National Consumer Disputes Redressal Commission (NCDRC): While deciding the instant revision petition filed by New India Assurance wherein, they had challenged the order passed by the SCDRC, Jaipur, whereby the insurance company was directed to pay to the aggrieved party Rs. 2, 27, 105/- and Rs. 25,000/- with interest @ 9% p.a. for damages sustained by their JCB machine from allegedly “falling down”; the Bench of Binoy Kumar (Presiding Member) and Justice Sudip Ahluwalia (Member), set aside the order of the State Commission and held that the complainant was not entitled to her insurance claim due to her omission to inform the police of the accident and her total silence in giving any description of the manner in which the accident had taken place, which could only lead to drawing up of an adverse inference against her and in favour of the Insurer's version that it was actually the case of over-turning.
The complainant Renu Devi Gupta had purchased J.C.B., DX Model, 2011 on 03-08-2011 by paying Rs. 21, 30,000/-. The said J.C.B. machine was insured on 02-08-2013 with the Insurance Co. for the period from 03-08-2013 to 02-08-2014.
On 08-09-2013, the said machine met with an accident by falling down about 14-15 ft. and got damaged. The information of accident was immediately given to the Insurance Company by the Complainant. The Insurance Company appointed its surveyor, who on 09-09-2013 inspected the place of incident and after verifying the site and the documents, gave instructions to send the machine for repairs. The Complainant managed to take out the machine by crane by paying Rs.14,500/- and transported it to Rajesh Motors Pvt. Ltd., and information of the same was given to the opposite party. The opposite party sent its surveyor to Rajesh Motors, who gave directions to open the machine. Thereafter, Rajesh Motors presented a bill for a sum of Rs. 5,32,345/- to the Complainant. The Complainant paid the bill amount and then filed the claim application for getting the insured claim amount and completed all formalities, but the insurance company did not pay that amount.
The Complainant informed the Opposite Party that the said machine was financed from HDFC Bank Finance and the monthly instalment of Rs. 59,853/- was being paid and that she was compelled to pay the repairing charges including the crane charges etc. The Insurance Company repudiated the claim and informed the Complainant via letter dated 14-03-2014 that the payment cannot be made as the said accident was caused due to “over-turning” and not “falling” of the machine.
Aggrieved with the repudiation, the complainant approached the District Consumer Court, which dismissed the complaint. The dismissal was appealed before the State Consumer Disputes Redressal Commission, and the order of the District Commission was set aside with directions to the Insurance Company to make payment of Rs. 2,27,105/- and Rs. 25,000/- with interest @ 9% p.a. from the date of institution of the complaint along with litigation expenses of Rs. 10,000/-.
Upon perusal of the facts, the NCDRC observed that the State Commission has decided the appeal relying on IFFCO-Tokio General Insurance Company Ltd. v. M.D.R. Constructions, 2019 SCC OnLine NCDRC 240, wherein the accident had occurred due to loosen soil on account of which the insured vehicle had lost control and had fallen from an elevated position causing damage to the insured machine and that there was no documentary evidence to establish that the damage was caused because of over-turning.
Perusing the evidence submitted by the parties, the Commission noted that the complainant had stated the damage caused to the JCB in cryptic fashion and had omitted to report the accident to the police as it was required by the terms and conditions. It was noted that the complainant had failed to give any description of whatsoever as to how or in what manner the accident had taken place.
Meanwhile, the Commission pointed out that the description provided by the opposite party via their surveyor was much more explicit. It was noted that the insurance company's description indicated that the JCB machine in the present case had actually got over-turned after getting dis-balanced and turning back, since its four wheels were found to have come upwards. The accident in the present case, therefore, cannot be simply wished away as merely an ‘accident' instead of ‘over-turning' which was visibly the actual case.
It was noted that no premium towards loss on account of over-turning was paid by the Complainant in seeking the insurance coverage even though it was a separate and distinct chargeable head under the India Motor Tariff Guidelines of the Tariff Advisory Committee.
The Commission while keeping in mind the acts and omissions of the complainant, allowed the revision petition and held that the complainant is not entitled insurance claim as the accident in the present case was an instance of over-turning for which separate coverage by an additional specified Premium was required to be done.
[New India Assurance Co. Ltd. v. Renu Devi Gupta, 2022 SCC OnLine NCDRC 767, decided on 22-12-2022]
Advocates who appeared in this case :
For the Petitioner: K.K. Bhat, Advocate
For the Respondent: Awnish Maithani, Advocate
Namit Saxena, Advocate
*Sucheta Sarkar, Editorial Assistant has prepared this brief.