Sudip Ahluwalia, Member

The present Complaint has been filed under the Consumer Protection Act, 1986 alleging deficiency in service on the part of the Opposite Parties in relation to settlement of Insurance Claim arising out of fire loss suffered by the Complainant in its insured business premises.

2. The factual background, in brief, is that the Complainant is stated to be engaged in business of electronic goods and had obtained Standard Fire and Special Perils Policy bearing No. 51230011140100000067 from Opposite Party No.1 for the period 24.06.2014 to 23.06.2015 covering stock for an insured sum of Rs.1,75,00,000/-. During the intervening night of 17.04.2015 and 18.04.2015, a fire occurred in the insured premises resulting in damage, allegedly, to the entire stock. Immediate intimation thereof was furnished to the Insurer, whereafter claim processing was undertaken through appointment of Surveyors.

3. The grievance of the Complainant is that despite full cooperation and submission of all requisite records including Stock Statements, Invoices and Books of Account, the Insurer ultimately released only Rs.1,40,14,523/- after effecting deductions which, according to the Complainant, were unjustified and arbitrary. Aggrieved by the same, the present Complaint was filed in which directions against the Opposite Parties for payment of the Outstanding Claim Amount of Rs. 34,85,477/- along with interest including pendent lite interest @18% per annum from 13.04.2016 till realisation along with ancillary reliefs.

4. Notice was issued upon Opposite Party Nos. 1 and 2 who have filed their Written Statement and resisted the Complaint. They have denied all the material averments made by the Complainant. The Opposite Parties, in their Written Statement, have raised preliminary objections regarding maintainability of the Complaint and have denied any deficiency in service, contending that the claim of the Complainant was processed strictly in accordance with the terms and conditions of the Insurance Policy and on the basis of the assessment made by duly appointed licensed Surveyors. It is averred that immediately upon receipt of the intimation of fire, survey proceedings were initiated and necessary documents were called for from the Complainant, whereafter detailed scrutiny of stock records, invoices and other financial documents was undertaken before determining the admissible loss. The Opposite Parties have relied upon two levels of assessment - primary final survey by McLarens Insurance Surveyors & Loss Assessors India Pvt. Ltd. and then a review by a CA Assessor. They claim that the deduction was not arbitrary but mathematically structured. The Opposite Parties averred that the Surveyor assessment is binding unless rebutted.

5. The Opposite Parties submitted that after considering the survey findings and reassessment, the net payable amount was correctly quantified at Rs. 1,40,14,523/- after lawful deductions towards dead stock @ 5%, salvage, under-insurance @ 1.84% and Policy excess @ 5%, all of which, according to them, were contractually permissible and technically justified. It was averred that the Complainant has not technically rebutted why any specific deduction is illegal. It is further averred that the Complainant accepted the said amount without protest at the relevant stage and executed Discharge Vouchers in full and final settlement, thereby bringing the contractual claim to a complete closure. The Opposite Parties have also asserted that repeated survey exercises were undertaken only to ensure fairness and accuracy in assessment and not for reducing their liability arbitrarily, and that no further amount is payable since the settlement already effected, represents the full admissible liability under the Policy.

6. Rejoinder on behalf of the Complainant to the Written Statement by the Opposite Parties has been filed; It has denied the averments made in the Written Statement except to the extent specifically admitted and has reiterated that the Opposite Parties have sought to justify arbitrary deductions without furnishing any cogent documentary basis for the same. It is asserted that the plea regarding lawful settlement of the Claim is misconceived, since the Complainant had consistently protested against the reduced payment immediately after receipt thereof and had repeatedly demanded disclosure of the detailed computation adopted by the Insurer.

7. The Complainant, through their Rejoinder, further submitted that the Discharge Vouchers relied upon by the Opposite Parties do not constitute voluntary full and final settlement, inasmuch as signatures were allegedly obtained on printed forms as a procedural requirement for release of the admitted Claim amount, without disclosure of the final adjusted figures. It is also averred that the survey reports relied upon by the Insurer cannot be treated as conclusive because successive reassessments themselves disclose uncertainty in the Insurer's own approach, and the deductions under the heads of dead stock, salvage, underinsurance and Policy excess have been mechanically applied without proper justification. The Complainant has accordingly reaffirmed that the Opposite Parties are liable for deficiency in service for withholding the balance admissible amount and for failing to respond satisfactorily to repeated written representations made by the Complainant.

8. Evidence by way of Affidavit has been filed on behalf of the Complainant by Mr. Ghanshyamdas Agarwal, partner in the Complainant firm. Evidence by way of Affidavit has been filed on behalf of the Opposite Party Nos. 1 and 2 by Mr. Pranab Mahay for The New India Assurance Company Ltd. Affidavit of Mr. Bijan Bihari Mohanty, the Surveyor of McLarens Insurance Surveyors & Loss Assessors India Pvt. Ltd. was also placed on record along with the Survey Report dated 09.09.2015. Pages 28 and 29 of the Evidence by way of Affidavit filed by the Opposite Parties are the two Discharge Vouchers. Further Supplementary Affidavits were also filed on behalf of the Complainant by Mr. Ghanshyamdas Agarwal and Mr. Sameer Agarwal. In the Supplementary Affidavit of Shri Ghanshyamdas Agarwal, it was claimed that signatures were obtained on blank printed forms at the time of release of admitted claim amount. In the Supplementary Affidavit of Shri Sameer Agarwal, it was stated that he was not partner of the Complainant Firm and lacked authority to bind the firm in any final settlement. It has also been pointed out that the two Discharge Vouchers that have surfaced on record are undated.

9. Heard Ld. Counsel for Complainant and the Opposite Parties, and perused the material available on record.

10. Ld. Counsel for the Complainant has contended that the Opposite Parties acted arbitrarily in curtailing the Insurance Claim despite there being no dispute either with regard to the subsistence of the Policy, occurrence of fire, or the factum of loss suffered by the Complainant in the insured premises. It was submitted that the Complainant had furnished all requisite claim documents including Stock Registers, Invoices, Books of Account and other supporting records as demanded during the survey proceedings, yet the Insurer failed to disclose any clear or rational basis for effecting substantial deductions from the assessed claim amount.

11. Ld. Counsel further submitted that successive appointment of more than one Surveyor itself demonstrates inconsistency in the claim assessment process, and that the earlier assessments were altered without any convincing explanation, thereby rendering the final computation doubtful. Reliance was placed on the judgments of the Hon'ble Supreme Court in the case of "Sri Venkateswara Syndicate Vs. Oriental Insurance Co. Ltd. & Anr., (2009) 8 SCC 507" and in the case of "New India Assurance Vs. Pradip Kumar, (2009) 7 SCC 787". It was also submitted that repeated representations dated 13.04.2016, 12.09.2016 and 04.10.2016 seeking explanation remained unanswered.

12. It was argued that deductions under the heads of dead stock, salvage, underinsurance and Policy excess were applied mechanically and without item-wise justification, while the subsequent reassessment reducing the admissible claim by a further amount was also unsupported by proper invoice-wise correlation. Reliance was placed on the judgment passed by the Hon'ble Supreme Court in "I.C. Sharma Vs. Oriental Insurance Co Ltd., AIR 2018 SC 416". Ld. Counsel has further contended that the Discharge Vouchers relied upon by the Opposite Parties cannot operate as valid full and final settlement, since the signatures were allegedly obtained only as a procedural requirement for release of admitted payment and not as an expression of free consent to the reduced settlement. To support this contention, the Complainant has relied on the judgment passed by the Hon'ble Supreme Court in "National Insurance Co Ltd. Vs. Sehtia Shoes, Civil Appeal No. 1602 of 2008" and another judgment passed by this Commission in the case of "Arihant industries Vs. United India Insurance Co., 2021 SCC OnLine NCDRC 8".

13. It was also submitted that the repeated protest letters addressed by the Complainant after receipt of payment, followed by a Legal Notice, clearly establish that the Complainant never accepted the reduced payment as final settlement, and therefore withholding of the balance amount constitutes deficiency in service for which the Complainant is entitled to the deducted amount together with interest, compensation and costs.

14. Ld. Counsel for the Opposite Parties has submitted that the Insurance Claim of the Complainant was processed strictly in accordance with the terms and conditions of the Policy and on the basis of assessment carried out by duly licensed Surveyors appointed under the statutory framework governing Insurance claims. It was contended that immediately upon receipt of intimation regarding the fire incident, survey proceedings were initiated and all relevant records produced by the Complainant were examined in detail before arriving at the final admissible amount. Ld. Counsel has argued that the final settlement of Rs.1,40,14,523/- was determined after lawful deductions towards dead stock, salvage, underinsurance and Policy excess, all of which were contractually permissible and technically justified on the basis of survey findings.

15. It was further submitted that appointment of more than one Surveyor or reassessment at different stages cannot by itself lead to any inference of arbitrariness, since such exercise was undertaken only to ensure accuracy and fairness in quantification of loss. Ld. Counsel also contended that the Complainant accepted the settled amount without raising any contemporaneous objection at the stage of disbursement and executed Discharge Vouchers acknowledging receipt in full and final settlement, thereby bringing the contractual claim to closure. It was argued that once such Discharge Vouchers were executed and payment accepted, no further claim survives in consumer jurisdiction unless fraud or coercion is strictly proved, which according to the Opposite Parties has not been established on record. Ld. Counsel has therefore contended that the Complaint is devoid of merit, that no deficiency in service can be attributed to the Insurer, and that the Complaint deserves dismissal with costs.

16. Before we proceed on to consider the validity of such deductions as made by the Insurance Company, it would be appropriate to first consider what were the pleadings made by the Complainant in its original Complaint.

17. The Complaint was conspicuously silent about the date(s) on which the accounts of Rs. 1,40,14,523/- had been deposited in its Bank Account. However, the Complainant mentioned about its letters dated 13.4.2016, 12.9.2016, and 5.10.2016 in which it had sought that the details of and grounds on which such reduced compensation was paid to it, and had also required the Opposite Party to share a copy of the Surveyor's report. Thereafter, on 22.11.2026, the Complainant issued a Legal Notice to the Opposite Party again seeking explanations to satisfy itself about the grounds on which the total claim submitted was not allowed and an amount to the extent of Rs. 34,85,477/- had been deducted from the total claimed amount of Rs. 1.75 crores.

18. But it is significant that there was no averment at all in the Complaint that any document(s)/Discharge Voucher(s) were signed by anyone on its behalf prior to deposit of the amounts transferred in the Complainant's Bank Account. Much less was there any pleading that the Discharge Vouchers, if any, had been signed from its side under any kind of distress, compulsion or economic duress.

19. On the other hand, it was the specific case of the Opposite Party that the deductions were made correctly on the basis of the Surveyor's Report and that the Discharge Vouchers had been signed on behalf of the Complainant. It may be mentioned that the evidence from the side of the Opposite Party alongwith an Affidavit of the Surveyor Mr. Bijan Behari Mohanty with his Report dated 9.9.2015 was filed in this Commission on 17.8.2023. Thereafter, on 15.5.2025, the Complainant filed a Supplementary Affidavit sworn by its Partner-Mr. Ghanshyam Das Agarwal, in which it was stated that the Discharge Vouchers were signed by his son-Mr. Sameer Agarwal on an assumption that the Opposite Party would pay the entire claimed amount to it. Another Affidavit was separately filed by Mr. Sameer Agarwal as well on behalf of the Complainant, although it transpires that he himself is not a Partner in the Complainant Firm. In the said Affidavit, Mr. Sameer Agarwal stated that he had signed on the blank Discharge Voucher Forms on the assumption that the entire claim amount would be paid to the Complainant Firm. Admittedly, Mr. Sameer Agarwal is the own son of Mr. Ghanshyam Das Agarwal (PW1) who filed the Complaint in his capacity as a Partner in the Complainant Firm. He, therefore, could not have been unaware of the development that the Discharge Vouchers had been signed by his son Sameer Agarwal especially considering that both of them share a common residential address as described in their respective Affidavits filed on 17.8.2023. To that extent, silence of the Complainant in the original Complaint regarding signing of the Discharge Vouchers by Mr. Sameer Agarwal prior to transfer of the compensation amount paid by the Insurance Company would ex facie appear to be wilful suppression of a material fact.

20. At any rate, in relation to the salvage value of Rs. 2,19,844/- as deducted in view of the Surveyor's report, it is seen that the Surveyor in his report had specifically stated that such amount was paid by the purchasers "Durga Sons" of Siliguri, to the Complainant vide Cheque No. 343313 dated 4.7.2015. But there was no denial of this claim of the Surveyor by the Complainant side even in their Supplementary Affidavits filed after the Surveyor's report had already come on record.

21. Further, a careful scrutiny also goes to show that under-Insurance at 1.84% was actually applicable as the value of the Insured goods according to the Complainant's own records was Rs. 1,78,28,156.15 paise whereas only an amount of Rs. 1.75 crores was the sum insured. In his Report, the Surveyor had also noted that the Complainant/Insured was itself convinced that dead Stock @ 5% from the claimed amount was applicable in the final assessment of the loss. Lastly, a perusal of the original Policy filed alongwith the evidence of the Opposite Party clearly shows that 5% of the claim was an opted deductible amount.

22. For the reasons mentioned in the preceding Para Nos. 20 & 21, there are no grounds to hold that any deductions as recommended by the Surveyor from the claim of the Complainant/Insured were unjustified. At any rate, wilful suppression of the factum of having signed the Discharge Vouchers prior to transfer of the amount sanctioned in favour of the Complainant by the Insurance Company, in the original Complaint as filed, would also detract from the overall credibility of the Complainant's case.

23. The Complaint is, therefore, dismissed. Parties to bear their own costs.

23. Pending application(s), if any, also stand disposed off as having been rendered infructuous.