi, Advocate, for Indian Bank.
2. M/s. Goyal and Company filed Consumer Complaint No. 25 of 2010, for directing United India Insurance Company Ltd. (the Insurer) to pay (i) balance insurance claim of Rs.75,20,335 with interest @18% per annum, with monthly rest, under two insurance policies (ii) Rs.10 lacs as compensation for mental torture and harassment (iii) Rs.3 lacs as the cost of litigation and (iv) Rs.50,000 as expenses incurred in preparation of photographs, debris sheet and map, etc. State Commission, by impugned order dated 07/11/2014, allowed the complaint and directed United India Insurance Company Ltd. to pay (i) balance insurance claim of Rs.59,08,872, (ii) Rs.1 lac as compensation and (iii) Rs.11,000 lacs as the cost of litigation. The Insured and the Insurer, both have filed their separate appeals. As these appeals arise out of the same order passed in one complaint as such, these appeals were consolidated and heard together.
3. The facts, as stated in the complaint and emerged from the documents attached with the complaint, are as follows:
(a) M/s. Goyal and Company (the Insured) was a sole proprietorship concern and dealing in wholesale business of ladies suits and clothes at Bathinda. The Insured had cash credit facility up to Rs.10 lacs from Syndicate Bank Bathinda, which was subsequently enhanced to Rs.20 lacs. Later on the Insured obtained cash credit facility from Indian Bank, Bathinda from 23/12/2008 and closed its account in Syndicate Bank, which was later on enhanced to Rs.30 lacs.
(b) United India Insurance Company Ltd. (for short the Insurer) is a public insurance company, engaged in the business of providing insurance services of different nature. M/s. Goyal and Company (the Insured) obtained Shopkeepers Insurance Policy vide Cover Note No. 68565, for a sum of Rs.10 lacs on 06/11/2007. It was renewed vide Cover Note No. 453425, (Policy No.200400/48/08/34/00000860) on 10/11/2008, by the Insurer through Syndicate Bank, valid from 11/11/2008 to 10/11/2009, sum insured was Rs.25 lacs, covering risk of Fire & Allied Perils, on stock of all kinds of cloths in trade, including furniture, fixture, fitting. The Insured obtained another Shopkeepers Insurance Policy on 17/08/2009, from the Insurer vide Cover Note No. 502452, i.e. Policy No. 200400/48/09/34/00000241, through Indian Bank, valid from 17/08/2009 to 16/08/2010, sum insured was Rs.70 lacs, covering risk of Fire & Allied Perils, on stock of all kinds of cloths in trade, including furniture, fixture, fitting. It was alleged that Indian Bank was Development Officer cum agent of the Insurer.
(c) On the intervening night of 17/18/10/2009, fire was broke out in the shop at ground floor. Smt. Rubina, the wife of Ramesh Kumar had another textile shop in the name of M/s. Balaji Textiles, on first floor of the same building. Sandeep Singh and Varinder Singh, who were living in the neighbourhood of the shop, noticed the fire at about 2:10 a.m. They informed Ramesh Kumar, the proprietor, who informed Fire Service Station Bathinda, from where, two fire tenders were deputed on the spot, which controlled the fire, after hectic efforts. But the fire caused extensive damages in the two shops. The Insured informed the local police about the fire incident, where it was registered vide DDR No. 10 dated 18/10/2009.
(d) The Insured informed the Insurer regarding the incident of the fire in the shops, on telephone on 18/10/2009 and in writing on 20/10/2009. The Ins
