india insurance

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Accident claim = whether; petitioner was entitled to receive Rs.5,00,000/- the amount for which vehicle was insured, or to get market price.= In the present case, as per surveyor G.S. Advani & Co. report, total cost of the repairs of the vehicle was Rs.3,05,000/- and market value of the vehicle was Rs.2,35,000/-. As per report of The Institute of Insurance Surveyors & Adjusters (Mumbai), Pune Unit, market value of damaged vehicle was Rs.2,35,000/- and salvage value of the vehicle was Rs.65,000/-. This report was given by the Committee of 3-independent surveyors after inspecting the vehicle and inquiry from market. In such circumstances, it can be presumed that value of the vehicle was around Rs.2,35,000/- and as per Condition No.4 of the insurance policy, petitioner was entitled only to receive Rs.2,35,000/-. In our judgment inDr. Vir Singh Malik Vs. The Oriental Insurance Co. Ltd. (Supra) case insured amount was allowed after depreciation because neither such condition was brought to our notice, nor report of independent surveyor regarding value of vehicle was placed. 11. In such circumstances, petitioner is not entitled to receive remaining Rs.2,63,500/-. Learned State Commission has not committed any error in dismissing appeal and upholding order of District forum dismissing complaint, though on other grounds. 12. Consequently, revision petition filed by the petitioner is dismissed with no order as to costs.

published in NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION                                                 NEW DELHI          REVISION PETITION NO. 1320 OF 2008 (From the order dated 02.11.2007 in Appeal No. 863/2001 of the State Consumer Disputes Redressal Commission, Mumbai, Circuit Bench at Aurangabad) Mrs. Laxmi Ramesh Sarda Partner in M/s. Zumberlal Sitaram Sarda, Sarda Lane, Ahmednagar                   …Petitioner/Complainant Versus The Manager United India Insurance Co. Ltd. Divisional Office, Kisan Kranti Bldg., Market Yard, Ahmednagar                            …Respondent/Opp. Party (OP) BEFORE      HON’BLE … Continue reading

Fire accident= When there is no clause not to make any constructions to the building with out permission – No claim should be rejected when fire accident was occurred due to short – circute – not concerned with building works = the petitioner issued an insurance policy number 201002/11/03/00372 called ‘Standard Fire and Special Perils Policy’ in favour of the complainant / respondent for a sum of Rs.20.50 lacs for the period 17.3.2004 to 16.03.2005. Out of this amount of Rs.20.50 lacs, Rs.20 lacs was meant for stocks of all kinds of sofa material, curtains cloth, mattresses, pillows, cushions, towels, bed sheets, etc., and Rs.50,000/- was the coverage for furniture, fixtures, fittings and electrical items. During the currency of the policy, fire occurred on 19.09.2004 at about 3:30 a.m. and the respondent estimated the loss to be Rs.20,68,090/-. An intimation was given by the respondent to the local police on the date of the fire and the insurance company was also intimated. The petitioner insurance company appointed a surveyor to assess the loss. Vide his report dated 29.01.2005, the surveyor assessed the loss at Rs.10,80,770/-. The surveyor also pointed out that at the time of loss, there was construction going on in the shop on the first and second floors of the building. In order to supply electric current to first and second floor, electric wires had been put on the main electric meter for the shop, which resulted in probable short-circuiting, leading to fire. The petitioner repudiated the claim, saying that there was violation of conditions of the policy, because construction was going on in the premises. = construction activity was being carried out at the premises in question and as per the surveyor’s report, the probable cause of fire could be due to short-circuiting, but we agree with the findings of the District Forum and State Commission that in this case also, the insurance company cannot escape responsibility to pay the claim under the Policy. We do not agree with the contention of the petitioner that the construction activity had resulted in increased risk for the insured stocks in question. It has also been made clear that there are separate electric connections for the ground floor and first floor and there are separate electricity meters for the same. It is not clear anywhere that the insured was required to obtain permission of the insurance company before starting the construction. The District Forum in their order have rightly assessed the value of the total stocks, in question and the value of the stocks lying safe in the godown, and allowed the claim after taking into consideration both these values. We, therefore, find no illegality or irregularity in the orders passed by the District Forum and State Commission which reflect true appreciation of the facts and circumstances on record. These orders are, therefore, upheld and the present revision petition stands dismissed with no order as to costs.

published in NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI   REVISION PETITION NO. 2381 OF 2012 (From the order dated 30.03.2012 in First Appeal No. 970/2008 of Punjab State Consumer Disputes Redressal Commission)   United India Insurance Co. Ltd. Regd. & Head Office 24, Whites Road Chennai – 600014 Through its Regional office No. 1 Kanchenjunga Building … Continue reading

M.V. ACT – WORKMEN’S COMPENSATION ACT= whether the appellant/insurance company was liable to pay the entire amount of compensation awarded to the claimants or its liability was restricted to that which was prescribed under the Workmen’s Compensation Act. = the liability to pay compensation in respect of death or bodily injury to an employee should not be restricted to that under the Workmen’s Compensation Act but should be more or unlimited. However, the determination would depend whether a policy has been taken by the vehicle owner by making payment of extra premium and whether the policy also contains a clause to that effect.

REPORTABLE IN THE SUPREME COURT OF INDIA CIVIL APPELLATE JURISDICTION CIVIL APPEAL NO. 8725 OF 2012   RAMCHANDRA ..Appellant Versus REGIONAL MANAGER UNITED INDIA INSURANCE CO. LTD. ..Respondent   J U D G M E N T GYAN SUDHA MISRA, J. The judgment and order dated 17.4.2007 passed by the High Court of Karnataka at … Continue reading

can an Insurance Company disown its liability on the ground that the driver of the vehicle although duly licensed to drive light motor vehicle but there was no endorsement in the licence to drive light motor vehicle used as commercial vehicle.= The heading “Insurance of Motor Vehicles against Third Party Risks” given in Chapter XI of the Motor Vehicles Act, 1988 (Chapter VIII of 1939 Act) itself shows the intention of the legislature to make third party insurance compulsory and to ensure that the victims of accident arising out of use of motor vehicles would be able to get compensation for the death or injuries suffered. The provision has been inserted in order to protect the persons travelling in vehicles or using the road from the risk attendant upon the user of the motor vehicles on the road. To overcome this ugly situation, the legislature has made it obligatory that no motor vehicle shall be used unless a third party insurance is in force. 18. Reading the provisions of Sections 146 and 147 of the Motor Vehicles Act, it is evidently clear that in certain circumstances the insurer’s right is safeguarded but in any event the insurer has to pay compensation when a valid certificate of insurance is issued notwithstanding the fact that the insurer may proceed against the insured for recovery of the amount. Under Section 149 of the Motor Vehicles Act, the insurer can defend the action inter alia on the grounds, namely, (i) the vehicle was not driven by a named person, (ii) it was being driven by a person who was not having a duly granted licence, and (iii) person driving the vehicle was disqualified to hold and obtain a driving licence. Hence, in our considered opinion, the insurer cannot disown its liability on the ground that although the driver was holding a licence to drive a light motor vehicle but before driving light motor vehicle used as commercial vehicle, no endorsement to drive commercial vehicle was obtained in the driving licence. In any case, it is the statutory right of a third party to recover the amount of compensation so awarded from the insurer. It is for the insurer to proceed against the insured for recovery of the amount in the event there has been violation of any condition of the insurance policy. In the instant case, admittedly the driver was holding a valid driving licence to drive light motor vehicle. There is no dispute that the motor vehicle in question, by which accident took place, was Mahindra Maxi Cab. Merely because the driver did not get any endorsement in the driving licence to drive Mahindra Maxi Cab, which is a light motor vehicle, the High Court has committed grave error of law in holding that the insurer is not liable to pay compensation because the driver was not holding the licence to drive the commercial vehicle. The impugned judgment is, therefore, liable to be set aside. 20. We, therefore, allow this appeal, set aside the impugned judgment of the High Court and hold that the insurer is liable to pay the compensation so awarded to the dependants of the victim of the fatal accident. However, there shall be no order as to costs.

published in http://judis.nic.in/supremecourt/filename=40464   Page 1 REPORTABLE IN THE SUPREME COURT OF INDIA CIVIL APPELLATE JURISDICTION CIVIL APPEAL NO… 4834 OF 2013 (Arising out of Special Leave Petition (Civil) No.5091 of 2009) S. IYYAPAN Appellant (s) VERSUS M/S UNITED INDIA INSURANCE COMPANY LTD. AND ANOTHER Respondent(s) JUDGMENT M.Y. Eqbal, J.: Leave granted. 2. The right of the … Continue reading

Insurance policy claim – The appellant’s father lodged a claim for compensation by asserting that his son had suffered loss of vision due to accidental fall. After long correspondence, the respondents rejected the claim on the ground that the same was not covered by the policy. = Phthisis Bulbi is the endstage anatomic condition of the eye in response to severe ocular disease,infection, inflammation, or trauma. Clinically, it is categorized by a soft strophic eye with disorganization of intraocular structures. Phthisis Bulbi can be caused due to ocular injury, radiation, infection, or diffusion disease. Initial damage to intraocular structures either from penetrating trauma or inflammation can eventually lead to widespread atrophy and disorganization of the eye – Dictionary of Cell and Molecular Biology and Radiology of the Orbit and Visual Pathways, by Jonathan J. Dutton, Prof. of Ophthalmology, University of North Carolina at Chepal Hill, USA.= it is clear that the State Commission and the National Commission committed serious error by dismissing the complaint of the appellant by assuming that his right eye was afflicted with the disease of Phthisis Bulbi and the same was the cause of loss of vision. They completely ignored the report of the Medical Board which had opined that Phthisis Bulbi can be caused due to injury caused due to fall. Before the State Commission, sufficient evidence was produced by the appellant to prove that he had an accidental fall on 22.10.1999 and as a result of that, right side of his head and the right eye were injured. Therefore, there is no escape from the conclusion that the appellant’s case was covered by the policy issued by respondent No.1 and the State Commission and the National Commission committed serious error by rejecting his claim. – In the result, the appeal is allowed, the impugned order as also the one passed by the State Commission dismissing the complaint filed by the appellant are set aside and the respondents are directed to pay compensation of Rs.7,00,000/- to the appellant with interest at the rate of 6% per annum from the date of filing the complaint. 16. The respondents are directed to pay the aforesaid amount to the appellant within a period of eight months from the date of receipt/production of copy of this judgment.

Page 1 NON-REPORTABLE IN THE SUPREME COURT OF INDIA CIVIL APPELLATE JURISDICTION CIVIL APPEAL NO.2759 OF 2013 (Arising out of SLP(C) No. 25991 of 2008) Sandeep Kumar Chourasia …Appellant versus Divisional Manager, the New India Insurance Company Ltd. and another …Respondents J U D G M E N T G. S. Singhvi, J. 1. Leave granted. … Continue reading

On the point of ‘burglar proof safe’, the say of the complainant is that at the time of obtaining the policy during 1995 he had enclosed along with the proposal form the design and plan of the strong room/safe, which stated that the vault would be embedded into the wall and would be made of a steel structure and only after their approval that the design was adequate to meet the safety requirement, he had got the same fabricated on the spot, which was further inspected by the representative of the opposite party-Insurance Company before accepting the proposal. It is only thereafter that the policy was issued and has been renewed from year to year. We quite agree with the learned counsel for the complainant that it is too late in the day for the opposite party-Insurance Company to now say that the safe was not ‘burglar proof’ having renewed the policy for a period of five years. The denial by the opposite party-Insurance Company that no such approval to the design or inspection of the fault/strong room was ever carried out by their representative would not cut much ice for the simple reason that in the absence of any schedule/design having been given to the complainant to suit their safety requirement, the objection cannot be treated as tenable or valid. -“Insurance Companies in genuine and bonafide claims of insured should not adopt the attitude of avoiding payments on one pretext or the other. This attitude puts a serious question mark on their credibility and trustworthiness. By adopting honest approach and attitude the insurance companies would save enormous litigation costs.” This observation of the Hon’ble Apex is fully applicable to the facts of the present case for the simple reason that if the opposite party-Insurance Company was not satisfied with the report of their surveyor, they ought to have sought further clarification from the surveyor on the points of disagreement and even thereafter if they were not satisfied, they ought to have referred the matter to a second surveyor before finally arriving at a conclusion as to whether or not to repudiate the claim. We further notice that the opposite party-Insurance Company has taken more than eight months to consider the report of the surveyor and only when the complainant pursued his case relentlessly that they have finally repudiated the claim. This was not expected of a service provider like the opposite party-Insurance Company and, therefore, they are liable for the deficiency in service.

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI     ORIGINAL PETITION NO. 5 OF 2003   Champaklal Hansraj Shah Sole Proprietor of RUSHABH JEWELLERS 2, Super Markets, Monghibhai Road Vile Parle (East) Mumbai-400057                                          …..  Complainant (s) Versus   United India Insurance Co. Ltd. Divisional Office – Malad 201, Jainson Plaza, 2nd Floor S.V. Road, Malad (West) Mumbai-400064                                          …… Opp. Party (ies)   BEFORE: HON’BLE MR. JUSTICE R.C. JAIN, PRESIDING … Continue reading

whether the appellant, United India Insurance Company Limited (insurer) is absolved of its obligations to the third party under the policy of insurance because the cheque 1Page 2 given by the owner of the vehicle towards the premium got dishonoured and subsequent to the accident, the insurer cancelled the policy of insurance.- the owner of the bus obtained policy of insurance from the insurer for the period April 16, 2004 to April 15, 2005 for which premium was paid through cheque on April 14, 2004. The accident occurred on May 11, 2004. It was only thereafter that the insurer cancelled the insurance policy by communication dated May 13, 2004 on the ground of dishonour of cheque which was received by the owner of the vehicle on May 21, 2004. The cancellation of policy having been done by the insurer after the accident, the insurer became liable to satisfy award of compensation passed in favour of the claimants. 21. In view of the above, the judgment of the High Court impugned in the appeal does not call for any interference. Civil appeal is dismissed. However, the insurer shall be at liberty to prosecute its remedy to recover the amount paid to the claimants from the insured. No order as to costs.

Page 1 REPORTABLE IN THE SUPREME COURT OF INDIA CIVIL APPELLATE JURISDICTION CIVIL APPEAL NO. 3589 OF 2012 (Arising out of SLP(C) No. 23511 of 2009) United India Insurance Co. Ltd. …. Appellant Versus Laxmamma & Ors. ….Respondents JUDGMENT R.M. Lodha, J. Leave granted. 2. The only question that arises for consideration in this appeal by … Continue reading

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION = In conclusion, this appeal has to be allowed and the order of the State Commission set aside. We order accordingly. It appears that the Insurance Company did not appoint any surveyor to assess the insurance claim of the petitioner/complainant and, given the lapse of time, it will not be useful or practicable to ask the Insurance Company to do so now. In such a situation, the only available course is to direct the Insurance Company to pay to the petitioner the insured value for the damaged 120 hoardings, the details of which were furnished by the petitioner (vide pages 85-87 of the paperbook of this appeal). This shall be subject to the “excess clause” and deduction of (i) salvage value of the 120 hoardings, in accordance with the terms of the policy and (ii) the sum of Rs.60,000/- already received by the petitioner/complainant (as token damages in terms of the order of the High Court in contempt petition). The amount so arrived at shall carry interest @ 9 per cent per annum from the date 90 days after the filing of the insurance claim till actual payment and the entire payment shall be made within 6 weeks of the date of this order. In the circumstances of the case, the parties shall bear their own costs.

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION     NEW DELHI FIRST APPEAL NO. 308 OF 2001 (From the order dated 08.08.2001 of the Andhra Pradesh State Consumer Disputes Redressal Commission, Hyderabad in Complaint Case no. 20 of 1984) M/s Haabia Advertising (India) Pvt. Ltd. Haabia House, Sethamapeta Visakhapatnam, Andhra Pradesh                                            Appellant Through its Managing Director M. Venkata Ratnam   versus   1. United India Insurance Company Ltd … Continue reading

how to fix compensation when a leg of driver was amputated = The decision reported in 2011 ACJ 1 (cited supra) has been relied upon both by the insurer as well as the claimant. In the said decision, the Apex Court has laid down that the ascertainment of the effect of permanent disability on the actual earning capacity involves three steps and the same has been laid down in paragraph 10, which reads as follows :

In the High Court of Judicature at Madras Dated : 04/1/2012 Coram : The Honourable Mr.Justice K.MOHAN RAM and The Honourable Mr.Justice G.M.AKBAR ALI CIVIL MISCELLANEOUS APPEAL(NPD)Nos.2597 and 2630 of 2011 and all connected pending MPs AND MP.NO.5 OF 2011 United India Insurance Co.Ltd., Rattan Bazaar, Chennai-3. Appellant in CMA No.2597/2011 and R2 in CMA.No.2630 … Continue reading

Insurance – Insurance company agreed to insure timber – Timber washed away due to flood – Insurance company repudiated claim in 1988 -Complaint filed in 1994 – Dismissed by National Consumer Commission as time barred – On facts, held: On date of flood, there was no insurance policy in existence nor any commitment on behalf of insurance company to make payment – Even accepting the case at its very best that the period of limitation was 3 years under s.44 of the Limitation Act, the complaint was, even then, beyond time – No case made out for interference by Supreme Court – Limitation Act, 1963 – s.44. Contract Act, 1872 – s.28 – Contract of insurance – Clause providing for forfeiture or waiver of the right itself if no action was commenced within period stipulated – Held: Not violative of s.28 – Though curtailment of period of limitation is not permissible in view of s.28 but extinction of the right itself unless exercised within a specified time is permissible and can be enforced. Respondent insurance company agreed to insure timber lying in forest areas of the State and issued cover note followed by an insurance policy to be purportedly valid for one year from 6th November, 1987 onwards. The timber was washed away some time in September, 1988 on account of heavy rains and consequent large scale flooding in the State. When appellant laid claim before the respondent, the latter vide its communication dated 13th October 1988 refuted its liability and repudiated the claim contending that the insurance policy was issued for 8 months only starting from 6th November, 1987 and ending on 5th July, 1988 and the period of one year mentioned in the policy was on account of a typographical mistake. It is alleged that Respondent even accepted additional premium after the policy was repudiated and still declined to make good the loss. Appellant filed complaint before National Consumer Commission. The Complaint was dismissed as time barred having been filed after expiry of the 12 months period stipulated by Clause 6(ii) of the insurance policy. The order passed by the National Consumer Commission was challenged in the present appeal on grounds that Clause 6(ii) of the insurance policy could not be sustained being violative of s.28 of the Contract Act, 1872 and in any event s.44 of the Limitation Act, 1963 provided a limitation period of 3 years from the date of disclaimer. =Dismissing the appeal, the Court HELD:1. It is clear from the record that the timber had been washed away some time in September, 1988 and after prolonged correspondence, the respondent ultimately vide its communication dated 13th October, 1988 repudiated the appellant’s claim. It is also clear from the counter affidavit filed by the respondent that the appellant had, vide its letter dated 7th November 1987, asked for insurance cover for a period of 8 months and that the period of one year fixed in the insurance policy was evidently a typographical mistake which had, in any case, been rectified in the records of the company on 17th December 1987, that is long before the flood. The claim of the appellant that the respondent company had, even after the 13th October 1988, impliedly admitted its liability under the policy also appears to be incorrect as the surveyors had been appointed on the persistent demand of the claimant/appellant and the premium taken thereafter was only to make good the deficiency in the premium that had been paid for the policy for the period of eight months. It is, therefore, apparent that as on the date of the flood, there was no insurance policy in existence or any commitment on behalf of the respondent to make the payment under the policy. Therefore, even accepting the case of the appellant at its very best that the period of limitation would be 3 years under Section 44 of the Limitation Act, the complaint would, even then, be beyond time, having been filed in April 1994. [Para 5] [1018-G-H; 1019-A-D] 2. As regards the issue of clause 6 (ii) of the insurance policy vis-a-vis s.28 of the Contract Act, 1872, the National Commission had relied upon the Sujir Nayak’s case to hold that the complaint could not be entertained as being time barred. In Sujir Nayak’s case, while dealing with an identical situation where a contract contained a provision prescribing a period of limitation shorter than that prescribed by the Limitation Act, it was held that the contractual provision was not hit by s.28 as the right itself had been extinguished. The plea of the appellant that in view of the Food Corporation of India’s case, the Sujir Nayak’s case was liable for reconsideration has no merit since in Sujir Nayak’s case, Food Corporation of India’s case was specifically considered. [Paras 6, 8 and 9] [1019-D; 1021-B-D] National Insurance Co. Ltd. vs. Sujir Ganesh Nayak & Co. & Anr. (1997) 4 SCC 366; Food Corporation of India vs. New India Assurance Co. Ltd. & Ors. (1994) 3 SCC 324; Vulcan Insurance Co. Ltd. vs. Maharaj Singh & Anr. (1976) 1 SCC 943 and Muni Lal vs. Oriental Fire & General Insurance Co. Ltd. & Anr. (1966) 1 SCC 90, referred to. Case Law Reference: (1997) 4 SCC 366 referred to Para 3 (1994) 3 SCC 324 referred to Para 3 (1976) 1 SCC 943 referred to Para 3 (1966) 1 SCC 90 referred to Para 3 CIVIL APPELLATE JURISDICTION : Civil Appeal No. 6347 of 2000. From the final Judgment and Order dated 16.8.2000 of the National Consumer Disputes Redressal Commission, New Delhi in Original Petition No. 95 of 1994. Naresh K. Sharma for the Appellant. K.L. Nandwani and Debasis Misra for the Respondent. =, , , 2009(1 )SCALE216 , 2008(13 )JT66

REPORTABLE IN THE SUPREME COURT OF INDIA CIVIL APPELLATE JURISDICTION CIVIL APPEAL NO. 6347 OF 2000 H.P. State Forest Company Ltd. ……..Appellant Vs. M/s. United India Insurance Co. Ltd. …….Respondent JUDGMENT HARJIT SINGH BEDI,J. 1. The facts leading to this appeal are as under: 2. In October 1987, a meeting was convened by the Managing … Continue reading

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