United India Insurance Co. Limited v. Purshotam Lal
2009-10-13
ARUN KUMAR GOEL
body2009
DigiLaw.ai
ORDER (Arun Kumar Goel, J.) (Retd.), President (Oral) - Admitted facts giving rise to this appeal are, that the respondent had obtained a Standard Fire and Special Perils Policy in the sum of Rs. 5,50,000/- qua the fruits etc. those were lying in the store of M/s Vishnu Fruit Company, Sabzi Mandi, Kangra whose owner/proprietor he was during the validity of the insurance policy. According, to respondent, 130 quintals of bananas were kept for ripening in 500 crates. Value of the bananas and the crates was Rs.1,78,250/-. These were totally damaged due to blast and as a result of it, respondent suffered loss. Besides the loss of Rs. 1,78,250/- suffered as aforesaid, respondent also lost his son, as per Mr. Vasudeva. 2. In this background, when intimation was sent to the appellants, claim of the respondent was not settled. This constituted deficiency in service, as such respondent filed Consumer Complaint No. 335/2006, before the District Forum below. 3. When put to notice, it was pleaded by the appellant by way of preliminary objections, that the complaint was not maintainable and the respondent having not come with clean hands. On merits insurance of all kinds of vegetables, fruit and other goods lying in the class-A constructed shop was admitted. At the same time while disputing its liability, insurance company pleaded that it is not liable to indemnify the respondent because he had used coal bhatti for ripening of bananas and as a result of it, there was blast causing damage to the bananas, as well as to the crates. This was prohibited as per terms of policy. District Forum below after hearing the parties, has allowed the complaint holding that the appellant liable to pay Rs. 1,23,299/- to the complainant within 30 days after the receipt of copy of the order, failing which this amount was to carry interest @ 9 % per annum from the date of complaint, i.e. 15.11.2006 till payment. Besides this amount, compensation in the sum of Rs. 5,000/. alongwith cost of litigation of Rs. 2,000/- has also been levied upon the appellant. Hence this appeal. 4. Mr. Bahl learned counsel for the appellant submitted, that his client is only liable to indemnify the respondent in this appeal, in case there was no violation of the policy conditions subject to which the vegetables and fruits etc. were insured with it.
2,000/- has also been levied upon the appellant. Hence this appeal. 4. Mr. Bahl learned counsel for the appellant submitted, that his client is only liable to indemnify the respondent in this appeal, in case there was no violation of the policy conditions subject to which the vegetables and fruits etc. were insured with it. Further according to him, District Forum below was in error when it held that the exclusions regarding use of coal bhatti and consequential loss due to such blast was not covered, as no extra premium had been charged to that effect. To the contrary per Mr. Bahl ripening through heating and drying was specifically excluded under the policy conditions. Prima facie in the face of these exclusions the submission of Mr. Bahl appears to be well founded. However keeping in view the Insurance. Regulatory and Development Authority (Protection of Policyholders' Interests) Regulation 2002, we feel that this appeal deserves to be dismissed. Because there is nothing on the complaint file that these regulations were complied with by the appellant. 5. Faced with this situation, Mr. Bahl forcefu1ly argued that question of establishing compliance that these Regulations of 2002 would arise only, when a case had been set out in the complaint that the terms and conditions of' policy were not explained on behalf of his client insurance company to the respondent when insurance was undertaken in this case. We are of the view that this submission is without substance, thus needs rejection. Reason being that when the law requires a particular thing to be done in a particular manner, unless it is shown to have been done in the said manner, no benefit can be derived on assumptions and presumptions, as was urged by Mr. Bahl. Regulation 3, of the aforesaid Regulations of 2002 (supra), reads as under:- "3. Point of Sale (1) Notwithstanding anything mentioned in regulation 2 {e} above, a prospectus of any insurance product shall clearly state the scope of benefits, the extent of insurance cover and in an explicit manner explain the warranties, exceptions and conditions of the insurance cover and, in case of life insurance, whether the product is participating {with-profits} or non-participating {without-profits}.
Point of Sale (1) Notwithstanding anything mentioned in regulation 2 {e} above, a prospectus of any insurance product shall clearly state the scope of benefits, the extent of insurance cover and in an explicit manner explain the warranties, exceptions and conditions of the insurance cover and, in case of life insurance, whether the product is participating {with-profits} or non-participating {without-profits}. The allowable rider or riders on the product shall be clearly spelt out with regard to their scope of benefits, and in no case, the premium relatable to all the riders put together shall exceed 30% of the premium of the main product. Explanation: The rider or riders attached to a life policy shall bear the nature and character of the main policy, viz. participating or non-participating and accordingly the life insurer shall make provisions, etc., in its books. {2} An insurer or its agent or other intermediary shall provide all material information in respect of a proposed cover to the prospect to enable the prospect to decide on the best cover that would be in his or her interest. xxxxxxxxxxxxxxxxxxxx" (Emphasis supplied) 6. A perusal of the above Regulation clearly indicates that there is no evidence produced by the appellant to show that it was complied with. Thus it can safely be held on the basis of material on record, that Regulation 3 extracted hereinabove has been complied more in its breach than compliance by the appellant while undertaking insurance in this case. 7. Further submission of Mr. Bahl, that all requirements envisaged under law including Regulation 3 (supra) having been explained to the respondent is to be presumed in this case at the time of insurance. Best person to have said something in this behalf was, who had undertaken insurance in this case. Why his affidavit has not been filed, learned counsel for the appellant had no answer. 8. Affidavit of Branch Manager has been placed on record on behalf of the appellant and was pressed into service by Mr. Bahl in support of this appeal. Admittedly he had not undertaken the insurance in this case, as such no benefit can be derived from it. Though Mr. Bahl wanted us to accept whatever he has stated in it. This prayer is rejected. 9. No other point is urged.
Bahl in support of this appeal. Admittedly he had not undertaken the insurance in this case, as such no benefit can be derived from it. Though Mr. Bahl wanted us to accept whatever he has stated in it. This prayer is rejected. 9. No other point is urged. In view of the aforesaid discussion, we find no merit in" this appeal which is accordingly dismissed while upholding the order of the District Forum below in Consumer Complaint No. 335/2006, dated 3.12.2008, leaving the parties to bear their own costs. All interim orders passed from time to time in this appeal shall stand vacated forthwith. Learned Counsel for the parties have undertaken to collect copy of this order free of cost from the Court Secretary as per rules. M.R.B.