Additional Claims Cannot Be Made Once The Claim Is Accepted Unconditionally: Uttarakhand State Commission Allows Insurance Company's Appeal

The Uttarakhand State Consumer Disputes Redressal Commission bench of Ms. Kumkum Rani (President) and Mr. B.S. Manral (Member) held that the no additional claims can be made after the complainant has accepted the insurance claim unconditionally. Brief facts: The Gogreen Buildtech Pvt. Ltd. (complainant) bought Standard Fire and Special Perils Policy from Reliance General Insurance Co. Ltd (appellant) on 26.05.2017, which was valid from 26.05.2017 to 25.05.2018. The complainant paid Rs. 88,620/- premium for the insurance. The policy was to be renewed from 04.06.2018 to 03.06.2019. But, on 01.12.2018 a fire broke out in the premises of company which led to mass loss of the property and goods. The complainant filed a claim of Rs. 15,00,000/- from the insurance company. The regional office of the appellant prepared a surveyor's report and sent it to their head office. The head office reviewed the report and agreed to pay Rs. 14,96,560/-. After deducing Rs. 3,82,674/- as depreciation, Rs. 64,500/- as salvage and excess amount of Rs. 52,649/-, the final amount was calculated at Rs. 9,96,916/-. The complainant agreed for deduction for salvage and excess but it objected on depreciation deduction as wrong and illegal. Upon request, the regional office of the insurance company did not correct the depreciation deductions and pressurized the complainant to agree on the final amount. Despite multiple requests for rectification of amount to the head office, the insurance company did not rectify the claim. On 28.05.2019, the complainant agreed to pay Rs. 9,96,916/- but it felt robbed by the appellant. Being aggrieved, the Complainant filed a complaint before the District Consumer Disputes Redressal Commission, Haridwar against the insurance company. Through an order dated 18.07.2020, the District Commission held Reliance General Insurance Co. Ltd liable. Dissatisfied by the order, the insurance company filed an appeal in the State Consumer Disputes Redressal Commission (“State Commission”). Contentions of Reliance General Insurance Co. Ltd: The Appellant contended complainant was engaged in commercial activity and was not entitled to any compensation from the insurance company. They also stated that the complainant gave a written consent for accepting the claim. The appellant denied deficiency in service as the settlement was based on surveyor's report. Further, it was pointed out that the complaint lacks legal ground as the claim has already been settled. Observation of the State Commission: The Commission held that the complainant has accepted the claim of Rs. 9,96,916/- without any dispute or coercion. Further there was no evidence that the insurance policy was deprecation-free, so the deduced amount is justified. The commission ruled that the surveyor report is an important piece of evidence and it cannot be set aside until contrary is proved. Reliance was placed on Sikka Papers Limited vs. National Insurance Company Limited and Others, (2009) 7 SCC 777, wherein it was held that a legitimate reason is required to depart from surveyor report. Further in National Insurance Company Ltd. vs. Manjit Singh and Ors., 2017 (4) CPR 384 (NC) it was held that the company should make payment as per report given by surveyor. The commission concluded that the claim is full and final and the complainant never raised any objection. It cited Yogesh Kumar Sharma (Dr.) vs National Insurance Company Ltd., II (2013) CPJ 178 (NC) wherein it was held that once claim has been settled unconditionally, then no additional compensation can be granted. Thus, there was no cause of action to file the complaint. The consumer has ceased to be a complainant and the privity of the contract between the consumer and the insurance company has ended. Therefore, the State Commission set aside the decision of the District Commission and the appeal was allowed. Case Title: Reliance General Insurance Co. Ltd. & Anr vs. The Gogreen Buildtech Pvt. Ltd. & Anr. Case No: First Appeal No.105 / 2020 Date of Pronouncement: 27.11.2024 Click Here To Read/Download Order

Additional Claims Cannot Be Made Once The Claim Is Accepted Unconditionally: Uttarakhand State Commission Allows Insurance Company's Appeal

Amrisha Kumari

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