Repudiation of Insurance Claim on the ground that the loss was outside policy
The Respondent had taken comprehensive insurance policy against fire and special perils for 30.6.2005 to 29.6.2006. On 1.8.2005, due to heavy rainfall, the factory collapsed causing damage to the plant, machinery, stocks and buildings.
The Surveyor of the Insurer had assessed the loss at Rs.8,89,176/- against the claim of Rs.91 lakhs of the respondent.
The appellant repudiated the claim on the ground that the loss was not due to the insured peril of “inundation” and fall outside policy.
In the consumer complaint, the appellant reiterated that the loss was due to inundation, but the Surveyor determined that the loss might have occurred due to gradual weakening of the walls and seepage which could not be covered by the policy.
The respondent filed rejoinder and for the first time stated that its independent Surveyor had confirmed that the damage was caused by inundation and loss was at Rs.46,97,085/-.
On that basis, the National Consumer Commission granted the said loss with interest.
HELD that the unilateral assessment of loss at Rs.46,97,085/- was based on the report of surveyor of the respondent, it was produced for the first time with the rejoinder after filing WS by the appellant, the appellant could not have denied it, it could not have assumed that the appellant had mutely accepted the same and that the said assessment was made without notice to the appellant and without its participation. In view of this, the matter was remanded back to the National Consumer Commission.
Judgment dated 7.4.2025 of the Supreme Court of India in Civil Appeal no.913 of 2023 of United India Insurance Co. Ltd and another Vs. M/s. Park Leather Industries Ltd.
