Insurance Claim Cannot Be Repudiated Solely On Basis Of Unsubstantiated Surveyor's Report: Kupwara District Commission
The District Consumer Disputes Redressal Commission, Kupwara, comprising Peerzada Qousar Hussain (President) and Ms. Nyla Yaseen (Member), held Bajaj Allianz General Insurance Company Ltd. liable for the wrongful repudiation of an insurance claim. The Commission allowed the complaint, observing that although a surveyor's report is an important piece of evidence, it cannot be treated as conclusive and must be examined alongside the other material available on record.
Brief Facts
Showkat Ahmad Mir, the complainant, had obtained a fire insurance policy from Bajaj Allianz General Insurance Company Ltd. (Opposite Party) for a sum insured of Rs. 20 lakh for his garment shop. The policy was valid from 22-08-2024 to 21-08-2025. On 03-11-2024, a fire broke out in the shop, causing extensive damage to the stock and furniture. Following the incident, the complainant informed the OP and submitted all necessary documents, including stock statements. The insurer appointed a surveyor to assess the loss. However, the OP repudiated the claim on 15-12-2024, treating it as a "No Claim" case based on the surveyor's report, which alleged that the purchase bills submitted by the complainant to the surveyor were fake.
The complainant approached the OP to request a copy of the surveyor's report and to request that his claim be reconsidered based on the genuine bills already submitted to the surveyor. However, the OP declined both requests. Aggrieved by the repudiation of his claim, the complainant approached the District Consumer Disputes Redressal Commission, Kupwara, seeking the insured amount along with compensation.
Arguments by the Opposite Party
Bajaj Allianz General Insurance Company Ltd.( Opposite Party) contended that the purchase invoices and bills submitted by the complainant in support of his claim were fabricated and could not be relied upon. The counsel argued. That the surveyor had verified the bills with the concerned dealers, who allegedly denied issuing them and stated that the goods mentioned therein had not been sold to the complainant. They argued that the claim was founded on fake documents and that its decision to reject the claim was lawful and justified.
Observations of the Commission
The District Commission observed that although a surveyor's report is an important piece of evidence, it cannot be treated as conclusive and must be examined alongside the other material available on record. The Commission noted that the OP had relied solely on the surveyor's opinion that the purchase bills submitted by the complainant were fake, but failed to produce any written statements or other documentary evidence to substantiate the allegation. It found that the surveyor's report lacked cogent material to support the claim that the bills were fabricated and that no evidence had been produced to show that the stock statements submitted by the complainant were false.
The Commission observed that the complainant had substantiated his claim by producing the insurance policy, claim documents, GST invoices, and stock statements authenticated by Punjab National Bank. It noted that the stock statements had been submitted to the bank in the ordinary course of business prior to the fire, in response to the complainant's claim regarding the existence of the insured stock. Accordingly, it concluded that, in the absence of any reliable evidence supporting the insurer's allegations, the Commission held that the repudiation of the claim could not be sustained and declared the repudiation of the claim arbitrary and untenable.
The Commission allowed the complaint and directed the insurance company to pay Rs. 19,10,350 towards the loss of the insured stock and Rs. 20,000 towards litigation expenses.
Case Title : Showkat Ahmad Mir vs Bajaj Allianz General Insurance Company Ltd
Case No : CC No: 148/2025