Sikka Papers Ltd. Vs.
National Insurance Co. Ltd. & Ors.  INSC 1129 (29 May 2009)
IN THE SUPREME COURT
OF INDIA CIVIL APPELLATE JURISDICTION CIVIL APPEAL NO. 6527 OF 2002 Sikka
Papers Limited ..Appellant Versus National Insurance Company Ltd. & Ors.
JUDGEMENT R.M. LODHA,
appeal under Section 23 of the Consumer Protection Act, 1996 (for short `the
Act') is at the instance of the complainant as its claim to the tune of of
Rs.35,06,000/- against the National Insurance Company Limited (for short
`insurer') has not been accepted in its entirety and the National Commission in
its judgment and order dated July 18, 2002 directed the insurer to pay to the
complainant an amount of Rs. 10,47,491 only along with interest at the rate of
12% from March 1, 2000, till the date of payment after adjusting the amount
facts from which the controversy arises are these:
Sikka Paper Limited, is a limited company engaged in the manufacture of paper
having a paper mill unit in District Muzaffarnagar (U.P.). For want of regular
and continuous supply of electricity from the Uttar State Electricity Board,
the complainant purchased the Diesel Generating Set of 1000 KVA of Kirloskar
Cumins Limited with alternator of 1250 KVA for the smooth running of its unit.
The said diesel generating set along with alternator was got insured by the
complainant for a period from April 8, 1999 to April 7, 2000 for Rs.35,00,000/-
vide insurance policy No. 451902/46/99/415. The complainant paid a premium
amount of Rs.55,860/- to the insurer.
December 25, 1999, the said generating set broke down and it could not start
again despite efforts. The concerned officers of the insurer were intimated in
this regard by the complainant and they were requested for arranging immediate
survey of the insured generating set. The first surveyor appointed by the
insurer is said to have completed his inspection on December 26, 1999 and
advised the complainant to send the engine to the authorized repairers viz.,
Cumins Diesel Sale and Service (India) Limited, Pune. On December 30, 1999, another
surveyor is said to have inspected the diesel generating set and identified the
damages and the complainant with the consent of the insurer, sent the diesel
generating set for repairs to authorized repairers at Pune. The authorized
repairers gave the estimate of expenses of repairs to the tune of
Rs.27,00,395/- and repaired the diesel generating set. The complainant is said
to have paid Rs. 25,00,000/- to the repairers.
case of the complainant is that all bills acquired and directed by the insurer
and their appointed surveyors and as required by the policy were handed over to
the insurer and the complainant was told that the actual expenses incurred by
them in the repairs of the diesel generating set as well as reinstatement
charges would be paid but later on they agreed to reimburse Rs.8,07,110/- only.
Constrained thereby, the complainant approached the National Commission and
claimed a sum of Rs.25,00,000/- towards repairs of diesel generating set;
mental harassment and damages along with interest and costs. The complainant
alleged that the insurer failed to discharge their obligations under the
insurance policy and with mala fide intention to defeat and delay its
legitimate claim, adopted all unwarranted and illegal devices.
insurer resisted the complaint and set up the plea that claim of Rs.8,07,110/-
was accepted as per the surveyor's report dated May 15, 2000; the surveyor
considered the damage caused as a result of the accident to the various parts
of the diesel generating set and wherever he found that replacement was
required, he provided for the same. The insurer stated that the surveyor
assessed the damages on the basis of only those items which were affected in
accidental damage and the balance items not following the scope of the policy
were disallowed. It was the case of the insurer that the parts which did not
suffer any damage as a result of accident were not liable to be replaced at the
expense of the insurer. The insurer also averred that the surveyor in its
report dated May 15, 2000 after considering the damage caused to the diesel
generating set has allowed amounts for carrying out the necessary replacement
of parts damaged in accident after deducting the depreciation. The deduction at
the rate of 25.71% as under-insurance was also sought to be justified.
The insurer denied
the claim towards mental harassment.
National Commission, inter alia, considered the matter thus:
"...We are also
unable to accept the figure given by the Complainant for purchase of the Engine
as well as while it meets the `capacity' requirement but not of `kind' i.e. a
cumin engine thus not meeting the requirement of the Terms of Policy as
reproduced earlier under the head `Sum Insured'. We find that the third Surveyor
has taken pains to explain each and every part of the repairs, freight etc. and
his assessment of loss is as per terms of the Policy which alone can form the
basis of payment to the Complainant. We also see further material on record
that estimates of Rs.25 lakhs for repairs relate to replacement of several
parts not affected by the incident but to prolong the life of the Engine. Full
reimbursement has been made for replacement of crankshaft, Main bearings,
connecting Rod bearing, oil coolers and Gears but not for cylinder liners,
Piston and Pistons rings as they are expendibles, to the extent that they are
subject to wear and tear on account of constant use. The latter contingency is
not covered by terms of the policy, hence cannot be allowed.
In the light of above
discussions, we direct the Opposite Party to pay to the Complainant an amount
of Rs.10,47,491/- as assessed by the third Surveyor along with interest @ 12%
from 1.3.2000 i.e. after two months of the receipt of the report of the second
Surveyor, till the date of payment after adjusting for the payment already
made. The Opposite Party shall also pay cost of Rs. 5000/- to the
heard the learned counsel for the parties. In the light of the contentions
advanced before us, the following two questions arise for our consideration:
(one) Whether the
insurer was justified in accepting report dated May 15, 2000 submitted by the
surveyor who had assessed the loss of Rs.14,45,000/- after deducting about
Rs.10,55,000/- from Rs.25,00,000/- i.e. actual amount paid by the complainant
for repairing the diesel generating set ? (two) Whether the insurer was
justified in deducting an amount of Rs.3,71,509.50 (25.71%) as under insurance
from the loss assessed at Rs.14,45,000/- by the surveyor in its report dated
May 15, 2000 ? re : question (one)
the complainant took machinery insurance policy to cover diesel generating set
of 1000 KVA with alternator of 1250 KVA from the insurer is not in dispute. The
said diesel generating set with alternator was got insured for the period from
April 8, 1999 to April 7, 2000. Although the said diesel generating set with
alternator was purchased by the complainant as per the invoice in 1997 for Rs.
45,00,000/-, it is not in dispute that sum insured for alternator was Rs.
9,00,000/- and diesel generating set Rs.26,00,000/- i.e., insurance cover was
for Rs. 35,00,000/- in all. It is also an admitted position that on December
25, 1999, the diesel generating set that was insured with insurer broke down and
could not be started. The spot survey was got conducted by the insurer and on
the advice of the surveyor, the diesel generating set was sent to authorized
repairers at Pune for repairs. The last surveyor's report is May 15, 2000.
According to the complainant, they paid a sum of Rs.25,00,000/- to the
repairers for the repairs of diesel generating set but the insurer relying upon
the report of the last surveyor agreed to reimburse the sum of Rs.8,07,110/-
only which was not acceptable to the complainant.
Vikram Greentech (I) Ltd. & Anr. v. New India Assurance Co. Ltd.,1 we
considered the essentials of insurance of contract thus:
insurance contract, is a species of commercial transactions and must be
construed like any other contract to its own terms and by itself. In a contract
of insurance, there is requirement of uberimma fides i.e. good faith on the
part of the insured. Except that, in other respects, there is no difference
between a contract of insurance and any other contract. The four essentials of
a contract of insurance are, (i) the definition of the risk, (ii) the duration
of the risk, (iii) the premium and (iv) the amount of insurance. Since upon
issuance of insurance policy, the insurer undertakes to indemnify the loss
suffered by the insured on account of risks covered by the insurance policy,
its terms have to be strictly construed to determine the extent of liability of
the insurer. The endeavour of the court must always be to interpret the words
in which the contract is expressed by the parties. The court while construing
the terms of policy is not expected to venture into extra liberalism that may
result in re- writing the contract or substituting the terms which were not
intended by the parties. The insured cannot claim anything more than what is
covered by the insurance policy. [General Assurance Society Cheriyan (1999) 6
SCC 451 and United India (2004) 8 SCC 644."
relevant portion of Machinery Insurance Policy taken by the complainant from
the insurer are :
"NOW THIS POLICY
OF INSURANCE WITNESSETH THAT subject to the terms and exemptions exclusions
provisions and conditions contained herein or endorsed hereon the Company will
at its own option by payment or reinstatement or repair indemnify the Insured
against unforeseen and sudden physical damage by any cause not 1 JT 2009 (5) SC
579 hereinafter excluded to any Insured property specified in the attached
Schedule whilst in the premises therein mentioned necessitating its immediate
repair or replacement.
GENERAL EXCEPTIONS .
THE COMPANY SHALL NOT
BE LIABLE UNDER THIS POLICY IN RESPECT OF:- 1.................................
5.Deterioration of or
wearing away or wearing out of any machine caused by or naturally resulting
from normal use or exposure.
It is a requirement
of this Insurance that the Sum Insured shall be equal to the cost of
replacement of the insured property by new property or the same kind and same
capacity which shall mean its replacement cost including freight dues and
customs duties if any and erection costs.
Basis of Indemnity:
a) In cases where
damage to an insured item can be repaired the Company will pay expenses
necessarily incurred to restore the damaged machine to its former state of
serviceability plus the cost dismantling and re-erection incurred for the
purpose of effecting the repairs as well as ordinary freight to and from a
repair-shop customs duties and dues if any to the extent such expenses have
been included in the Sum Insured if the repairs are executed at a workshop
owned by Insured, the Company will pay the cost of materials and wages incurred
for the purpose of the repairs plus a reasonable percentage to cover overhead
No deduction shall be
made for depreciation in respect of parts replaced except those with limited
life but the value of any salvage will be taken into account if the cost of
repairs as detailed herein above equals or exceeds the actual value of the 8
machinery insured immediately before the occurrence of the damage the
settlement shall be made on the basis provided for in (b) below.
If the sum insured is
less than the amount required to be insured as per Provision 1 hereinabove the
Company will pay only in such proportion as the sum insured bears to the amount
required to be insured.
Every item is more
than one shall be subject to this condition separately.
has been argued on behalf of the complainant that the insured must be
reimbursed for the entire repairs costs incurred by it in repair of diesel
generating set since as per insurance policy, the insurer was responsible for
the payment of any sort of loss or reinstatement or repair and indemnify the
insured in all respects. Relying upon the policy, it was submitted that it was
the duty of the insurer to pay the necessary expenses incurred to restore the
damaged generating set to its former state and the cost of dismantling and
erection etc. We find it difficult to accept the aforestated contention since
it overlooks the General Exceptions incorporated in the policy that provide
that the insurer shall not be liable under the policy in respect of
deterioration of or wearing away or wearing out of machine caused by or
naturally resulting from normal use or exposure. In other words, the policy does
not provide for protection against wear and tear that the machinery had
undergone and that the insured may have chosen to replace. The provision of
`sum insured' viz., the cost of replacement of insured property by new property
of the same kind and same capacity is subject to the exception that repair or
replacement shall not extend to the machinery or parts which have undergone
normal wear and tear due to its use and exposure. In terms of the Machinery
Insurance Policy taken by the insured, the insurer is required to reimburse the
insured to the extent of moneys spent on repairs or replacement of the
machinery to the kind of position that it was before the incident of damage.
this backdrop, before we turn to the surveyor's report dated May 15, 2000, we
deem it proper to notice Section 64 UM(2) of the Insurance Act, 1938 that reads
"64-UM (2)- No
claim in respect of a loss which has occurred in India and requiring to be paid
or settled in India equal to or exceeding twenty thousand rupees in value on
any policy of insurance, arising or intimated to an insurer at any time after
the expiry of a period of one year from the commencement of the Insurance
(Amendment) Act, 1968, shall, unless otherwise directed by the [Authority], be
admitted for payment or settled by the insurer unless he has obtained a report,
on the loss that has occurred, from a person who holds a licence issued under
this section to act as a surveyor or loss assessor 10 (hereafter referred to
as "approved surveyor or loss assessor"):
Provided that nothing
in this sub-section shall be deemed to take away or abridge the right of the
insurer to pay or settle any claim at any amount different from the amount
assessed by the approved surveyor or loss assessor."
in New India Assurance Company Limited v. Pradeep Kumar 2, we had occasion to
consider the aforesaid provision and we held thus :
"The object of
the aforesaid provision 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 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). In other words although the
assessment of loss by the approved surveyor is a pre-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 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."
last surveyor in his report dated May 15, 2000 assessed the loss thus :
2 2009 (6) SCALE 253 I)
Working of Claim under Invoice No.60/184989 dated 13.01.2000 of M/s.CDSS :
We have allowed
Labour Charges at Rs.80,000. Rs.80,000 Octroi Charge Rs.16,200 Freight Charges
Rs.16,000 Transit Insurance Rs.
------------------- Rs.1,15,700 Works Contract Tax 4% 4,628 --
----------------- Rs.1,20,328 II) Working of Claim under Invoice No.60/184990
dated 31/1/2000 of M/s. CDSS:
1) "Kit -Crank
Shaft" - Part No.AR 388113400K9 - 1 No.
52 (vide Page 1,
Sr.No.1 of Subject invoice) Add 4% Work contract Tax Rs. 55,235.83
------------------------ Rs.14,36,131.35 The subjects Kit -Crank Shaft is
comprising of set Main Bearings & connecting Rod Bearings, the reasonable
total value for them is taken at Rs.1,35,131.35.
Less Reasonable cost
for set of main bearings & Connecting rod bearings Rs. 1,35,131.35
------------------------- - Rs.13,01,000/- Thus , bifurcation of costs are as
under:- Cost of Crank Shaft Rs.13,01,000 Cost of set of main bearings &
bearings Rs. 1,35,131 --------- ---------- Rs.14,36,131.35 A) Assessment for
Cost for Crank Shaft
Rs.13,01,000 Less additional policy excess for the Crank shaft as per
endorsement ..20% Rs. 2,60,200 12 ------------------- Net Loss Rs.10,40,800 B)
Assessment for set of main bearings & connecting rod bearings:- Cost for
the set Rs. 1,35,131.35 Less reasonable depreciation ..50% Rs. 67,565.67
------------------------ Net Loss after depreciation Rs. 67,565.67 2) Gears - 2
Nos. @ Rs.2587.69 - Part No.3177095 (Vide Page 6,Sr.
No.91 of subject
Invoice) Rs. 7,763.07 Add 4% work contract Tax Rs. 310.52 Rs. 8,073.59 Less
reasonable depreciation 50% Rs. 4,036.79 Net Loss after depreciation Rs.
4,036.80 Thus, net loss after depreciation for (1) & (2)= A + B + Gears
above for items under Invoice No.60/184990 Rs.11,12,402.47 III) Working of
claim under Invoice No. 60/184991 Dt. 31/01/2000 of M/s.CDSS Core Coolers (Oil
collers) - 4 Nos. @ 54,205.42 - Part No.3627295 Rs. 2,16,821.68 Add 4% Work
contract Tax Rs. 8,672.87 This is not a Limited life item and hence there is no
any depreciation applicable for it under the policy Net Loss Rs. 2,25,494.55
Thus net loss under all the three Invoice as per claim bill works out to I) +
II) + III) Rs.14,58,225.02 Less reasonable Salvage at scrap value Rs. 13,225.02
Rs.14,45,000.00 Less under-insurance -25.71% vide page No.13 Rs. 3,71,509 .50
Rs.10,73,490.50 Say Rs.10,73,491 Less Policy Excess Rs. 26,000 Net assessed
parts which had suffered due to wear and tear on account of constant use,
although replaced could not form part of claim for reimbursement under the
terms of policy and, therefore, surveyor in its report dated May 15, 2000
cannot be said to have wrongly rejected such claim. It is true that surveyor's
report is not the last word but then there must be legitimate reasons for
departing from such report. In our view, the complainant has failed to show any
reason justifying rejection of surveyor's report dated May 15, 2000.
re : question (two)
the Dictionary of Insurance (Second Edn.) by C. Bennett,
"under-insurance" is explained thus:
occurs when the amount of insurance is less than the full value of property
insured and means that the insured pays a smaller premium than that required as
the rate is fixed on the basis of full values being insured. It leads to
partial loss claims being scaled down by average (qv.)."
"average" is explained thus:
property insurance if a sum insured is `subject to average', and the sum
insured is less than the value at risk at the time of loss, the claim will be
reduced in the same proportion. The measure combats under-insurance."
per the invoice, the diesel generating set and the alternator was purchased by
the complainant in the year 1997 for Rs.45,25,000/-. The complainant, however,
got the insurance cover valuing diesel generating set (Rs.26,00,000/-) and
alternator (Rs.9,00,000/-), in all for Rs.35,00,000/-. Apparently, therefore,
there is an element of under-insurance. There is merit in the contention of
learned counsel for the insurer that the value of the item is always declared
by the insured at the time of issuance of the insurance policy while the
element of under-insurance is calculated by the insurer at the time of
assessment of loss.
Although on behalf of
the complainant, it was contended that under-insurance, if any, must be
calculated at the time of issuance of policy and could not be deducted at the
time of assessment of the loss but we find it difficult to accept the same. The
policy provides that if the sum insured is less than the amount required to be
insured, the insurer will pay only in such proportion as the sum insured bears
to the amount insured. In accordance with the said provision in the policy if
the surveyor applied the pro-rata formula and deducted 25.71% from the loss so
assessed i.e. Rs.3,71,509.50 from the sum payable as under-insurance, such
deduction cannot be faulted.
are, thus, of the view that the National Commission did not commit any error in
accepting the Surveyor's report dated May 15, 2000 as the assessment made
there-under is proper and in accordance with the provisions of the policy.
way of footnote, we may observe that claim of Rs.10,00,000/- made by the
complainant for mental harassment is wholly misconceived and untenable. The
complainant is a company and, therefore, claim for mental harassment is not
legally permissible. It is only the natural person who can claim damages for
mental harassment and not the corporate entity.
all, we find that the consideration of the matter by the National Commission
does not suffer from any legal flaw justifying interference by us.
is, accordingly, dismissed with no order as to costs.
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