Case: New India Assurance Co. Ltd Vs. Pradeep Kumar

Surveyor and only thereafter the vehicle could have been repaired by the owner. He submitted that the complainant failed to make out any case as to why the survey reports of the Approved Surveyors Vivek Arora and B.B. Garg should be rejected. The learned Counsel for the insurance company would also urge that the insurance company was not liable to indemnify for new parts. 10. We are unable to accept the contentions of the learned Counsel for the insurance company. That the vehicle that was insured with the insurance company met with an accident and fell down into the Khud 300 feet deep below the road is not in dispute. The survey reports of Vivek Arora as well as B.B. Garg, upon which reliance has been placed by the insurance company show that the vehicle got extensively damaged in this accident. Its Assembly, Bonnet, Cabin, Tool Box, Body, Chasis, Diesel Tank, Pressure Regulator, Pressure Pipe, Brake Booster, Steering Wheel, Head Lights, Main Leaf LHS Front, Front shockers, Steering Worm, Air Cleaner, Cross Member Rear 2nd, Propeller Shafts, Front Axle, Silencer, Engine Chamber etc. had sustained major damage. The approved Surveyors in their reports have recorded their satisfaction that the aforementioned damages to the said vehicle would have occurred in that mishap. Vivek Arora in his survey report also noted that the damages noticed to the said vehicle were in conformity with the description of the accident mentioned in the claim form and details of damages noted by the spot Surveyor. Curiously, the spot survey report conducted by Manoj Kumar Aggarwal has been withheld by the insurance company. At Item No.11, under the Head “summary of assessment” in the survey report by Vivek Arora, original estimate is recorded thus: “Original EstimateTotal Labour ChargesRs. 1,30,440/-Total cost of spare partsRs. 0,36,090/-Total:Rs. 1,66,580/-” The enclosures with the survey report at item No.2 records: “Estimate: Original and Suppl. 3 pages” But this enclosure has been suppressed by the insurance company. The vehicle was removed by the complainant to the workshop only after the survey was conducted by Manoj Kumar Aggarwal (approved surveyor nominated by the insurance company for spot survey). 11. However, Vivek Arora in his survey report made the following assessment for the reasons best known to him: “Total Labour Charges:Rs. 52,000.00Total cost of spare partsRs.11,874.37Less:DepreciationNo.10% & 50%Rs. 3,669.58Excess if any—Salvage value (Appx.)Rs. 1,000.00Appx. Net LossRs. 59,304.82" 12. The insurance company got the survey done again through B.B. Garg (Approved Surveyor) who made an additional assessment of Rs. 3,512.72 to the assessment made by Vivek Arora.13. On the face of the vouchers and bills for parts as well as labour charges submitted by the complainant, all the three Consumer Fora accepted the complainant’s claim and did not accept these survey reports. Pertinently, the vehicle was not even 2 year old at the time of accident. 14. Section 64-UM(2) of the Act 1938 reads: “No claim in respect of a loss which has occurred in India and requiring to be paid or settled in India equal to or exceeding twenty thousand rupees in value on any policy of insurance, arising or intimated to an insurer at any time after the expiry of a period of one year from the commencement of the Insurance (Amendment) Act, 1968, shall, unless otherwise directed by the Authority, be admitted for payment or settled by the insurer unless he has obtained a report, on the loss that has occurred, from a person who holds a licence issued under this section to act as a Surveyor or Loss Assessor (hereafter referred to as “approved Surveyor or Loss Assessor”):Provided that nothing in this Sub-section shall be deemed to take away or abridge the right of the insurer to pay or settle any claim at any amount different from the amount assessed by the approved Surveyor or Loss Assessor.” 15. The object of the aforesaid provision is that where the claim in respect of loss required to be paid by the insurer is Rs.20,000/- or more, the loss must first be assessed by an approved Surveyor (or Loss Assessor) before it is admitted for payment or settlement by the insurer. Proviso appended thereto, however, makes it clear that insurer may settle the claim for the loss suffered by insured at any amount or pay to the insured any amount different from the amount assessed by the approved Surveyor (or Loss Assessor). In other words although the assessment of loss by the approved Surveyor is a pre-requisite for payment or settlement of claim of twenty thousand rupees or more by insurer, but Surveyor’s report is not the last and final word. It is not that sacrosanct that it cannot be departed from; it is not conclusive. The approved Surveyor’s report may be basis or foundation for settlement of a claim by the insurer in respect of the loss suffered by the insured but surely such report is neither binding upon the insurer nor insured.16. So far as the case in hand is concerned, the claim of the complainant has been accepted by the Consumer Fora as it was duly supported by original vouchers, bills and receipts. It has been held that the actual expenses incurred by the complainant comes to Rs.1,39,438/- in getting the truck repaired apart from the expenses on account of haulage of truck and carrying it to the workshop. Taking into account actual expenses incurred and the interest that the complainant had to pay to the bank from which the loan was obtained for that amount, the District Forum awarded a sum of Rs. 1,58,409/- to the complainant and insurance company was directed to make that payment along with interest at the rate of 12% per annum. At the first blush, we had some doubt whether the interest paid by the complainant to the bank could have been awarded, but on deeper scrutiny we found that no such ground has been set up in the appeal. As a matter of fact, this aspect was not even raised before the National Commission.

Decision (1 = appeal accepted, 0 = rejected): 0

Explanation:
0[ds]10. We are unable to accept the contentions of the learned Counsel for the insurance company. That the vehicle that was insured with the insurance company met with an accident and fell down into the Khud 300 feet deep below the road is not in dispute. The survey reports of Vivek Arora as well as B.B. Garg, upon which reliance has been placed by the insurance company show that the vehicle got extensively damaged in this accident. Its Assembly, Bonnet, Cabin, Tool Box, Body, Chasis, Diesel Tank, Pressure Regulator, Pressure Pipe, Brake Booster, Steering Wheel, Head Lights, Main Leaf LHS Front, Front shockers, Steering Worm, Air Cleaner, Cross Member Rear 2nd, Propeller Shafts, Front Axle, Silencer, Engine Chamber etc. had sustained major damage. The approved Surveyors in their reports have recorded their satisfaction that the aforementioned damages to the said vehicle would have occurred in that mishap. Vivek Arora in his survey report also noted that the damages noticed to the said vehicle were in conformity with the description of the accident mentioned in the claim form and details of damages noted by the spot Surveyor. Curiously, the spot survey report conducted by Manoj Kumar Aggarwal has been withheld by the insurance company.The insurance company got the survey done again through B.B. Garg (Approved Surveyor) who made an additional assessment of Rs. 3,512.72 to the assessment made by Vivek Arora.13. On the face of the vouchers and bills for parts as well as labour charges submitted by the complainant, all the three Consumer Fora accepted theclaim and did not accept these survey reports. Pertinently, the vehicle was not even 2 year old at the time of accident.The object of the aforesaid provision is that where the claim in respect of loss required to be paid by the insurer is Rs.20,000/or more, the loss must first be assessed by an approved Surveyor (or Loss Assessor) before it is admitted for payment or settlement by the insurer. Proviso appended thereto, however, makes it clear that insurer may settle the claim for the loss suffered by insured at any amount or pay to the insured any amount different from the amount assessed by the approved Surveyor (or Loss Assessor). In other words although the assessment of loss by the approved Surveyor is afor payment or settlement of claim of twenty thousand rupees or more by insurer, butreport is not the last and final word. It is not that sacrosanct that it cannot be departed from; it is not conclusive. The approvedreport may be basis or foundation for settlement of a claim by the insurer in respect of the loss suffered by the insured but surely such report is neither binding upon the insurer nor insured.16. So far as the case in hand is concerned, the claim of the complainant has been accepted by the Consumer Fora as it was duly supported by original vouchers, bills and receipts. It has been held that the actual expenses incurred by the complainant comes to Rs.1,39,438/in getting the truck repaired apart from the expenses on account of haulage of truck and carrying it to the workshop. Taking into account actual expenses incurred and the interest that the complainant had to pay to the bank from which the loan was obtained for that amount, the District Forum awarded a sum of Rs. 1,58,409/to the complainant and insurance company was directed to make that payment along with interest at the rate of 12% per annum. At the first blush, we had some doubt whether the interest paid by the complainant to the bank could have been awarded, but on deeper scrutiny we found that no such ground has been set up in the appeal. As a matter of fact, this aspect was not even raised before the National Commission.