KEDAR NATH SWAIN vs New India Insurance Co. Ltd.

THIS is a complaint alleging deficiency in insurance service.

CASE of complainant is that he is owner of a bus bearing registration number ORA 1595 which was insured by the insurer, New India Assurance Co. Ltd. of which opposite party is the Divisional Manager covered the risk on receipt of premium for the period between 16.1.1990 and 15.1.1991. During the policy period, bus met with an accident on 10.8.1990. On the next day complainant filed his claim. Immediately on the very day a Surveyor was appointed. Surveyor assessed the loss on 12.8.1990. On 14/15.8.1990 with the permission of opposite party, bus was brought to a repairing garage for repair. Surveyor visited the garage on 19.8.1990. Complainant visited the Surveyor several times for one year till 19.8.1991. He also approached opposite party during that period. Opposite party appointed a third Surveyor in September, 1991. But there being no settlement till 23.2.1992 this Complaint has been filed. Case of opposite party is that vehicle was insured at Calcutta. On receipt of information of accident on 13.8.1990, D.K. Mohanty was appointed as Surveyor for spot survey. Sri Mohanty visited spot on 14.8.1990 and submitted his report. On 6.5.1991, Surveyor prepared his final report indicating details of damage and estimated the same to be Rs. 66,717.08 paise. This report was received on 25.6.1991. Opposite party sent all documents to the branch of the business at Calcutta for settlement on 16.7.1991. Opposite party deputed P.C. Mohanty as Surveyor again since the damage exceeded Rs. 15,000/-. This is practice of the insurer. Sri Mohanty sent several letters to complainant on 19.7.1991, 25..1991, 31.8.1991, 5.12.1991 and 6.1.1992 to submit some documents to assess actual damage caused to vehicle. Complainant did not turn up to show the salvage. Hence Surveyor submitted independent report on 14.2.1992. Opposite party intimated the Calcutta office that report could not be given on account of non-cooperation of complainant. It is stated that complainant is entitled to get Rs. 66,717.08 paise as reported by Surveyor.

We are happy that in this case opposite party has explained in detail the circumstances under which the settlement was not possible. All statements of insurers should be in line with this statement. That also should be filed within 30 days of the receipt of complaint since subsequent conduct is also a circumstance to be taken into account in adjudicating the question of negligence. This should be remembered by insurers.

WHEN we called upon Mr. Debasis Das to state the further period that would be necessary to settle the claim, Mr. Das intimated that the amount "is to be sanctioned by the Calcutta office to which documents have been submitted and on that account, due to non-receipt of order of sanction, claim could not be settled. Mr. Das submitted that granted fortnight''s accommodation, final decision on the claim shall be intimated to complainant. Amount which is decided to be paid, shall be intimated to complainant within that period if dissatisfied, he can move for arbitration. There is no doubt that some delay has been caused in settling the claim which is not reasonable. This is a case where the Surveyors are not free from blemishes. Requiring a claimant to supply materials for a long period and keeping the report pending on that account may in some circumstances give rise to an inference of extraneous consideration of the Surveyor. In some cases it may give rise to suspicion of expectation of illegal gratification. If a report could be submitted on 14.2.1992, it could have been submitted earlier also. In this case, before directing payment of compensation, we are inclined to give opportunity to the insurer whom opposite party represents to finalize the claim of the complainant within 30th of April, 1993. Since this order is passed in presence of Mr. Debasis Das, learned Counsel for the insurer delay in receipt of copy of the order will not be a ground not to finalize within the date fixed. Any amount settled to be paid shall be enclosed to the final settlement by way of a crossed cheque in the name of the complainant without insisting for a certificate of full and final payment of the claim. In case this direction is not complied with within the time stipulated, insurer shall pay compensation at the rate of Rs. 200/- per day to the claimant from 1.5.1993 till compliance of this order. On receipt of the final decision of the insurer with crossed cheque for the amount settled, complainant can call upon the insurer referring the dispute relating to further amount to an arbitrator if the terms of the policy so envisage and on receipt of the request from the complainant, the insurer shall either refer the dispute to arbitrator or intimate the cause for which it is not possible.

THIS complaint is disposed of with the aforesaid directions. Complaint disposed of.