LexNEW INDIA ASSURANCE COMPANY LIMITED versus PRADEEP KUMAR
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[2009] 16 (ADDL.) S.C.R. 508 A NEW INDIA ASSURANCE COMPANY LIMITED v. PRADEEP KUMAR (Civil Appeal No. 3253 of 2002) B APRIL 9, 2009 [D.K. JAIN AND R.M. LODHA, JJ.] Consumer Protection - Insurance claim for vehicle damaged in accident - Insurance company offering lesser ' c than the claimed amount on the basis of approved surveyor's report - Insured getting the vehicle repaired from the loan amount taken from Bank - Claim of amount spent towards repair and the interest on loan amount - Non-payment - Complaint before consumer forum alleging deficiency in D service-Consumer fora with concurrent finding accepting the claim - On appeal, held: Claim of the insured was rightly accepted - Insurer could have deviated from surveyor's report .. - Surveyor's report may only be basis for settlement of claim, and it is not conclusive - Insurance Act, 1938- s. 64-UM (2). E A heavy motor vehicle (open body truck), owned by the respondent-complainant and insured with the appellant-Insurance Company, met with an accident. Respondent got the vehicle repaired by taking loan from F the Bank. Thereafter, he claimed the expenses incurred for repair and the interest paid to the Bank on the loan '. amount from the appellant-insurer. He then filed a complaint before consumer forum alleging deficiency in service by the Insurance Company and claimed an amount of Rs. 1, 58, 409/-. The stand of the Insurance G Company was that initially the spot survey was conducted and thereafter survey of the vehicle was conduced by two different approved surveyors. As per "' the estimate of the last survey, Rs. 63,771/- was offered '. to the complainant, which he refused. Consumer forum H 508 NEW INDIA ASSURANCE COMPANY LIMITED v. 509 PRADEEP KUMAR • awarded the claim of the appellant. The order was A confirmed to State Consumer Commission and National Consumer Commission. Hence the present appeal. Dismissing the appeal, the Court HELD: 1. The object of s. 64-UM (2) of Insurance Act, B 1938 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 c 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). Although the . assessment of loss by the approved surveyor is a pre- D '\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 E 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. [Para 15) [516-B-E] ' . 2. The survey reports of the two approved surveyors, F 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 G Pipe, Brake Booster, Steering Wheel, Head Lights, Main J-eaf 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 H 510 SUPREME COURT REPORTS [2009) 16 (ADDL.) S.C.R. A recorded their satisfaction that the aforementioned • damages to the said vehicle would have occurred in that mishap. One of the approved surveyors, in his survey report also noted that the damages noticed to the said vehicle were in conformity with the description of the B accident mentioned in the claim form and details of damages noted by the spot surveyor. The spot survey report has been withheld by the Insurance Company. In the survey report by this surveyor, original estimate is " recorded to be Rs. 1,66,580/-. The enclosures with the c survey report at item No.2 records: "Estimate: Original and Suppl. 3 pages". But this enclosure has been suppressed by the Insurance Company. [Para 10) (514- A-DJ D 3. The claim of the complainant has been accepted by the co
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