United India Insurance Co. Ltd vs Surat Ram

Dr. S.M. Kantikar, J

Heard learned counsel for the revisionist - insurance co. and perused the material on record.

Brief facts, shorn of unnecessary details, are that the respondent - complainant was the owner of a vehicle (car) and the vehicle was insured with the revisionist - insurance co. for the period 18.11.2013 to 17.11.2014. The vehicle got damaged due to an accident on 02.09.2014. Information about the accident was given to the police as well as to the insurance co. It was alleged by the complainant that even after the completion of all formalities, his claim was not settled.

The contention of the revision petitioner - insurance co. was that the complaint was not maintainable. There was delay of about one month in giving intimation about the incident. The claim of the complainant was closed vide letter dated 17.02.2015 due to non-fulfillment of the codal formalities even after several requests.

The District Forum vide its Order dated 24.03.2017 allowed the complaint, inter alia holding that :

"6.....The vehicle in question was totally damaged in this accident and as such the OP has no justification to have asked for the repair estimate from the complainant. It is true that there has been delay in giving intimation about this accident by the complainant to the OP, but no prejudice has been caused to the OP by the delay caused in giving intimation by the complainant. The surveyor appointed by the OP had verified the loss by conducting spot survey. Therefore, the delay caused in giving intimation of loss in this case cannot be held to be fundamental breach of the terms and conditions of the insurance policy and on this count the OP cannot deny claim to the complainant.

As a sequel to our discussion above, we hold that since the complainant has not committed any fundamental breach of the terms and conditions of the policy and the documents required by the OP from the complainant are already on record. Therefore, the OP is directed to settle the claim of the complainant on the basis of total loss within 45 days from the date of receipt of the copy of this order. In case the complainant is not satisfied with the settlement of claim by the OP, he is at liberty to approach this forum again in accordance with law. Accordingly, this complaint stands disposed of in the aforesaid terms."

The insurance co. appealed in the State Commission. The State Commission heard both sides, appraised the evidence and through a reasoned Order dated 11.06.2018 dismissed the appeal, inter alia holding that:

"10 . Surveyor cum loss assessor has specifically submitted that driving license of deceased driver was not produced because same was missing as reported by insured to the surveyor cum loss assessor. Surveyor cum loss assessor has specifically mention in the report that he has perused insurance policy, copy of police report, copy of R.C , and copy of postmortem report issued from civil hospital Arki of deceased Suresh driver. State Commission is of the opinion that driving license could not be produced by the insured because driving license was in the possession of driver and driver of vehicle had died in the accident. All other documents were submitted by insured before surveyor cum loss assessor . State commission is of the opinion that report submitted by surveyor cum loss assessor is binding upon insurance company because surveyor cum loss assessor was authorized agent of the insurance company and documents submitted to the authorized agent of the insurance company would be deemed to be submission of documents to the insurance company under law.

- - - We have carefully perused the repudiation letter dated 17-2-2015 annexure- R- I issued by opposite party to the complainant. There is no recital in repudiation letter dated 17.02.2015 issued by the opposite party that claim was repudiated on the ground of delayed submission of intimation of accident to insurance company. State Commission is of the opinion that it is not expedient in the ends of justice and on the principle of natural justice to allow the insurance company to take the plea of delay intimation of accident in pleadings after filing of consumer complaint by complainant under Consumer Protection Act, 1986 . See 2018 (1) CLT titled Tata AIG Insurance Co. Ltd. Versus Dr. Tilak Gupta and others. "

This revision has been filed under section 21(b) of the Act 1986 against the said Order dated 11.06.2018 of the State Commission. Section 21 (b) reads as below:

....to call for the records and pass appropriate orders in any consumer dispute which is pending before or has been decided by any State Commission where it appears to the National Commission that such State Commission has exercised a jurisdiction not vested in it by law, or has failed to exercise a jurisdiction so vested, or has acted in the exercise of its jurisdiction illegally or with material irregularity.

We specifically note that it is not disputed that the premium had been paid, the policy was valid, an accident had occurred, the driver of the vehicle expired in the accident, an F.I.R. was lodged with the police, information was given to the insurance co., a surveyor of the insurance co. was appointed.

We find the Order of the State Commission to be well-appraised and well-reasoned. The State Commission concurred with the District Forum. We note in particular the observations of the two fora quoted in paras 3 and 4 above. Within the meanings and scope of section 21(b), we find no grave error in appreciating the evidence by the two fora below, as may cause to require re-appreciation of the evidence in revision. On the face of it, we find no jurisdictional error, or a legal principle ignored, or miscarriage of justice.

There is no reason evident to interfere with the concurrent findings of the District Forum and the State Commission.

We note that the District Forum had directed the opposite party - insurance co. to settle the claim of the complainant on the basis of total loss within 45 days from the date of receipt of a copy of its Order. In our considered view, it is just and appropriate, and albeit also necessary, that the insurance co. shall pay interest from 45 days of receipt of a copy of the District Forum's Order till the date of actual payment, at the rate prescribed for fixed deposit in a scheduled nationalised bank (take, State Bank of India) in the corresponding period; if floating / varying / different rates of interest were prescribed in the corresponding period, the higher rate shall be taken for this instant computation.

The revision petition is disposed of with directions as above.

Needless to add that the District Forum shall proceed with execution as per the law.

Let a copy each of this Order be sent to the District Forum and to the respondent - complainant within ten days by the Registry.