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| Insurance Companies shall consider belated flood claims on merits: DB | | | Early Times Report
Srinagar, May 18: In response to petitions related to claims regarding the loss during flash floods in valley, the Division Bench (DB) of State High Court comprising, Chief Justice N Paul Vasanthakumar and Justice Ali Mohammad Magrey dismissed the appeal of Insurance Company with the direction to register the claims and process the claims on merits without reference to the delay in submission of the claims.
This people friendly order has been passed in two appeals filed by the National Insurance Company Limited against the judgment of J&K State Consumer Disputes Redressal Commission, Srinagar, dated 02.01.2015, wherein the Commission has directed the appellant to entertain/register the claims made by the respondents in these appeals for settlement of their insurance claims on merits.
A Division Bench of State High Court after hearing Adv J A Kawoosa for the Insurance Company whereas Adv S M Ayoub for the complainant dismissed the appeal of Insurance Company with the direction to register the claims and process the claims on merits without reference to the delay in submission of the claims.
Division Bench after hearing both the sides observed that in these cases the policy itself contemplates extension of time therefore the submission of claim within 15 days of the loss is directory and not mandatory. In exercise of that power only the Insurance Company extended the time to submit the claims by the insured persons who sustained loss up to 01/10/2014. Moreover, this Court in CMP No. 3/2014 in PIL No. 1-Gupkar/2014 ( G A Lone and anr v Union of India and Ors dated 01/10/2014) noticed the number of claims received by the Insurance Companies including that of the appellant and insofar as the Bajaj Allianze was concerned, up to the date of order that was on 01/10/2014, 4870 intimations/claims were received and the Company could settle only 197 cases.
It was submitted to court that similarly the ICICI Lambard General Insurance Company had received 266 intimations/claims but not even a single claim was finalized. Insofar as the United India Insurance Company received 2431 claims and it could finalize only 26 claims. The National Insurance Company which has received 2962 claims could finalize only 85 claims. Division Bench further observed that it is a well settled law that while interpreting the provisions/clauses, the ground realities should be borne in mind and whether the claims made are bonafide or purposely delayed has to be determined on the facts of each case. In such circumstances the Commission was perfectly right in set aside the rejection order of not entertaining the claims of the respondents on the ground of delayed submission and was justified in issuing directions to the appellant to register the claims and process the claims on merits without reference to the delay in submission of the claims and dismissed the appeals.
The brief facts necessary for disposal of these appeals are that the complainants/ respondents herein being aggrieved over the rejection of their insurance claims, stating that within 15 days of the alleged loss/damage of the insured properties the policy holders have not submitted their claims, filed complaints before the J&K State Consumer Disputes Redressal Commission, Srinagar. The case of the claimants before this Commission was that they have insured their buildings/goods with the appellant under policy Nos. 421008/48/14/3600000131 and 421001/11/13/3100000936 and due to the unprecedented floods faced in Srinagar in 2014 their buildings/goods which were having insurance coverage, were damaged and the respondents lodged insurance claims on 20/11/2014 and27/11/2015 respectively i.e. after 81 and 83 days of loss. The said claims were not entertained by the appellant-Company for the reason that claims for indemnification of loss could be lodged within 15 days as per the terms and conditions of the Insurance Policy and the policy does not allow admission of any such claim and assumes no risk in case the claim is beyond the period prescribed under the policy of insurance. According to the appellant, the Insurance Company was accepting intimations up to 01/10/2014 for flood victims, keeping in view the sensitivity of the floods. The Commission, relying on the Circular issued by the Insurance Regulatory and Development Authority dated 20/09/2011, set aside the rejection order as the claimants were presumptively prevented by the situation due to Jhelum flood of September, 2014 which reduced Srinagar City to a ghost city during which time even offices of Insurance Company were totally disarrayed and directed the appellant to register the claims and settle the same on merits according to law. (JNF) |
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