Repudiation of Fire Insurance Claim on Surveyor’s report – Legality
Judgment dated 27.3.2023 of the State Consumer Disputes Redressal Commission, Chattisgarh at Raipur
Fire Insurance Policy for building and stocks of Saw Mill – Repudiation of insurance claim for loss in fire on Surveyor’s report that the insured premises were used as a saw mill and plywood lamination workshop, whereas, policy was for storage of stocks only – Importance of Surveyor’s report in Repudiation or Grant of claim – Repudiation based on Surveyor’s report is legal and valid – limited jurisdiction of Consumer Forum to doubt Surveyor’s report if contrary evidence is not adduced.
The complainant had taken Standard Fire and Special Perils Policy from the respondent for Rs.1 crore for building and stocks, for the period of 19.12.2016 to 18.12.2017.
On 29.5.2017, fire broke out in the insured premises and on intimation of fire and claim of Rs.93 lakhs for the loss on the same day, the respondent appointed the Surveyor.
On 2.6.2017 the Surveyor conducted the survey of the premises. By the letter dated 6.6.2017 the Surveyor made queries and asked for certain documents. This was complied with by the complainant.
On 26.4.2018, the respondent informed that “if we do not receive any reply from your end we would have no option but to close your claim as no-claim”.
On 14.5.2018, the Surveyor submitted the report.
On 27.9.2018, the complainant had received the letter of repudiation of insurance claim by the respondent on the ground that the “loss had not occurred due to the insured peril, the insured premises were used as a saw mill and plywood lamination workshop, whereas, policy was for storage of stocks only.
On consideration of the Surveyor’s report, photographs and the record, it was found that there is no reason to doubt the Surveyor’s report. As a result, the jurisdiction of the Consumer Forum to go further would stop. The entire case hinges around the report. No evidence was adduced to doubt integrity, honesty or adequacy in the quality, skill and nature of the duties and responsibilities of the Surveyor. Repudiation of claim on such proper and correct. The complaint was dismissed.
On the preliminary objection that the complainant is carrying on business for commercial purpose and therefore, is not a consumer, it was held that the policy is taken for insurance and not related to business or profit. Hence, the complaint is maintainable.
On another ground of limitation, it was held that the cause of action to file complaint arose on the date of repudiation of insurance claim and therefore, the complaint was filed within limitation.
Complaint Case No. CC/19/56 – Shukla Saw Mill Vs. The Oriental Insurance Company Limited
