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2025 Supreme(Online)(NCDRC) 3638

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
Mr. Subhash Chandra, Presiding Member, AVM J. Rajendra, AVSM VSM (Retd.), Member
National Insurance Co. Ltd., Regional Office Hashubhai Chamber – Appellant
Versus
Shri Ramesh Kanji Cham – Respondent
FIRST APPEAL NO. 305 OF 2010



Advocates:
For the Appellants: Mr.K.K Bhat
For the Respondent: Mr. Madhurendra Kuma, Ms. Nita Sukhanandi

The acceptance of an insurance settlement under protest does not forfeit the right to pursue further claims, affirming the consumer's right amid shortcomings in service.

Headnote:(A) Consumer Protection Act, 1986 - Section 19 - Marine Hull Insurance - Claim under Marine Hull Insurance Policy filed for the vessel 'MIRAJ' - Claim significantly reduced by insurer from Rs. 73,00,000 to Rs. 21,44,500 on grounds of inadequate justification, leading to dispute over acceptance of full and final settlement - The court held that acceptance under protest allows pursuit of claim for balance amount. (Paras 3, 5, 16)

(B) Jurisdiction - Claims arising from incidents beyond territorial waters are maintainable - The court’s obligation included examining delay in claims processing, duty on insurer to provide evidential justifications, and the role of surveyor's reports in settlement discussions - Failure to adequately consider these factors represents deficiency in service. (Paras 6, 14, 18, 22)

Facts of the case:
The case involved the Complainant, an owner of a marine vessel who claimed damages from an Insurer following an incident leading to the vessel's sinking in Dubai Creek. The Insurer, after detailed assessment, offered a much reduced settlement, leading to the Complainant's appeal for further compensation and recognition of delay and service deficiency by the Insurer.

Findings of Court:
The Complainant entitled to recover additional compensation of Rs. 60,000 and interest accrued from the due date of settlement as forms of compensation for undue delays in claim processing. The Insurer directed to pay interest at specified rates for delays involved in claim processing.

Issues: The main issues focused on the validity and circumstances of the full and final settlement, dealing with reported deficiencies in the insurance service, and the effectiveness of the claim dispute mechanism.

Ratio Decidendi: The court reaffirmed that receiving a settlement under protest preserves the right to pursue additional compensation, emphasized the critical nature of timely claims processing, and maintained the importance of the surveyor's report in evaluating claims assessments.

Result: Appeal allowed with directions for payment of compensation plus interest.

Table of Content
1. appeal filed under consumer protection act regarding claim delays. (Para 1 , 2 , 3)
2. insured vessel claim facts presented, highlighting inadequate insurer response. (Para 4 , 5 , 6 , 8)
3. opponents argue non-maintainability of claim based on alleged consumer status. (Para 7 , 10 , 11)
4. court emphasizes importance of timely claims response and survey integrity. (Para 12 , 14 , 15 , 18)
5. justice awarded through interest calculations on delayed payments. (Para 16 , 17 , 20 , 22)
6. conclusion and disposal of the appeal. (Para 23)

JUDGMENT

1. The Appellants/OPs filed the instant Appeal under Section 19 of the Consumer Protection Act, 1986 (“the Act”), against State Consumer Disputes Redressal Commission, Lucknow (“State Commission”) Order dated 30.04.2010 in CC No. 01/2006 allowing the Complaint.

2. As per the Registry report, there is 76 days delay in filing this Appeal. For the reasons stated in IA /02/2010, the delay is condoned.

3. For convenience, the parties in the present matter are being referred to as per position held in the Consumer Complaint.

4. Brief facts of the case, as per the Complainant, are that the Complainant is the owner of Motor Vessel "MIRAJ" utilized for self- employment in the shipping business, transporting materials between locations as per customer requirements. The Complainant adhered to the pre-requisite terms of Opposite Party (OP) Insurer by obtaining a valuation report for the vessel prior to obtaining insurance. Thus, M/s JB Boda Surveyors Pvt. Ltd. issued a report determining the market value at Rs.1,15,00,000 on 07.02.1996. Upon consideration of this valuation, OP Insurer issued policy No. 300506/22/08/4102748 for Rs.1,05,00,000 covering the period from 08.02.1997 to 07.02.1998 collecting the premium of Rs.70,705 from the Complainant.

5. On 11.05.1997, as reported in Khalij Times newspaper on 12.05.1997, the Complainant's vessel keeled over on its left side at the Deira side of Dubai creek, settling in the mud shortly after 09.00 AM. The Complainant, upon receipt of this information, promptly notified the OP Insurance Company and subsequently submitted all requisite documentation. The OP Insurer registered the claim under Marine Hull Claim No.300506/41/97/98/04. The Complainant submitted a claim for Dhs. 7.56 Lakhs (equivalent to approx. Rs.73,00,000), but after about five years of correspondence, the OP offered only Rs.21,44,000 vide DD dated 31.10.2002, representing this as full and final settlement. The Complainant, having previously requested an on-account payment of Rs. 21 lakhs on 08.08.2002, and later reminding the OP on 01.10.2002, accepted the belated payment under explicit protest. On 31.10.2002, the Complainant transmitted a fax to the OP Insurance Company acknowledging receipt under protest and requesting detailed calculations justifying the substantial reduction of the claimed Rs.73,00,000 to the offered Rs.21,44,500. OP-2, responding by letter dated 03.01.2003, provided cursory claim consideration details but omitted justification for disallowed items and failed to provide copies of the survey report or claim note. Following this inadequate response, the Complainant issued reminders via fax on 08.12.2003, and subsequently on 11.07.2004, requesting settlement of the balance claim amount. OP-1, responding on 02.09.2004, asserted that they had re-examined the claim file, concluding that settlement had been processed in accordance with surveyor assessments and that full and final payment had been made, precluding further action or review. The Complainant promptly contested this position vide letter dated 16.10.2004, registering strong protest against the purported reexamination, asserting that the claim had not been settled according to policy terms and conditions, emphasizing the under-protest acceptance, and demanding the balance of Rs.52,86,475 as calculated per documentation submitted during claim lodgement. Due to continuing silence and delay from both OPs, the

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