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2011 DIGILAW 181 (JK)

New India Assurance Company Ltd. & Ors. v. Ghulam Hassan Mir

2011-04-20

HAKIM IMTIYAZ HUSSAIN, HASNAIN MASSODI

body2011
Per Massodi, J.:- 1. The controversy involved in all the three above captioned Civil 1st. Miscel­laneous Appeals is by a large identical and the appeals are thus together taken up for disposal. 2. Challenge in CIMA No. 106/2008 is to the judgement of State Consumer Disputes Redressal Commission ("State Commission" for short) dated 22.09.2008, in complaint titled Ghulam Hassan Mir v. New India Insurance Company whereby the State Commission has directed the appellant to pay an amount of Rs. 17,15,729 along with interest at the rate of 8% per annum from 27.09.2002 i.e. the date of loss till final payment of the award amount and further allowed litigation costs in the amount of Rs. 5,000/-. 3. The Civil 1st. Miscellaneous Appeal No. 181/2009 calls in question judge­ment of the State Commission dated 05.08.2009 whereby the Appellant Insurance Company has been directed to pay an amount of Rs. 13,33,065/- to the respondent with 8% annual interests with effect from the date two months after the receipt of the Surveyors report till the final payment is made and also to pay Rs. 10,000/- to the respondent as litigation charges. 4. The appellant-respondent in CIMA No. 106/2008 through the medium of CIMA No. 27/2009 seeks modification of the State Commission judgement dated 22.09.2008 as regards the quantum of compensation directed to be paid to him by the appellant company as also rate of interest awarded by the State Commission. 5. The admitted facts are as under:- CIMA No. 106/2008 The respondent on 12.05.2002 obtained an Insurance Policy bearing No. 48-94170 from the Appellant company for an amount of Rs. 23.00 lacs for his residential building and further for an amount of Rs. 4.00 lacs in respect of household goods. The appellant Company agreed to indemnify the respondent subject to the terms and conditions laid down therein, the loss if any to the insured building and goods due to fire and allied perils during the period of 12 months with effect from noon 02.05.2002 to noon 01.05.2003. As ill luck wfauld have it, the insured building and goods on 27.09.2002 during the validity of the insurance policy, suffered extensive loss on account of cross firing/shelling between the Security Forces and unidentified gunmen. The occurrence led to registration of case FIR 116/2002 at local police station. The respondent reported the loss to the appellant insurance company. As ill luck wfauld have it, the insured building and goods on 27.09.2002 during the validity of the insurance policy, suffered extensive loss on account of cross firing/shelling between the Security Forces and unidentified gunmen. The occurrence led to registration of case FIR 116/2002 at local police station. The respondent reported the loss to the appellant insurance company. The report prompted appointment of M/s. Allaqband & Associates as preliminary Surveyor followed by appointment of Sh. AJ. Dillon, Surveyor, for assessment of loss to the insured property. The Surveyor assed the loss at Rs. 18, 30,000-00. The appellant Company taking the loss assessed as exorbitant remitted the assessment report to the Surveyor for a second look and not even satisfied with the reassessed loss of Rs. 17,27,000-00 got it re-examined by Shri Vinod Bhan who re-assed and reduced it to Rs. 13.00 lacs. CIMA No. 181/2009 The respondent on 3rd April 2005 took out an insurance policy from the appellant company for an amount of Rs. 19.00 lacs for stock trade of pesticides and allied items of his business concern run under the name and style of M.S. A.R. Enterprises, College Road Sopore. The insurance was effective from 3rd April 2005 to 2nd April 2006. While the insurance policy was operational and in force, an encounter took place between the Security Forces and militants near the insured property and in the Security Forces operation the insured property got damaged. The occurrence led to regis­tration of an FIR at local police station. The fire mis hap was reported to the appellant company. The Surveyor was appointed and loss to the insured property assessed at Rs. 13,33,065/-CIMA No. 27/2009 The Surveyor appointed by the respondent company (appellant in CIMA 106/2008) assessed the loss to the insured property at Rs. 18,30,886/-. The respondent company found the loss assessed excessive and referred the matter for reassessment to the Surveyor. The loss on review was reassessed as Rs. 17, 27,000/-. The appellant aggrieved that the assessment did not reflect the loss to the insured property, and that it was a case of total loss seeks reimbursement of the loss to the extent the property was insured i.e. full amount under the insurance policy. 6. The loss on review was reassessed as Rs. 17, 27,000/-. The appellant aggrieved that the assessment did not reflect the loss to the insured property, and that it was a case of total loss seeks reimbursement of the loss to the extent the property was insured i.e. full amount under the insurance policy. 6. By the time the decision could be taken regarding payment of assessed amount to the respondent, it dawned on the appellant Company that in terms of Tariff Advisory Committee- Statutory Authority under the Insurance Act, Circu­lar dt. 13th March 2002 effective 01.04.2002, the terrorism cover was to be issued as a separate cover in conjunction with Riot, Strike and Malicious Damage (RSMD) cover. The Circular was made applicable to all the claims arising out of the policies issued from 1st. April 2002. The Circular incorporated a Terrorism, Damage, Exclusion, Warranting Clause in the Insurance Policies issued from 01.04.2002 that reads as under:- "Notwithstanding any Provisions to the contrary within this Insurance, it is agreed that this Insurance excludes loss, damage, cost, or expense of what so ever in nature directly or indirectly by, resulting from or in connection with any act of terrorism regardless of any other cause or event contributing concurrently or any other consequence to the loss"...... Warranty also excludes loss, damage, cost or expanses whatsoever in nature directly or indirectly caused by, resulting from or in connection with any action taken in-controlling, preventing, suppressing or in any way relating to action taken in respect of any act of terrorism". 7. The appellant Company opining that the insurance claim put forth by the respondent fell within the Terrorism, Damage, Exclusion warranty Clause, repudi­ated the insurance claim and conveyed its decision to the respondent vide commu­nication dated 17th June 2004. The respondent aggrieved of the communication dated 17th June 2004 requiring the respondent to prove that the Terrorism, Damage, Exclusion warranty Clause did not apply to the claim in question, filed a complaint under Section 2(g), 2(o) read with Section 15 of the Jammu and Kashmir Consumer Protection Act, 1987 with the State Commission. The respondent aggrieved of the communication dated 17th June 2004 requiring the respondent to prove that the Terrorism, Damage, Exclusion warranty Clause did not apply to the claim in question, filed a complaint under Section 2(g), 2(o) read with Section 15 of the Jammu and Kashmir Consumer Protection Act, 1987 with the State Commission. The respondent complained that the inaction on the part of appellant company in settling the claim amounted to "deficiency in service" and sought a direction to the appellant company to pay the principle insurance amount along-with interest at the rate of 18% on account of loss suffered as also the compensation of Rs. 1.00 lace as litigation costs. The appellant Company in its written version reiterated its stand that the case fell within the ambit of Terrorism, Damage Exclusion Warranty Clause and that the appellant Company was not under an obligation to indemnify the respondent. 8. The State Commission held the Terrorism, Damage, Exclusion, Warranty Clause to be extraneous to the terms and conditions of Insurance Contract and in the facts and circumstances of the case not binding on the parties and concluded that there was deficiency in service on part of the Insurance Company in settling the lawful claim of the respondent under the Insurance Contract. The State Commission allowed the claim to the extent of Rs. 17,15,729/- with interest at the rate of 8% per annum from the date of loss till final payment of award amount. 9. The State Commission award is questioned on the grounds that the State Commission failed to appreciate the controversy involved, in its right perspective. The Commission is said to have failed to notice that the Terrorism, Damage, Exclusion, warranty Clause, in terms of the Circular issued by Tariff Advisory Committee had become operational in respect of all the insurance policies with effect from 01.04.2002 and that as the insurance policy in question was issued on 2nd May 2002, the aforesaid Clause was operational in respect of the insurance policy obtained by the respondent. It is contended that the appellant company was not under any obligation to append the copy of the Circular dated 13th March 2002 with the insurance policy in question or provide copy of the Circular to the respondent and mere failure to provide copy of the Circular to the respondent would not by itself exclude its application to the insurance policy in question. The appellant Company also is aggrieved with interest awarded by the State Commis-sion on the award amount and claims it to be in conflict with the law occupying the field. It is insisted, that the interest on the award amount may be awarded with effect from the date three months after the receipt of survey report and not the date of the loss. 10. We have gone through the memorandum of appeal and perused the State Commission record. 11. We have heard Learned Counsel for the parties. 12. The Tariff Advisory Committee, Circular No. FT/1/2002 dated 13th March 2002, admittedly was effective from 01.04.2002. The Circular made the revised Provision applicable in case of insurance policies taken out after from 1st. April 2002. In terms of Circular, Riot, Strike, Malicious and Terrorism Damage cover under the Standard Fire and Special Perils Policy (Material Damage) was renamed as Riot, Strike, Malicious, Damage Cover. The Circular in effect excluded Terrorism, Damage from the Riot, Strike, Malicious, Damage Cover under the Standard Fire and Special Perils Policy and provided for a Terrorism cover as a separate cover. The Circular also shifted onus of proving contrary, to the insured in the event Insurance Company alleged that the loss or damage was caused due to action taken in controlling, preventing, suppressing or in any way, relied to action taken in respect of any act of terrorism. 13. The respondent took out the insurance policy from the appellant company on 2nd May 2002 i.e. about seven weeks after Tariff Advisory Committee Circular dated 13th March 2002 was issued and four weeks after the circular came into force. The appellant company nonetheless did not inform the respondent at the lime the respondent took out the insurance policy that terms and conditions of the Insurance Contract were revised by Circular No. FT/1/2002 dated 13th March 2002 to the extent it related to loss on account of terrorist activities. The appellant company did not only withhold the information from the respondent, but receive an amount of Rs. 810/- as premium to cover damage/loss on account of terrorist acts as additional amount of premium over and above the Fire and Special Perils Premium. The appellant Company did not inform the respondent, change in terms and conditions of the policy when the loss was reported and not even a little less than two years thereafter. 810/- as premium to cover damage/loss on account of terrorist acts as additional amount of premium over and above the Fire and Special Perils Premium. The appellant Company did not inform the respondent, change in terms and conditions of the policy when the loss was reported and not even a little less than two years thereafter. The appellant company in the circumstances, cannot wriggle out of its liability under the Insurance Contract to indemnity the loss to the insured property as assessed by its Surveyor and Loss Assessor on the ground of changes in terms and conditions of the Insurance Contract neither incorporated in Insurance Con­tract nor communicated/conveyed to the respondent. 14. The Commission was right in rejecting the case set up by the appellant company to escape liability to indemnify the respondent. It needs no emphasis, that contract of Insurance including one of fire insurance has principle of good faith as its edifice. It is a contract of uberrimae fidie. The parties to Insurance Contract are expected nay required to pbserve utmost good faith while entering into such contract. The principle of good faith does not only bind down the party taking out an insurance policy, but also the Insurance Company. The manner insured as compared with the insurer, is expected to have better knowledge about the subject matter of insurance and required to disclose all material facts regarding the subject matter insurer, same way the insurer is expected to be well aware of different aspects of the insurance cover including the extent and limitation of liability under the Insurance policy and duty bound to disclose all material facts in respect of the insxirance policy to the insured. The principle obligates the contracting parties to disclose and transmit all material information so that the contracting parties take an informed decision while taking out or selling an insurance policy, is done, with vital information held or kept back can not be said to have been done in good faith. The appellant company in the present case while withholding Tariff Advisory Committee Circular dated 13th March 2002 and not incorporating the revised clause in the insurance policy can not be said to have acted in good faith and insist that the Circular revised clause was binding on the respondent. The conclusion drawn by the State Commission and the reasons record in support thereof, are thus in conformity with law. 15. The conclusion drawn by the State Commission and the reasons record in support thereof, are thus in conformity with law. 15. The grounds urged in CIMA No. 27/2009 to question the State Commission judgement dated 22.09.2008 to the extent it relates to quantum of compensation the respondent company has been directed to pay to the appellant, are devoid of any substance. Mere fact, that the Surveyor on review of the earlier assessment made reassessment of the loss at a little less than the earlier assessment is no reason to question the reassessment made in absence of any malafide's not pleaded in the appeal. The respondent company was well within its power to go through the Surveyors report and in the event any discrepancies were found, request the Surveyor to reassess the loss. The appellant fails to realise that the los & to the insured property on its second reassessment was found by Sh. Vinod Bhan to be Rs. 13.00 lacs. The State Commission did not take notice of the second reassessment by Sh. Vinod Bhan, and instead relied on the first reassessment by the Surveyor who had earlier assessed the loss at Rs. 18,30,000-00. The story of total loss sought to be set up by the appellant does not sound convincing and inspire confidence. The griev­ance as regards rate of interest is also misplaced. The State Commission as a matter of fact has awarded interest from the date earlier to the date with effect from which it ought to have been awarded. The State Commission has awarded the interest from the date of loss while as the interest is to be awarded from a reasonable interval after the date of receipt of the Surveyors report. Needless to mention that it is the Surveyors report that concretizes the matter as regards indemnification/payment of compensation to the insured. The State Commission, it needs to be pointed out, has in judgement rendered on 22.09.2008 in Complaint titled Ghulam Hassan Mir v. Divisional Manager New India Assurance Company (Complaint No. 28/2004) awarded interest on compensation amount with effect from date of loss and in judgement rendered on 05.08.2007 in complaint titled M/s. A. R. Enterprises v. New India Assurance Company (Complaint No. 54/2008) awarded interest on compen­sation amount with effect from two months after the receipt of Purveyors report. 16. 16. For the reasons discussed the CIMA's 181/2009 and 27/2009 are meritless, and liable to be dismissed. There is no merit in the CIMA 106/2008 except to the extent it calls in question the date of award of interest. There appears to be substance in the case set up by the appellant that the State Commission ought to have awarded interest on the awarded amount with effect from the date three months after the report of the Surveyor/loss Assessor was received, and not from the date of the loss. In the circumstances CIMA's 27/2009, 181/2009 are dismissed. In CIMA 106/2008 while up-holding the State Commission Award dated 22.09.2008, interest on the award amount is directed to be paid by the appellant company with effect from the date three months after the date of receipt of the report of the Sur­veyor/Loss Assessor whereby Rs. 17,15,72/- is assessed as loss to the insured property. CIMA 27/2009 and CIMA 181/2009 dismissed. CIMA No. 106/2008 disposed of.