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2022 Supreme(Online)(NCDRC) 38
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
MR. RAM SURAT RAM MAURYA, PRESIDING MEMBER
M/S. Goyal and Company – Appellant
Versus
UNITED INDIA INSURANCE COMPANY LIMITED & ANR. – Respondent
FIRST APPEAL NO. 4 OF 2015|FIRST APPEAL NO. 417 OF 2015
For the Appellant:Mr. Aman Preet Singh Rahi, Advocate
For Respondent-1:Mr. Rajesh K. Gupta, Advocate
For Respondent-2:Mr. Himanshu Munshi, Advocate
Reliability of evidence and sound documentation are essential in insurance claims, particularly for assessing losses.
Headnote:(A) Consumer Protection Act, 1986 - Sections 12 and 13 - Insurance claim disputed due to alleged undervaluation - Insured claimed loss of over Rs.8 million based on incorrect stock assessments; Surveyor's findings led to lower settlement - The court emphasized the necessity for reliable documentation and the insurer's obligation to appoint a surveyor for losses exceeding Rs.25,000 under Insurance Act - The court found discrepancies in the insured's financial records, indicating exaggerated claims and lack of corroborative evidence. (Paras 11, 12, 17)
(B) The Insured had asserted extensive damages from a fire incident on 18.10.2009, but failed to satisfactorily provide evidence to support his claims - The surveyor's report, though not sacrosanct, provided substantial grounds for assessing the loss. (Paras 3, 4, 6, 9)
| Table of Content |
|---|
| 1. claim details and procedural issues regarding the insurance policy. (Para 2 , 3 , 4 , 5) |
| 2. factual assertions related to the fire incident and initial reporting. (Para 6 , 7) |
| 3. discussions on the importance of evidence and validation of stock claims. (Para 8 , 9 , 13) |
| 4. clarification on surveyor's role and the necessity of corroborative evidence. (Para 10 , 11) |
| 5. final assessment of the insurable loss and court's ruling. (Para 12 , 14 , 15 , 16 , 17) |
ORDER
FA/4/2015
For the Appellant : Mr. Aman Preet Singh Rahi, Advocate
For Respondent-1 : Mr. Rajesh K. Gupta, Advocate
For Respondent-2 : Mr. Himanshu Munshi, Advocate
FA/417/2015
For the Appellant : Mr. Rajesh K. Gupta, Advocate
For Respondent-1 : Mr. Mr. Aman Preet Singh Rahi, Advocate
For Respondent-2 : Mr. Himanshu Munshi, Advocate
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.7520335/- 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.50000/- 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.5908872/-, (ii) Rs.1/- lac as compensation and (iii) Rs.11000/- 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 AM. They informed Ramesh Kumar, the proprietor, who inform
