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2025 Supreme(Online)(NCDRC) 2874
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
MR. BINOY KUMAR, PRESIDING MEMBER, MRS. SAROJ YADAV, MEMBER
M/S. PRIDE COKE PVT. LTD. – Appellant
Versus
M/S. NEW INDIA ASSURANCE CO. LTD. – Respondent
CONSUMER COMPLAINT NO. NC/CC/592/2020
For the Complainants: .
For the Opposite Party: .
Insurance policies must be interpreted strictly as per their language; ambiguity should favor the insured, attributing losses correctly under policy terms.
Headnote:(A) Consumer Protection Act, 1986 - Section 21(a)(i) - Insurance Policy - Claim for damages due to flooding - Complainant claimed Rs.6,82,98,361/-; Insurance Company offered Rs.44,24,562/-, arguing pecuniary jurisdiction and consumer status, rejected amendments; Final assessment acknowledged total damages of Rs.89,58,874/- for coke stock. (Paras 4, 17, 20)
(B) Policy Interpretation - Importance of precise language in insurance policies highlighted; Lack of clarity in policy description leads to ambiguity - Complainants entitled to full assessment of loss adequately covered under policy terms. (Paras 1, 16, 18)
Facts of the case:
Complainant operates a coal processing facility with extensive insurance coverage. Flood resulted in significant damage; claim remained unprocessed, leading to this complaint.
Findings of Court:
The Court found the Insurance Company liable for Rs.1,33,83,436/- along with interest due to misassessment.
Issues: Determination of consumer status, jurisdiction, and admissibility of claim were crucial to the case.
Ratio Decidendi: The ruling emphasized contractual interpretation in favor of the insured, affirming the admissible claims based on surveyor's findings.
Result: The Insurance Company directed to pay the assessed amount.
| Table of Content |
|---|
| 1. details of complaint and preliminary facts leading to the claim. (Para 1 , 2 , 3) |
| 2. communications regarding claim and assessment of damages. (Para 4 , 5 , 6) |
| 3. arguments regarding consumer status and validity of claims. (Para 9 , 12 , 13) |
| 4. assessment and interpretation of policy coverage. (Para 14 , 18) |
| 5. final ruling and orders for payment. (Para 19 , 20 , 21) |
ORDER
Binoy Kumar, Presiding Member
1. The present Consumer Complaint, i.e., CC/592/2020, is filed under Section 21 (a) (i) of the Consumer Protection Act, 1986 (for short, the Act), by M/S. Pride Coke Pvt. Ltd. (hereinafter referred to as the Complainant) against M/S New India Assurance Co. Ltd. (hereinafter referred to as the Opposite Party), alleging deficiency in service and unfair trade practice and seeking claimed amount along with other ancillary reliefs.
2. The brief facts leading up to the present Complaint are that the Complainant owns a th coal processing facility at 12 Mile, Jorabat, Vill.- Amber, Kamrup, Assam, India-781132, with a superstructure valued at Rs.1,55,00,000/-, furniture and electrical installations worth Rs.1,04,00,000/-, and coal stock valued at Rs.18,25,00,000/-. The Complainant procured an Insurance Policy from the Opposite Party to safeguard against any untoward incidents affecting the Complainant's plant. The Opposite Party issued a Standard Fire and Special Perils Policy to the Complainant under policy number 51230611180100000023 for the period 24.05.2018 to 23.05.2019. The Opposite Party provided insurance coverage totalling Rs.27,99,00,000/-, for which the Complainant paid a premium of Rs.4,08,332/-. This insurance policy protected the following sections of the plant against destruction: the building’s superstructure, its plinth and foundation, plant machinery and accessories, any stocks (including those in process), and the compound wall. The previous Standard Fire and Special Perils Policy (Policy No. 51230611180100000023) expired on 23.05.2019, following which a new Policy (Policy No. 51230611190100000036) was issued, effective until midnight on 23.05.2020.
3. On 23.08.2018, heavy rainfall and flooding occurred in Kamrup area, impacting life and property in the region. Within the Coke Unit, the Complainant stored 306 metric tons of Raw Coal, 2560 metric tons of Lam Coke, and 300 metric tons of Coke Breeze. Intense rainfall around 8.30 pm led to the overflow of a deep storm drain, causing water to inundate the premises and its surroundings. The rapid influx of water submerged the coal and coke stocks up to 4-5 feet by 11 pm, resulting in extensive damage not only to the stored goods but also to the ovens, superstructure, plant, and machinery.
4. A formal communication dated 24.08.2018 was sent by the Complainant to the Opposite Party's Divisional Manager and the Bank i.e Punjab National Bank, notifying them of the flood incident at the plant and highlighting the existence of the Insurance Policy. Despite 20 months elapsing since the flood, the Complainant's claim remained unprocessed. Initial and Final Spot Surveys were conducted on 25.08.2018 and 27.08.2018, respectively, by the Surveyors; however, despite multiple requests, the Survey Report has not been furnished to the Complainant. A Right to Information (RTI) letter dated 26.02.2020 was dispatched to the Opposite Party's Senior Divisional Manager, requesting for the Survey Report.
5. The Complainant, through Mr. Partha Sengupta, an eminent Engineer/Scientist, had an inspection carried out on the Coke Unit on 31.08.2018, and 01.09.2018. In his report, Mr. Sengupta determined a total monetary loss of Rs.6,20,34,400/-. This report was subsequently submitted to the Opposite Party, which duly acknowledged its receipt. The Complainant repeatedly requested an imprest payment of Rs.4,00,00,000/- from the Opposite Party for loss caused due to flood, sending letters on 27.09.2018, 19.11.2018 and 12.03.2019. The Complainant submitted yet another claim bill on 27.12.2018 for
