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2022 Supreme(Online)(Del) 7398

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Viswanath (Presiding Member), Ram Surat Ram Maurya, MEMBER
Park Leather Industries Ltd. v. United India Insurance Co. Ltd.
Consumer Complaint No. 1234 of 2007



The court affirmed that damages due to inundation are covered under the insurance policy, and failure to provide policy terms invalidated the insurance company's repudiation.

Headnote:(A) Consumer Protection Act, 1986 - Section 21(a)(1) - Insurance claim for loss due to inundation - Claim repudiated by Insurance Company on grounds of not being an insured peril - Held, damage was caused by inundation which is covered under policy as stated in statement of eye-witnesses. (Paras 23, 24)

(B) Maintainability of complaint - Where facts require examination of witnesses, summary proceedings may still accommodate the grievance. The Consumer Forum must provide an accessible remedy for aggrieved parties. (Paras 12, 13)

Facts of the case:
Complaint arises from damage to property insured against fire and special perils during heavy rainfall leading to the collapse of the factory shed. Surveyors’ assessments differed regarding cause and extent of damages with the Complainant contesting the repudiation of the claim.

Findings of Court:
Evidence and statements support the Complainant's assertion that loss was due to inundation which is covered under policy. Lack of terms and conditions being shared invalidates the denial of claim.

Issues: The key issues included whether the loss was due to an insured peril and if the Complaint was maintainable under the Consumer Protection Act despite disputed facts.

Ratio Decidendi: The court emphasized that the insurance policy covers loss due to inundation, highlighting that the terms must be communicated to ensure insured parties are aware of their rights.

Result: Opposite Parties are directed to pay Complainant Rs. 46,97,085 with interest.

Table of Content
1. claim for insurance due to inundation. (Para 1 , 2 , 3)
2. repudiation of claim and defense by insurance company. (Para 4 , 5 , 6)
3. maintainability of the complaint despite complex facts. (Para 12 , 14 , 20)
4. compensation guided by surveyor's assessments and policy terms. (Para 23 , 24)

1. The present Complaint is filed under S.21(a)(1) of the Consumer Protection Act, 1986 .

2. The Complainant is a Limited Company incorporated under the Companies Act and operates in leather processing business, having one of its establishments at Runkata, Agra. The building, plant & machinery and stocks of the Complainant were comprehensively insured against Fire and Special Perils by Opposite Parties, vide Policy No. 080404/11/05/00147, from 30.6.2005 to 29.6.2006. The Complainant paid a premium of Rs. 72,126 under the Policy for risk cover as follows:
Buildings including boundary wall, cables. Meter Board & other similar goods for sum assured Rs. 1 Crore.



3. The case of the Complainant is that in the night of 1.8.2005, due to heavy rain the factory shed fell down causing huge damage to the building, plant & machinery and stocks. On 2.8.2005, the Complainant sent intimation regarding the loss caused by inundation in the premises to Opposite Party No. 2 requesting them to appoint a Surveyor to assess the loss. The Complainant submitted the claim of Rs. 91 lakh. The Complainant wrote letter dated 4.8.2005 to Opposite Party No. 2 stating that the Complainant had not received any Policy document after paying the premium on 29.6.2005. On the request of the Complainant, the Opposite Party No. 2 supplied a duplicate copy of the Policy without terms & conditions of the Policy.

4. Opposite Party No. 2 deputed Mr. Dhanesh Kumar Sharma as Surveyor & Loss Assessor. The Complainant received letter dated 3.8.2005 from the Surveyor, seeking information and documents from the Complainant. The Complainant, vide letter dated 9.8.2005, submitted reply fulfilling the requirement and requested the Surveyor to supply Preliminary Survey Report to them. The Complainant received letter dated 23.8.2005 from the Surveyor, requiring further information and documents which was supplied by the Complainant, vide its letters dated 1.9.2005 and 19.10.2005. The Complainant, vide letter dated 28.11.2005, informed Opposite Party No. 2 that the reconstruction at the premises was being done. Inspection be done so that the Complainant could remove the waste material from the site. Despite letter dated 28.11.2005, no final visit was made by the Surveyor. The Surveyor, however, assessed the loss at Rs. 8,89,176. After one and a half years from the date of the incident, the Complainant received a letter dated 19.12.2006 from Opposite Party No. 2, repudiating the claim of the Complainant stating as follows:
The loss was not due to insured peril of inundation as claimed, hence the same is outside the purview of the policy.
After receiving the repudiation letter, the Complainant sent letters dated 20.4.2007 and 13.6.2007 to Opposite Party No. 2 that repudiation of the claim was arbitrary and illegal and requested to review the decision but no response was received from Opposite Party No. 2 till the date of filing the Complaint. Aggrieved by the repudiation of the claim, the Complainant filed the instant Consumer Complaint with this Commission with the following prayer:
A - Require respondents (Insurance Co.) to pay Rs. 91,50,00 towards losses suffered by the complainant due to inundation.
B - Require respondents (Insurance Co.) to pay interest on the aforesaid value of claim of such other value @18% p.a. from the date of incident, i.e. 1.8.2005.
C - Require respondents (Insurance Co.) to pay Rs. 15 Lac by way of compensation for harassment, loss suffered by the complaint due to inaction / delay on the part of respondents.
D - Pass such other & further order as this Hon'ble Commission may deem just, fit & proper under the circumstances.






5. Opposite Parties resisted the Complai






































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