The State Jammu and Kashmir Consumer Disputes Redressal Commission has held private insurance firm ICICI Lombard liable for deficiency in service for allegedly not settling a Baramulla resident’s claim after his house was damaged in the 2017 flash floods that caused severe losses in the region. The consumer body accordingly ordered the payment of Rs 22.99 lakh as insurance claim and compensation to the man.
President Nighat Sultana and member Maheep Gupta were hearing the plea of one Mohammad Ishaq Rather, who claimed extensive damages to his residential property due to the natural calamity. The man sought an insurance claim, but the insurance company denied it, saying the damage was not caused by any event covered under the insurance policy.
The commission, however, on June 24 held, “It is the insurance company that is to be blamed for its failure to take the necessary steps to safeguard its interest. We must also mention here that even the photographs of the loss were not placed on records by the insurance company as would have enabled us to draw our own independent inference/conclusion.”
The man’s house, insured with ICICI Lombard, was reportedly damaged after heavy rains on April 6, 2017, due to flash floods. He claimed that the damages were covered under the policy, which was operational during the time of the calamity.
The company, however, rejected the claim, stating that the damage was not caused by any specific event covered under the policy. Aggrieved by the rejection, the man approached the commission for compensation.
Major cracks: Surveyor report
The insurance company appeared before the commission on August 20, 2018, and was directed to submit arguments and the claim file. Due to its absence for over six months before the commission, the company had lost the right to file a written version of their stand, or place evidence on record. The commission further noted no attempt by the insurer to examine the complainant or his witnesses. On October 9, 2024, company’s counsel placed a “no claim” survey report.
The body, however, noted that the surveyor had recorded that the building was “still in damaged condition” with “major cracks on various portions of the building”, without alterations to the floor or the nearby ground.
The commission held that since the company never contested the claim and never took evidence of witnesses, the onus was on the company for failing to take necessary steps to defend its case. The commission did not treat the loss as “total loss” as the man did not refer to any collapse and no supporting evidence was also placed on record.
It noted that although the house was insured for Rs 30 lakh, there was no reliable material to calculate the degree of loss and awarded compensation on an “approximation basis”. Observing that half of the insured amount was “just compensation”, the commission awarded Rs 15 lakh to the house owner for the physical damage to the property and Rs 7.64 lakh towards the delay in settlement with a 6 per cent annual interest from December 27, 2017 to June 24, 2026. Besides, Rs 35,000 was to be paid towards mental agony and litigation expenses.
The commission suggested that all insurance companies and banks should revisit their “case monitoring system” to avoid such “inevitable adverse orders”.
For consumer-related grievances, individuals may contact the consumer helpline in their respective states (Jammu and Kashmir Consumer Commission Helpline: 1800 180 7114) or call the National Consumer Helpline at 1915 for assistance.( _IE_)
