The following case highlights the need to retain all vouchers, bills and payment records in case a claim happens in the absence of which the loss assessed by the surveyor will be taken as final.
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Case Details
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Ram Singh aged 45 years, s/o Naranjan Singh r/o Village & Post Office: Badala, Tehsil and Distt. Amritsar at present r/o village Dhoot Kalan, Block Bhunga, Tehsil and District Hoshiarpur.
.......... Complainant
versus
1. United India Insurance Co. Ltd., G.T. Road, Dasuya, Distt. Hoshiarpur, through its Branch Manager.
2.
ICICI Bank Ltd., Ist Floor, 36, The Mall, Amritsar, through its Branch Manager.
........... Opposite Parties
1. The complainant namely Ram Singh has filed the present complaint, under Section 12 of the Consumer Protection Act, 1986 (as amended upto date) “herein after referred as the Act”. Stated briefly, the facts of the case are that the vehicle bearing registration No. PB02-AR-9946 was under HPA through OP No. 2. That OP No. 2 got insured the said vehicle from OP No. 1 – United India Insurance Co. Ltd.
2.
It is the allegation of the complainant that on 26.1.2007, the said vehicle was being driven by Sh. Jaswant Singh from Bhunga to Hoshiarpur.That when the said vehicle reached near village Abbowal, it met with an accident with tractor trolley. The driver, Jaswant Singh was holding a valid driving licence. The vehicle was badly damaged in the accident. The matter was reported to PS Hariana on 31.1.2007. The complainant also informed the opposite party about the accident. The opposite party deputed the surveyor.
3.
It is further the case of the complainant that he got repaired the said vehicle from Basra Sales Corporation and Manohar Auto Diesel and Electricals. M/s. M.L. Mehta & Company, the surveyor assessed the net loss to the tune of Rs. 58,216.73, whereas the complainant had spent the amount of Rs. 1,13,822/- on the repair of the vehicle. The detail of the amount spent upon the repair of the vehicle had been given vide para No. 4 of the complaint.
4.
It is the allegation of the complainant that the opposite party No. 1 had not allowed the payment of the actual loss. It is prayed that the OP No. 1 may be directed to pay Rs. 1,13,822/- alongwith interest and litigation costs.
5.
The OP No. 1 filed the reply. The preliminary objections vis-a-vis maintainability, pre-mature, suppression of material facts and cause of action were raised. On merits, the claim put forth by the complainant has been denied. However, it is admitted that the vehicle No. PB-02-AR-9946 was insured with the replying OP. It is denied that the accident took place on 26.1.2007. That DDR No. 8 dated 31.1.2007 is a result of manipulation with the police of PS Hariana to get the false claim. It is denied that the replying OP allowed the complainant to get the vehicle repaired.
6.
It is further replied that the preliminary survey was conducted by Mr. Sham Sunder Sharma, who submitted his report dated 21.2.2007, and thereafter, a final survey report dated 20.9.2007 was obtained from M.L. Mehta and Co., Surveyor and Loss Assessors, who after considering the estimate bills of M/s. Basra Sales Corporation, Jalandhar and M/s. Bachan Brothers, Denting Works, Jalandhar, assessed the loss to the tune of Rs. 58,216.73. It is denied that the complainant has spent the amount of Rs. 1,13,822/- on the repair of the vehicle. It is denied that the complainant got the vehicle repaired from M/s. Basra Sales Corporation and Manohar Auto Diesel and Electricals. The bills as per detail given under Sr. No. (i) to (x) in para No. 4 of the complaint had not been submitted to the replying OP at the time of assessment of the loss to the vehicle. The other alleged bills mentioned under Sr. No. (i) to (x) in para No. 4 of the complaint regarding repair had been manipulated to get false claim.
7.
The OP No. 2 was proceeded against ex-parte on 18.3.2009.
8.
In order to prove the case, the complainant tendered in evidence his affidavit – Ex. C-1, copy of insurance policy – Mark-A, survey report dated 20.9.2007 – Ex. C-2, copy of RC – Mark-B, original cheque dated 15.1.2009 – Ex. C-3, another cheque dated 15.1.2009 – Ex. C-4, DDR dated 31.1.2007 – Ex. C-5, copy of DL dated 9.3.2006 – Mark-C, bill dated 1.10.2008- Mark-D, bills – Mark-E, Mark-F, bill dated 3.1.2009 – Mark-G, bills dated 3.9.2008 – Mark-H, Mark-J, bill dated 31.3.2009 – Mark-K, bills dated 17.4.2007 – Mark-L, Mark-M, Mark-N, bill dated 2.1.2009 – Mark-O, bill dated 20.3.2007 – Mark-P, bill dated 8.4.2007 – Mark-Q, bill dated 3.4.2007 – Mark-R, receipt of Parking charges – Mark-S, Fee for survey – Mark-T, Labour charges – Mark-U, affidavit of Sh. Harish Kumar – Ex. C-6 and closed the evidence.
9.
In rebuttal, the OP No. 1 tendered in evidence affidavit of Ashwani Verma – Ex. OP-2, additional affidavit of Ashwani Verma- Ex. OP-3, Motor Survey report dated 21.2.2007 – Mark OP-4 (3 sheets), estimate of Basra Sales Corporation – Mark OP-5 (4 sheets), estimate of Bachan Brothers – Mark OP-6 (2 sheets), photocopy of DDR – Mark OP-7, letter dated 29.1.2009 – Mark OP-8 and closed the evidence on behalf of OP NO. 1.
10.
The learned counsel for the complainant and OP No. 1 filed written arguments. We have gone through the written submissions and record of the file minutely.
11.
The other facts are admitted. The complainant has claimed that OP No. 1 may be directed to pay Rs. 1,13,822/- alongwith interest and litigation costs, whereas OP No. 1 – Insurance Company had raised the plea that the surveyor has assessed the net loss to the tune of Rs. 58,216.73. Therefore, the only point which calls determination from this Court is whether the complainant is entitled for the amount of Rs. 1,13,822/- or Rs. 58,216.73?
12.
The OP No. 1 filed the written arguments. That vide Para No. 4, at Page No. 4 of the written arguments, the OP No. 1 had stated that they are ready to pay the amount assessed by the Surveyor qua Survey Report – Ex. OP-1 dated 20.9.2007 subject to deduction of Rs. 2,500/-, the value of salvage.
13.
The complainant has produced on record the Invoices/Bills – Mark-D to Mark-H, Mark-J to Mark-R. Admittedly, the complainant has neither produced on record the receipts nor the affidavits of the persons to whom the payment was made to prove the actual payment, therefore, it loses its evidentiary value and on the contrary, the OP-1 has placed on record the report of the M/s. M.L. Mehta & Co., the surveyor & loss assessor – Ex. OP-1, qua which the nett. loss to the vehicle in dispute had been assessed to the tune of Rs.58,216.73. Since the complainant has failed to produce the receipts to prove the payment of Rs.1,13,822/-, therefore,the report of the Surveyor qua Ex. OP-1 is to be accepted as the Surveyor is an expert and also an independent person to assess the damage caused to the vehicle of the complainant , thus, we are of the opinion that the claim of the complainant can be allowed on the basis of the Survey Report – Ex. OP-1.
14.
As a result of the above discussion, the complaint is accepted and the opposite party No. 1 is directed to pay Rs.58,216.73 to the complainant with interest @ 9 % per annum from the date of filing the complaint i.e. 27.1.2009 till realization alongwith litigation expenses of Rs.1000/- within one month. Copy of the order be sent to the parties free of cost. File be consigned to the record.
Thursday, June 30, 2011
Tuesday, June 28, 2011
Is a surveyor an investigator or only an assessor?
Well this case is one that should be posed to may a surveyor and it might just rub them the wrong way. The question that I can take away from this case is "Is a surveyor an investigator or only an assessor?" Looks like the answer is a surveyor is only an assessor and not an investigator. Well do you like it. Let me know.
The claim details are as under
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Claim Details
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M/s. Sood Chemical Industries (P) Ltd., New Abadi, Hoshiarpur, through Sh. Sheel Sood, Director.
.......... Complainant
versus
1.
United India Insurance Co.Ltd., Jalandhar Road, Hoshiarpur, through its Branch Manager.
2.
United India Insurance Co.Ltd., Regd. Office: 24, Whites Road, Chennai.
3.
Jasjit Vij, Surveyor, M/s. Vij Engineers Enterprise, Surveyor & Loss Assessor, BMC Chowk, Jalandhar City.
........... Opposite Parties
1.
The complainant namely M/s. Sood Chemical Industries (P) Ltd., has filed the present complaint thought its Director, Sh. Sheel Sood, under Section 12 of the Consumer Protection Act, 1986 (as amended upto date) “hereinafter referred as the Act”. Put briefly, the facts of the case are that the complainant-company is having its godown situated at Bharwain Road in the revenue estate of village Sukhiawad. The complainant company on 13.8.2008 was having in its stock huge quantity of chemicals and other material alongwith barrels. The detail has been given vide para No. 3 of the complaint.
2.
It is further the case of the complainant that the goods lying in the godown were duly insured with opposite parties No. 1 and 2. It is further the case of the complainant that the company purchased standard fire and special perils policy from opposite parties No. 1 and 2 on 30.4.2008 valid upto 29.4.2009. The complainant paid Rs. 5393.00 as premium on 1.5.2008 to opposite parties No. 1 and 2.
3.
It is further the case of the complainant that on 13.8.2008, there were unprecedented rains in the area and because of that the water entered in the premises/godown of the complainant and caused heavy loss. The detail of the loss had been given vide para No. 5 of the complaint. That the complainant suffered loss to the tune of Rs. 2,36,342.40 on account of flushing away of the material and empty barrels due to unprecedented rains. The complainant reported the matter to PS Sadar and DDR No. 22 was recorded and the complainant also lodged the claim with opposite parties No. 1 and 2, who in turn appointed the surveyor to assess the loss.
4.
It is the allegation of the complainant that it was to his surprise that the surveyor – OP No. 3 on 1.11.2008, wrote a letter that he met the representative of the complainant. The broken locks of main gate and drums were lying there in tilted position and there was no loss of any stock/material. That the representative of the complainant told that the locks of main gate got broken due to impact of water and chemical drums washed away, which is unbelievable. That the fire policy does not cover theft of stocks. It is further averred that the surveyor – OP No. 3 for certain reasons prepared the survey report to the detriment of the complainant. It is further averred that the surveyor did not contact the representative of the complainant-company nor he visited the site in order to assess the loss on the spot. The surveyor prepared the report while sitting in his office. The complainant made a request to the opposite parties No. 1 and 2 to admit the claim, but of no consequences, hence this complaint.
5.
The opposite parties No. 1 and 2 filed the joint reply. The preliminary objections vis-a-vis maintainability, jurisdiction, estoppel and non-joinder of necessary parties were raised. On merits, the claim put forth by the complainant has been denied. It is denied that the Godown of the complainant situated at Bharwain Road, Hoshiarpur is insured with the replying opposite parties. As per insurance policy, the property of the complainant situated at Nai Abadi, Hoshiarpur was insured. However, it is admitted that the complainant obtained the fire policy from the replying opposite parties, which was valid from 30.4.2008 to 29.4.2009. It is admitted that the intimation regarding the alleged loss dated 13.8.2008 was given to the replying opposite parties, and thereafter, OP No. 3 was deputed to assess the loss.
6.
It is further replied that OP No. 3 visited the spot and clicked the photographs of the building alleged to be a godown of the insured. The lock was lying broken. That no loss can be caused as alleged by the complainant and fraud is being played with the insurance company to get a false claim. It is admitted that the loss due to flood is covered by the insurance policy. The claim was rightly repudiated by the insurance company, as per survey report dated 18.9.2008. The repudiation of the claim vide letter dated 24.9.2008 is legal.
7.
The opposite party No. 3 was proceeded against ex-parte on 11.5.2009.
8.
In order to prove the case, the complainant tendered in evidence affidavit of Sheel Sood – Ex. C-1, copy of DDR – Mark C-1, copy of claim form – Mark C-2, copy of Policy – Mark C-3, copy of Cover Note – Mark C-4, copy of Resolution – Mark C-5, copy of letter of Insurance Company – Mark C-6, copy of letter by complainant – Mark C-7, copy of bills – Mark C-8, Mark C-9 and Mark C-10 and closed the evidence on behalf of the complainant.
9.
In rebuttal, the opposite parties No. 1 and 2 tendered in evidence Insurance Policy – Ex. OP-1, letter dated 24.9.2008 – Ex.OP-2, letter dated 18.9.2008 of M/s. Vij Engineers – Ex. OP-3, photographs – Ex. OP-4 and Ex. OP-5, affidavit of Sh. S.K. Aggarwal, Divisional Manager, United India Insurance Company Ltd., Hoshiarpur – Ex.OP-6, and affidavit of Sh. Jasjit Singh, Prop., M/s. Vij Engineers Enterprises – Ex. OP-7.
10.
That vide order dated 19.8.2009, the opposite parties No. 1 and 2 – insurance company were allowed to place on record the copy of the Survey Report dated 18.9.2008.
11.
The learned counsel for the complainant and opposite parties No. 1 and 2 have filed written arguments. We have gone through the written submissions and record of the file minutely.
12.
The learned counsel for the opposite parties No. 1 and 2, Sh. Brij Thakur argued that the property of the complainant situated at Nai Abadi, Hoshiarpur was insured with the insurance company. It was further argued that as the Godown of the complainant situated at Bharwain Road, Hoshiarpur is not insured with the insurance company, therefore, the complaint deserves to be dismissed. The learned counsel for opposite parties No. 1 and 2 made a reference to the insurance policy – Ex. OP-1 and on its title page, it has been recorded that the property of the complainant situated at Nai Abadi, Hoshiarpur was insured, whereas the alleged loss pertains to the property, situated at Bharwain Road, which is not covered under the policy – Ex. OP-1.
13.
The learned counsel for opposite parties No. 1 and 2 further argued that the claim was repudiated by the insurance company as per the recommendation of the Surveyor qua Ex. OP-2 and Ex. OP-3. It was argued that Ex. OP-2 is a repudiation letter dated 24.9.2008. The claim has been repudiated by the insurance company on the following ground :
“As per Survey Report the loss is outside the scope of policy.”
13.
Ex. OP-3 is a letter written by M/s. Vij Engineer's Enterprise, Surveyors and Loss Assessors, Jalandhar City dated 18.9.2008, wherein it has been stated by the Surveyor that “chemical barrels washed away due to flood water after breaking lock of main gate which is beyond believable and unknown person took away chemical barrels. There was no loss to chemical barrels under the fire policy, so, claimed loss is outside the scope of policy.
14.
Now, the points which call determination from this Court are :
i) Whether the godown of the complainant was insured with opposite parties No. 1 and 2.
ii) Whether the loss suffered by the complainant is covered by the insurance policy.
iii) What is the loss caused to the complainant?
15.
The complainant has produced the Cover Note – Mark C-4 issued by opposite parties No. 1 and 2 on the record. The close scrutiny of the said Cover Note clearly depicts that the godown situated at Sukhiabad, Bharwain Road, Hoshiarpur belonging to M/s. Sood Chemical Industries Pvt. Ltd., Nai Abadi, Hoshiarpur was insured by the opposite parties No. 1 and 2 – insurance company. The relevant portion of the Cover Note under the Head “Property Insured & Terms” - Mark C-4 is reproduced as under :-
“On stock of Rosin & other like chemicals including other items pertaining to insured trade wholst stored/lying in A-Class godown at Sukhiabad, Bharwain Road, Hoshiarpur of M/s. Sood Chemical Industries Pvt. Ltd., Nai Abadi, Hoshiarpur.”
16.
The learned counsel for the opposite parties No. 1&2 submitted that the Cover Note is valid only for 30 days, and thereafter, the insurance policy is issued, therefore, the complainant cannot draw any advantage from the Cover Note issued by the insurance company, referred to above.
17.
This limb of the argument raised by the learned counsel for the insurance company did not hold any water, as the Cover Note – Mark C-4 had been issued by insurance company-opposite parties No. 1 and 2, and none else, and insurance company cannot take departure from its recitals. Since qua Mark C-4, it is specifically recorded/depicted that the godown situated at Sukhiabad, Bharwain Road, Hoshiarpur belonging to M/s. Sood Chemical Industries Pvt. Ltd., was insured, therefore, it is held that the godown of the complainant situated at Sukhiabad, Bharwain Road, Hoshiarpur, was insured with the opposite parties No. 1 and 2 – insurance company. It will not be out of place to state that the insurance policy is to be issued on the basis of the Cover Note issued by the insurance company and in this case, on the basis of the Cover Note – Mark C-4. Therefore, it can be held without any hesitation that the Cover Note – Mark C-4 is the basis to prepare the Insurance Policy – Ex. OP-1 and Mark C-3.
18.
The opposite parties have repudiated the claim of the complainant qua – Ex. OP-2 on the ground that as per survey report the loss is outside the scope of policy. Ex. OP-2 is repudiation letter and Ex. OP-3 is a letter dated 18.9.2008 written by M/s. Vij Engineer's Enterprises, Surveyors and Loss Assessors to the insurance company, wherein it has been stated that “chemical barrels washed away due to flood water after breaking the lock of main gate,which is beyond believable and unknown person took away chemical barrels. We do not find any loss to chemical barrels under fire policy. So, claimed loss is outside the scope of policy.”
19.
The learned counsel for the complainant argued that the surveyor is not an investigator. That the duty of the surveyor is to assess the loss to the property. The complainant has produced on record the copy of the DDR – Mark CA dated 13.8.2008 recorded with PS Sadar, Hoshiarpur, wherein it has been recorded that at Sukhiabad there is a godown of Sood Chemical Industry. The water has entered in the godown, causing loss to chemicals. The complainant has alleged in the complaint that on 13.8.2008, there were unprecedented rains in the area and because of that the water entered into the premises/godown and caused heavy loss. The said averment contained in the complaint is supported by the DDR – Mark CA. In view of this, the letter of Surveyor and Loss Assessor – Ex. OP-3, wherein it has been recorded that unknown person took away chemical barrels is not sufficient to conclude that the loss is caused by theft and not by flood water. That vide para No. 12 of the reply, the opposite parties No. 1 and 2 had specifically admitted that the loss due to flood is covered by the policy – Ex. OP-1.
20.
The D.D.R. - Mark CA has been recorded by the policy – government officials in the discharge of their official functions, consequently it is held that the loss has been caused due to flood/unprecedented rains. The letter written by the Surveyor – Ex. OP-3 is not sufficient to rebut the DDR dated 13.8.2008 – Mark CA. Moreso, the DDR has been recorded on the day,the occurrence took place.
21.
The complainant has produced on record the bills – Mark C-8 to Mark C-10 to prove the loss. Mark C-8 is an invoice dated 6.6.2008 of Rs. 95,001/- issued by New Tech Polymers (India), Mark C-9 is a bill dated 18.7.2008 of Rs. 56,160/- issued by Bassi Mroof Gram Udyog and Mark C-10 is an invoice of Cardinal Resins dated 8.8.2008 of Rs. 1,21,150/-. The documents – Mark C-8 to Mark C-10, referred to above, go unrebutted, as the opposite parties No. 1 and 2 – insurance company had not got assessed the loss. However, it has been clarified vide para No. 5 of the complaint that the complainant has actually suffered the loss to the tune of Rs. 2,36,342.40, therefore, in the circumstances, it is held that the complainant is entitled for compensation of Rs.2,36,342.40/-.
22.
The learned counsel for the opposite parties No. 1 and 2 - insurance company submitted that since the loss caused to the complainant is not proved, therefore, the matter should be referred to the Civil Court. The reliance was placed on 2008(3) CPR 292 (NC), United India Insurance Co. Ltd. Versus M/s. Sri Dwarika Dhees Industries. Since the complainant to prove the loss has produced on record the bills/invoices – Mark C-8 to Mark C-10 and the said bills/invoices go unrebutted, therefore, it does not lie in the mouth of the ld. Counsel for opposite parties No. 1 and 2 that the loss caused to the complainant has not been proved. Since the opposite parties No. 1 and 2 have failed to make the payment of Rs. 2,36,342.40, it amounts to deficiency in service on their part.
23.
As a result of the above discussion, the complaint of the complainant is accepted and the opposite parties No. 1 and 2 are directed to pay Rs. 2,36,342.40 with interest @ 9% per annum from the date of filing of complaint i.e. 27.3.2009 till realization. Litigation expenses are assessed at Rs. 2,000/- to be paid by the opposite parties No. 1 and 2 to the complainant within one month from the date of receipt of copy of the order. Copy of the order be sent to the parties free of cost. File be consigned to the record room.
The claim details are as under
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Claim Details
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M/s. Sood Chemical Industries (P) Ltd., New Abadi, Hoshiarpur, through Sh. Sheel Sood, Director.
.......... Complainant
versus
1.
United India Insurance Co.Ltd., Jalandhar Road, Hoshiarpur, through its Branch Manager.
2.
United India Insurance Co.Ltd., Regd. Office: 24, Whites Road, Chennai.
3.
Jasjit Vij, Surveyor, M/s. Vij Engineers Enterprise, Surveyor & Loss Assessor, BMC Chowk, Jalandhar City.
........... Opposite Parties
1.
The complainant namely M/s. Sood Chemical Industries (P) Ltd., has filed the present complaint thought its Director, Sh. Sheel Sood, under Section 12 of the Consumer Protection Act, 1986 (as amended upto date) “hereinafter referred as the Act”. Put briefly, the facts of the case are that the complainant-company is having its godown situated at Bharwain Road in the revenue estate of village Sukhiawad. The complainant company on 13.8.2008 was having in its stock huge quantity of chemicals and other material alongwith barrels. The detail has been given vide para No. 3 of the complaint.
2.
It is further the case of the complainant that the goods lying in the godown were duly insured with opposite parties No. 1 and 2. It is further the case of the complainant that the company purchased standard fire and special perils policy from opposite parties No. 1 and 2 on 30.4.2008 valid upto 29.4.2009. The complainant paid Rs. 5393.00 as premium on 1.5.2008 to opposite parties No. 1 and 2.
3.
It is further the case of the complainant that on 13.8.2008, there were unprecedented rains in the area and because of that the water entered in the premises/godown of the complainant and caused heavy loss. The detail of the loss had been given vide para No. 5 of the complaint. That the complainant suffered loss to the tune of Rs. 2,36,342.40 on account of flushing away of the material and empty barrels due to unprecedented rains. The complainant reported the matter to PS Sadar and DDR No. 22 was recorded and the complainant also lodged the claim with opposite parties No. 1 and 2, who in turn appointed the surveyor to assess the loss.
4.
It is the allegation of the complainant that it was to his surprise that the surveyor – OP No. 3 on 1.11.2008, wrote a letter that he met the representative of the complainant. The broken locks of main gate and drums were lying there in tilted position and there was no loss of any stock/material. That the representative of the complainant told that the locks of main gate got broken due to impact of water and chemical drums washed away, which is unbelievable. That the fire policy does not cover theft of stocks. It is further averred that the surveyor – OP No. 3 for certain reasons prepared the survey report to the detriment of the complainant. It is further averred that the surveyor did not contact the representative of the complainant-company nor he visited the site in order to assess the loss on the spot. The surveyor prepared the report while sitting in his office. The complainant made a request to the opposite parties No. 1 and 2 to admit the claim, but of no consequences, hence this complaint.
5.
The opposite parties No. 1 and 2 filed the joint reply. The preliminary objections vis-a-vis maintainability, jurisdiction, estoppel and non-joinder of necessary parties were raised. On merits, the claim put forth by the complainant has been denied. It is denied that the Godown of the complainant situated at Bharwain Road, Hoshiarpur is insured with the replying opposite parties. As per insurance policy, the property of the complainant situated at Nai Abadi, Hoshiarpur was insured. However, it is admitted that the complainant obtained the fire policy from the replying opposite parties, which was valid from 30.4.2008 to 29.4.2009. It is admitted that the intimation regarding the alleged loss dated 13.8.2008 was given to the replying opposite parties, and thereafter, OP No. 3 was deputed to assess the loss.
6.
It is further replied that OP No. 3 visited the spot and clicked the photographs of the building alleged to be a godown of the insured. The lock was lying broken. That no loss can be caused as alleged by the complainant and fraud is being played with the insurance company to get a false claim. It is admitted that the loss due to flood is covered by the insurance policy. The claim was rightly repudiated by the insurance company, as per survey report dated 18.9.2008. The repudiation of the claim vide letter dated 24.9.2008 is legal.
7.
The opposite party No. 3 was proceeded against ex-parte on 11.5.2009.
8.
In order to prove the case, the complainant tendered in evidence affidavit of Sheel Sood – Ex. C-1, copy of DDR – Mark C-1, copy of claim form – Mark C-2, copy of Policy – Mark C-3, copy of Cover Note – Mark C-4, copy of Resolution – Mark C-5, copy of letter of Insurance Company – Mark C-6, copy of letter by complainant – Mark C-7, copy of bills – Mark C-8, Mark C-9 and Mark C-10 and closed the evidence on behalf of the complainant.
9.
In rebuttal, the opposite parties No. 1 and 2 tendered in evidence Insurance Policy – Ex. OP-1, letter dated 24.9.2008 – Ex.OP-2, letter dated 18.9.2008 of M/s. Vij Engineers – Ex. OP-3, photographs – Ex. OP-4 and Ex. OP-5, affidavit of Sh. S.K. Aggarwal, Divisional Manager, United India Insurance Company Ltd., Hoshiarpur – Ex.OP-6, and affidavit of Sh. Jasjit Singh, Prop., M/s. Vij Engineers Enterprises – Ex. OP-7.
10.
That vide order dated 19.8.2009, the opposite parties No. 1 and 2 – insurance company were allowed to place on record the copy of the Survey Report dated 18.9.2008.
11.
The learned counsel for the complainant and opposite parties No. 1 and 2 have filed written arguments. We have gone through the written submissions and record of the file minutely.
12.
The learned counsel for the opposite parties No. 1 and 2, Sh. Brij Thakur argued that the property of the complainant situated at Nai Abadi, Hoshiarpur was insured with the insurance company. It was further argued that as the Godown of the complainant situated at Bharwain Road, Hoshiarpur is not insured with the insurance company, therefore, the complaint deserves to be dismissed. The learned counsel for opposite parties No. 1 and 2 made a reference to the insurance policy – Ex. OP-1 and on its title page, it has been recorded that the property of the complainant situated at Nai Abadi, Hoshiarpur was insured, whereas the alleged loss pertains to the property, situated at Bharwain Road, which is not covered under the policy – Ex. OP-1.
13.
The learned counsel for opposite parties No. 1 and 2 further argued that the claim was repudiated by the insurance company as per the recommendation of the Surveyor qua Ex. OP-2 and Ex. OP-3. It was argued that Ex. OP-2 is a repudiation letter dated 24.9.2008. The claim has been repudiated by the insurance company on the following ground :
“As per Survey Report the loss is outside the scope of policy.”
13.
Ex. OP-3 is a letter written by M/s. Vij Engineer's Enterprise, Surveyors and Loss Assessors, Jalandhar City dated 18.9.2008, wherein it has been stated by the Surveyor that “chemical barrels washed away due to flood water after breaking lock of main gate which is beyond believable and unknown person took away chemical barrels. There was no loss to chemical barrels under the fire policy, so, claimed loss is outside the scope of policy.
14.
Now, the points which call determination from this Court are :
i) Whether the godown of the complainant was insured with opposite parties No. 1 and 2.
ii) Whether the loss suffered by the complainant is covered by the insurance policy.
iii) What is the loss caused to the complainant?
15.
The complainant has produced the Cover Note – Mark C-4 issued by opposite parties No. 1 and 2 on the record. The close scrutiny of the said Cover Note clearly depicts that the godown situated at Sukhiabad, Bharwain Road, Hoshiarpur belonging to M/s. Sood Chemical Industries Pvt. Ltd., Nai Abadi, Hoshiarpur was insured by the opposite parties No. 1 and 2 – insurance company. The relevant portion of the Cover Note under the Head “Property Insured & Terms” - Mark C-4 is reproduced as under :-
“On stock of Rosin & other like chemicals including other items pertaining to insured trade wholst stored/lying in A-Class godown at Sukhiabad, Bharwain Road, Hoshiarpur of M/s. Sood Chemical Industries Pvt. Ltd., Nai Abadi, Hoshiarpur.”
16.
The learned counsel for the opposite parties No. 1&2 submitted that the Cover Note is valid only for 30 days, and thereafter, the insurance policy is issued, therefore, the complainant cannot draw any advantage from the Cover Note issued by the insurance company, referred to above.
17.
This limb of the argument raised by the learned counsel for the insurance company did not hold any water, as the Cover Note – Mark C-4 had been issued by insurance company-opposite parties No. 1 and 2, and none else, and insurance company cannot take departure from its recitals. Since qua Mark C-4, it is specifically recorded/depicted that the godown situated at Sukhiabad, Bharwain Road, Hoshiarpur belonging to M/s. Sood Chemical Industries Pvt. Ltd., was insured, therefore, it is held that the godown of the complainant situated at Sukhiabad, Bharwain Road, Hoshiarpur, was insured with the opposite parties No. 1 and 2 – insurance company. It will not be out of place to state that the insurance policy is to be issued on the basis of the Cover Note issued by the insurance company and in this case, on the basis of the Cover Note – Mark C-4. Therefore, it can be held without any hesitation that the Cover Note – Mark C-4 is the basis to prepare the Insurance Policy – Ex. OP-1 and Mark C-3.
18.
The opposite parties have repudiated the claim of the complainant qua – Ex. OP-2 on the ground that as per survey report the loss is outside the scope of policy. Ex. OP-2 is repudiation letter and Ex. OP-3 is a letter dated 18.9.2008 written by M/s. Vij Engineer's Enterprises, Surveyors and Loss Assessors to the insurance company, wherein it has been stated that “chemical barrels washed away due to flood water after breaking the lock of main gate,which is beyond believable and unknown person took away chemical barrels. We do not find any loss to chemical barrels under fire policy. So, claimed loss is outside the scope of policy.”
19.
The learned counsel for the complainant argued that the surveyor is not an investigator. That the duty of the surveyor is to assess the loss to the property. The complainant has produced on record the copy of the DDR – Mark CA dated 13.8.2008 recorded with PS Sadar, Hoshiarpur, wherein it has been recorded that at Sukhiabad there is a godown of Sood Chemical Industry. The water has entered in the godown, causing loss to chemicals. The complainant has alleged in the complaint that on 13.8.2008, there were unprecedented rains in the area and because of that the water entered into the premises/godown and caused heavy loss. The said averment contained in the complaint is supported by the DDR – Mark CA. In view of this, the letter of Surveyor and Loss Assessor – Ex. OP-3, wherein it has been recorded that unknown person took away chemical barrels is not sufficient to conclude that the loss is caused by theft and not by flood water. That vide para No. 12 of the reply, the opposite parties No. 1 and 2 had specifically admitted that the loss due to flood is covered by the policy – Ex. OP-1.
20.
The D.D.R. - Mark CA has been recorded by the policy – government officials in the discharge of their official functions, consequently it is held that the loss has been caused due to flood/unprecedented rains. The letter written by the Surveyor – Ex. OP-3 is not sufficient to rebut the DDR dated 13.8.2008 – Mark CA. Moreso, the DDR has been recorded on the day,the occurrence took place.
21.
The complainant has produced on record the bills – Mark C-8 to Mark C-10 to prove the loss. Mark C-8 is an invoice dated 6.6.2008 of Rs. 95,001/- issued by New Tech Polymers (India), Mark C-9 is a bill dated 18.7.2008 of Rs. 56,160/- issued by Bassi Mroof Gram Udyog and Mark C-10 is an invoice of Cardinal Resins dated 8.8.2008 of Rs. 1,21,150/-. The documents – Mark C-8 to Mark C-10, referred to above, go unrebutted, as the opposite parties No. 1 and 2 – insurance company had not got assessed the loss. However, it has been clarified vide para No. 5 of the complaint that the complainant has actually suffered the loss to the tune of Rs. 2,36,342.40, therefore, in the circumstances, it is held that the complainant is entitled for compensation of Rs.2,36,342.40/-.
22.
The learned counsel for the opposite parties No. 1 and 2 - insurance company submitted that since the loss caused to the complainant is not proved, therefore, the matter should be referred to the Civil Court. The reliance was placed on 2008(3) CPR 292 (NC), United India Insurance Co. Ltd. Versus M/s. Sri Dwarika Dhees Industries. Since the complainant to prove the loss has produced on record the bills/invoices – Mark C-8 to Mark C-10 and the said bills/invoices go unrebutted, therefore, it does not lie in the mouth of the ld. Counsel for opposite parties No. 1 and 2 that the loss caused to the complainant has not been proved. Since the opposite parties No. 1 and 2 have failed to make the payment of Rs. 2,36,342.40, it amounts to deficiency in service on their part.
23.
As a result of the above discussion, the complaint of the complainant is accepted and the opposite parties No. 1 and 2 are directed to pay Rs. 2,36,342.40 with interest @ 9% per annum from the date of filing of complaint i.e. 27.3.2009 till realization. Litigation expenses are assessed at Rs. 2,000/- to be paid by the opposite parties No. 1 and 2 to the complainant within one month from the date of receipt of copy of the order. Copy of the order be sent to the parties free of cost. File be consigned to the record room.
Case shows why it is important to submit a complaint in a timely manner.
The following case shows that courts will not entertain a complaint if it does not fall within the time frame for making a complaint. Hence make sure that when a claim is repudiated by an insurance company you file a complaint as soon as possible. Else you might lose the battle even before it starts.
The details of the case are as follows.
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Case Details
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1. Shri Naginder Singh
2. Sudarshan Singh
3. Inder Singh
4. Ravinder Singh
5. Deepak Chauhan all sons of Sh. Het Ram, R/o Vill. Kotla Mahal, Tehsil rajgarh, Distt. Sirmaur, H.P.
… Complainants.
Versus
United India Insurance Co. Ltd.
Through its Branch Manager,Solan,
Distt. Solan. H.P. … Opposite party.
O R D E R:
This complaint has been filed by the complainant, by invoking the provisions of Section 12 of the Consumer Protection Act, 1986. The complainants aver that they are registered owner of a tractor bearing registration No.HP-16-0243, which was insured, by them, with the OP-Company, for a period of one year commencing from 20.01.2003 to 19.01.2004. They further aver that the aforesaid vehicle, unfortunately, met with an accident, on, 01.05.2003, during the currency of the insurance policy and suffered extensive damage. It is further averred that, the factum of the vehicle, having met, with an accident, was reported to the OP-Company, as also, to the Police. Thereafter, they lodged a insurance claim with the OP-Company, who instead of settling it, dilly-dallied the same on one ground or other. Hence, it is averred that, there is apparent deficiency in service on the part of the OP-Company and accordingly relief to the extent as detailed in the relief clause be awarded in favour of the complainant.
2. The OP-Company, in its written version, to the complaint, raised preliminary objections vis-à-vis maintainability of the complaint, and breach of terms and conditions of the insurance policy. On merits, it is contended that at the time of accident, two unauthorized passengers were traveling in the tractor. They have also contended that since the claim was repudiated vide letter dated 30.11.2004, hence, the complaint, being time barred, is not maintainable. Hence, it is denied, that, there was any deficiency in service on their part or that they have indulged in an unfair trade practice.
3. Thereafter, the parties adduced evidence, by way of affidavits, and, documents in support of their respective, contentions.
4. We have heard the learned counsel for the parties at length and have also thoroughly scanned the entire record of the case.
5. During the course of the arguments, the learned counsel for the OP-Company, has vigorously urged before us that the present complaint, filed by the complainants, before this forum is not maintainable, inasmuch, as it has been filed, on, 06.09.2007, whereas, the claim was repudiated as reflected in letter dated 30.11.2004, duly addressed to the complainant, hence, the complaint being time barred, is liable to be dismissed on this score alone.
6. As per the mandate of the Consumer Protection Act, 1986, as detailed in Section 24A, The District Forum, the State Commission or the National Commission, shall not admit a complaint, unless, it is filed within two years from the date on which the cause of action has arisen. In the present case, undisputedly, the accident took place on, 01.05.2003, and thereafter, the OP-Company vide Annexure OP-3, repudiated the claim of the complainant, on, 30.11.2004, whereas, the complaint came to be lodged before this Forum, on, 06.09.2007, i.e. after three years from the date of repudiation of the claim of the complainants by the OP-Company or the accrual of clause of action. The complainants have neither filed any application seeking condonation of delay nor have given any reasons in the complaint, for filing the complaint so belatedly.
7. Hence, without going into the merits of the case, the only conclusion, which is sprouting from the aforesaid conclusion, is, that the complaint filed by the complainants before this Forum, on, 06.09.2007, cannot be entertained by this forum, it, being hopelessly time barred. As such, it is to be held, that, their, is, belated delay on the parts of the complainants in approaching this Forum, for redressal of their grievances, which cannot be gone into by this forum, for lack of jurisdiction by this Forum. Hence, the complaint is dismissed, being hopelessly time barred. No order as to the cost.
9. The learned counsel for the parties undertook to collect the certified copy of this order from the office, free of cost, as per rules. The file after due completion, be consigned to record room.
The details of the case are as follows.
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Case Details
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1. Shri Naginder Singh
2. Sudarshan Singh
3. Inder Singh
4. Ravinder Singh
5. Deepak Chauhan all sons of Sh. Het Ram, R/o Vill. Kotla Mahal, Tehsil rajgarh, Distt. Sirmaur, H.P.
… Complainants.
Versus
United India Insurance Co. Ltd.
Through its Branch Manager,Solan,
Distt. Solan. H.P. … Opposite party.
O R D E R:
This complaint has been filed by the complainant, by invoking the provisions of Section 12 of the Consumer Protection Act, 1986. The complainants aver that they are registered owner of a tractor bearing registration No.HP-16-0243, which was insured, by them, with the OP-Company, for a period of one year commencing from 20.01.2003 to 19.01.2004. They further aver that the aforesaid vehicle, unfortunately, met with an accident, on, 01.05.2003, during the currency of the insurance policy and suffered extensive damage. It is further averred that, the factum of the vehicle, having met, with an accident, was reported to the OP-Company, as also, to the Police. Thereafter, they lodged a insurance claim with the OP-Company, who instead of settling it, dilly-dallied the same on one ground or other. Hence, it is averred that, there is apparent deficiency in service on the part of the OP-Company and accordingly relief to the extent as detailed in the relief clause be awarded in favour of the complainant.
2. The OP-Company, in its written version, to the complaint, raised preliminary objections vis-à-vis maintainability of the complaint, and breach of terms and conditions of the insurance policy. On merits, it is contended that at the time of accident, two unauthorized passengers were traveling in the tractor. They have also contended that since the claim was repudiated vide letter dated 30.11.2004, hence, the complaint, being time barred, is not maintainable. Hence, it is denied, that, there was any deficiency in service on their part or that they have indulged in an unfair trade practice.
3. Thereafter, the parties adduced evidence, by way of affidavits, and, documents in support of their respective, contentions.
4. We have heard the learned counsel for the parties at length and have also thoroughly scanned the entire record of the case.
5. During the course of the arguments, the learned counsel for the OP-Company, has vigorously urged before us that the present complaint, filed by the complainants, before this forum is not maintainable, inasmuch, as it has been filed, on, 06.09.2007, whereas, the claim was repudiated as reflected in letter dated 30.11.2004, duly addressed to the complainant, hence, the complaint being time barred, is liable to be dismissed on this score alone.
6. As per the mandate of the Consumer Protection Act, 1986, as detailed in Section 24A, The District Forum, the State Commission or the National Commission, shall not admit a complaint, unless, it is filed within two years from the date on which the cause of action has arisen. In the present case, undisputedly, the accident took place on, 01.05.2003, and thereafter, the OP-Company vide Annexure OP-3, repudiated the claim of the complainant, on, 30.11.2004, whereas, the complaint came to be lodged before this Forum, on, 06.09.2007, i.e. after three years from the date of repudiation of the claim of the complainants by the OP-Company or the accrual of clause of action. The complainants have neither filed any application seeking condonation of delay nor have given any reasons in the complaint, for filing the complaint so belatedly.
7. Hence, without going into the merits of the case, the only conclusion, which is sprouting from the aforesaid conclusion, is, that the complaint filed by the complainants before this Forum, on, 06.09.2007, cannot be entertained by this forum, it, being hopelessly time barred. As such, it is to be held, that, their, is, belated delay on the parts of the complainants in approaching this Forum, for redressal of their grievances, which cannot be gone into by this forum, for lack of jurisdiction by this Forum. Hence, the complaint is dismissed, being hopelessly time barred. No order as to the cost.
9. The learned counsel for the parties undertook to collect the certified copy of this order from the office, free of cost, as per rules. The file after due completion, be consigned to record room.
Non scientific construction of structure leads to dismissal of the claim
This is another interesting case where United India Insurance company was able to reject a claim based on the fact that the structure that was used was not built in a scientific manner. This case clearly shows that an owner of the property cannot get benefit from an insurance policy if the structure is badly built and this results in the claim or accident.
Details of the claim are given below.
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Claim Details
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Shri Yogeshwar Dutt S/o Shri Goria Ram,
R/O Paplota, PO Domehar, Tehsil Arki,
Distt. Solan (H.P.)
… Complainant
Versus
United India Insurance Company Ltd.
The Mall, Solan through its Branch Manager. …Opposite Party.
O R D E R:
Sureshwar Thakur (District Judge) President:- The instant complaint has been filed by the complainant, by invoking the provisions of Section 12 of the Consumer Protection Act, 1986. The complainant, avers that he being owner of the Brick kiln named and styled as B.K.G. Bricks Gram Udyog at village Paplota, P.O. Domehar, Tehsil Arki, District Solan, H.P., purchased one insurance policy bearing No.819767, on, 06.12.2005 from the OP-Company, which was valid upto 05.12.2006. He further alleged that on, 21.10.2006, the brick stock got fire and explosion, hence, the entire stock was destroyed in the said fire and explosion.
The complainant, further, proceeded to aver, that, the aforesaid fire incident, was brought to the notice of the OP-Company, as such, got the loss assessed. Thereafter, the complainant supplied the requisite documents to the OP-Company for settlement of the insurance claim, but the OP-Company, instead of settling his claim, repudiated the same, on, 01.04.2006, illegally and wrongly. Hence, it is averred that there is apparent deficiency in service on the part of the OP-Company and accordingly relief to the extent as detailed in the relief clause be awarded in favour of the complainant.
2. The OP-Company, in its written version, to the complaint, raised preliminary objections vis-à-vis maintainability of the complaint, inasmuch, as, that there is no cause of action, locus standi to file the present complaint, and non-joinder of necessary party. On merits, it is denied that the complainant purchased the insurance policy, rather, the same was issued in the name of HPSCDC Solan. It is also denied that the brick kiln was insured by the complainant.
They contend that a standard Fire and Special Perils Insurance policy bearing No.111301/11/05/11/00000645, w.e.f. 06.12.2005 to 05.12.2006, was purchased by HPSCD Corporation, Solan A/c Yogeshwar Dutt, from the OP-Company covering the risk of Plant and Machinery for Rs.2.00 lacs and stock of finished and unfinished goods for Rs.2.00 lacs. It is further contended that on the night of 21.01.2006, an explosion took place in the said kiln due to gas formation from the burning coal inside the kiln causing partial damage to the kiln, hence, only 25000 bricks were found to be broken and damaged on account of the aforesaid explosion, hence, it is denied that the total loss was caused to the brick kiln. They further contend that the brick kiln, was not covered by the insurance policy. Hence, it is denied, that, there was any deficiency in service on their part or that they have indulged in an unfair trade practice.
3. Thereafter, the parties adduced evidence, by way of affidavits, and, documents in support of their respective, contentions.
4. We have heard the learned counsel for the parties at length and have also thoroughly scanned the entire record of the case.
5. Undisputedly, the policy, as purchased by the complainant from the OP-Company, took within, its, ambit destruction or damage caused to the Brick Kiln, of the complainant. An explosion, took place, on, 21.01.2006 in the property of the complainant as insured with the OP-Company. The OP-Company succinctly has repudiated the claim of the complainant, on, the score of the purported cause of the explosion as had occurred in the Brick Kiln factory of the complainant, falling within the scope of the exclusionary clause, of, Annexure R-1, annexed with the file of the case, inasmuch, as, in the eventuality of the destruction having come to be caused to the insured property by, its, own fermentation, natural heating or spontaneous combustion, then, the liability of the OP-Company, to, indemnify the complainant the damage caused to the property insured, is, exculpated.
6. The OP-Company, to, sustain, its, contention, has relied upon Annexure R-2, which, is, the report of the Surveyor & Loss Assessor, in, which, he, has detailed the cause of explosion and which cause of fire/explosion in the Brick Kiln of the complainant, which, is, the property insured with the OP-Company, has been anvilled on, the strength of the statement of the complainant, in which he has attributed the said explosion, to gas formation, as had occurred in the ignited coal set, a, fire, to, bake the raw bricks. The cause of fire attributed in the report of the Loss Assessor, anvilled, on, the statement of the complainant, which statement exists, on, record, as, Annexure R-5, being neither controverted or repulsed and, its, perusal foisting truthfulness to the cause of explosion, in, the Brick Kiln as attributed in the report of the Loss Assessor, hence, assumes conclusiveness.
7. With the conclusion as formed above and with the existence on record of the photographs of the Brick Kiln, whose perusal divulges the fact that the complainant had taken to bake bricks in the Brick Kiln plant not designed in a scientific manner, rather, it being, a, plant fabricated by local methods, obviously, the act of the complainant in setting a fire, the coal heaped along with raw bricks, which ignited coal, admittedly, as, revealed in Annexure R-5 resulted, in, gas formation and explosion of the lot of bricks heaped in the Brick Kiln.
With the complainant admittedly having resorted not to bake bricks in a Brick Kiln Plant, fabricated in a scientific manner in accordance with an approved project, rather, his having taken to adopt local as well, as, unscientific methods, to bake bricks, which, local method, as, borne out by the admission of the complainant proved disastrous or in other words, when the, local methods, admittedly resulted, in, the explosion in the Brick Kiln, causing by gas formation, arising from the ignited coal used for baking of the bricks, hence, inevitably, given the square and unimpeachable admission, of, the complainant, we are led, hence, to the sequel, that, the OP-Company has been able to clinchingly prove, that, the cause of explosion admittedly as was caused by gas formation arising from the burning of coal used for baking bricks in a unscientifically fabricated Brick Kiln Plant, emphatically falls within the scope, of, the exclusionary clause, as referred, to, above.
8. With the OP-Company, having proved the cause of explosion in the Brick Kiln of the complainant having been caused by the facts falling within the exclusionary clause, accordingly, the repudiation of the claim of the complainant by it, was tenable, hence, no deficiency in service can be attributed on the part of the OP-Company.
9. Resultantly, the complaint deserves dismissal as such we dismiss the same. No order as to the costs. The learned counsel for the parties undertook to collect the certified copy of this order from the office, free of cost, as per rules. The file after due completion, be consigned to record room.
Details of the claim are given below.
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Claim Details
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Shri Yogeshwar Dutt S/o Shri Goria Ram,
R/O Paplota, PO Domehar, Tehsil Arki,
Distt. Solan (H.P.)
… Complainant
Versus
United India Insurance Company Ltd.
The Mall, Solan through its Branch Manager. …Opposite Party.
O R D E R:
Sureshwar Thakur (District Judge) President:- The instant complaint has been filed by the complainant, by invoking the provisions of Section 12 of the Consumer Protection Act, 1986. The complainant, avers that he being owner of the Brick kiln named and styled as B.K.G. Bricks Gram Udyog at village Paplota, P.O. Domehar, Tehsil Arki, District Solan, H.P., purchased one insurance policy bearing No.819767, on, 06.12.2005 from the OP-Company, which was valid upto 05.12.2006. He further alleged that on, 21.10.2006, the brick stock got fire and explosion, hence, the entire stock was destroyed in the said fire and explosion.
The complainant, further, proceeded to aver, that, the aforesaid fire incident, was brought to the notice of the OP-Company, as such, got the loss assessed. Thereafter, the complainant supplied the requisite documents to the OP-Company for settlement of the insurance claim, but the OP-Company, instead of settling his claim, repudiated the same, on, 01.04.2006, illegally and wrongly. Hence, it is averred that there is apparent deficiency in service on the part of the OP-Company and accordingly relief to the extent as detailed in the relief clause be awarded in favour of the complainant.
2. The OP-Company, in its written version, to the complaint, raised preliminary objections vis-à-vis maintainability of the complaint, inasmuch, as, that there is no cause of action, locus standi to file the present complaint, and non-joinder of necessary party. On merits, it is denied that the complainant purchased the insurance policy, rather, the same was issued in the name of HPSCDC Solan. It is also denied that the brick kiln was insured by the complainant.
They contend that a standard Fire and Special Perils Insurance policy bearing No.111301/11/05/11/00000645, w.e.f. 06.12.2005 to 05.12.2006, was purchased by HPSCD Corporation, Solan A/c Yogeshwar Dutt, from the OP-Company covering the risk of Plant and Machinery for Rs.2.00 lacs and stock of finished and unfinished goods for Rs.2.00 lacs. It is further contended that on the night of 21.01.2006, an explosion took place in the said kiln due to gas formation from the burning coal inside the kiln causing partial damage to the kiln, hence, only 25000 bricks were found to be broken and damaged on account of the aforesaid explosion, hence, it is denied that the total loss was caused to the brick kiln. They further contend that the brick kiln, was not covered by the insurance policy. Hence, it is denied, that, there was any deficiency in service on their part or that they have indulged in an unfair trade practice.
3. Thereafter, the parties adduced evidence, by way of affidavits, and, documents in support of their respective, contentions.
4. We have heard the learned counsel for the parties at length and have also thoroughly scanned the entire record of the case.
5. Undisputedly, the policy, as purchased by the complainant from the OP-Company, took within, its, ambit destruction or damage caused to the Brick Kiln, of the complainant. An explosion, took place, on, 21.01.2006 in the property of the complainant as insured with the OP-Company. The OP-Company succinctly has repudiated the claim of the complainant, on, the score of the purported cause of the explosion as had occurred in the Brick Kiln factory of the complainant, falling within the scope of the exclusionary clause, of, Annexure R-1, annexed with the file of the case, inasmuch, as, in the eventuality of the destruction having come to be caused to the insured property by, its, own fermentation, natural heating or spontaneous combustion, then, the liability of the OP-Company, to, indemnify the complainant the damage caused to the property insured, is, exculpated.
6. The OP-Company, to, sustain, its, contention, has relied upon Annexure R-2, which, is, the report of the Surveyor & Loss Assessor, in, which, he, has detailed the cause of explosion and which cause of fire/explosion in the Brick Kiln of the complainant, which, is, the property insured with the OP-Company, has been anvilled on, the strength of the statement of the complainant, in which he has attributed the said explosion, to gas formation, as had occurred in the ignited coal set, a, fire, to, bake the raw bricks. The cause of fire attributed in the report of the Loss Assessor, anvilled, on, the statement of the complainant, which statement exists, on, record, as, Annexure R-5, being neither controverted or repulsed and, its, perusal foisting truthfulness to the cause of explosion, in, the Brick Kiln as attributed in the report of the Loss Assessor, hence, assumes conclusiveness.
7. With the conclusion as formed above and with the existence on record of the photographs of the Brick Kiln, whose perusal divulges the fact that the complainant had taken to bake bricks in the Brick Kiln plant not designed in a scientific manner, rather, it being, a, plant fabricated by local methods, obviously, the act of the complainant in setting a fire, the coal heaped along with raw bricks, which ignited coal, admittedly, as, revealed in Annexure R-5 resulted, in, gas formation and explosion of the lot of bricks heaped in the Brick Kiln.
With the complainant admittedly having resorted not to bake bricks in a Brick Kiln Plant, fabricated in a scientific manner in accordance with an approved project, rather, his having taken to adopt local as well, as, unscientific methods, to bake bricks, which, local method, as, borne out by the admission of the complainant proved disastrous or in other words, when the, local methods, admittedly resulted, in, the explosion in the Brick Kiln, causing by gas formation, arising from the ignited coal used for baking of the bricks, hence, inevitably, given the square and unimpeachable admission, of, the complainant, we are led, hence, to the sequel, that, the OP-Company has been able to clinchingly prove, that, the cause of explosion admittedly as was caused by gas formation arising from the burning of coal used for baking bricks in a unscientifically fabricated Brick Kiln Plant, emphatically falls within the scope, of, the exclusionary clause, as referred, to, above.
8. With the OP-Company, having proved the cause of explosion in the Brick Kiln of the complainant having been caused by the facts falling within the exclusionary clause, accordingly, the repudiation of the claim of the complainant by it, was tenable, hence, no deficiency in service can be attributed on the part of the OP-Company.
9. Resultantly, the complaint deserves dismissal as such we dismiss the same. No order as to the costs. The learned counsel for the parties undertook to collect the certified copy of this order from the office, free of cost, as per rules. The file after due completion, be consigned to record room.
Case that shows no insurance without payment of premium.
This is an interesting case where the insurance company decision to not pay the claim was upheld because of non payment of premium. The sad part is that the insured did not stop paying the premium but the insurance company did not collect the premium because of a government circular. But the judgement makes it clear that there is no coverage if there is not premium payment irrespective of who has committed the mistake.
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Case Details
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1 Smt Lata Saini W/o Late Shri Jagat ram Saini, Resident of North Oak, Old Building, sanjauli , Shimla-6
2 Ms. Shelly saini Daughter of late Sh.Jagat Ram Saini
3 Ms. Silpa
4 Baby Shweta, daughters of late Shri Jagat Ram Saini.
5 Master Rohit S/o Late Sh. Jagat Ram saini Sr. No. 4& 5 being minor represented by their mother and natural guardian Smt. Late saini W/o Late Jagat Ram Saini. All resident of Northoak Building Sanjauli, Shimla-6.
… Complainant.
Versus
1 The Secretary Education, Govt. of H.P. Shimla-171002.
2 The Director of, Elementary Education, Himachal Pradesh, Near Main Bus Stand , Shimla-1.
3 The Head Master, govt. Middle SchooI, Mool Koti (Mashobra), The. 7 Distt. Shimla ( H.P.)
4 The Divisional Manager, United India Insurance Company Ltd. Timber House,Cart Road, Shimla. …Opposite Parties.
O R D E R:
Sureshwar Thakur (District Judge) President:- This complaint has been filed by the complainant, by invoking the provisions of Section 12 of the Consumer Protection Act, 1986. It is averred that late Shri Jagat Ram Saini, husband of the complainant No.1 and father of complainants No.2 to 5, was serving as Drawing Teacher with the OP No.3, whereas the OPs no.1 & 2 were the employer of the deceased and OP N.4 is the insurance company, with whom the deceased was insured under Personal Accident Scheme, for an amount of Rs.2.00 lacs vide notification dated 24.02.2006. It is alleged that the deceased died in harness on, 10.07.2006 when he was in active service and after his death, the OPs were requested the release the insurance premium in their favour, which they failed to do so. Hence, feeling aggrieved and dissatisfied, it is averred that, there is apparent deficiency in service on the part of the OPs and accordingly relief to the extent as detailed in the relief clause be awarded in favour of the complainant.
2. The OPs No.1 to 3, in their written version, to the complaint, raised preliminary objections vis-à-vis maintainability of the complaint, lack of cause of action, limitation, jurisdiction etc. On merits, it is admitted that Shri Jagat Ram was serving as drawing teacher with the OPs, who died in car accident. They further contend that the deceased was assured for Rs.2.00 lacs on payment of premium of Rs.91/- under group personal accident insurance scheme, hence, group personal accident insurance renewal amount of Rs.70/- could not be deducted from the deceased salary. The OP No.4, in its separate written version, to the complaint, contended that the deceased died after the period of the policy was over and was not covered under the policy, hence the policy has expired on 31.12.2005, while the deceased died on, 10.07.2006. Hence, it is denied, that, there was any deficiency in service on their part or that they have indulged in an unfair trade practice.
3. Thereafter, the parties adduced evidence, by way of affidavits, and, documents in support of their respective, contentions.
4. We have heard the learned counsel for the parties at length and have also thoroughly scanned the entire record of the case.
5. The deceased, who was working as drawing master, with the OP, while in service, met with an accident, on, 10.07.2006. An FIR with regard to the incident came to be registered in the Police Station, Dhalli and is appended as Annexure-B. After the death of the deceased, the complainant being the legal heir of the deceased, lodged a claim before the OPs, for, indemnifying to them the amount of insurance under Group Personal Accident Insurance Scheme.
6. The OP No.4-Company has come to repudiate the claim of the complainant on the ground that since no premium from the salary of the deceased covering his risk, was deducted, as a result of which the policy was not in existence, hence, did not cover the risk of the deceased, as such, the complainants are not entitled to claim the amount of the insurance.
7. Be that as it may, the scheme known as Group Personal Accident Insurance was introduced by the Government of H.P., hence, applicable w.e.f. 01.01.2005 to 31.12.2005, which was renewed on, 01.03.2006, and made effective from 05.04.2006, vide letter No. Fin(F)9-2/2006 dated 12.07.2006, which was circulated to the OPs No.1 to 3 only in the month of August, 2006, and since, the deceased had already expired on 10.07.2006, as such the premium could not be deducted from his salary by the OP No.3, hence, his risk remained not covered.
Hence, in the absence of non-existence of Group Personal Accident Insurance Scheme, in favour of the deceased, the OP No.4-Company was well within its right to repudiate the claim of the complainant. Thus, considering the facts and circumstances of the case, as no insurance policy was in existence, at the time of the death of the deceased, and since, the OP No.3 has assigned good reasons for non-deduction of the premium from his salary, hence, no negligence can be attributed to the OP No.3 for lack of non-deduction of premium from his salary, hence, OP No.4-Company cannot be held liable to indemnify the complainant. Hence, the repudiation of the claim of the complainant cannot be said to be suffering from any infirmity, as such, is legal and valid.
8. In the light of the above, we find no force in this complaint, and the same being without any merit, is liable to be dismissed, hence, we order accordingly. No order as to the costs. The learned counsel for the parties undertook to collect the certified copy of this order from the office, free of cost, as per rules. The file after due completion, be consigned to record room.
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Case Details
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1 Smt Lata Saini W/o Late Shri Jagat ram Saini, Resident of North Oak, Old Building, sanjauli , Shimla-6
2 Ms. Shelly saini Daughter of late Sh.Jagat Ram Saini
3 Ms. Silpa
4 Baby Shweta, daughters of late Shri Jagat Ram Saini.
5 Master Rohit S/o Late Sh. Jagat Ram saini Sr. No. 4& 5 being minor represented by their mother and natural guardian Smt. Late saini W/o Late Jagat Ram Saini. All resident of Northoak Building Sanjauli, Shimla-6.
… Complainant.
Versus
1 The Secretary Education, Govt. of H.P. Shimla-171002.
2 The Director of, Elementary Education, Himachal Pradesh, Near Main Bus Stand , Shimla-1.
3 The Head Master, govt. Middle SchooI, Mool Koti (Mashobra), The. 7 Distt. Shimla ( H.P.)
4 The Divisional Manager, United India Insurance Company Ltd. Timber House,Cart Road, Shimla. …Opposite Parties.
O R D E R:
Sureshwar Thakur (District Judge) President:- This complaint has been filed by the complainant, by invoking the provisions of Section 12 of the Consumer Protection Act, 1986. It is averred that late Shri Jagat Ram Saini, husband of the complainant No.1 and father of complainants No.2 to 5, was serving as Drawing Teacher with the OP No.3, whereas the OPs no.1 & 2 were the employer of the deceased and OP N.4 is the insurance company, with whom the deceased was insured under Personal Accident Scheme, for an amount of Rs.2.00 lacs vide notification dated 24.02.2006. It is alleged that the deceased died in harness on, 10.07.2006 when he was in active service and after his death, the OPs were requested the release the insurance premium in their favour, which they failed to do so. Hence, feeling aggrieved and dissatisfied, it is averred that, there is apparent deficiency in service on the part of the OPs and accordingly relief to the extent as detailed in the relief clause be awarded in favour of the complainant.
2. The OPs No.1 to 3, in their written version, to the complaint, raised preliminary objections vis-à-vis maintainability of the complaint, lack of cause of action, limitation, jurisdiction etc. On merits, it is admitted that Shri Jagat Ram was serving as drawing teacher with the OPs, who died in car accident. They further contend that the deceased was assured for Rs.2.00 lacs on payment of premium of Rs.91/- under group personal accident insurance scheme, hence, group personal accident insurance renewal amount of Rs.70/- could not be deducted from the deceased salary. The OP No.4, in its separate written version, to the complaint, contended that the deceased died after the period of the policy was over and was not covered under the policy, hence the policy has expired on 31.12.2005, while the deceased died on, 10.07.2006. Hence, it is denied, that, there was any deficiency in service on their part or that they have indulged in an unfair trade practice.
3. Thereafter, the parties adduced evidence, by way of affidavits, and, documents in support of their respective, contentions.
4. We have heard the learned counsel for the parties at length and have also thoroughly scanned the entire record of the case.
5. The deceased, who was working as drawing master, with the OP, while in service, met with an accident, on, 10.07.2006. An FIR with regard to the incident came to be registered in the Police Station, Dhalli and is appended as Annexure-B. After the death of the deceased, the complainant being the legal heir of the deceased, lodged a claim before the OPs, for, indemnifying to them the amount of insurance under Group Personal Accident Insurance Scheme.
6. The OP No.4-Company has come to repudiate the claim of the complainant on the ground that since no premium from the salary of the deceased covering his risk, was deducted, as a result of which the policy was not in existence, hence, did not cover the risk of the deceased, as such, the complainants are not entitled to claim the amount of the insurance.
7. Be that as it may, the scheme known as Group Personal Accident Insurance was introduced by the Government of H.P., hence, applicable w.e.f. 01.01.2005 to 31.12.2005, which was renewed on, 01.03.2006, and made effective from 05.04.2006, vide letter No. Fin(F)9-2/2006 dated 12.07.2006, which was circulated to the OPs No.1 to 3 only in the month of August, 2006, and since, the deceased had already expired on 10.07.2006, as such the premium could not be deducted from his salary by the OP No.3, hence, his risk remained not covered.
Hence, in the absence of non-existence of Group Personal Accident Insurance Scheme, in favour of the deceased, the OP No.4-Company was well within its right to repudiate the claim of the complainant. Thus, considering the facts and circumstances of the case, as no insurance policy was in existence, at the time of the death of the deceased, and since, the OP No.3 has assigned good reasons for non-deduction of the premium from his salary, hence, no negligence can be attributed to the OP No.3 for lack of non-deduction of premium from his salary, hence, OP No.4-Company cannot be held liable to indemnify the complainant. Hence, the repudiation of the claim of the complainant cannot be said to be suffering from any infirmity, as such, is legal and valid.
8. In the light of the above, we find no force in this complaint, and the same being without any merit, is liable to be dismissed, hence, we order accordingly. No order as to the costs. The learned counsel for the parties undertook to collect the certified copy of this order from the office, free of cost, as per rules. The file after due completion, be consigned to record room.
Motor Insurance case study with United India Insurance - More than one passenger
This is an interesting case that I found on the internet. This case was between United India Insurance and the owner of a JCB that met with an accident. The JCB in question at the time of the accident had two occupants when in fact the JCB has as per its manual only one seat. This made United India Insurance reject the claim stating this was in violation. But the court rejected this view taking and allowed this claim to be paid as non standard. The details of the claim are stated below.
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CASE DETAILS
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Surinder Singh son of Sh.Dalip Singh Prop of M/S Surender Traders resident of village Brot, Post Office Barsu, Tehsil Sadar, District Mandi, H.P
…Complainant.
V/S
United India Insurance company Ltd Divisional Office at Jail Road, Mandi Town, District Mandi, H.P./ through its Divisional Manager.
..Opposite party.
ORDER.
This order shall dispose of a complaint under Section 12 of the Consumer Protection Act, 1986
( hereinafter referred to as the “Act”) instituted by the complainant against the opposite party. The complainant averred that he is registered owner of vehicle No. HP-65-3499 ( JCB)which was duly insured with the opposite party vide policy Annexure C-2 for the period from 16-6-2008 to 15-6-2009under comprehensive insurance policy. That the JCB in question met with an accident on 26-7-2008 at Palampur ,District Kangra due to sudden failure of brakes while it was being driven by complainant himself having valid driving license . The accident was promptly reported to the opposite party who deputed their surveyor for inspection of damage caused to the JCB in the accident who after inspection advised him to repair the vehicle from some authorized dealer. The vehicle was repaired by spending Rs.80,000/- at Nerchowk . After repair of the vehicle, the same was again inspected by the surveyor of the opposite party and all the original cash memos of entire repair and spare charges and entire copies of documents were submitted to the surveyor for early settlement of the claim . The complainant averred that at the time of the accident one helper Sh. Panku @ Om Parkash son of Sh.Chand Ram was also injured in the accident of the vehicle .
The complainant further averred that the claim was not settled by the opposite party and he had served the opposite party with legal notice dated 20-11-2008 ,but despite that the claim was not settled nor responded the notice which act on the part of the opposite party amounts to deficiency in service as well as unfair trace practice .With these averments , the complainant had sought a direction to the opposite party to pay Rs.80,000/- as own damage claim of the vehicle alongwith interest at the rate of 12 % per annum from 26-7-2008 till final payment Apart from this, Rs.20,000/- as also been claimed as compensation besides costs of complaint.
2. The opposite party filed reply wherein it had taken preliminary objections that the complainant is not a consumer of the opposite party and as such the complaint is not maintainable and that there is no deficiency in service on its part. On merits ,the opposite party had admitted the insurance of the vehicle and its accident . It has been admitted that information of accident was given to it. It has also been admitted that the complainant had repaired the vehicle but it has been denied that he had spent a sum of Rs.80,000/- but pleaded that the surveyor deputed by it had assessed the loss vide report dated 30-8-2008 Annexure O-1 at Rs.46,067.94 paise as per the terms and conditions of the policy subject to deposit of salvage , value of which had been assessed at Rs.5500/-.
The opposite party had pleaded that while processing the claim it was found that one unauthorized person was being carried in the vehicle at the time of the accident and as per the registration certificate the seating capacity of the vehicle is One only i.e. driver and since it is violation of terms and conditions of the insurance policy, therefore ,the opposite party was constrained to repudiate the claim and same was duly communicated to the complainant vide letter dated 21-1-2009 Annexure O-2. Rest of the contents of the complaint have been denied being wrong. The opposite party had prayed for dismissal of the complaint .
3. The complainant had filed rejoinder reiterating the contents of the complainant and controverted those as made in the reply.
4. We have heard the ld. counsel for both the parties and have carefully gone through the record. Be it stated that the insurance of the vehicle and its accident is not in dispute. However, the claim of the complainant has been repudiated on the ground that one unauthorized person was sitting in the vehicle at the time of the accident alongwith driver whereas the seating capacity of the vehicle is only one i.e. Driver.
The fact that one other person was also sitting in the vehicle has also not been disputed by the complainant and in the complaint it has been pleaded that at the time of accident one helper Sh, Panku @ Om Parkash son of Sh. Chand Ram also sustained injuries . The perusal of the registration certificate annexure C-1 reflects that seating capacity of the vehicle is only one i.e. driver . Therefore, in view of the admission of the complainant himself , it has become clear that one other person was sitting in the vehicle in question alongwith driver. Since the seating capacity of the vehicle is one, therefore, we have no hesitation to conclude that the vehicle was being plied in violation of the terms and conditions of the insurance policy.
5 The next question, which arises for determination is as to whether the opposite party was justified in repudiating the claim of the complainant as a whole on this score or not .The answer to this poser in all fairness would be in the negative for the reason that opposite party had failed to prove and establish that the carrying of one unauthorized passenger in the vehicle was the sole and contributory cause of the accident. No evidence has been led by the opposite party to this effect. In our opinion, it cannot be said that said breach is such a breach that the owner should in all event be denied indemnification.
This breach cannot be termed as fundamental breach empowering the opposite party to repudiate the claim as a whole . As a matter of fact , the complainant or his driver by allowing unauthorized passenger in the vehicle has contravened the limitation clause as to use in the policy and in case of such breach, it is clause 10 of the Procedural Manual of Motor Claims which is applicable and as per the same , where there is any breach including breach of limitation as to use , the claim has to be considered and paid as Non Standard claim. The clause 10 of the Procedural Manual of the Motor Claim is reproduced here asunder:-
“ 10. Non Standard Claims .
Following standard claims
Following types of claims shall be considered as non standard claim and shall be settled as indicates below after recording the reasons.
Description Percentage of settlement
Under declaration Deduct 3 years difference
Of licensed carrying in premium from the
Capacity amount of claim or deduct 25 % of claim amount whichever is higher
Overloading of Pay claims not exceeding
Vehicle beyond 75% of admissible claim
Licensed carrying
Capacity
Any other breach Pay up to 75% of admissible claim
Of warranty/condition
of policy including
limitation as to use
6 The Hon’ble National Commission in its
various decisions had held that if the vehicle is used contrary to the terms and conditions of the policy, the insurance company has to treat the claim as per the guidelines applicable for settlement of non standard claims and the percentages are also duly indicated in clause 10 of the Procedural Manual of Motor Claims . In the case titled National Insurance Company vs Muni Lal Yadav 2001(2) CPR-1( NC), the vehicle was insured as private vehicle but used as public vehicle at the time of accident. Hon’ble National Commission after relying upon the observations of Hon’ble Supreme Court in the case of B.V. Nagaraju vs M/S Oriental Insurance Company ltd II(1996)CPJ-18(SC) and M/S Skandia Insurance company ltd vs Kokilaben Chaudravadan 1987(2) SCC-654 had held that the claim is to be settled in accordance with Skandia’s case approved in B.V. Nagaraju case and according to Motor Claims guidelines applicable for settlement of non standard claims.
In the present case also , the claim of the complainant is covered under clause 10 of the Procedural Manual of Motor Claims which provides that for “ any other breach of warranty/ condition of policy including limitation as to use” the claim shall be settled as non standard claim and pay up to 75% of the admissible claim. Therefore, in view of the aforesaid decisions of Hon’ble Apex Court as well as of the Hon’ble National Commission and also in view of the Motor Claims guidelines, it will be appropriate to direct the opposite party to treat the claim of complainant as non standard claim and to pay 75% of the compensation to which he is entitled.
7 Now the next question which arises for consideration before this Forum is as to what amount the complainant is entitled on account of loss suffered by him due to accident of the vehicle .The complainant in his complaint had claimed Rs.80,000 /- as repair charges .On the other hand, the opposite party has stated in its reply that loss assessed by the surveyor is Rs.46067/- subject to deposit of salvage, value of which has been assessed at Rs. 5500/-.The opposite party has also adduced in evidence the copy of report of Surveyor Sh. Mohinder K Sharma Annexure O-1which corroborates the version of the opposite party that the loss assessed by the surveyor on account of accident of the vehicle in question is to the tune of Rs.46067/- and value of salvage has been assessed at Rs.5500/-.The report of Surveyor is an important document and it cannot be brushed aside without sufficient reasons.
The Hon’ble National Consumer Disputes Redressal Commission in United India Insurance company vs Jadhav Kirana Store , III (2005)CPJ-79(NC) has held that the Surveyor report is an important document and it should not be shunned without sufficient reasons. Therefore, in the absence of any satisfactory evidence to the contrary , we accept the report of Surveyor and in view of the same , we hold that the liability of the opposite party with respect to the damage caused to the vehicle is Rs.46,067/- subject to deposit of salvage and the complainant is entitled to 75% of this amount which comes to Rs.34,550/-.
8 In the light of above discussion, the complaint is partly allowed and the opposite party is directed to pay Rs.34,550 /- with interest at the rate of 9% p.a. from the date of filing of the complaint till realization subject to the deposit of salvage value of which has been assessed at Rs.5500/-. If the complainant fails to deposit the salvage in that event the opposite party shall be entitled to deduct the amount of salvage as assessed by the surveyor .In addition to this, the opposite party is also directed to pay Rs.1500/- as costs of litigation to the complainant.
9 Copy of this order be supplied to the parties free of cost as per Rules.
10 File, after due completion be consigned to the Record Room.
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CASE DETAILS
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Surinder Singh son of Sh.Dalip Singh Prop of M/S Surender Traders resident of village Brot, Post Office Barsu, Tehsil Sadar, District Mandi, H.P
…Complainant.
V/S
United India Insurance company Ltd Divisional Office at Jail Road, Mandi Town, District Mandi, H.P./ through its Divisional Manager.
..Opposite party.
ORDER.
This order shall dispose of a complaint under Section 12 of the Consumer Protection Act, 1986
( hereinafter referred to as the “Act”) instituted by the complainant against the opposite party. The complainant averred that he is registered owner of vehicle No. HP-65-3499 ( JCB)which was duly insured with the opposite party vide policy Annexure C-2 for the period from 16-6-2008 to 15-6-2009under comprehensive insurance policy. That the JCB in question met with an accident on 26-7-2008 at Palampur ,District Kangra due to sudden failure of brakes while it was being driven by complainant himself having valid driving license . The accident was promptly reported to the opposite party who deputed their surveyor for inspection of damage caused to the JCB in the accident who after inspection advised him to repair the vehicle from some authorized dealer. The vehicle was repaired by spending Rs.80,000/- at Nerchowk . After repair of the vehicle, the same was again inspected by the surveyor of the opposite party and all the original cash memos of entire repair and spare charges and entire copies of documents were submitted to the surveyor for early settlement of the claim . The complainant averred that at the time of the accident one helper Sh. Panku @ Om Parkash son of Sh.Chand Ram was also injured in the accident of the vehicle .
The complainant further averred that the claim was not settled by the opposite party and he had served the opposite party with legal notice dated 20-11-2008 ,but despite that the claim was not settled nor responded the notice which act on the part of the opposite party amounts to deficiency in service as well as unfair trace practice .With these averments , the complainant had sought a direction to the opposite party to pay Rs.80,000/- as own damage claim of the vehicle alongwith interest at the rate of 12 % per annum from 26-7-2008 till final payment Apart from this, Rs.20,000/- as also been claimed as compensation besides costs of complaint.
2. The opposite party filed reply wherein it had taken preliminary objections that the complainant is not a consumer of the opposite party and as such the complaint is not maintainable and that there is no deficiency in service on its part. On merits ,the opposite party had admitted the insurance of the vehicle and its accident . It has been admitted that information of accident was given to it. It has also been admitted that the complainant had repaired the vehicle but it has been denied that he had spent a sum of Rs.80,000/- but pleaded that the surveyor deputed by it had assessed the loss vide report dated 30-8-2008 Annexure O-1 at Rs.46,067.94 paise as per the terms and conditions of the policy subject to deposit of salvage , value of which had been assessed at Rs.5500/-.
The opposite party had pleaded that while processing the claim it was found that one unauthorized person was being carried in the vehicle at the time of the accident and as per the registration certificate the seating capacity of the vehicle is One only i.e. driver and since it is violation of terms and conditions of the insurance policy, therefore ,the opposite party was constrained to repudiate the claim and same was duly communicated to the complainant vide letter dated 21-1-2009 Annexure O-2. Rest of the contents of the complaint have been denied being wrong. The opposite party had prayed for dismissal of the complaint .
3. The complainant had filed rejoinder reiterating the contents of the complainant and controverted those as made in the reply.
4. We have heard the ld. counsel for both the parties and have carefully gone through the record. Be it stated that the insurance of the vehicle and its accident is not in dispute. However, the claim of the complainant has been repudiated on the ground that one unauthorized person was sitting in the vehicle at the time of the accident alongwith driver whereas the seating capacity of the vehicle is only one i.e. Driver.
The fact that one other person was also sitting in the vehicle has also not been disputed by the complainant and in the complaint it has been pleaded that at the time of accident one helper Sh, Panku @ Om Parkash son of Sh. Chand Ram also sustained injuries . The perusal of the registration certificate annexure C-1 reflects that seating capacity of the vehicle is only one i.e. driver . Therefore, in view of the admission of the complainant himself , it has become clear that one other person was sitting in the vehicle in question alongwith driver. Since the seating capacity of the vehicle is one, therefore, we have no hesitation to conclude that the vehicle was being plied in violation of the terms and conditions of the insurance policy.
5 The next question, which arises for determination is as to whether the opposite party was justified in repudiating the claim of the complainant as a whole on this score or not .The answer to this poser in all fairness would be in the negative for the reason that opposite party had failed to prove and establish that the carrying of one unauthorized passenger in the vehicle was the sole and contributory cause of the accident. No evidence has been led by the opposite party to this effect. In our opinion, it cannot be said that said breach is such a breach that the owner should in all event be denied indemnification.
This breach cannot be termed as fundamental breach empowering the opposite party to repudiate the claim as a whole . As a matter of fact , the complainant or his driver by allowing unauthorized passenger in the vehicle has contravened the limitation clause as to use in the policy and in case of such breach, it is clause 10 of the Procedural Manual of Motor Claims which is applicable and as per the same , where there is any breach including breach of limitation as to use , the claim has to be considered and paid as Non Standard claim. The clause 10 of the Procedural Manual of the Motor Claim is reproduced here asunder:-
“ 10. Non Standard Claims .
Following standard claims
Following types of claims shall be considered as non standard claim and shall be settled as indicates below after recording the reasons.
Description Percentage of settlement
Under declaration Deduct 3 years difference
Of licensed carrying in premium from the
Capacity amount of claim or deduct 25 % of claim amount whichever is higher
Overloading of Pay claims not exceeding
Vehicle beyond 75% of admissible claim
Licensed carrying
Capacity
Any other breach Pay up to 75% of admissible claim
Of warranty/condition
of policy including
limitation as to use
6 The Hon’ble National Commission in its
various decisions had held that if the vehicle is used contrary to the terms and conditions of the policy, the insurance company has to treat the claim as per the guidelines applicable for settlement of non standard claims and the percentages are also duly indicated in clause 10 of the Procedural Manual of Motor Claims . In the case titled National Insurance Company vs Muni Lal Yadav 2001(2) CPR-1( NC), the vehicle was insured as private vehicle but used as public vehicle at the time of accident. Hon’ble National Commission after relying upon the observations of Hon’ble Supreme Court in the case of B.V. Nagaraju vs M/S Oriental Insurance Company ltd II(1996)CPJ-18(SC) and M/S Skandia Insurance company ltd vs Kokilaben Chaudravadan 1987(2) SCC-654 had held that the claim is to be settled in accordance with Skandia’s case approved in B.V. Nagaraju case and according to Motor Claims guidelines applicable for settlement of non standard claims.
In the present case also , the claim of the complainant is covered under clause 10 of the Procedural Manual of Motor Claims which provides that for “ any other breach of warranty/ condition of policy including limitation as to use” the claim shall be settled as non standard claim and pay up to 75% of the admissible claim. Therefore, in view of the aforesaid decisions of Hon’ble Apex Court as well as of the Hon’ble National Commission and also in view of the Motor Claims guidelines, it will be appropriate to direct the opposite party to treat the claim of complainant as non standard claim and to pay 75% of the compensation to which he is entitled.
7 Now the next question which arises for consideration before this Forum is as to what amount the complainant is entitled on account of loss suffered by him due to accident of the vehicle .The complainant in his complaint had claimed Rs.80,000 /- as repair charges .On the other hand, the opposite party has stated in its reply that loss assessed by the surveyor is Rs.46067/- subject to deposit of salvage, value of which has been assessed at Rs. 5500/-.The opposite party has also adduced in evidence the copy of report of Surveyor Sh. Mohinder K Sharma Annexure O-1which corroborates the version of the opposite party that the loss assessed by the surveyor on account of accident of the vehicle in question is to the tune of Rs.46067/- and value of salvage has been assessed at Rs.5500/-.The report of Surveyor is an important document and it cannot be brushed aside without sufficient reasons.
The Hon’ble National Consumer Disputes Redressal Commission in United India Insurance company vs Jadhav Kirana Store , III (2005)CPJ-79(NC) has held that the Surveyor report is an important document and it should not be shunned without sufficient reasons. Therefore, in the absence of any satisfactory evidence to the contrary , we accept the report of Surveyor and in view of the same , we hold that the liability of the opposite party with respect to the damage caused to the vehicle is Rs.46,067/- subject to deposit of salvage and the complainant is entitled to 75% of this amount which comes to Rs.34,550/-.
8 In the light of above discussion, the complaint is partly allowed and the opposite party is directed to pay Rs.34,550 /- with interest at the rate of 9% p.a. from the date of filing of the complaint till realization subject to the deposit of salvage value of which has been assessed at Rs.5500/-. If the complainant fails to deposit the salvage in that event the opposite party shall be entitled to deduct the amount of salvage as assessed by the surveyor .In addition to this, the opposite party is also directed to pay Rs.1500/- as costs of litigation to the complainant.
9 Copy of this order be supplied to the parties free of cost as per Rules.
10 File, after due completion be consigned to the Record Room.
Sunday, June 26, 2011
New India corporate office contact information
New India corporate offices - corporate office for New India Assurance Co. Ltd.
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Here is the information found on the above site as on 27/06/2011
Corporate Head office Address:
The New India Assurance Co. Ltd.
87, M.G. Road, Fort,
Mumbai 400 001.
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Here is the information found on the above site as on 27/06/2011
Corporate Head office Address:
The New India Assurance Co. Ltd.
87, M.G. Road, Fort,
Mumbai 400 001.
New India Posts 8600 Crore global Premium
Just found out that New India Assurance Co. Ltd. has received rupees 8600 crore global premium. Wow. That is great. The news was found at its web site.
Monday, June 20, 2011
Insurance Institute of India Licenciate Exam questions and answers Regulation of Insurance Business
IC 14 – Regulation of Insurance Business – Model Questions
I. Select the appropriate answer to complete the sentence (Checking learning - Direct)
i. Insurance business is transacted in India primarily as per the provisions of:
a. Insurance Regulatory and Development Authority Act, 1999
b. Insurance Act, 1938
c. Life Insurance Corporation Act, 1956
d. Employees State Insurance Act, 1948
e. Motor Vehicles Act 1938
Ans: b. Insurance Act, 1938.
ii. Section 64 C of the Insurance Act, 1938 contains provisions relating to:
a. Insurance Regulatory and Development Authority
b. Life Insurance Corporation of India
c. The Life Insurance Council
d. General Insurance Corporation of India
e. Tariff Advisory Committee
Ans: c. The Life Insurance Council
II. State which of the statements is/are correct (Checking learning - Direct)
i. Functions of the Executive Committee of the General Insurance Council includes:
a. To advise and assist general insurers
b. To underwrite general insurance business
c. To advise and assist life insurance companies
d. To settle all complicated general insurance claims
e. To audit all general insurance companies
Ans: a. To advise and assist general insurers
ii. As per IRDA Regulations, insurers should ensure that their advertisements present a correct picture. This provision is most important in the case of:
a. The Government
b. Insurance Regulatory and Development Authority
c. Auditors
d. Policyholders
e. Shareholders
Ans: d. Policyholders
III. Answer the questions below by selecting the correct answer: (Checking learning - Direct)
i. Which provision of the Insurance Act 1938 specifies about nomination by policyholder?
a. Section 38
b. Section 39
c. Section 40
d. Section 41
e. Section 45
Ans: b. Section 39
ii. Which Regulation of IRDA provides for a Grievance Redressal Procedure?
a. IRDA (Policyholders’ Interests) Regulations, 2002
b. IRDA (Meetings) Regulations, 2000
c. IRDA (Regulation of Indian Insurance Companies) Regulations, 2000
d. IRDA (Reinsurance Advisory Committee) Regulations, 2001
e. IRDA (Micro-insurance) Regulations, 2005
Ans: a. IRDA (Policyholders’ Interests) Regulations, 2002
IV. Fill in the Blanks using the appropriate word(s) (Checking understanding - Indirect)
i. Redressal of Public Grievances Rules, 1998 created the system of ____
a. Insurance Agency
b. Insurance Surveyors
c. Insurance Ombudsman
d. State Commission
e. Consumer Forum
Ans: c. Insurance Ombudsman
ii. The technique of making small deposits in various financial institutions so that they do not attract the attention of legal/ enforcement authorities is called ______
a. Phishing
b. Smurfing
c. Internet surfing
d. Know Your Customer
e. Subrogation
Ans: b. Smurfing
V. Select the expanded form of the abbreviation given (Checking understanding - Indirect)
i. Select the expanded form of AML as used in insurance
a. Anti-Money Laundering
b. Anti-Money Lending
c. Adjuster of Monetary Losses
d. Averages of Marine Losses
e. Adjustment of Motor Losses
Ans: a. Anti-Money Laundering
ii. Select the expanded form of ULIP used in insurance
a. Unit Linked Investment Policy
b. Universal Life Insurance Policy
c. Umbrella Life Insurance Policy
d. Unit Linked Insurance Policy
e. Underwriting Linked Insurance Policy
Ans: d. Unit Linked Insurance Policy
VI. Select the word(s) that most closely matches the given term. (Checking understanding - Indirect)
i. Which of the following terms matches closest with ‘Rebates’?
a. Financial Inducement
b. Investment Planning
c. Infrastructure Bonds
d. Assignment of Policy
e. Transfer of Policy
Ans: a. Financial Inducement
ii. Which of the following terms matches closest with ‘Nomination’?
a. Loss of Property Documents
b. Loss of Merchandise
c. Loss of Life
d. Loss of Baggage
e. Loss of Passport
Ans: c. Loss of Life
VII. Which of the following terms is dissimilar to the other four options? (Find the odd-man out?) (Checking application of learning)
i. Which of the following authorities is dissimilar to the other four?
a. District Forum
b. State Commission
c. National Commission
d. Law Commission
e. Ombudsman
Ans: d. Law Commission
ii. Which of the following types of nominations is dissimilar to the other four?
a. In favour of spouse
b. In favour of minor child
c. In favour of major child
d. In favour of adopted child
e. In favour of insurance agent
Ans: e. In favour of insurance agent
I. Select the appropriate answer to complete the sentence (Checking learning - Direct)
i. Insurance business is transacted in India primarily as per the provisions of:
a. Insurance Regulatory and Development Authority Act, 1999
b. Insurance Act, 1938
c. Life Insurance Corporation Act, 1956
d. Employees State Insurance Act, 1948
e. Motor Vehicles Act 1938
Ans: b. Insurance Act, 1938.
ii. Section 64 C of the Insurance Act, 1938 contains provisions relating to:
a. Insurance Regulatory and Development Authority
b. Life Insurance Corporation of India
c. The Life Insurance Council
d. General Insurance Corporation of India
e. Tariff Advisory Committee
Ans: c. The Life Insurance Council
II. State which of the statements is/are correct (Checking learning - Direct)
i. Functions of the Executive Committee of the General Insurance Council includes:
a. To advise and assist general insurers
b. To underwrite general insurance business
c. To advise and assist life insurance companies
d. To settle all complicated general insurance claims
e. To audit all general insurance companies
Ans: a. To advise and assist general insurers
ii. As per IRDA Regulations, insurers should ensure that their advertisements present a correct picture. This provision is most important in the case of:
a. The Government
b. Insurance Regulatory and Development Authority
c. Auditors
d. Policyholders
e. Shareholders
Ans: d. Policyholders
III. Answer the questions below by selecting the correct answer: (Checking learning - Direct)
i. Which provision of the Insurance Act 1938 specifies about nomination by policyholder?
a. Section 38
b. Section 39
c. Section 40
d. Section 41
e. Section 45
Ans: b. Section 39
ii. Which Regulation of IRDA provides for a Grievance Redressal Procedure?
a. IRDA (Policyholders’ Interests) Regulations, 2002
b. IRDA (Meetings) Regulations, 2000
c. IRDA (Regulation of Indian Insurance Companies) Regulations, 2000
d. IRDA (Reinsurance Advisory Committee) Regulations, 2001
e. IRDA (Micro-insurance) Regulations, 2005
Ans: a. IRDA (Policyholders’ Interests) Regulations, 2002
IV. Fill in the Blanks using the appropriate word(s) (Checking understanding - Indirect)
i. Redressal of Public Grievances Rules, 1998 created the system of ____
a. Insurance Agency
b. Insurance Surveyors
c. Insurance Ombudsman
d. State Commission
e. Consumer Forum
Ans: c. Insurance Ombudsman
ii. The technique of making small deposits in various financial institutions so that they do not attract the attention of legal/ enforcement authorities is called ______
a. Phishing
b. Smurfing
c. Internet surfing
d. Know Your Customer
e. Subrogation
Ans: b. Smurfing
V. Select the expanded form of the abbreviation given (Checking understanding - Indirect)
i. Select the expanded form of AML as used in insurance
a. Anti-Money Laundering
b. Anti-Money Lending
c. Adjuster of Monetary Losses
d. Averages of Marine Losses
e. Adjustment of Motor Losses
Ans: a. Anti-Money Laundering
ii. Select the expanded form of ULIP used in insurance
a. Unit Linked Investment Policy
b. Universal Life Insurance Policy
c. Umbrella Life Insurance Policy
d. Unit Linked Insurance Policy
e. Underwriting Linked Insurance Policy
Ans: d. Unit Linked Insurance Policy
VI. Select the word(s) that most closely matches the given term. (Checking understanding - Indirect)
i. Which of the following terms matches closest with ‘Rebates’?
a. Financial Inducement
b. Investment Planning
c. Infrastructure Bonds
d. Assignment of Policy
e. Transfer of Policy
Ans: a. Financial Inducement
ii. Which of the following terms matches closest with ‘Nomination’?
a. Loss of Property Documents
b. Loss of Merchandise
c. Loss of Life
d. Loss of Baggage
e. Loss of Passport
Ans: c. Loss of Life
VII. Which of the following terms is dissimilar to the other four options? (Find the odd-man out?) (Checking application of learning)
i. Which of the following authorities is dissimilar to the other four?
a. District Forum
b. State Commission
c. National Commission
d. Law Commission
e. Ombudsman
Ans: d. Law Commission
ii. Which of the following types of nominations is dissimilar to the other four?
a. In favour of spouse
b. In favour of minor child
c. In favour of major child
d. In favour of adopted child
e. In favour of insurance agent
Ans: e. In favour of insurance agent
Insurance Institute of India Licenciate Exam questions with answers
IC 11 – Practice of General Insurance – Model Questions
I. Select the appropriate answer to complete the sentence (Checking learning - Direct)
i. As per structured formula under the Motor Vehicle Act, victims of fatal injuries are paid compensation on the basis of:
a. Age and sex
b. Age and number of dependents
c. Income and size of family
d. Age and income
e. Income and number of dependents
Ans: d. Age and income.
ii. As per the Insurance Act, every insurer has to prepare at the end of financial year
a. Balance Sheet
b. Profit and Loss Account
c. Revenue Account for each class of Insurance business
d. Accounts of receipts and payments in respect of share-holders’ funds
e. All of the above
Ans: e. All of the above
II. State which of the statements is/are correct (Checking learning - Direct)
i. The Third Party Administrator’s role mainly involves
a. Canvassing business for the insurer.
b. Issuing documents on behalf of the insurer
c. Arranging for reinsurance
d. Sending renewal notices
e. Checking and paying insurance claims
Ans: e. Checking and paying insurance claims
ii. Time Policies relate to:
a. Fire insurance
b. Hull insurance
c. Personal Accident insurance
d. Workmen’s Compensation insurance
e. Motor vehicles insurance
Ans: b. Hull insurance
III. Answer the questions below by selecting the correct answer: (Checking learning - Direct)
i. Which clause specifies the perils insured in a scheduled form of policy?
a. Preamble Clause
b. Recital Clause
c. Operative Clause
d. Consideration Clause
e. Attestation Clause
Ans: c. Operative Clause
ii. Which of the following types of insurances is mandatory?
a. Motor Own Damage
b. Motor Third Party Legal Liability
c. Personal Accident Insurance
d. Product Liability
e. Professional Liability
Ans: b. Motor Third Party Legal Liability
IV. Fill in the Blanks using the appropriate word(s) (Checking understanding - Indirect)
i. The minimum paid up capital required for a General Insurance Company is Rs. ____
a. 25 crores
b. 50 crores
c. 75 crores
d. 100 crores
e. 200 crores
Ans: d. 100 Crores
ii. In ‘Hit and Run’ cases, claims are settled from _______
a. Solatium Fund
b. IRDA’s contingency Fund
c. Insuring Company’s reserves
d. Motor Third Party Pool
e. State Government’s funds.
Ans: a. Solatium Fund
V. Select the expanded form of the abbreviation given (Checking understanding - Indirect)
i. Select the expanded form of FPA as used in insurance
a. Freight Payable Assured
b. Free of Particular Average
c. Fire Perils Added
d. Fixed Peripherals Added
e. Free Passengers Avoided
Ans: b. Free of Particular Average
ii. Select the expanded form of ALOP used in insurance
a. Advance Loss of Profits insurance
b. Agreed Loss of Profits insurance
c. Additional Loss of Profits insurance
d. Associated Loss of Profits insurance
e. Authorised Loss of Profits insurance
Ans: a. Advance Loss of Profits insurance
VI. Select the word(s) that most closely matches the given term. (Checking understanding -
Indirect)
i. Which of the following terms matches closest with ‘Professional indemnity cover’?
a. Hospitals Nursing homes
b. Insurance Companies
c. Commercial Banks
d. Fast Moving Consumer Goods
e. Practicing Surgeons
Ans: e. Practicing Surgeons
ii. Which of the following terms matches closest with ‘Composite Policy’?
a. Shopkeepers’ insurance
b. Janatha Personal Accident insurance
c. Critical Care Health insurance
d. Marine Cargo insurance
e. Electronic Equipment insurance
Ans: a Shopkeepers’ insurance
VII. Find out which of the given statements is/are incorrect (Checking application of learning)
i. Members of the Insurance Advisory Committee are drawn to represent the interests of different groups like:
a. Surveyors, agents, advocates
b. Commerce, transport,
c. Consumer fora, industry, intermediaries,
d. Research bodies, organisations engaged in safety and loss prevention
e. Employees’ association in the insurance sector, agriculture,
Ans: a. Surveyors, agents, advocates
ii. A Surveyor’s role includes:
a. Checking the admissibility of the loss
b. Quantification of the loss
c. Giving comments on the loss
d. Suggesting risk management measures
e. Reporting major losses to IRDA.
Ans: e. Reporting major losses to IRDA.
VIII. Which of the following terms is dissimilar to the other four options? (Find the odd-man out?) (Checking application of learning)
i. Which of the following covers is dissimilar to the other four options?
a. Loss of Passport
b. Loss of Profits
c. Loss of checked in baggage
d. Delay in receiving checked in baggage
e. Cancellation/ Re-routing of scheduled fight
Ans: b. Loss of Profits
ii. Which of the following types of insurances is dissimilar to the other four options?
a. Builders’ Risks insurance
b. Hut insurance
c. Crop insurance
d. Livestock insurance
e. Health insurance
Ans: a. Builders’ Risks insurance
I. Select the appropriate answer to complete the sentence (Checking learning - Direct)
i. As per structured formula under the Motor Vehicle Act, victims of fatal injuries are paid compensation on the basis of:
a. Age and sex
b. Age and number of dependents
c. Income and size of family
d. Age and income
e. Income and number of dependents
Ans: d. Age and income.
ii. As per the Insurance Act, every insurer has to prepare at the end of financial year
a. Balance Sheet
b. Profit and Loss Account
c. Revenue Account for each class of Insurance business
d. Accounts of receipts and payments in respect of share-holders’ funds
e. All of the above
Ans: e. All of the above
II. State which of the statements is/are correct (Checking learning - Direct)
i. The Third Party Administrator’s role mainly involves
a. Canvassing business for the insurer.
b. Issuing documents on behalf of the insurer
c. Arranging for reinsurance
d. Sending renewal notices
e. Checking and paying insurance claims
Ans: e. Checking and paying insurance claims
ii. Time Policies relate to:
a. Fire insurance
b. Hull insurance
c. Personal Accident insurance
d. Workmen’s Compensation insurance
e. Motor vehicles insurance
Ans: b. Hull insurance
III. Answer the questions below by selecting the correct answer: (Checking learning - Direct)
i. Which clause specifies the perils insured in a scheduled form of policy?
a. Preamble Clause
b. Recital Clause
c. Operative Clause
d. Consideration Clause
e. Attestation Clause
Ans: c. Operative Clause
ii. Which of the following types of insurances is mandatory?
a. Motor Own Damage
b. Motor Third Party Legal Liability
c. Personal Accident Insurance
d. Product Liability
e. Professional Liability
Ans: b. Motor Third Party Legal Liability
IV. Fill in the Blanks using the appropriate word(s) (Checking understanding - Indirect)
i. The minimum paid up capital required for a General Insurance Company is Rs. ____
a. 25 crores
b. 50 crores
c. 75 crores
d. 100 crores
e. 200 crores
Ans: d. 100 Crores
ii. In ‘Hit and Run’ cases, claims are settled from _______
a. Solatium Fund
b. IRDA’s contingency Fund
c. Insuring Company’s reserves
d. Motor Third Party Pool
e. State Government’s funds.
Ans: a. Solatium Fund
V. Select the expanded form of the abbreviation given (Checking understanding - Indirect)
i. Select the expanded form of FPA as used in insurance
a. Freight Payable Assured
b. Free of Particular Average
c. Fire Perils Added
d. Fixed Peripherals Added
e. Free Passengers Avoided
Ans: b. Free of Particular Average
ii. Select the expanded form of ALOP used in insurance
a. Advance Loss of Profits insurance
b. Agreed Loss of Profits insurance
c. Additional Loss of Profits insurance
d. Associated Loss of Profits insurance
e. Authorised Loss of Profits insurance
Ans: a. Advance Loss of Profits insurance
VI. Select the word(s) that most closely matches the given term. (Checking understanding -
Indirect)
i. Which of the following terms matches closest with ‘Professional indemnity cover’?
a. Hospitals Nursing homes
b. Insurance Companies
c. Commercial Banks
d. Fast Moving Consumer Goods
e. Practicing Surgeons
Ans: e. Practicing Surgeons
ii. Which of the following terms matches closest with ‘Composite Policy’?
a. Shopkeepers’ insurance
b. Janatha Personal Accident insurance
c. Critical Care Health insurance
d. Marine Cargo insurance
e. Electronic Equipment insurance
Ans: a Shopkeepers’ insurance
VII. Find out which of the given statements is/are incorrect (Checking application of learning)
i. Members of the Insurance Advisory Committee are drawn to represent the interests of different groups like:
a. Surveyors, agents, advocates
b. Commerce, transport,
c. Consumer fora, industry, intermediaries,
d. Research bodies, organisations engaged in safety and loss prevention
e. Employees’ association in the insurance sector, agriculture,
Ans: a. Surveyors, agents, advocates
ii. A Surveyor’s role includes:
a. Checking the admissibility of the loss
b. Quantification of the loss
c. Giving comments on the loss
d. Suggesting risk management measures
e. Reporting major losses to IRDA.
Ans: e. Reporting major losses to IRDA.
VIII. Which of the following terms is dissimilar to the other four options? (Find the odd-man out?) (Checking application of learning)
i. Which of the following covers is dissimilar to the other four options?
a. Loss of Passport
b. Loss of Profits
c. Loss of checked in baggage
d. Delay in receiving checked in baggage
e. Cancellation/ Re-routing of scheduled fight
Ans: b. Loss of Profits
ii. Which of the following types of insurances is dissimilar to the other four options?
a. Builders’ Risks insurance
b. Hut insurance
c. Crop insurance
d. Livestock insurance
e. Health insurance
Ans: a. Builders’ Risks insurance
Insurance Institute of India model question paper with Answer
02 – Practice of Life Insurance – Model Questions
I. Select the appropriate answer to complete the sentence (Checking learning - Direct)
i. In cases where a Life Insurance Agent collects the premium from the policyholder and remits it to the insurer’s office, he is acting as an agent of __________:
a. IRDA
b. the Insurance Company
c. the Policyholder
d. the broker
e. the general public
Ans: b. the Insurance Company
ii. A policy where the policyholder makes a one-time payment of premium, is known as a ______________:
a. Money-back policy
b. Single premium policy
c. Salary Savings Scheme policy
d. Half-yearly policy
e. Annual policy
Ans: b. Single premium policy
II. i. State which of the statements given below is correct (Checking learning - Direct)
a. An organisation can exist only with employees
b. An organisation can exist only with different sections
c. An organisation can exist only with its own office building
d. An organisation can exist without a purpose
e. An organisation will grow as years pass by
Ans: a. An organisation can exist only with employees
ii. State which of the statements given below is correct (Checking learning - Direct)
a. People generally feel that life related risks are imminent
b. Religious beliefs interfere with the purchase of life insurance
c. People are always keen to buy insurance
d. Life insurance cannot be denied to anyone at any time
e. Life insurance is to be sold to people who are not in good health
Ans: b. Religious beliefs interfere with the purchase of life insurance
III. Answer the questions below by selecting the correct answer: (Checking learning - Direct)
i. Which of the following is/ are important activities of an organisation’s Accounts Department?
a. Keeping control on cash
b. Investments of funds
c. Processing bills
d. Reconciling bank statements
e. All of the above
Ans: e. All of the above
ii. Which of the following is an important reason for insurers to sell life insurance policies through agents?
a. The benefits of life insurance policies are simple and clear to all
b. People can decide which policy is best for them
c. Agents have to earn their commissions
d. Agents have to meet their marketing targets
e. Many people require personalised guidance for selecting the right policy
Ans: e. Many people require personalised guidance for selecting the right policy
IV. Fill in the Blanks using the appropriate word(s) (Checking understanding - Indirect)
i. Compared to the premium for a Whole Life plan, the premium for an Endowment plan will be ____________ for the same age
a. more
b. less
c. the same
d. double
e. half
Ans: a. more
ii. A nomination can be made only in favour of ________________
a. a bank
b. spouse and children with guardian
c. spouse and minor children
d. parents, spouse and children
e. any individual
Ans: d. any individual
V. Select the expanded form of the abbreviation given (Checking understanding - Indirect)
i. Select the expanded form of SA as commonly used in life insurance
a. Sum Assured
b. Surrender of Assurance
c. Supplementary Assurance
d. Stamp Act
e. Survivor’s Annuity
Ans: a. Sum Assured
ii. Select the expanded form of OR as commonly used in life insurance
a. Oral Rehydration
b. Once Renewed
c. Ordinary Rates
d. Ordinary Renewal
e. Ombubsman’s Assurance
Ans: c. Ordinary Rates
iii. Select the expanded form of SV as commonly used in life insurance
a. Summary Valuation
b. Selected Value
c. Surrender Value
d. Stamp Value
e. Survivor Value
Ans: c. Surrender Value
VI. Select the word(s) that most closely matches the given term. (Checking understanding - Indirect)
i. Which of the following terms matches closest with ‘Automatic Teller Machines’?
a. Divisional Offices
b. Branch Offices
c. Agents
d. Information Kiosks
e. Interactive Voice Response Systems
Ans: d. Information Kiosks
ii. Which of the following terms matches closest with ‘Foreclosure’?
a. Surrender Value
b. Nominee
c. Death Claim
d. Maturity Claims
e. Bonus
Ans: a. Surrender Value
VII. i. Find out which of the given statements is incorrect (Checking application of learning)
a. An organisation must have a purpose
b. An organisation is identified by its actions
c. An organisation is identified by the building it occupies
d. A organisation can sue and be sued
e. A organisation can own assets
Ans.: c. An organisation is identified by the building it occupies.
ii. Find out which of the given statements is incorrect (Checking application of learning)
a. Accounts department has to monitor cash flow from subordinate offices
b. Marketing department has to monitor business inflow
c. Marketing department has to monitor performance of agents
d. Actuarial department is responsible for settling death claims
e. Underwriting department has to assess risk and determine premium
Ans.: d. Actuarial department is responsible for settling death claims.
VIII. Which of the following terms is dissimilar to the other four options? (Find the odd-man out?) (Checking application of learning)
i. Which of the following terms is dissimilar to the other four in the context of insurable interest in life insurance?
a. Employer
b. Creditor
c. Surety
d. Employee
e. Debtor
Ans: e. Debtor
ii. Which of the following terms is dissimilar to the other four in the context of death claims in life insurance?
a. Early claims
b. Non-early claims
c. Foreclosure
d. Claimant’s statement
e. Deeds of Assignment
Ans: c. Foreclosure.
I. Select the appropriate answer to complete the sentence (Checking learning - Direct)
i. In cases where a Life Insurance Agent collects the premium from the policyholder and remits it to the insurer’s office, he is acting as an agent of __________:
a. IRDA
b. the Insurance Company
c. the Policyholder
d. the broker
e. the general public
Ans: b. the Insurance Company
ii. A policy where the policyholder makes a one-time payment of premium, is known as a ______________:
a. Money-back policy
b. Single premium policy
c. Salary Savings Scheme policy
d. Half-yearly policy
e. Annual policy
Ans: b. Single premium policy
II. i. State which of the statements given below is correct (Checking learning - Direct)
a. An organisation can exist only with employees
b. An organisation can exist only with different sections
c. An organisation can exist only with its own office building
d. An organisation can exist without a purpose
e. An organisation will grow as years pass by
Ans: a. An organisation can exist only with employees
ii. State which of the statements given below is correct (Checking learning - Direct)
a. People generally feel that life related risks are imminent
b. Religious beliefs interfere with the purchase of life insurance
c. People are always keen to buy insurance
d. Life insurance cannot be denied to anyone at any time
e. Life insurance is to be sold to people who are not in good health
Ans: b. Religious beliefs interfere with the purchase of life insurance
III. Answer the questions below by selecting the correct answer: (Checking learning - Direct)
i. Which of the following is/ are important activities of an organisation’s Accounts Department?
a. Keeping control on cash
b. Investments of funds
c. Processing bills
d. Reconciling bank statements
e. All of the above
Ans: e. All of the above
ii. Which of the following is an important reason for insurers to sell life insurance policies through agents?
a. The benefits of life insurance policies are simple and clear to all
b. People can decide which policy is best for them
c. Agents have to earn their commissions
d. Agents have to meet their marketing targets
e. Many people require personalised guidance for selecting the right policy
Ans: e. Many people require personalised guidance for selecting the right policy
IV. Fill in the Blanks using the appropriate word(s) (Checking understanding - Indirect)
i. Compared to the premium for a Whole Life plan, the premium for an Endowment plan will be ____________ for the same age
a. more
b. less
c. the same
d. double
e. half
Ans: a. more
ii. A nomination can be made only in favour of ________________
a. a bank
b. spouse and children with guardian
c. spouse and minor children
d. parents, spouse and children
e. any individual
Ans: d. any individual
V. Select the expanded form of the abbreviation given (Checking understanding - Indirect)
i. Select the expanded form of SA as commonly used in life insurance
a. Sum Assured
b. Surrender of Assurance
c. Supplementary Assurance
d. Stamp Act
e. Survivor’s Annuity
Ans: a. Sum Assured
ii. Select the expanded form of OR as commonly used in life insurance
a. Oral Rehydration
b. Once Renewed
c. Ordinary Rates
d. Ordinary Renewal
e. Ombubsman’s Assurance
Ans: c. Ordinary Rates
iii. Select the expanded form of SV as commonly used in life insurance
a. Summary Valuation
b. Selected Value
c. Surrender Value
d. Stamp Value
e. Survivor Value
Ans: c. Surrender Value
VI. Select the word(s) that most closely matches the given term. (Checking understanding - Indirect)
i. Which of the following terms matches closest with ‘Automatic Teller Machines’?
a. Divisional Offices
b. Branch Offices
c. Agents
d. Information Kiosks
e. Interactive Voice Response Systems
Ans: d. Information Kiosks
ii. Which of the following terms matches closest with ‘Foreclosure’?
a. Surrender Value
b. Nominee
c. Death Claim
d. Maturity Claims
e. Bonus
Ans: a. Surrender Value
VII. i. Find out which of the given statements is incorrect (Checking application of learning)
a. An organisation must have a purpose
b. An organisation is identified by its actions
c. An organisation is identified by the building it occupies
d. A organisation can sue and be sued
e. A organisation can own assets
Ans.: c. An organisation is identified by the building it occupies.
ii. Find out which of the given statements is incorrect (Checking application of learning)
a. Accounts department has to monitor cash flow from subordinate offices
b. Marketing department has to monitor business inflow
c. Marketing department has to monitor performance of agents
d. Actuarial department is responsible for settling death claims
e. Underwriting department has to assess risk and determine premium
Ans.: d. Actuarial department is responsible for settling death claims.
VIII. Which of the following terms is dissimilar to the other four options? (Find the odd-man out?) (Checking application of learning)
i. Which of the following terms is dissimilar to the other four in the context of insurable interest in life insurance?
a. Employer
b. Creditor
c. Surety
d. Employee
e. Debtor
Ans: e. Debtor
ii. Which of the following terms is dissimilar to the other four in the context of death claims in life insurance?
a. Early claims
b. Non-early claims
c. Foreclosure
d. Claimant’s statement
e. Deeds of Assignment
Ans: c. Foreclosure.
Insurance Institute of India Licenciate Model Question Paper with answers
IC 01 – Principles of Insurance – Model Questions
I. Select the appropriate answer to complete the sentence (Checking learning - Direct)
i. Insurance works on the principle of:
a. Sharing of losses
b. Probabilities
c. Large numbers
d. Randomness
e. All of the above
Ans: e. All of the above.
ii. Insurance helps to:
a. Prevent adverse situations from occurring
b. Reduce the financial consequences of adverse situations
c. Negate all consequences of adverse situations
d. Make assets continuously productive
e. All of the above
Ans: b. Reduce the financial consequences of adverse situations.
II. State which of the statements is/are correct (Checking learning - Direct)
i. The term ‘Risk’ includes:
a. Damage to machinery and property
b. Impact on the health or life of a person
c. Leakage of toxic products into the atmosphere
d. Effect on the healthy life of the neighbourhood
e. All of the above
Ans: e. All of the above.
ii. The main purpose of having Life insurance is:
a. As an avenue for long-term investment
b. As a medium for getting income tax benefits from savings
c. As a governmental programme for reducing poverty
d. As an avenue for short-term investment
e. None of the above
Ans: e. None of the above.
III. Answer the questions below by selecting the correct answer: (Checking learning - Direct)
i. Which of the following intermediaries do not require IRDA’s licence/ approval to operate in India?
a. Insurance Brokers
b. Insurance Agents
c. Third Party Administrators
d. Surveyors
e. All the above intermediaries require IRDA’s licence/ approval
Ans: e. All the above intermediaries require IRDA’s licence/ approval
ii. An actuary is expected to:
a. Make an exact forecast of the future liabilities of policies
b. Make a reasonable forecast of the future liabilities of policies
c. Calculate the premium required to cover a risk on a long-term basis
d. Find the probability of an insured event to happen in non-life policies
e. All the above statements are incorrect
Ans: b. Make a reasonable forecast of the future liabilities of policies
IV. Fill in the Blanks using the appropriate word(s) (Checking understanding - Indirect)
i. The principle of _____________ ensures that an insured does not profit by
insuring with multiple insurers
a. Subrogation
b. Contribution
c. Co-insurance
d. Indemnity
e. Particular Average
Ans: b. Contribution
ii. The principle of average applies when the value is _____________ in the
proposal
a. Understated
b. Overstated
c. Not ascertainable
d. Negligible
e. Only sentimental
Ans: a. Understated
iii. Fidelity Guarantee Policies cover losses due to fraud by ____________
a. Employees
b. Customers
c. Borrowers
d. Suppliers
e. Financiers
Ans: a. Employees
V. Select the expanded form of the abbreviation given (Checking understanding - Indirect)
i. CTL as used in insurance
a. Contributory Total Loss
b. Constructive Total Loss
c. Construction Totally Lost
d. Contractors’ Total Loss
e. Co-insurer’s Tally of Loss
Ans: b. Constructive Total Loss
ii. GA as used in insurance
a. General Assurance
b. General Average
c. General Adjustment
d. Guaranteed Assurance
e. Guaranteed Average
Ans: b. General Average
VI. Select the word(s) that most closely matches the given term. (Checking understanding -
Indirect)
i. Which of the following terms matches closest with ‘Family Floater’?
a. Health insurance
b. Property insurance
c. Accidental injury
d. Consequential loss
e. Marine Partial Loss
Ans: a. Health insurance
ii. Which of the following terms matches closest with ‘Asbestosis’?
a. Products
b. Pension
c. Rough Weather
d. Workmen’s Compensation
e. Long Term Policies
Ans: d. Workmen’s Compensation
VII. Find out which of the given statements is incorrect (Checking application of learning)
i. Regarding ‘Exclusions’ find out the incorrect statement.
a. Exclusions are indicated in the policy
b. Exclusions are perils or circumstances not covered
c. Exclusions limit the coverage under the policy
d. Exclusions do not deal with risk coverage
e. All the above statements are incorrect.
Ans: d. Exclusions do not deal with risk coverage
ii. Which of the following statements is incorrect in respect of brokers?
a. Brokers require to undergo training before being licensed
b. Brokers are appointed by insured to take care of their interests
c. Brokers have to pass examinations before being licensed
d. Brokers should be registered companies or firms
e. Brokers are allowed to negotiate with different insurers for the same insured
Ans: d. Brokers should be registered companies or firms
VIII. i. Which of the following terms is dissimilar to the other four options? (Find the odd-man out?) (Checking application of learning)
a. Jettison
b. Hit and Run
c. Sue and Labour
d. Salvage
e. Contamination
Ans: b. Hit and Run
ii. Which of the following terms is dissimilar to the other four options? (Find the odd-man out?) (Checking application of learning)
a. Post-hospitalisation expenses
b. Expenses on treatment of pre-existing diseases
c. Reinstatement value
d. Funeral expenses
e. Ambulance charges
Ans: c. Reinstatement value
I. Select the appropriate answer to complete the sentence (Checking learning - Direct)
i. Insurance works on the principle of:
a. Sharing of losses
b. Probabilities
c. Large numbers
d. Randomness
e. All of the above
Ans: e. All of the above.
ii. Insurance helps to:
a. Prevent adverse situations from occurring
b. Reduce the financial consequences of adverse situations
c. Negate all consequences of adverse situations
d. Make assets continuously productive
e. All of the above
Ans: b. Reduce the financial consequences of adverse situations.
II. State which of the statements is/are correct (Checking learning - Direct)
i. The term ‘Risk’ includes:
a. Damage to machinery and property
b. Impact on the health or life of a person
c. Leakage of toxic products into the atmosphere
d. Effect on the healthy life of the neighbourhood
e. All of the above
Ans: e. All of the above.
ii. The main purpose of having Life insurance is:
a. As an avenue for long-term investment
b. As a medium for getting income tax benefits from savings
c. As a governmental programme for reducing poverty
d. As an avenue for short-term investment
e. None of the above
Ans: e. None of the above.
III. Answer the questions below by selecting the correct answer: (Checking learning - Direct)
i. Which of the following intermediaries do not require IRDA’s licence/ approval to operate in India?
a. Insurance Brokers
b. Insurance Agents
c. Third Party Administrators
d. Surveyors
e. All the above intermediaries require IRDA’s licence/ approval
Ans: e. All the above intermediaries require IRDA’s licence/ approval
ii. An actuary is expected to:
a. Make an exact forecast of the future liabilities of policies
b. Make a reasonable forecast of the future liabilities of policies
c. Calculate the premium required to cover a risk on a long-term basis
d. Find the probability of an insured event to happen in non-life policies
e. All the above statements are incorrect
Ans: b. Make a reasonable forecast of the future liabilities of policies
IV. Fill in the Blanks using the appropriate word(s) (Checking understanding - Indirect)
i. The principle of _____________ ensures that an insured does not profit by
insuring with multiple insurers
a. Subrogation
b. Contribution
c. Co-insurance
d. Indemnity
e. Particular Average
Ans: b. Contribution
ii. The principle of average applies when the value is _____________ in the
proposal
a. Understated
b. Overstated
c. Not ascertainable
d. Negligible
e. Only sentimental
Ans: a. Understated
iii. Fidelity Guarantee Policies cover losses due to fraud by ____________
a. Employees
b. Customers
c. Borrowers
d. Suppliers
e. Financiers
Ans: a. Employees
V. Select the expanded form of the abbreviation given (Checking understanding - Indirect)
i. CTL as used in insurance
a. Contributory Total Loss
b. Constructive Total Loss
c. Construction Totally Lost
d. Contractors’ Total Loss
e. Co-insurer’s Tally of Loss
Ans: b. Constructive Total Loss
ii. GA as used in insurance
a. General Assurance
b. General Average
c. General Adjustment
d. Guaranteed Assurance
e. Guaranteed Average
Ans: b. General Average
VI. Select the word(s) that most closely matches the given term. (Checking understanding -
Indirect)
i. Which of the following terms matches closest with ‘Family Floater’?
a. Health insurance
b. Property insurance
c. Accidental injury
d. Consequential loss
e. Marine Partial Loss
Ans: a. Health insurance
ii. Which of the following terms matches closest with ‘Asbestosis’?
a. Products
b. Pension
c. Rough Weather
d. Workmen’s Compensation
e. Long Term Policies
Ans: d. Workmen’s Compensation
VII. Find out which of the given statements is incorrect (Checking application of learning)
i. Regarding ‘Exclusions’ find out the incorrect statement.
a. Exclusions are indicated in the policy
b. Exclusions are perils or circumstances not covered
c. Exclusions limit the coverage under the policy
d. Exclusions do not deal with risk coverage
e. All the above statements are incorrect.
Ans: d. Exclusions do not deal with risk coverage
ii. Which of the following statements is incorrect in respect of brokers?
a. Brokers require to undergo training before being licensed
b. Brokers are appointed by insured to take care of their interests
c. Brokers have to pass examinations before being licensed
d. Brokers should be registered companies or firms
e. Brokers are allowed to negotiate with different insurers for the same insured
Ans: d. Brokers should be registered companies or firms
VIII. i. Which of the following terms is dissimilar to the other four options? (Find the odd-man out?) (Checking application of learning)
a. Jettison
b. Hit and Run
c. Sue and Labour
d. Salvage
e. Contamination
Ans: b. Hit and Run
ii. Which of the following terms is dissimilar to the other four options? (Find the odd-man out?) (Checking application of learning)
a. Post-hospitalisation expenses
b. Expenses on treatment of pre-existing diseases
c. Reinstatement value
d. Funeral expenses
e. Ambulance charges
Ans: c. Reinstatement value
Licenciate Examination details for Insurance Institute of India
Name of the Exam : Licentiate
Languages Available : English,Hindi
Exam Centres :
Tutions : Oral, Postal
General : Qualification , General Info
Branches : Life , Non Life
Fees :
Indian (Rs.) Overseas (USD)
Life Membership Fee 300 40
Registration Fee 100 20
Examination Fee (per subject) 150 20
Late Fee 100 --
Examination Hand Book 50 10
Subjects for the Licentiate Exam Life Branch : (Detailed Syllabus)
Code Subject Next Exam On Next Exam Time Course No Course Fee Available In Year of Edition
01 Principles of Insurance (Principles of Life Assurance) 07-May-2006 9:30 - 12:30 I.C.01 75 English, Hindi 1999
02 Practice of Life Assurance (Practice of Life Assurance) 07-May-2006 2:00 - 5:00 I.C.02 75 English, Hindi 1999
12 Insurance Business Environment (Elements of Modern Commerce) 14-May-2006 9:30 - 12:30 I.C.12 75 English, Hindi 1999
Top
Subjects for the Licentiate Exam Non Life Branch : (Detailed Syllabus)
Code Subject Next Exam On Next Exam Time Course No Course Fee Available In Year of Edition
01 Principles of Insurance (Principles of General Insurance) 07-May-2006 9:30 - 12:30 I.C.01 75 English, Hindi 1999
11 Practice of General Insurance (Practice of General Insurance) 07-May-2006 2:00 - 5:00 I.C.11 75 English, Hindi 1999
12 Insurance Business Environment (Elements of Modern Commerce) 14-May-2006 9:30 - 12:30 I.C.12 75 English, Hindi 1999
Top
Qualification :
a) Candidate must have successfully completed Matriculation, S.S.L.C., S.S.C. or any equivalent examination
b) lMust have worked either in the field or in an insurance office for a period of atleast three years prior to the date of submission of his entry form.
General Info :Only the fundamentals of principles & practice of Insurance(Life and Non-Life) and Insurance Business Environment are to be grasped Fully.This is essentially an introductory course.
Time Limit - Four years of eight consecutives chances from the date of first entry for the examinations. Individual papers passed earlier lapse after this time limit,and also the exemption granted earlier.
Languages Available : English,Hindi
Exam Centres :
Tutions : Oral, Postal
General : Qualification , General Info
Branches : Life , Non Life
Fees :
Indian (Rs.) Overseas (USD)
Life Membership Fee 300 40
Registration Fee 100 20
Examination Fee (per subject) 150 20
Late Fee 100 --
Examination Hand Book 50 10
Subjects for the Licentiate Exam Life Branch : (Detailed Syllabus)
Code Subject Next Exam On Next Exam Time Course No Course Fee Available In Year of Edition
01 Principles of Insurance (Principles of Life Assurance) 07-May-2006 9:30 - 12:30 I.C.01 75 English, Hindi 1999
02 Practice of Life Assurance (Practice of Life Assurance) 07-May-2006 2:00 - 5:00 I.C.02 75 English, Hindi 1999
12 Insurance Business Environment (Elements of Modern Commerce) 14-May-2006 9:30 - 12:30 I.C.12 75 English, Hindi 1999
Top
Subjects for the Licentiate Exam Non Life Branch : (Detailed Syllabus)
Code Subject Next Exam On Next Exam Time Course No Course Fee Available In Year of Edition
01 Principles of Insurance (Principles of General Insurance) 07-May-2006 9:30 - 12:30 I.C.01 75 English, Hindi 1999
11 Practice of General Insurance (Practice of General Insurance) 07-May-2006 2:00 - 5:00 I.C.11 75 English, Hindi 1999
12 Insurance Business Environment (Elements of Modern Commerce) 14-May-2006 9:30 - 12:30 I.C.12 75 English, Hindi 1999
Top
Qualification :
a) Candidate must have successfully completed Matriculation, S.S.L.C., S.S.C. or any equivalent examination
b) lMust have worked either in the field or in an insurance office for a period of atleast three years prior to the date of submission of his entry form.
General Info :Only the fundamentals of principles & practice of Insurance(Life and Non-Life) and Insurance Business Environment are to be grasped Fully.This is essentially an introductory course.
Time Limit - Four years of eight consecutives chances from the date of first entry for the examinations. Individual papers passed earlier lapse after this time limit,and also the exemption granted earlier.
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