J&K State Commission Dismisses ₹35 Lakh Insurance Claim Over Suppression of Material Facts

  • J&K State Commission Dismisses ₹35 Lakh Insurance Claim Over Suppression of Material Facts
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    The Jammu and Kashmir State Consumer Disputes Redressal Commission, Srinagar, comprising President (Officiating) Nighat Sultana and Member Maheep Gupta, has dismissed a consumer complaint against National Insurance Company Ltd., holding that the complainants deliberately suppressed material facts regarding the insurance surveyor's visit and attempted to mislead the Commission. The Commission also noted that the complainants had failed to produce documentary evidence to substantiate their claimed loss of ₹35 lakh.

    Facts:

    The complainants, Muzaffar Ahmad Dar and Ubaid Ahmed Dar, sons of Late Abdul Rehman Dar and residents of Mahatajpora Bypass, Batmaloo, Srinagar, filed a consumer complaint against National Insurance Company Limited and its policy-issuing office at Srinagar, alleging deficiency in service in connection with an insurance claim.

    The dispute arose after heavy rainfall and snowfall on February 9, 2015, allegedly created a flood-like situation that caused extensive damage to their residential house and household goods. The complainants claimed to have suffered losses amounting to approximately Rs. 35 lakh and alleged that despite promptly informing the insurance company about the incident, no surveyor was deputed to assess the damage and no details of the loss were sought from them.

    They also claimed to have obtained a report regarding the damage from the concerned police station. Accordingly, they approached the Jammu and Kashmir State Consumer Disputes Redressal Commission, seeking directions to the insurance company to pay Rs. 31.50 lakh, being the sum insured under the policy, along with Rs. 50,000 each towards mental harassment and litigation expenses.

    Contentions of the Insurance Company:

    The insurance company contested the complaint, stating that it had appointed an IRDA-authorised surveyor, M/s Andrabi Surveyors, who recommended treating the claim as a 'No Claim' in a report dated April 10, 2016. It further claimed that the complainants had been informed of this recommendation through a letter dated April 27, 2015.

    The complaint was filed on April 25, 2016. During its pendency, the Commission was wound up in October 2019 and revived proceedings on February 14, 2024. The insurance company's right to lead evidence was subsequently closed on May 2, 2025, after it failed to produce evidence despite opportunities. Both parties later submitted their written arguments in November 2025 and April 2026, respectively.

    Observation and Decision:

    The Commission observed that the complainants had failed to produce any documentary evidence to substantiate their claim of having suffered losses amounting to ₹35 lakh. It noted that the complainants were required not only to establish that the loss was caused by an insured peril during the policy period but also to substantiate the quantification of the loss.

    The Commission further noted that both complainants, in their evidence affidavits, maintained that no surveyor had been deputed by the insurance company. However, during cross-examination, both admitted that the surveyor had visited their premises three days after the incident.

    The Commission also observed that the complainants had subsequently changed their stand in their written arguments by challenging the survey report as biased, improper and procedurally defective, without explaining the reasons for departing from their earlier position.

    Holding that the complainants had deliberately suppressed material facts and attempted to mislead the Commission, it relied on the principle that "one who comes to equity must come with clean hands".

    Accordingly, the Commission dismissed the complaint, holding that the complainants had not approached it with clean hands. It directed both parties to bear their own costs.

    Case Title :  MUZAFFAR AHMAD DAR V/S NATIONAL INSURANCECase Number :  C.C. No.37 of 2016
    Praveen Mishra

    Praveen Mishra is a Correspondent at LiveLaw. He covers consumer cases and reports on matters from various High Courts. A law graduate, he has been a part of LiveLaw for more than two years.

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