Insurance claim repudiation based on failure to submit required documents

The instant appeal is directed against the judgment dated 3 September, 2012 passed by the National Consumer Disputes Redressal Commission(hereinafter being referred to as the “National Commission”) affirming the repudiation claim of the appellant by letter dated 11 September, 2007. In consequence thereto, the appellant submitted claim under the policy but that came to be repudiated by the respondent by its communication dated 11 September, 2007 on the premise that the appellant has failed to submit the required documents which is in breach of condition no. Letter dated 11 September, 2007 pursuant to which the claim was repudiated by the respondent Insurance Company is reproduced as under:- “THE NEW INDIA ASSURANCE COMPANY LIMITED 214-217, AMARSINHJI SHOPPING MALL TOWER ROAD, HIMATNAGAR 383001 11 September 2007 WITHOUT PREJUDICE To M/S. Patel Surveyors Pvt.

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We have also issued a final notice to you on 12.07.2007 to comply with the requirement/documents/information asked by the surveyor but you have not submitted the documents/requirements/information as required by the surveyors.

Thanking you, Yours faithfully, BRANCH MANAGER CC TO; GANDHINAGAR DO CC TO: AHMEDABAD R.O.” 4.

Although the appellant has got the damages/loss assessed by its own Surveyor who submitted his report on 16 October, 2007 after making spot verification in reference to fire which took place on 20 October, 2006 and assessed the damages to the tune of Rs.86 Lakhs but as there was no evidence available with the appellant on record, the appellant had restricted to the Surveyor’s report appointed by the respondent Company who submitted its report on 1 June, 2007.

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The repudiation was challenged by the appellant by filing its claim petition before the Gujarat State Consumer Disputes Redressal Commission(hereinafter being referred to as the “State Commission”) by filing of a Consumer Complaint

No 39 of 2007 that came to be dismissed by the State Commission by an Order dated 16 January, 2012 on the premise that the appellant failed to furnish the required documents as desired by the respondent Company and accordingly the claim has been rightly repudiated in terms of Clause 6(b) of the policy. was appointed by the respondent Company who had examined in extenso the loss/damage which took place due to fire on 20 October, 2006, and proceeded on the basis of preliminary survey carried out on 21 October, 2006 and after taking into consideration the physical inspection of the site and the material available on record made an assessment of the loss/damage suffered by the appellant to the tune of Rs. Per contra, learned counsel for the respondents, while supporting the finding returned by the National Commission in the impugned judgment submits that indisputedly from the material which has come on record, on the directions of the Court, the factory was closed on 11 July, 2006 and consequent upon that, the power was disconnected on 18 August, 2006 and there was no manufacturing at the time when fire took place on 20 October, 2006 and just after 13 days of the commencement of the Insurance policy, with effect from 7 October 2006, fire occurred on 20 October, 2006. 1,20,00,000/- was renewed from 7 October, 2006 to 6 October 2007 and after its renewal, devastating fire took place in the factory on 20 October, 2006 in which the appellant suffered huge losses.

It is also not disputed that the appellant has never put any claim in the last 6 to 7 years during the above period and when the policy was renewed from 7 October, 2006 to 6 October, 2007, unfortunately, the devastating fire took place on 20 October, 2006 for unknown reasons. Once that assessment has been made regarding the loss/damage which took place due to fire dated 20 October, 2006 and that was not disputed by the respondent Company, repudiating the claim invoking clause 6(b) of the policy, in our considered view, was unfair and is not legally sustainable.

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The respondent Company shall make necessary compliance of the Order of this Court within two months.

Case Title: KARNAVATI VENNERS PVT. LTD. Vs. NEW INDIA ASSURANCE CO. LTD. . (2023 INSC 112)

Case Number: C.A. No.-003893-003893 / 2013

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