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2022 Supreme(Online)(Del) 7416

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Ram Surat Ram Maurya, MEMBER
M/s. Aristo Texcon Private Limited – Appellant
Versus
United India Insurance Company Limited – Respondent
Consumer C. No. 53 of 2014



Advocates:
For the Appellants/Petitioners: Mr. Anil Agarwalla
For the Respondents: None

Insurance claims must be supported by credible evidence; exaggerated or fabricated claims can lead to repudiation.

Headnote:(A) Insurance Act - Standard Fire and Special Perils Policy - Clauses 6 and 8 - The Insured claimed compensation for losses resulting from a factory fire, which the Insurer contested, alleging exaggerated claims based on fabricated documents. The Insured failed to provide required proof of loss and relevant documentation demanded by the Insurer during investigation. As a result, the Insurer repudiated the claim. (Paras 2-4, 6-12)

(B) Evidence - Burden of Proof - The surveyor’s and Investigator’s findings suggested doubt regarding the authenticity of the Insured’s claims. The Insurer's repudiation of the claim was grounded on finding insufficient evidence supporting the legitimacy of claimed losses. (Paras 8-13)

Facts of the case:
The complainant’s factory was damaged in a fire incident, and a claim was filed with the Insurer for substantial financial losses due to the fire. Despite providing documentation, discrepancies in evidence led the Insurer to doubt the claims.

Findings of Court:
The claim was dismissed as the evidence was insufficient and the allegations of exaggeration were substantiated.

Issues: The court addressed whether the Insured demonstrated legitimate loss and whether the surveyor's findings justified the Insurer's claim repudiation.

Ratio Decidendi: The court emphasized the importance of credible evidence in insurance claims and upheld the Insurer's decision given the lack of substantiated proof from the Insured, affirming the repudiation of the claim.

Result: Complaint dismissed.

Table of Content
1. claim lodged following a fire incident. (Para 2 , 3 , 4)
2. insurer contested claim based on lack of credible evidence. (Para 5 , 6 , 8 , 11)
3. court upheld insurer's claim repudiation dues to exaggerated claims. (Para 12 , 13)

1. Heard Mr. Anil Agarwalla, Advocate, for the complainant. None appeared for the opposite parties.

2. M/s. Aristo Texcon Private Limited (the Insured) has filed above complaint for directing United India Insurance Company Limited (the Insurer) to pay (i) Rs. 3,28,50,037.26 with interest, as the insurance claim, (ii) Rs. 2 crores, as the compensation for mental agony and harassment, (iii) cost of litigation; and (iv) any other relief, which is deemed fit and proper, in the facts and circumstances of the case.

3. The facts, as stated in the complaint and emerged from the documents attached with the complaint, are as follows:
(a) M/s. Aristo Texcon Private Limited (the complainant) (the Insured) was a private company, registered under the Companies Act, 1956 and engaged in the business of manufacture and sale of elastic, tapes, laces, mattresses, pillows, cushions and readymade garments. Its factory was situated at Plot No. 20-45, Radhanath Chowdhary Road, Tangra Industrial Estate - II, Kolkata.
(b) United India Insurance Company Limited (the Insurer) was a Public Insurance Company and engaged in the business of providing different types of insurance services to the general public. The Insured obtained 'Standard Fire and Special Perils Policy' No. 030400/11/11/00000158, for a sum of Rs. 7.10 crores (Rs. 1.10 crore on Building, Rs. one crore, on Plant, Machinery & Accessories and Rs. 5 crores on Stock), for a period of 31.5.2011 to 30.5.2012, from the Insurer.
(c) A massive fire broke up around 21:00 hours on 19.2.2012, in the factory premises of the Insured, which was a seven storied building. 19.2.2012 (Sunday) was a holiday for the factory, as such, apart from, the security guard, no employee was there. On coming to know about the fire, the security guard immediately informed to Fire Service Station, from where 5-6 fire tenders were sent on the spot, which doused the fire upto 24.00 hours, in night. Fire was initiated from ground floor and spread up to first and second floors. Disaster Management Team also came on the spot, who sealed the building, for forensic investigation to find out the root cause of the fire.
(d) The Insured informed the Insurer about fire incident and loss at its factory premises on 20.2.2012 and submitted a claim form to Divisional office on 20.2.2012, giving estimated loss to Rs. 6 crores. The Insurer appointed Mr. P.S. Ramnathan, Coimbatore (opposite party - 2), as the surveyor on 21.2.2012. The surveyor reached Kolkata on 22.2.2012 and asked the Insurer to provide a local person, (knowing Bengalilanguage) as his assistant. The Insurer deputed one Mr, Dasgupta, to assist the surveyor. The surveyor inspected the factory premises on 22.2.2012, took photographs, videography and prepared inventory, in presence of the Director of the Insured. The surveyor asked the Insured to segregate the burnt articles. Time to time the surveyor demanded papers for assessment of loss, which were supplied by the Insured. As advised, the Insured supplied an item - wise list of the loss / claim on 3.3.2012, in which total claim was mentioned as Rs. 3,25,27,455.31.
(e) The Insurer also appointed M/s. S.N. & Associates, Kolkata (opposite party - 3) as the Investigator. The major part of the claim of the Insured was loss of 72,000 readymade garments and its packing. The Insured informed that it had received Purchase Order of 72000 ladies ready made garments, from Spectrum World FZC, Rak, U.S.E., dated 20.12.2011. The Insured purchased fabrics from M/s. Sanjay Enterprises, Room No.320, 3rd Floor, 7/1, Grant Lane, Kolkata, Hanuman Traders, 14, Jella Para, 1st Bye Lane, Howrah and United Trading Company, 17/1, Atindra Mukherjee Lane, Howrah, which were got tailored from M/s. Mangla Traders, Amta,

































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