National Insurance Company Limited v. Mohammad Mansoor Bhat
2023-05-29
MOKSHA KHAJURIA KAZMI, N.KOTISWAR SINGH
body2023
DigiLaw.ai
JUDGMENT : MOKSHA KHAJURIA KAZMI, J. 1. The Consumer Protection Act is a social benefit - oriented legislation. It is a beneficial legislation which proposes to confer a benefit on individuals or class of persons. The beneficial legislation means a statute which is interpreted liberally and has given the widest possible meaning, which the language permits and to secure remedy to the victim who is unjustly denied of relief. A welfare legislation construes liberal approach to be adopted and purposive construction which would effectuate the object of the welfare legislation with respect to the expressions used in the statute. 2. Preamble declares the object with which the enactment has been proposed and what it seeks to accomplish. Preamble assumes active role in case of any ambiguity in the interpretation of a provision in the statute. PREAMBLE: “An Act to provide for better protection of interest of consumers and for that purpose to make provision for the establishment of consumer councils, and other authorities for the settlement of consumers’ disputes and for matters connected therewith”. 3. Appellant herein, has assailed the order dated 28.05.2018, passed by J & K State Consumer Disputes Redressal Commission at Srinagar, (for short, State Commission), in the Complaint No. 13 of 2008, titled as Mohammad Mansoor Bhat vs. Divisional Manager, National Insurance Co. Ltd., whereby the State Commission, after accepting the report of the surveyor dated 29.10.2002, has directed Insurance Company – Appellant to pay an amount of Rs. 5,00,000/- (Rupees Five Lakhs) along with interest @ 8% from the date of filing of complaint less by 10% depreciation. National Insurance Company - Appellant has also been directed to pay the litigation cost of Rs. 25,000/- to the respondent (complainant therein). FACTUAL BACKGROUND OF THE CASE 4. The complainant/respondent was running a Diagnostic Centre, for conducting ultrasonography at Hospital Road, Shopian. In this behalf a loan was obtained by him from J&K Bank, Shopian, and as a condition precedent to such loan agreement, the equipment was insured with the Anantnag Branch of Appellant - Insurance Company under policy No. 421002/11/00/750019 for a total sum of Rs. 9,00,000/- (Nine Lakhs). The insurance policy was valid from 24.12.2001 till 23.12.2002. It is stated that during the validity of said policy, the insured equipment was stolen by burglars during the intervening night of 26/27-10-2002.
9,00,000/- (Nine Lakhs). The insurance policy was valid from 24.12.2001 till 23.12.2002. It is stated that during the validity of said policy, the insured equipment was stolen by burglars during the intervening night of 26/27-10-2002. The incident was reported to the concerned police station and the case was registered under FIR No. 295/02, P/S Shopian. The intimation of loss was also given to the Insurance Company, who deputed M/s Elite Surveyors to assess the loss. The surveyor visited the spot and demanded documents from the complainant/respondent which were provided to the Surveyor except the final police report, which was not issued for want of a letter of requisition from the Appellant. It is stated that on the basis of the preliminary details of loss, the surveyor had assessed the loss of Rs. 5,00,000/- (Five Lakhs), in terms of report dated 29.10.2002 as per physical verification but no final report was submitted by the surveyor. It is stated that in the month of October 2006, the complainant was conveyed that the claim has been closed as “No-claim” for want of Final Police Report. The complainant filed complaint before the State Commission, and raised his claim for indemnification of loss stated to have been caused due to burglary of his ultrasound unit which was closed as “No-claim” by the Appellant for want of Final Police Report. 5. The State Commission on 28.05.2018 passed the order, the operative portion whereof is reproduced hereunder:- “Coming to the present case as discussed herein above, there is no proof of the value of the machinery. The only substantial piece of evidence is the report of surveyor dated 29.10.2002 where he has assessed loss to the tune of Rs. 5.00 lac. Then this report has not been submitted before the Commission but has been found in the claim file of Insurance Company. It is only after procuring the claim file, this Commission became aware of such an assessment. Therefore we are inclined to accept the survey report and directed insurance company to pay an amount of Rs. 5.00 lac along with interest @ 8% from the date of complaint less by 10% depreciation. Litigation costs of Rs. 25,000/- is also awarded in favour of the complainant. The awarded amount shall be paid within a period of six weeks from today.
5.00 lac along with interest @ 8% from the date of complaint less by 10% depreciation. Litigation costs of Rs. 25,000/- is also awarded in favour of the complainant. The awarded amount shall be paid within a period of six weeks from today. It is further directed that all the counsel who are appearing for the insurance companies will procure certified copy of this order to be served to their respective companies. Matter stands disposed of accordingly.” ARGUMENTS ADVANCED BY THE PARTIES 6. It is submitted by the learned counsel for the Appellant, that the complaint was resisted by the Appellant inter alia on the grounds that the respondent did not challenge the “No-Claim” decision within a period of 12 calendar months from the date of disclaimer i.e., 31.05.2005, under the terms and conditions of the policy of insurance and that the respondent was required to provide all the required documents to substantiate the loss caused to his ultrasound unit in terms of the final Surveyor report vide letter dated 04.09.2003, in order to establish the loss caused to his unit and the proximate cause of loss. 7. It is submitted that during trial, the Appellant submitted the original envelope of letter dated 31.05.2005, to the State Commission and also the copies of the letters to indicate that the letters were sent through registered post to the complainant. 8. It is submitted that during trial, the respondent failed to establish that he provided requisite information and documents to the Surveyor or to the Appellant. The State Commission has erred in law in holding that the Appellant was required under law to obtain Police Final Investigation Report from the concerned SSP. In this context, the Appellant relies upon General Condition No.4 clause (c), which states that “the insured shall tender to the company all reasonable information, assistance, and proofs in connection with any claim hereunder”. It is submitted that the respondent miserably failed to submit the documents to substantiate the claim raised with the Appellant and in respect of loss caused to his unit and to get Police Final Investigation Report from SSP and, as such, respondent has violated the condition No .04 of the insurance policy.
It is submitted that the respondent miserably failed to submit the documents to substantiate the claim raised with the Appellant and in respect of loss caused to his unit and to get Police Final Investigation Report from SSP and, as such, respondent has violated the condition No .04 of the insurance policy. It is further submitted that the reliance placed upon by the State Commission on the preliminary information of the surveyor in which he has estimated the loss @ Rs.5,00,000/-, is not sustainable, as the surveyor could not assess the loss for want of documents. Neither the respondent produced any documentary evidence before the State Commission in this behalf. 9. Learned counsel for the Appellant – Insurance Company, in support of his contentions, has referred to and relied upon the judgments of the Apex Court, passed in case titled (i) “National Insurance Co. Ltd v. Sujir Ganesh Nayak & Co. & Anr”, reported as AIR 1997 SC 2049 and (ii) “National Insurance Company Ltd. v. The Chief Electoral Officer & Ors, reported as 2023 SCC Online SC 115. 10. Per contra, the learned counsel for the respondent submits that the surveyor conducted the spot inspection on 29.04.03 and prepared an inventory of stolen machinery and demanded certain documents, the respondent submitted the documents except the Final Police Report, which could not be submitted for want of letter of a requisition from the Appellant. It is submitted that the settlement of the claim of the respondent was delayed initially for want of final survey report and ultimately in the month of October 2006, the complainant-respondent herein, was conveyed that the claim had been closed as “No claim” for want of Final Police Report, which constrained the respondent to approach State Commission for indemnification of the loss suffered by him. As such, there is no delay on the part of the complainant in filing the complaint. Moreover, it is submitted that the Appellant - Insurance Company had written few communications to the concerned SSP for procuring the Final Investigation Report, but the same was not handed over to the Appellant despite repeated requests for many years. Therefore, it was not within the ambit of the respondent to procure the Final Police Report and to submit before the Appellant – Insurance Company. As such, it is not covered in terms of General Condition No.4 clause (c) as reasonable information. 11.
Therefore, it was not within the ambit of the respondent to procure the Final Police Report and to submit before the Appellant – Insurance Company. As such, it is not covered in terms of General Condition No.4 clause (c) as reasonable information. 11. Learned counsel for the respondent, in support of his contentions, has relied upon the judgment passed by the Hon’ble Supreme Court of India in case titled Gurmel Singh v. Branch Manager, National Insurance Co. Ltd. in Civil Appeal No. 4071 of 2022 decided on 20.05.2022, and has referred to paragraph No. 4.1 of the said judgment, which is taken note of hereinbelow:- 4.1 “In the present case, the Insurance company has become too technical while settling the claim and has acted arbitrarily. The appellant has been asked to furnish the documents which were beyond the control of the appellant to procure and furnish. Once, there was a valid insurance on payment of huge sum by way of premium and the Truck was stolen, the insurance company ought not to have become too technical and ought not to have refused to settle the claim on non-submission of the duplicate certified copy of certificate of registration, which the appellant could not produce due to the circumstances beyond his control. In many cases, it is found that the insurance companies are refusing the claim on flimsy grounds and/or technical grounds. While settling the claims, the insurance company should not be too technical and ask for the documents, which the insured is not in a position to produce due to circumstances beyond his control.” 12. We have heard learned counsels for the parties and have perused the material on record. 13. The contentions raised by the Appellant are, first, that the State Commission failed to appreciate the fact that the complaint was not filed within the period of 12 calendar months from the date of disclaimer. The State Commission has not addressed to this plea in the judgment and has erred in law to dispose of the complaint in favour of the respondent.
The State Commission has not addressed to this plea in the judgment and has erred in law to dispose of the complaint in favour of the respondent. Secondly, the respondent failed to establish that he provided all sort of information and documents to the surveyor or to the Appellant to prove the proximate cause of loss required to be proved under policy of insurance in terms of General Condition No. 4 clause (c), which specifies that the insured has to tender all reasonable information, assistance and proofs in connection with any claim and thirdly that the State Commission has decided the claim of the complainant on the basis of the preliminary report of estimation made by the surveyor on 29.10.2002, which was not the final report. 14. The State Commission has very elaborately taken care of the objections supra, raised by the Appellant and has decided the issues as under:- 4. “It is not in dispute that machinery installed in the diagnostic centre was insured with the insurance company at that point of time when burglary took place and the policy was in force. However to conclude as to whether burglary has taken place, certain requirements are to be complied by both the parties. The complainant has sought indemnification of loss and has placed copy of FIR and insurance policy indicating the machinery which was insured at the relevant point of time as also the statement of witness indicating that burglary has taken place. On the other hand, insurance company was required to submit survey report as also the police report before they could have processed the claim of the complainant in the present case. What appears to have happened is that insurance company sent a written communication to the SSP concerned for procuring the final investigation report. Having received no response from the concerned SSP, they closed the claim of complainant whereas it was an obligation on them to procure this final report as they could not shift this burden on the complainant. The stand of OP insurance company is that they had informed the complainant regarding procuring of final report from SSP concerned. However, there is no written communication on record to suggest that any such communication was ever made by the insurance company to the complainant. The jural relationship between the complainant and the insurance company requires certain compliances to be performed by both the parties.
However, there is no written communication on record to suggest that any such communication was ever made by the insurance company to the complainant. The jural relationship between the complainant and the insurance company requires certain compliances to be performed by both the parties. Procuring of final police report was on the insurance company which they had failed to do. Advocate Lone appearing for OP insurance company states that the complainant had failed to comply with the requirements of submitting final police report even though effort was made by the company to procure the same but there was no response from SSP Pulwama.” 5. “While examining the contentions of rival parties, it clearly emerges that obligation was on insurance company to procure the final police report. The effort made by them in procuring the report from concerned SSP appears to be half hearted attempt. They could not be absolved of their obligation to procure final investigation report. Their failure to do the same would make them liable to indemnify the loss. While scanning aforesaid two communications addressed to SSP, Shopian, there is no mention as to whether these communication have even dispatched from their office or not, neither is there any postal receipt to show that communication has been sent through registered post. Be that as it may. The fact remains that insurance company has failed to discharge this obligation in procuring the final police investigation report. They cannot escape the liability of indemnifying the loss to the complainant.” 6. “Next question is as to how much compensation the complainant is entitled to. There is no proof of actual cost of machinery. All that is said is that machinery was costing Rs. 8.50 lac and the sum assured was Rs. 9.00 lac. There is no other proof. The complainant states that this is the value of the machinery which fact has been accepted by the insurance company by insuring it for a sum of Rs. 9.00 lac. There is one report submitted by the surveyor on 29.10.2002 which is part of claim file, which suggests that actual estimated loss is Rs. 5.00 lac. This is the only proof of the value of the machinery. It is strange that while insuring this machinery, its actual value have not been assessed by the insurance company which fact was their fundamental duty.
5.00 lac. This is the only proof of the value of the machinery. It is strange that while insuring this machinery, its actual value have not been assessed by the insurance company which fact was their fundamental duty. Their stand seems that they do these things in a good faith. The insured can show the value of property higher than what its actual cost is by paying nominal premium. Any loss caused to the machinery or goods would entail consequence on insurance company to reimburse the claimant to the extent for which it has been insured. This seems to be a practice followed by insurance companies. The only point of time they get agitated is when the claim is registered. This is a practice which requires to be depreciated as it leads to manipulation of the system by both the claimant and the insurer. We say so because if the loss caused to the property or stocks which is valued higher than their cost, the greater financial liability will lie on the insurance company. The observation made above is required to be complied with by all the insurance companies.” 15. From the above, it becomes quite evident that the State Commission has decided the issues raised by the Appellant in its right perspective. Even if the Final police report is considered after more than two decades, it would only reflect the negligence of the police authorities or would result in further trial against accused persons, if any found, till date but, in no case it can absolve the Insurance Company of the liability to indemnify the respondent for the loss suffered by him due to the burglary, as such, he needs to be compensated at least after 21 years. 16. In a decision delivered in case titled National Insurance Co. Ltd. v. Harsolia Motors and Others, in Civil Appeal Nos. 5352-5353 of 2007, decided on 13.04.2023, the Apex Court in paragraph Nos. 21 to 24 held as under:- 21. “The Act, 1986 is a social benefit-oriented legislation and, therefore, the Court has to adopt a constructive liberal approach while construing the provisions of the Act. To begin with the Preamble of the Act, 1986 which can afford useful assistance to ascertain the legislative intention, it was enacted to provide for the protection of the interests of consumers.
“The Act, 1986 is a social benefit-oriented legislation and, therefore, the Court has to adopt a constructive liberal approach while construing the provisions of the Act. To begin with the Preamble of the Act, 1986 which can afford useful assistance to ascertain the legislative intention, it was enacted to provide for the protection of the interests of consumers. Use of the word “protection” furnishes key to the minds of makers of the Act. Various definitions and provisions which elaborately attempt to achieve this objective have to be construed in this light without departing from the settled law that a Preamble cannot control otherwise plain meaning of a provision. 22. In fact, the law meets long felt necessity of protecting the common man from such wrong for which the remedy under ordinary law for various reasons has become illusory. Various legislations and regulations permitting the State to intervene and protect interests of the consumers have become a haven for unscrupulous ones as the enforcement machinery either does not move or it moves ineffectively and inefficiently for reasons which are not necessary to be stated. 23. The importance of the Act lies in promoting welfare of the society by enabling the consumer to participate directly in the market economy. A scrutiny of various definitions such as “consumer”, “service”, “trader”, “unfair trade practice” indicates that legislature has attempted to widen the ambit and reach of the Act. Each of these definitions are in two parts, one explanatory and the other inclusive. The explanatory or the main part itself uses expressions of amplitude indicating clearly its wide sweep within its ambit to widen such things which otherwise would have been beyond its natural import. 24. The provisions of the Act, 1986 thus have to be construed in favour of the consumer to achieve the purpose of enactment as it is a social benefit-oriented legislation. The primary duty of the Court/Commission while construing the provisions of such an Act is to adopt a constructive approach subject to that it should not do violence to the language of the provisions and is not contrary to attempted objective of the enactment.” 17. As welfare statutes are aimed at protection and promotion of social and economic well-being of its citizen, they should be construed widely and liberally.
As welfare statutes are aimed at protection and promotion of social and economic well-being of its citizen, they should be construed widely and liberally. Such statute should be interpreted in such a way that the power conferred by them is achieved and it benefits the particular class or category of people for whom it is intended by the legislature. Therefore, it becomes the duty of the court to interpret a provision, specially a welfare statute by giving it a wider meaning rather than restrictive meaning. 18. We, therefore, uphold the order dated 28.05.2018, passed by State Commission, thereby, dismissing the instant appeal, being devoid of any merit. Appellant - Insurance Company is directed to release the awarded amount along with interest in terms of order dated 28.05.2018, within a period of six weeks from the date of passing of this judgment. Interim orders, if any, subsisting shall stand vacated. 19. The Appellant - Insurance Company has annexed the Bank draft bearing No. 080513 dated 24.07.2018, of an amount of Rs. 1,06,792/- (One Lakh Six Thousand Seven Hundred Ninety Two Only), as 25% of the awarded amount deposited before State Commission, Srinagar, on 26.07.2018, the amount so deposited is directed to be released forthwith in favour of the respondent. In case the awarded amount is deposited before Registry of this Court, same shall be released in favour of the respondent.