Back
2022 Supreme(Online)(NCDRC) 37
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 Appellants/Petitioners: Mr. Aman Preet Singh Rahi, Mr. Rajesh K. Gupta
For the Respondents: Mr. Rajesh K. Gupta, Mr. Aman Preet Singh Rahi, Mr. Himanshu Munshi
The Insured must provide adequate proof of loss for insurance claims; failure to substantiate claims leads to dismissal.
Headnote:(A) Insurance Act, 1938 - Section 68 UM - Fire accident in insured premises - Dispute regarding quantum of loss claimed under two insurance policies - State Commission awarded partial compensation; Insured felt inadequately compensated - Essential to prove loss with requisite documentation as required under the policy - Surveyor's report contested by insured but found credible based on available evidence. (Paras 3, 8, 11-16)
(B) Consumer Protection Act, 1986 - Position of evidence in insurance claims - Surveyor’s findings are not sacrosanct, yet bear significant weight - Correctness of surveyor's report must be substantiated against presented record; Insured must cooperate fully. (Paras 10, 11)
(C) Third-party responsibility - Requisite documents and verification by bank and surveyor not sufficiently established by Insured - Claim without substantiation leads to dismissal. (Paras 13-16)
Facts of the case:
The Insured claimed losses amounting to Rs. 8,626,123/- due to a fire incident but was only compensated Rs. 843,788/-, resulting in appeals regarding assessment of loss and responsibility.
Findings of Court:
The Insured failed to provide adequate documentation and evidence for the claimed losses, leading to the dismissal of the appeal.
Issues: The court examined the adequacy of the evidence provided for the claim and the credibility of the insurance surveyor's findings.
Ratio Decidendi: The burden was on the Insured to prove the loss with supporting documentation; inadequate proof results in unfavorable ruling against the Insured.
Result: The appeals were adjudicated, leading to the dismissal of the initial complaint and allowance of the Insurer's appeal.
| Table of Content |
|---|
| 1. fire incident leading to insurance claim. (Para 2 , 3) |
| 2. court's dismissal of claim due to insufficient proof. (Para 7 , 17) |
| 3. assessment of losses and credibility of surveyor. (Para 8 , 10) |
| 4. burden of proof lies on the insured. (Para 11 , 16) |
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 informed Fire Service Station Bathinda, from where, two fire tenders were deputed on the spot, which controlled the fire, after hectic efforts. But the fire caused extensive damages in the two shops. The Insured info
