DB directive on flood claims

Excelsior Correspondent
SRINAGAR, May 18: Division Bench of State High Court comprising Chief Justice N Paul Vasanthakumar and Justice Ali Mohammad Magrey today directed the insurance companies to consider belated flood 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.
After hearing Advocate J A Kawoosa for the insurance company whereas Advocate S M Ayoub for the complainant, Division Bench dismissed the appeal of insurance company with the direction to register and process the claims on merits without reference to the delay in submission of the same.
“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 losses up to 01.10.2014”, DB said, adding “moreover, this Court in CMP No. 3/2014 in PIL No. 1-Gupkar/2014 ( G A Lone and Another Versus Union of India and Others dated 01.10.2014) noticed the number of claims received by the insurance companies including that of the appellant and insofar as the Bajaj Allianz 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”.
“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 is concerned, it received 2431 claims and could finalize only 26 claims. The National Insurance Company which has received 2962 claims could finalize only 85 claims. Thus it is clear that even the claims received in time could not be settled due to flood situation prevailing as the insurance companies could not assess the damages through surveyors”, the DB said.
“It is thus beyond doubt that when the insurance companies themselves could not process the claims submitted within time, they cannot be permitted to plead that the insured were not prevented due to floods in submitting their claims within the stipulated time”, the DB said, adding “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 Consumer Disputes Redressal Commission was perfectly right in setting 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”, the DB said.