Order Name: Sanjay Foods India Pvt. Ltd. Vs. United India Insurance Company Limited
Case No.: F.A. No. 834/2015
The National Commission for Consumer Disputes, headed by Mr. Subhash Chandra and Dr. Sadhna Shanker, recently ruled that an insurance claim can’t be dismissed solely due to alleged delays by the insurance surveyor or the insurer themselves.
Here’s a brief recap of the case: The plaintiff owned a factory that produced oil from cotton seeds. They had purchased a Standard Fire and Special Perils Policy from United India Insurance for their building, machinery, and stock. When a fire occurred at their factory, they promptly reported it to the insurance company. Despite reports from the Fire Brigade and Electrical Inspector, the insurer denied the claim, stating that the fire’s cause, as determined by their surveyor, wasn’t covered under the policy. The plaintiff then took the issue to the State Commission, which also dismissed the complaint. The plaintiff then appealed to the National Commission.
The insurer’s argument was based on their surveyor’s investigation of the fire site. The surveyor found no signs of heat, fire, flame, or smoke from the affected cotton seeds. They also noted that the Fire Brigade had used water to extinguish the fire, and there was no visible smoke or fumes. Based on these findings, the insurer denied the claim, stating that the self-combustion of the stock, a condition not covered under the policy, caused the fire.
The National Commission, after reviewing the case, upheld the State Commission’s order. They pointed out that the policy in question was a Standard Fire Peril Policy, with no additional coverage for self-combustion. The Commission referred to two significant Supreme Court rulings. The first emphasized that a surveyor’s report must be given due importance, especially when a claim exceeds Rs.20,000/-. The second ruling clarified that a surveyor’s report is not the final word and could be challenged. Despite this, the Commission found that the plaintiff had failed to provide conclusive evidence that the fire was caused by external reasons, like an electrical short circuit.
The Commission also stated that any alleged delays by the surveyor or the insurer in finalizing the report could not be grounds for dismissing the same. Based on the evidence, they concluded that the fire’s cause was spontaneous combustion, which the policy did not cover.
In conclusion, the National Commission saw no reason to interfere with the State Commission’s order and dismissed the appeal. This judgment underscores the importance of understanding the terms of your insurance policy and knowing exactly what it covers and excludes.
