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2013 DIGILAW 423 (CAL)

UNITED INDIA INSURANCE CO. LTD. v. ORIENTAL RUBBER WORKS

2013-07-05

ASHOK BHAN, VINEETA RAI

body2013
JUDGMENT The Order of the Commission was delivered by : Rai, Member.––United India Insurance Co. Ltd., Appellant herein and Opposite Parties before the West Bengal State Consumer Disputes Redressal Commission, Kolkata (hereinafter referred to as the State Commission) have filed the present First Appeal against the order of the State Commission which had allowed the complaint of deficiency in service filed by Oriental Rubber Works, Respondent herein and Complainant before the State Commission. 2. FACTS: Respondent, who is a partnership firm carrying on the business of manufacturing of rubber products like hospital sheets, gumboots, rain coats, ground sheets, air pillows etc. which they supply to various Hospitals, Railway, Defence Ministry and in the open market, had taken a Standard Fire and Special Perils Policy on 20.07.2004 from Appellant-Insurance Company to cover the stocks of raw material and finished goods against various perils for a total sum of Rs.75 Lakhs. The insurance policy was valid till 19.07.2005 and the raw material and finished goods were hypothecated to Union Bank of India. On 05.06.2005 at 11.00 p.m. a fire broke out in the factory/workshop of the Respondent, as a result of which extensive damage was caused to the raw material, finished goods as also to the building. It was controlled by the Fire Services after several hours. The incident of fire was reported to the Police and also to the Appellant/Insurance Company vide letter dated 06.06.2005 with a request to depute a Surveyor to assess the loss. Appellant/Insurance Company appointed one M.N. Zutshi as Surveyor, who visited the site on three occasions and after conducting a detailed survey submitted its report to the Appellant/Insurance Company Respondent on the basis of stocks lying in the finished goods section of the factory and other items destroyed claimed an amount of Rs. 43,85,817/-. Respondent later came to know that the Surveyor had assessed the loss at Rs.33,91,954/- but despite requests, the Surveyor's report was not made available to the Respondent. Also despite several reminders to the Appellant/Insurance Company, the claim was not settled by them. Being aggrieved by the deficiency in service in not settling the claim on the part of Appellant/Insurance Company, Respondent filed a complaint before the State Commission and requested that the Appellant/Insurance Company be directed to pay it a sum of Rs. Also despite several reminders to the Appellant/Insurance Company, the claim was not settled by them. Being aggrieved by the deficiency in service in not settling the claim on the part of Appellant/Insurance Company, Respondent filed a complaint before the State Commission and requested that the Appellant/Insurance Company be directed to pay it a sum of Rs. 43,85,817.30 being the amount claimed in respect of the loss of damaged raw materials and finished goods with interest @ 12% per annum from 05.06.2005 till its realization as also Rs. 50,000/- as compensation for harassment, mental agony etc. 3. Appellant/Insurance Company on being served filed a written reply denying that there was any deficiency in service on their part. It was stated that the Surveyor, who had been appointed to assess the loss could not finalize its report because fake and fabricated documents were supplied by the Respondent and further there was non-cooperation regarding production of some other documents. The insuree/Respondent also deliberately concealed information from the Surveyor that a large portion of the goods, which were destroyed in the fire, were items which had been rejected by the departments of Government of India as also not entertained since these were supplied after the stipulated date. The above facts were confirmed by Argus Associates, an Investigator, appointed to look into this aspect as also government departments. The Appellant/Insurance Company, therefore, repudiated the claim on 13.12.2007 (i.e. during the pendency of the proceedings before the State Commission) in terms of Policy Condition No.8 of the insurance policy, which inter alia provides that if any fraudulent claim is made on the basis of a false declaration to obtain benefits under the policy, then all benefits shall be forfeited. In the instant case since false claims had been made by suppressing that large number of rejected items had been included in the loss incurred and, thus, misleading the Surveyor, the claim was rightly repudiated. 4. In the instant case since false claims had been made by suppressing that large number of rejected items had been included in the loss incurred and, thus, misleading the Surveyor, the claim was rightly repudiated. 4. The State Commission after hearing the parties and on the basis of evidence produced before it, allowed the complaint by observing as fellows; "The contention of the Insurer is that materials are available before them showing that the validity of the order for delivery of the concerned goods, expired on 31.3.2005 and the materials placed for delivery were rejected by the Authority who placed the order for such goods and such rejection being prior to the date when fire broke out the said goods could not be treated as goods for delivery to the said Authority under their order. In this connection we have considered the materials available before us and we do not find that insurance coverage was only for materials which were made ready for delivery under any particular valid order. On behalf of the Insurer also no Clause of the Policy was shown for the purpose of holding that compensation would be paid by the Insurer only for the finished products which are covered by a valid delivery order. In absence of any such materials coverage of the policy has to be treated as available to the insured for the raw materials and finished goods lying within the premises as covered by the said policy. In the present case there is no dispute that raw materials and finished goods were damaged by the fire. The Surveyor's report shows also clearly the said fact showing damage by fire of the goods belonging to the insured. In such circumstances rejection of the goods or expiry of the valid order for delivery, do not appear to be a factor for consideration. In view of the above findings as regards no requirement for a valid order or rejection of some materials, the alleged application of Clause 8 of the policy also does not appear to be justified as in view of such findings the disclosure by the insured of validity of the orders has no bearing." The State Commission, therefore, directed the Appellant/Insurance Company to pay the Respondent the amount assessed by the Surveyor regarding the loss caused i.e. Rs. 33,91,954/-, Rs. 20,000/- as compensation and Rs. 33,91,954/-, Rs. 20,000/- as compensation and Rs. 2000/- as costs within a period of two months from the date of the order, failing which the entire amount was to carry interest @ 10% per annum for the entire period of default till realization. 5. Being aggrieved by the above order, the present first appeal has been filed. 6. Learned counsel for both parties made oral submissions. 7. Counsel for the Appellant/Insurance Company while reiterating the facts as stated before the State Commission contended that the subsequent enquiries indicated that the loss assessed by the Surveyor had to be revisited since 70% of the finished items destroyed in the fire were rejected items. In this connection Counsel for the Appellant/Insurance Company brought to our notice a letter written by the Government of India, Ministry of Defence indicating that a large number of items (Boot Knee) had been rejected by them and also that orders for over 7000 pairs of Boot Knee were cancelled since Respondent failed to supply the same within the extended delivery period. While all these issues alongwith the report of the Investigator was being reexamined by the Surveyor, Respondent without waiting for the final report of the Surveyor filed a complaint before the State Commission. Counsel for the Appellant/Insurance Company further brought to our notice what it termed as the "second report" of the Surveyor M.N. Zutshi confirming the report of the Investigator and agreeing that action under Policy Condition No.8 would be attracted. 8. Counsel for the Respondent on the other hand stated that the above contentions were not factually correct. The Surveyor had in his detailed survey report taken into account all facts, including deducting 10% from the assessed amount to adequately take care of rejections, old stocks, obsolescence as well as remaining unaccepted and undelivered stocks, the facts of which were not suppressed by the Respondent. The Surveyor had also taken into consideration the profits and associated selling overheads and made necessary deductions of the same as per the calculation in its survey report. Therefore, the question of rejecting the claim in terms of Policy Condition No.8 of the insurance policy was not justified. The Surveyor had also taken into consideration the profits and associated selling overheads and made necessary deductions of the same as per the calculation in its survey report. Therefore, the question of rejecting the claim in terms of Policy Condition No.8 of the insurance policy was not justified. The letter written by the Surveyor which the Appellant/Insurance Company has termed as the "second report" is only a communication to the Appellant/Insurance Company commenting on the report of the Investigator and confirming that the rejected items had been taken into account and necessary deductions made in its survey report and further on the basis of some observations advising that Policy Condition No.8 could be attracted. Counsel for the Respondent contended that these conjectural observations and did not impact on the loss assessed by the Surveyor. The State Commission after considering all these facts had rightly concluded that the Appellant/Insurance Company was not justified in repudiating the claim and should have settled the claim in terms of the report of the Surveyor. 9. We have considered the submissions made by learned Counsel for the parties and have gone through the evidence on record. The facts pertaining to the Respondent taking an insurance policy for his goods from the Appellant/Insurance Company and a fire taking place in the insured premises, in which a number of stocks were destroyed, is not in dispute. Appeal is dismissed.