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Rajasthan High Court · body

2019 DIGILAW 290 (RAJ)

United India Insurance Company Limited v. Uma Polymers Ltd. through its Company Secretary Khalid Hussain S/o Shri Ajamat Ali

2019-01-23

ASHOK KUMAR GAUR

body2019
ORDER : 1. The present writ petition is being decided finally with the consent of the learned counsels for the parties. 2. The petitioner – Insurance Company has filed the writ petition challenging the Award dated 19.11.2018 passed by the Permanent Lok Adalat, Jodhpur. The Permanent Lok Adalat, while allowing the claim petition filed by the respondent No.1, has directed the petitioner to pay claim amount of Rs.19,99,637/- and after deduction of GST of Rs.4,28,872/- to pay remaining amount of Rs.15,70,765/- (Rupees Fifteen Lacs Seventy Thousand Six Hundred Sixty Five only) together with interest @ 9% per annum from 02.04.2018 (the date of filing the claim petition). 3. The petitioner-Company has pleaded in the writ petition that a package policy in respect of a private Car No. RJ-19-CH-0099 was issued by the petitioner-Company providing insurance coverage to the aforesaid vehicle from 15.10.2016 to 14.10.2017 subject to the terms, conditions and exclusions as provided in the standard terms and conditions of the package policy. The company has placed on record the insurance policy as Annexure-1 with the instant petition. 4. The petitioner has pleaded in the petition that during the currency of the insurance policy, a claim intimation was received vide communication dated 01.07.2017 informing that on 27.06.2017, it was raining in Jodhpur and while going from Shastri Nagar to Railway Station, the car stopped suddenly near Mathura Das Mathur Hospital (MDM). The petitioner-Company has pleaded that the intimation was said to be given to the dealer in this regard and the dealer is said to have arranged crane and lifted the car for Jaipur. 5. The petitioner-Company has pleaded that the dealer had initially submitted a preliminary estimate of Rs.52,632/- and after receiving the claim intimation, the petitioner-Company appointed M/s Apex Insurance Surveyors and loss Assessors Pvt. Ltd. (an authorized and licenced Surveyor and Loss Assessor) to assess the loss caused to the insured vehicle. It is pleaded that the authorized surveyor and loss assessor carried out survey of damaged vehicle on various visits and on the inspection of the vehicle, water was found inside the air cleaner, its resonator, filter and ducts, therefore, the authorized surveyor requested the workshop to remove oil sump to verify the condition of the engine. It is pleaded that the authorized surveyor and loss assessor carried out survey of damaged vehicle on various visits and on the inspection of the vehicle, water was found inside the air cleaner, its resonator, filter and ducts, therefore, the authorized surveyor requested the workshop to remove oil sump to verify the condition of the engine. It is pleaded that after removal of oil and oil sump, excessive water was found mixed with the oil and fine metal particles were also found in the oil, therefore, the surveyor and assessor requested the workshop engineers for dismantling of the engine to ascertain the damage. It is pleaded that after persuasions, the engine was dismantled in the presence of the authorized surveyor and on dismantling of the engine, it was observed by the authorized surveyor that the insured car was moved in accumulated water of about 2.5 ft. or more resultantly the water was sucked by the resonator installed just behind front grill which was instantly sucked by the powerful engine and entered inside the engine cylinder block, resulting in sudden hydrostatic lock to pistons and on account of which their connecting rod could not sustain sudden jerk and got bent. 6. The petitioner-Company has pleaded that the surveyor observed that the driver of the vehicle continued to drive the vehicle in deep water resultantly piston seizure took place damaging cylinder block and overheating crankshaft, main bearing and other engine parts. The petitioner-Company has pleaded that looking to the damage on all major parts of the engine, the authorized workshop of BMW preferred to replace entire engine assembly and accordingly, a huge bill of repairing was raised. 7. The petitioner-Company has pleaded that the authorized surveyor and loss assessor assessed loss caused to the vehicle till hydrostatic lock stage of the engine and submitted his report assessing the loss of Rs.7,34,349/-. The surveyor, while reporting about the damage to the car, is further said to have observed that consequential damages on account of negligence on the part of the driver were not payable under the general exclusion clause of the policy. 8. The petitioner has pleaded that the respondent No.1 had submitted a representation dated 08.11.2017 whereby it was informed to the petitioner-Company that the amount spent in repair of the car was Rs.19,99,637/- and the surveyor had allowed certain parts and repair for Rs.7,34,349/-. 8. The petitioner has pleaded that the respondent No.1 had submitted a representation dated 08.11.2017 whereby it was informed to the petitioner-Company that the amount spent in repair of the car was Rs.19,99,637/- and the surveyor had allowed certain parts and repair for Rs.7,34,349/-. The respondent informed that once the vehicle emerged in the water and as per the terms and conditions, the loss was due to inundation which was covered in the package policy and as such, there was no justification to reject the claim in respect of the necessary parts replaced by the repairer. 9. The petitioner has pleaded that after receiving the representation from the respondent, the petitioner-Company is said to have called comments from the surveyor and the authorized surveyor provided its comments on 24.11.2017 and finally petitioner-Company found Rs.5,67,686/- was payable in receipt of claim. 10. The respondent No.1 did not accept the amount and finally filed an application under Section 22-B of the Rajasthan Legal Services Authorities Act, 1987 before the Permanent Lok Adalat, Jodhpur. The respondent in his claim petition made a claim that the entire amount incurred in the repair of the vehicle, i.e., Rs.19,99,637/- along with interest @ 15% per annum w.e.f. 01.09.2017 was required to be paid and further Rs.1,00,000/- as compensation was also claimed. 10. The Permanent Lok Adalat, Jodhpur, after considering the rival claims between the parties, has passed the order dated 11.11.2018, which is impugned in the instant writ petition. 11. The Permanent Lok Adalat framed two issues which are reproduced as hereunder:- ^^1- D;k izkFkhZ dh iz'uxr chfer ch,eMCY;w dkj la[;k vkj-ts- 19&lh,p&0099 ds cjlkr esa nq?kZVukxzLr gksus ls mldks ejEer djokus ij [kpZ dh xbZ jkf'k ds nkos esa ls dVkSfr;ka dh xbZ gS] tks fof/kuqlkj gS \ 2- D;k izkFkhZ dk izkFkZuk&i= Lohdkj fd, tkus ;ksX; ik;k tkrk gS \^^ 12. The Permanent Lok Adalat has considered the clauses of general exception of the policy and after considering the Condition Nos. 4 and 6 came to the conclusion that if the expenses have been incurred in repair of the vehicle, the petitioner-Company is liable to pay the same and petitioner has charged Rs.19,857.42 towards ‘Nil Depreciation Without Excess”. 13. This Court considers it proper to quote the relevant Clauses/Conditions of the Insurance Policy issued to the claimant. The relevant Clauses/Conditions are as under:- “SECTION–I. LOSS OR DAMAGE TO THE VEHICLE INSURED 1. 13. This Court considers it proper to quote the relevant Clauses/Conditions of the Insurance Policy issued to the claimant. The relevant Clauses/Conditions are as under:- “SECTION–I. LOSS OR DAMAGE TO THE VEHICLE INSURED 1. The Company will indemnify the insured against loss or damage to the vehicle insured hereunder and/or its accessories whilst thereon i. by fire explosion self ignition or lightning; ii. by burglary housebreaking or theft; iii. by riot and strike; iv. by earthquake (fire and shock damage); v. by flood typhoon hurricane storm tempest inundation cyclone hailstorm frost; vi. by accidental external means; vii. by malicious act; viii. By terrorist activity; ix. whilst in transit by road rail inland-waterway lift elevator or air; x. by landslide rockslide; 2. The Company shall not be liable to make any payment in respect of :- (a) consequential loss, depreciation, wear and tear, mechanical or electrical breakdown failures or breakages. (b) damage to tyres and tubes unless the vehicle insured is damaged at the same time in which case the liability of the company shall be limited to 50% of the cost of replacement. And (c) any accidental loss or damage suffered whilst the insured or any person driving the vehicle with the knowledge and consent of the insured is under the influence of intoxicating liquor or drugs. GENERAL EXCEPTIONS (Applicable to all Sections of the Policy) The Company shall not be liable under this Policy in respect of: 1. ……………..…. ……………………. ….…..…….…….. 2. ……………..…. ……………………. ….…..…….…….. 3. ……………..…. ……………………. ….…..…….…….. 4. (i) Any accident loss or damage to any property whatsoever or any loss or expense whatsoever resulting or arising there from or any consequential loss (ii) any liability of whatsoever nature directly or indirectly caused by or contributed to by or arising from ignising radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. For the purposes of this exception combustion shall include any self-sustaining process of nuclear fission. CONDITIONS This Policy and the Schedule shall be read together and any word or expression to which a specific meaning has been attached in any part of this Policy or of the Schedule shall bear the same meaning wherever it may appear. 1. ……………..…. ……………………. ….…..…….…….. 2. ……………..…. ……………………. ….…..…….…….. 3. ……………..…. ……………………. ….…..…….…….. 4. CONDITIONS This Policy and the Schedule shall be read together and any word or expression to which a specific meaning has been attached in any part of this Policy or of the Schedule shall bear the same meaning wherever it may appear. 1. ……………..…. ……………………. ….…..…….…….. 2. ……………..…. ……………………. ….…..…….…….. 3. ……………..…. ……………………. ….…..…….…….. 4. The Insured shall take all reasonable steps to safeguard the vehicle from loss or damage and to maintain it in efficient condition and the Company shall have at all times free and full access to examine the vehicle or any part thereof or any driver or employee of the insured. In the event of any accident or breakdown, the vehicle shall not be left unattended without proper precautions being taken to prevent further damage or loss and if the vehicle be driven before the necessary repairs are effected any extension of the damage or any further damage to the vehicle shall be entirely at the insured’s own risk.” 14. The learned counsel for the petitioner Mr. Vyas submitted that the bare perusal of the terms and conditions of the Policy clearly excludes the claim of the respondent-claimant. 15. The learned counsel has submitted that the bare perusal of the Condition No. 4 makes it clear that in the event of any accident or breakdown, the vehicle shall not be left unattended without proper precautions being taken to prevent further damage or loss and if the vehicle be driven before the necessary repairs are effected any extension of the damage or any further damage to the vehicle shall be entirely at the insured’s own risk. 16. The learned counsel submitted that in the instant case, the Permanent Lok Adalat has not considered the very important aspect of the matter that the vehicle of the respondent if stopped due to water on the road and the vehicle was further driven, the Insurance Company cannot be made liable as per the said policy. 17. The learned counsel further argued that the Surveyor’s Report which was prepared clearly revealed that the damage was caused to the engine and certain other parts and in the normal course, if the vehicle was not stopped immediately when it came into contact with the water, the Insurance Company cannot be made liable and it is the insured who is responsible. 18. 18. The learned counsel further submitted that the Insurance Policy and the conditions thereof are required to be strictly adhered too by both the parties and in the event of violation of the policy, the Insurance Company cannot be made liable. 19. The learned counsel further argued that the Permanent Lok Adalat has not looked into the relevant policy conditions which excluded the coverage of the loss which is said to be suffered by the respondent. 20. The learned counsel submitted that the Permanent Lok Adalat has only been swayed with the fact that since the extra premium was paid towards “Nil Depreciation Without Excess” and as such, the loss suffered by the insured will be covered due to payment of such extra premium. The learned counsel submitted that the Company was liable to indemnify only for the parts which were replaced as per the policy and conditions. However, the coverage for which the extra premium was paid, the same cannot cover the risk which had occasioned due to no fault of the insurer. 21. The learned counsel for the petitioner has placed reliance on a judgment reported in (2009) 7 SCC 777 in the matter of Sikka Papers Limited Vs. National Insurance Company Limited & Ors. 22. The learned counsel submitted that the Apex Court has reiterated the principle that Surveyor/Loss Assessor’s Report carries weight and until there are reasons for departing from the report, such report is to be given due weightage. The learned counsel submitted that in the instant case, once the report was given by the Surveyor that the engine of the vehicle in question was affected due to accumulated water and the damage in the accident was due to the escape of water, due to gross negligence by the insured driver by making forceful efforts to run/move/drag the car. The learned counsel submitted that the Surveyor’s Report had categorically recorded a finding that the respondent No.1 had used the force or made the efforts to run the car and as such, the report of the Surveyor ought to have been considered by the Permanent Lok Adalat, while deciding the claim case. 23. The learned counsel for the petitioner Mr. The learned counsel submitted that the Surveyor’s Report had categorically recorded a finding that the respondent No.1 had used the force or made the efforts to run the car and as such, the report of the Surveyor ought to have been considered by the Permanent Lok Adalat, while deciding the claim case. 23. The learned counsel for the petitioner Mr. Vyas further submitted that if there is a contract between the parties and the terms and conditions of the contract are required to be adhered too and no outside help can be sought to interpret such clauses of the contract until such clauses are meaningless. 24. The learned counsel, while placing reliance on a judgment reported in (2004) 8 SCC 644 in the matter of United India Insurance Co, Ltd. Vs. Harchand Rai Chandan Lal, submitted that the Insurance Policy between the insurer and the insured represents a contract between the parties. The insurer cannot pay anything more than covered under the insurance policy. 25. Per contra, the learned counsel Mr. Anil Bhandari appearing for the respondent No.1 submitted that no error has been committed by the Permanent Lok Adalat, while passing the order dated 19.11.2018. The learned counsel submitted that in the incident which had taken place clearly proved that there was no negligence on the part of the driver, who was driving the vehicle at the relevant time. The learned counsel has drawn attention of this court towards the statement of the driver – Chhagan Singh, the document has been filed as Annexure-R/1/2 with the reply. 26. The learned counsel submitted that the driver of the vehicle in question clearly deposed that he was coming from Railway Station after dropping some guests and it was raining heavily and the moment he reached near the MDM Hospital, there was a flow of water and the vehicle was parked on the left side and at the moment, the water came in contact with the vehicle and the vehicle suddenly stopped. The learned counsel submitted that the statement of the driver specifically shows that after stopping of the vehicle, he parked the vehicle and tried to move the car in order to get out from the water which was flowing at that place including the road leading to the Shastri Nagar. 27. The learned counsel for the respondent Mr. The learned counsel submitted that the statement of the driver specifically shows that after stopping of the vehicle, he parked the vehicle and tried to move the car in order to get out from the water which was flowing at that place including the road leading to the Shastri Nagar. 27. The learned counsel for the respondent Mr. Bhandari has submitted that the Surveyor’s Report clearly records a finding that the damage was caused to the engine and certain other parts and the same was covered under Section 1 of the Policy where loss occurred as per Clause I (v). The learned counsel submitted that Insurance Company is required to indemnify against the loss or damage to the vehicle insured occurred as a result of flood typhoon, hurricane storm, tempest inundation cyclone hailstorm frost. 28. The learned counsel further submitted that the reliance on Condition No. 4 of Section III has wrongly been placed by the petitioner-Company. The learned counsel submitted that there is no finding by any person that the vehicle was driven after breakdown. The learned counsel submitted that until some evidence or tangible proof was produced by the Insurance Company that after stoppage of the vehicle in question, the same was driven and as such, damage was caused to the said vehicle by making efforts. The learned counsel submitted that in absence of such findings, it cannot be said that there has been violation of Condition No. 4 of the policy. 29. The learned counsel for the respondents has placed reliance on a judgment of Allahabad High Court reported in MACD 2018 (4) (All.) 1813 in the case of N.I.A.C.L. (The) & Anr. Vs. M/s Siddharth Associate & Anr. The learned counsel submitted that the Allahabad High Court has taken a view that if the damage caused to the insured vehicle is not denied as a part of damage than the damage which is being denied is not a consequential damage but an accidental damage. The relevant para 13 of the said judgment is reproduced hereunder- “13. Thus exclusion clause deals with consequential loss. The policy clearly provides for indemnify loss or damage to the vehicle insured caused by accidental external means. The petitioner has claimed that damages caused to the vehicle, caused accidentally and not for consequential loss. The relevant para 13 of the said judgment is reproduced hereunder- “13. Thus exclusion clause deals with consequential loss. The policy clearly provides for indemnify loss or damage to the vehicle insured caused by accidental external means. The petitioner has claimed that damages caused to the vehicle, caused accidentally and not for consequential loss. The fact that accidental damage was caused to the insured vehicle has not been denied as part of damage was allowed by the petitioner. The part of damage, which is being denied is not a consequential damage but an accidental damage.” 30. The learned counsel has also placed reliance on an order passed by the National Consumer Disputes Redressal Commission in the matter of Tata AIG General Insurance Co. Vs. M/s. Ambience Leasing Pvt Ltd. & Ors., decided on 06.02.2017. The learned counsel submitted that in a similar situation where engine of the vehicle was damaged due to hydro-locks and other parts of the engine like inundation, chambers etc. got damaged and same was result on account of flood, the National Consumer Disputes Redressal Commission has taken similar view in the aforesaid case. 31. I have heard learned counsel for the parties and perused the material available on record. 32. This Court finds that the Permanent Lok Adalat, while passing the order impugned, has taken into account “Nil Depreciation Without Excess” clause and has also considered the general exceptions which are given in the Insurance Policy. This Court finds that the Permanent Lok Adalat has not committed any error while coming to the conclusion that the respondent – insured was liable to be paid the repair charges which were incurred due to the incident which had taken place. 33. This Court finds no substance in the submission of the learned counsel for the petitioner that the Surveyor’s Report has not been given due weightage. 34. This Court finds that the Insurance Company has not produced any evidence/proof that the vehicle was used or an effort was made after it had stopped. The reliance only on the statement or observation of the Surveyor that the insured had made forceful efforts to run the vehicle and as such, he disallowed the claim, this Court finds that only on surmises and conjectures, if the report is prepared by the Surveyor that the vehicle was forcefully run, such report cannot have much weightage for considering the claim of the insured. 35. This Court finds that the petitioner-Company has repudiated the claim of the respondent though the vehicle in question was got damaged due to the incident which had taken place, however, denying the claim on the ground that the owner/ insured was liable for further damage as he tried to use the vehicle. This Court finds that the Condition No. 4 which is relied by the learned counsel for the petitioner Mr. Vyas, cannot be pressed into service in the instant case until there was evidence to the effect that after the vehicle was got struck in the water, the same was tried to be driven further or some force was used. 36. This Court finds that the report of the Surveyor is just narrating about the incident or damage which is caused to the engine or other important parts. It is not understandable as to how, the damage was caused to the several parts of the engine and connecting rod, pistons, resonators and all were affected and were not in a proper position to move the car. 37. This Court finds that the Apex Court has laid-down the law that the terms of the contract or the conditions which are agreed thereto are required to be strictly followed and no assistance can be sought from other sources. This Court finds that there is no quarrel on the said proposition which has been laid down by the Apex Court. However, in the present facts of the case, the policy itself provides that if there is a loss or damage to the vehicle in certain contingencies, the Insurance Company has to indemnify the insured against the loss or damage. 38. The learned counsel for the petitioner contends that the Apex Court in the case of Sikka Papers Limited (supra) has laid-down the principle that if the Insurance Company does not cover parts of the machinery which were required to be replaced due to wear and tear, the Insurance Company is justified in assessing the claim excluding such parts. The learned counsel further submitted that the Apex Court in the said case has further laid-down the law that due weightage is to be given to the report of the Surveyor. 39. The learned counsel further submitted that the Apex Court in the said case has further laid-down the law that due weightage is to be given to the report of the Surveyor. 39. This Court on close scrutiny of the facts on the aforesaid case before the Apex Court and considering the principle of law laid-down, finds that if there are legitimate reasons for departing from the report, the inference can be drawn by the Courts, as to whether such report will be a final word or not. 40. In the present case, the report which is given by the Surveyor cannot be treated as a last word for the reason that in any part of the report, it is not said by the Surveyor that damage has been done to the particular parts of the engine and no evidence or proof has been produced showing that the owner/insured had tried to use force to move or drag the car and accordingly, in his opinion this part was not liable to be indemnified. The report of Surveyor is based on assumption that driver of vehicle continued to drive forcefully, therefore, seizure took place. Considering the facts of the present case, this Court finds that the Surveyor’s Report cannot be given much credence. 41. This Court does not find that any error has been committed by the Permanent Lok Adalat and accordingly this Court finds that the present writ petition lacks merits and the same is hereby dismissed.