National Consumer Disputes Redressal
Balamurugan Automobiles vs United India Insurance Co. Ltd. & Anr. on 9 October, 2023
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI CONSUMER CASE NO. 881 OF 2015 1. BALAMURUGAN AUTOMOBILES (THROUGH ITS MANAGING PARTNER)
93/3, NEW BYE PASS ROAD, VELLORE ...........Complainant(s) Versus 1. UNITED INDIA INSURANCE CO. LTD. & ANR. (THROUGH ITS MANAGER)
11 A-M.C. ROAD,
AMBUR-635802 VELLORE 2. UNITED INDIA INSURANCE CO. LTD. (THROUGH ITS MANAGER)
24, WHITES ROAD, CHENNAI-600014 ...........Opp.Party(s)
BEFORE: HON'BLE MR. JUSTICE A. P. SAHI,PRESIDENT
FOR THE COMPLAINANT : FOR THE COMPLAINANT : MR. TISHAMPATI SEN, ADVOCATE
MR. HIMANSHU KAUSHAL, ADVOCATE FOR THE OPP. PARTY : FOR THE OPPOSITE PARTIES : MR. AMIT KUMAR SINGH, ADVOCATE
Dated : 09 October 2023 ORDER
JUSTICE A. P. SAHI, PRESIDENT
1.The complainant is an authorized dealer for sales, service and spares of two wheelers, three wheelers and other vehicles manufactured by M/s. TVS Motors.
2. The complainant contends that it is running its main showroom establishment at 93/3, New Bye Pass Road, Vellore. It also has its additional establishments including one at 63/1 and 63/B in Kakithattadai on Arcot Road in Vellore and two other premises within the establishment run by the complainant namely at 7-A, Railway Station Road, Ranipet and the other at S.R.R. Thirumana Mahal Complex, Ocheri.
3. In order to secure its business the complainant proposed and obtained a Standard Fire and Special Peril Policy from the opposite party (United India Insurance Company Limited). A copy of the proposal form has been brought on record by the Insurance Company annexed at page 23 of the written statement. It is relevant to note that the said proposal form submitted by the complainant has neither been denied nor contradicted. The said proposal form was submitted in the year 2009 against which a policy was issued effective from 22.04.2009 to 21.04.2010. The said policy is also not disputed. The description of the property insured has been referred to as per the schedule attached to the policy.
4. The same policy was renewed for the period 24.04.2010 to 21.04.2011 copy whereof has been filed on record and is again not disputed. The address shown on the cover page of the policy document indicates the name of the complainant with the address 93/3, New Bye Pass Road, Vellore. However the recitals in the policy under the heading of description of property covered does not mention the property of New Bye Pass Road, Vellore.
5. The properties mentioned in the policy are 63/1 and 63/B Kakithattadai on Arcot Road, Vellore, 7A-Railway Station Road, Ranipet and S.R.R. Thirumana Mahal Complex ,Ocheri.
6. Learned counsel for the complainant advancing his submissions states that an unfortunate incident took place when the said policy was subsisting between 23.04.2012 to 22.04.2013. At about 11 p.m. on 07.01.2023, a fire broke out in the premises at 93/3, New Bye Pass Road, Vellore which has resulted in a heavy loss of about more than one crore and a claim was raised for Rs.1.31 crores.
7. The investigator appointed by the Insurance Company submitted a report on 19.04.2013 and categorically opined that the location risk was not of the premises where the accident took place and therefore the claim was inadmissible. However the surveyor had indicated its own opinion about a clerical error in the address on the policy and since the complainant is the only dealer of TVS at Vellore, the error made by the branch office at Ambur deserves to be rectified. A letter was written by the Divisional Manager on 21.08.2013 also indicating that the said error was inadvertent and if the policy and the proposal form has been signed by the complainant with an incorrect description of the address, it can be viewed as a layman's fault.
8. The claim was repudiated vide letter dated 06.11.2013, which is extracted herein under:-
"As advised by our Regional Office vide their mail dated 19/08/2013, we regret to inform you that your above Fire claim stands repudiated on the following grounds.
"The above referred policy covered the premises at 63/1 & 63/B Arcot road, Kakithapattarai, Vellore. But the claim has been preferred for the property at 93/3, New Bye Pass road, Vellore."
Since the location of loss is not covered by the insured, the competent authority has repudiated the claim."
9. After repudiation the complainant submitted a representation with the grievance cell of the Insurance Company on 06.05.2014. Thereafter, the complainant was informed by letter dated 12.11.2014 that no review is possible and the competent authority has upheld the decision of repudiation.
10. The dispute therefore narrows down to the fact as to whether the accident which was reported to have taken place at 93/3, New Bye Pass Road at Vellore was covered under the risk policy and matches with the description thereof or not.
11. Learned counsel for the complainant heavily relying on the investigation report as also the letter of the Divisional Manager dated 21.08.2013 has urged that the error in the description of property attributed to the Insurance officials would not denude the complainant merely because a different address has been mentioned in the description. He submits that it was understood by the complainant as also the Insurance Company that the business was running at 93/3, New Bye Pass Road, Vellore and therefore this was the property which was covered under the policy for which full premium had been paid. It is submitted that the policy covers the entire risk of the properties including the premises for which the claim has been raised and consequently in view of the evidence that has been brought on record it is established that the Insurance Company had also clearly accepted the coverage of the risk of the said premises at 93/3, New Bye Pass Road, Vellore which has been erroneously declined through the repudiation letter.
12. Learned counsel for the Insurance Company has urged that right from the proposal up to all the renewals of the said policy, which also covers the period in question, leaves no room for doubt that the only coverage that was extended was in respect of three properties mentioned in the policy and the description does not in any way include the address of 93/3, New Bye Pass Road, Vellore. He further submits that an incorrect inference is being drawn and undue advantage is sought to be taken of the mentioning of the address for communication with the complainant which is mentioned on the top cover of the policy. He submits that the said address is not part of the description of the property which is covered under the policy. The same property has been covered continuously right from 2009 till 2013 that does not include the New Bye-Pass Road premises, which is evident from the copies of the proposal form and the policies issued 2009 onwards. The contention is that there is neither any deviation nor any change in the description of property and hence the mentioning of the address of 93/3, New Bye Pass Road, Vellore on the top cover which is only an address for communication, does not bring the said property within the fold of risk coverage.
13. Learned counsel for the complainant urged that the complainant is a layman and therefore his understanding while filling up the proposal form or receiving the policy document cannot deprive him of the legitimate claim of the losses of goods and building that was suffered in the accident. In the given circumstances the claim petition deserves to be allowed and the Insurance Company should be directed to make good the losses by indemnifying the complainant with the amount specified in the complaint.
14. Having heard learned counsel for the parties, Insurance is a matter of contract which is to be spelt out and understood on the specific terms in which it has been entered between the parties. It is admitted on record that the description of the property insured under the risk policy does not specify the place where the accident has taken place. To the contrary there are only three properties mentioned in the proposal form filled up by the complainant and also in the policy that was issued pursuant thereto including the renewal of the policy covering the period of 2013 when the accident occurred. Thus the rule of contra preferentem cannot be pressed into service in order to interpret the terms and conditions or the description in the policy by reading the address of the property which is mentioned on the cover of the policy. It is to be noted that the risk description does not contain the address that is mentioned on the top cover of the policy. Thus no such intention by way of any fiction can be drawn when the facts are absolutely clear. The property bearing municipal number 93/3, New Bye Pass Road, Vellore was not insured nor its risk was covered in any way under the policy.
15. The argument of the learned counsel for the complainant that the complainant was a layman cannot be accepted, in as much as, the complainant who is running such a huge business is expected to be aware at least of the extent of risk coverage of the property and the sum insured. A layman may not be a member of any profession, legal, medical, etc. or not having special knowledge of a certain subject, but cannot plead ignorance of a fact stated or recorded voluntarily by himself. One can say that the various clauses of the policy are not read very minutely but the specific description of the property given in the proposal form has been filled up by the complainant himself voluntarily and therefore the plea that he is a layman, and was unable to understand the consequences of the description in the policy, is totally unacceptable. There is no rational basis for accepting this argument and otherwise also it is not logical.
16. There is another argument advanced by the learned counsel for the complainant that it was for a very short period between 2009 and 2010 that there was a shifting of the showroom at New Bye Pass Road and it is during that period that the proposal form had been filled up. What the learned counsel intended to convey was that the top cover reflected the correct address and the description of the properties mentioned inside the policies should be understood to include the premises at 93/3, New Bye Pass Road, Vellore as well. This argument has been stretched too far and there is no evidence to indicate that the complainant had ever informed the Insurance Company about the shifting of the business or relocation of the premises. This argument is therefore neither supported by any evidence nor does it logically flow from the contents of the documents on record which are undisputed where the description of the property is specific. There is no explanation by the complainant as to why the complainant omitted to mention the New Bye Pass Road, Vellore property in the proposal form or even sought its correction through some intimation even thereafter for almost 4 years when the policy was renewed up to 2013.
17. From a conspectus of the aforesaid facts and also the FIR lodged by the complainant it is evident that the accident took place at 93/3, New Bye Pass Road, Vellore and not at the properties mentioned and covered under the policy. The complainant had also mentioned the address of the New Bye Pass Road, Vellore premises in the claim form and the investigation report by the investigator of the Insurance Company also mentions the same premises but in the absence of any recital of the premises in any of the policy coverage documents, the claim is unsustainable.
18. A lot was argued about an error in the description of the property and heavy reliance on the address mentioned on the top cover of the policy. Emphasis was laid on the recitals of the letter dated 21.08.2013 written by the Divisional Manager of the Insurance Company. Suffice it to say that there is no error nor any attempt was made to get it corrected as observed above. Coming to the letter of the Divisional manager, the least said the better. It clearly runs counter to the coverage proposed and the policy issued by the Insurance Company. The said letter seems to be overenthusiastic in its expressions and appears to have been steered full sail to favour the complainant. It is an embellishment, tailored and window dressed to make the communication address on the top cover of the policy appear as the insured premises. This overzealousness on the part of the Divisional Manager omits to remember that the Insurance funds are held in public trust and any sweeping recommendations contrary to the policy descriptions will do more harm and undermine the faith of investors. The terms of an insurance contract are sacrosanct and the purpose is to secure and indemnify a genuine loss, and not to promote profiteering. The letter dated 21.08.2013 strikes a dent into the confidence of the insurance business, and the learned counsel for the Insurance Company was unable to defend the same. The claim therefore cannot succeed on the incorrect opinion of the Divisional Manager nor is it worth relying on as it is against the terms of the policy. The complaint therefore cannot succeed and is accordingly dismissed. All pending applications also stands disposed off.
.........................J A. P. SAHI PRESIDENT