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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION |
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ORIGINAL PETITION NO. 263 OF
1999 |
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GLORIOUS PLASTICS LTD. |
........ Complainant (s) |
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Vs. |
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NATIONAL INSURANCE CO. LTD. & ANR. |
........ Opposite party(ies) |
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BEFORE: |
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HON'BLE
MR. JUSTICE M. B. SHAH, PRESIDENT HON’BLE MR. JUSTICE
K.S.GUPTA, MEMBER |
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For the Complainant : Mr.Kedar Nath Tripathi,. Advocate |
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For the Opposite party : Ms. Sakshi Mittal & Mr. V. Singh, Advocates |
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Dated |
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ORDER |
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M.B.SHAH, J. PRESIDENT.
Heard the Ld. Counsel for the parties.
The insured M/s Glorious Plastics Ltd. has filed the complaint against
National Insurance Company Ltd. for reimbursement of a sum of Rs.80 Lakh for
the loss suffered by it and for a sum of Rs.16,80,000/- towards interest lost
as on
On the basis of the claim, on
Repeatedly, the complainant himself
and through its agent Mr.H.K.Shah, made enquiries from the Insurance Company as
well as the Surveyor. Special efforts
were made to find out the policy and finally, on
Admittedly, there is no specific
letter of repudiation of the claim.
However, in the written version, Insurance Company has given reasons for
not settling the claim. Thereafter, on
In this view of the matter, the learned Counsel on behalf of the Complainant submitted that:
(i). the Surveyor, for unknown reasons, after visiting the factory premises on 8th August, 1995 failed to submit his assessment report within a reasonable time;
(ii). Non-assessment of loss by the Surveyor for the moulds is contrary to the well established trade practice that in plastic industries moulds are part and parcel of the machineries;
(iii). In support thereof, he relied upon the opinion of the Tariff Advisory Committee which is binding on the Insurance Company;
(iv). There was no justifiable reason for the Insurance Company to linger on the assessment or non-assessment of the loss suffered by the Complainant for years together;
(v). He submitted that even the Insurance Company repeatedly reminded the Surveyor to assess the loss and submit survey report. In support thereof he referred to the letter written by the Manager of the Insurance Company that he was dissatisfied by non-submission of survey report by the Surveyor.
He,wrote a letter on
“Dear Sir,
RE: Fire loss on 04.08.95 –
A/c.
M/s. Glorious Plastics Ltd.,
Situated at Mumbai
The aforesaid claim has been assigned to you for survey and
assessment. However, in the absence of
completion of the survey, Insured unhappy with the service, approached
In order to sort out the matter amicably a meeting between the Insured
alongwith the Officials of the Underwriting Office and Officials from RO was
organized on 21.01.2000 when the following were preset:
1) Mr. Ajay Podar ) Representing
2) Mr. Umes Kumar ) Insured.
1) Mr. S. Sinha Ray, D. M.,
DO-VIIL
1) Mr. S. B. Jadhav,
A.O., )
From
2) Mr. S. B. Kotian,
A.O. ) RO
At the outset, the DM of DO-VIII gave a brief resume of the pending
claim and informed the Insured that the surveyors could not assess the loss
because you have not furnished the necessary documents to the surveyors. In this connection Insured produced as
documentary evidence copies of several letters sent to you with the information
such as:
1)
Loss of tools/machinery accessories as
shown under the heading “Gross Block” in their balance sheet as on 31.03.95.
2)
List of tools/machinery accessories
damaged;
3)
List of tools/machinery accessories not
damage;
4)
List of repairs carried out by them.
This letter of the Insured’s addressed to you have been acknowledge by
you while receiving and also the same has been dispatched to our underwriting
DO with due acknowledgement. This
information has been furnished to you by the Insured vide their letter dated
22.12.98. In the light of the above
we do not understand why the assessment was not completed as yet. In case, however, you needed further
information you could have sought the same from the Insured, whereas there is
no correspondence in their file showing any of your further requirements.
You are, therefore, requested to let us know why the assessment
is pending in spite of all the information submitted by the Insured to you
as per Insured’s submission. Moreover
you will appreciate the claim is very old and we cannot keep the same pending
by making provision for the outstanding claims year after year. Please treat the matter as urgent and let the
DO have your reply with supporting documents for enabling them to take
appropriate decision without any further delay”.
Thereafter, on
“Ref: Pending Survey Report
We refer to our earlier letter dated 18.1.2000 and subsequent meeting we had with our client at our Regional office on 21.1.2000 in presence of the concerned Fire Department Officer. We understand that insured has already submitted the documents to your office, long back and as such we fail to understand, why the report (assessment) not yet submitted to us.
Please note due to the above reason, our position become very awkward
and the concerned client has filed a Petition before the National
Consumer Disputes Redressal Commission on 10th Dec., 1999 for which
we have to reply the reason for non-settlement.
In view of the above, you are once again requested to submit your report
without any further loss of time.”
As
against this, the learned Counsel for the Insurance Company submitted as under:
.A. No loss suffered by the Complainant:
The fire occurred in the first floor occupied by another party. During the visit of the Surveyors on 7.8.1995, the flooring of the first floor premises was found to be unaffected. The Complainant had informed the Surveyor that the Complainant would check the machine and inform the Surveyor accordingly, because the Complainant was under the suspicion that because of the water used for extinguishing the fire, the machinery would have been damaged. But, the Complainant did not inform the Surveyor even on 16.8.1995 when a telephonic conversation was exchanged between the Surveyor and the Complainant. Further, the Complainant did not convey the Insurance Company the estimated loss, as is evident from his letter dated 23.11.1995.
.B. Even after nine months the Complainant did not cooperate with the Surveyors:
(a). even after the inordinate delay of nine months from the date of loss in making the claim, the Complainant did not cooperate with the Surveyors. The Complainant did not submit all the documents even after an inordinate delay of more than 3 years in complying with the requirements of the Surveyors and that too in piecemeal;
(b). The Complainant did not submit documents for a period of one year, and, for the first time, the Complainant sent some documents on 13.1.1998, i.e. after two years and five months and that too not as required by the Surveyors. Thereafter the Insurance Company wrote letter dated 8.12.1997 and 18.8.1998, but the Complainant did not bother to supply the documents as required by the Surveyors. The opposite party once again by letter dated 19.8.1998 requested the Complainant to comply with the requirements of the Surveyors to enable them to process for preparation of the survey report. Thereafter, by letter dated 13.3.2001 it was brought to the notice of the Complainant that the Surveyor had not received the required documents. Thereafter, the Surveyors submitted their report dated 29.6.2001 assessing the loss at Rs.20,203/-.
.C. Claim with regard to loss of moulds clearly falls under the exclusion clause (i)(iv).
(i). The loss which is mainly in respect of moulds, clearly falls under the exclusion clause (i) and (iv) of the policy.
(ii). In interpreting documents relating to a contract of insurance the duty of the court is to interpret the words in which the contract is expressed by the parties and it is not for the court to make a new contract, however reasonable, if the parties have not made it themselves.
(iii). the circular of the Tariff Advisory Committee is dated 30.6.1998, which cannot be given retrospective effect.
(iv). After the completion of the contract, no material alteration can be made in its terms except by mutual consent.
(v). The Complainant has failed to prove the loss and also the amount of loss on moulds, as is established from the cross examination of Mr.Ajay Poddar, Director of the Complainant Company.
(vi). The Complainant’s net loss is Rs.20,203/- as assessed by the Surveyors.
(vii). There is no averment as to why the Complainant remained silent for nine months after the occurrence of the peril.
.D. The terms of the contract have to be construed strictly without altering the nature of the contract as it may affect the interest of parties adversely. Reliance is placed by the opposite party on the following decisions:
(i). General Insurance Society Ltd. Vs. Chandmull Jain & Anr. AIR 1966 SC 1644
(ii). Polymat Industries Pvt. Ltd. Vs. National Insurance Co. Ltd. AIR 2005 SC 286;
(iii). Oriental Insurance Co. Ltd. Vs. Samayanallur Primary Agricultural Coop. Bank, (1999) 8 SCC 543
.E. The circular of the TAC (Tariff Advisory Committee) sought be be relied upon by the Complainant is dated 30.6.1998 and cannot be given retrospective effect. In the instant case the alleged occurrence is of August, 1995.
.F. After the completion of the contract, no material alteration can be made in its terms except by mutual consent. Reliance is placed on United India Insurance Co. Ltd. Vs. M.K.J. Corporation, (1996) 6 SCC 428.
Findings:
Survey Report:
For deciding the controversy, we would
first refer to the survey report. Some portion thereof as quoted in their written
version, is as under:
“The occurrence:
As reported, on Thursday
the 3rd August, 1995, at about 6.00 pm, the factory of M/s
innovation Garments Ltd., and the office of M/s.Neoluxe Laminates (both on the
first floor) were closed and locked by them and nobody slept inside.
The keys were with the gate office.
On Friday the 4th August, 1995, at about 5.30 am, a whatchman
on his rounds noticed smoke coming out from an air-conditioner in the office of
M/sNeoluxe Laminates.
The Watchman immediately raised an alarm and ran to inform the
supervisor in the plastic blow-moulding factory of the insured, which was on
the ground floor of the building and which was working at that time.
Immediately, the watchman and the supervisor ran to the main gate and
phoned up the fire brigade. In the meantime, the fire had spread and smoke was
coming out from various sides of the first floor. The fire brigade arrived
shortly, broke down the entrance shutter and started fire fighting.
The fire had spread swiftly, covering up furniture, etc. in the office
of M/s. Innovation garments Ltd.
The fire was abated by about 6.30 am and was controlled and extinguished
soon thereafter by firemen with 8 lines of 8 motor pumps.
However, the entire office of M/sNeoluxe Laminates and almost the entire
factory of M/s. Innovation Garments Ltd. except for a small room on the
southern end were caught up and were gutted.
The Bombay Fire Salvage Corps of the loss Prevention Association of
India ltd., also attended and rendered etc., on the ground floor with 24
tarpaulins.
A copy of the report from the Bombay Fire Salvage Corps is enclosed
herewith.
The Bhoiwada Police had attended at the site and the matter was recorded
at the police station.
A copy of the entry recorded in the Bhoiwada Police Station Diary, along
with the English translation thereof are enclosed herewith.
A Police Panchanama was also made at the site.
A copy of their Panchanama along with the English translation thereof are enclosed herewith.
THE
CAUSE:
The fire is believed to have been caused by an electrical short-circuit in the office of M/s.Neoluxe Laminates, on the first floor of the main building.”
“We received instructions from the insurers on 7.8.1995 along with a
copy of the above mention to survey and assess the said loss.
We
visited the insured’s above mentioned premises on 8.8.1995 and met there Shri
Pavan Podar. During the visit the entire first floor with the roof and
contents therein we found to have been severely burnt / damaged.
The machinery/accessories in the insured’s premises on the ground floor were found to have been covered by tarpaulins, bearing Fire Salve Corporations thereon and belonging to them.
The
insured had suspected their machinery/accessories on the ground floor to
have been damaged by water used for extinguishing the fire.
We were
informed that the factory compound had already been surrounded by water
accumulated due to excessive rain, as a result of which their machinery,
tools and accessories remained submerged under water.
We were
shown the water marking along the walls.
We were
informed by Shri Pavan Podar that if the loss would not be significant they
would not press for the claim.
On 14th
May, 1996, Shri Ajay Podar informed us that they wanted to prefer the claim and
on that very day they submitted their claim on moulds and dies.
On the
same day we informed Shri Ajay Podar
that the loss claim was on moulds and dies was not justifiable.
THE
ASSESSMENT OF LOSS:
(1) Tools & Accessories (Moulds/dies) Rs.39,23,376.00
(2) Cost of repairs to machines Rs. 6,39,539.00
(3) Machinery & Accessories Rs.57,50,000.00
(Moulds/dies)
The claim statements to have that effect is enclosed herewith.
The insured have submitted quotations for these (Moulds/Dies) from M/s. Vasco & M/s. Tharaghandi Industries.
On examining these quotations they clearly show that these items are moulds.
On examining the “Schedule No.6” “Fixed Assets” of the Insured’s balance sheets it was found that they have declared their “Machinery” and “Moulds/Dies” as under:
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Year |
Item No. |
Assets |
Net Block Value (In Rs.) |
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1993 |
(i) |
Machinery |
7,15,175.56 |
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(k) |
Moulds and Dies |
9,32,328.54 |
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1994 |
(i) |
Machinery |
4,87,190.91 |
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(k) |
Moulds and Dies |
41,03,175.45 |
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1995 |
(i) |
Machinery |
2,97,745.72 |
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(l) |
Moulds and Dies |
91,34,816.62 |
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1996 |
(i) |
Machinery |
7,28,362.23 |
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(l) |
Moulds and Dies |
10,85,140.27 |
Copies of the “Schedule No.6” “Fixed Assets” are enclosed herewith.
A careful examination of the insured’s claim show that the major part of the claim comprises of loss/damages to moulds and dies.
It is thus necessary to examine whether the moulds and dies are covered under the above mentioned policy.
The above mentioned policy issued to the insured clearly shows that following items are covered.
(1) tools & Accessories Rs. 30,00,000.00
(2) Machinery & Accessories Rs. 50,00,000.00
(3) Stock & Stock in process Rs. 5,00,000.00
________________
Rs. 85,00,000.00
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Thus, it
is clear that mould and dies are not covered under the policy.
Further
examination of the policy shows that under “Exclusions””
This
insurance does not cover unless otherwise expressly stated in the policy, loss
or damage to
(iv)
Manuscript, plans, drawings or designs, patterns, models or
moulds.
The insured have reported that the factory compound had already been
surrounded by water accumulated due to excessive rain, as a result of which
their machinery, tools and accessories remained submerged under water.
That period was peak monsoon period and there was flooding in the low
lying areas of city Mumbai and its suburbs.
Since the insured is claiming on account of flood it is necessary to
examine the scope of cover in the above mentioned policy.
On examining the above mentioned policy issued to the insured, it
clearly shows that the risks due to fire, lightening, explosion/implosion,
impact, damage, air craft damage, riot, strike, malicious and terrorist damage
risks have been covered.
Storm, cyclone, typhoon, tempest, hurricane, tornado, flood and
inundation risks are not indicated in the policy.
It is further strengthened by the fact that additional premium
chargeable under the tariff for this additional risks has also not been
paid/charged.
Since the insured is pressing hard for settlement, we are without
prejudice, assessing the loss, as under:
Item Amount
Electric motors Rs. 13,024.00
Electric motors Rs.
6,237.00
Electric motors Rs.
3,545.00
Electric motors Rs.
2,400.00
Electric motors Rs.
3,655.00
____________
Rs. 28,861.00
Less: Depreciation at 30% Rs. 8,658.00
____________
Insured’s net loss Rs.
20,203.00”
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From the aforesaid survey report it is
apparent that a devastating fire had taken place on the first floor of the
building, in which the insured was having his factory on the ground floor.
The Bombay Fire Salvage Corps of the
loss Prevention Association of India Ltd., has also submitted its report. The
fire was abated and controlled by firemen with 8 lines of 8 motor pumps. The
cause of fire as stated by them is short-circuit. He visited the premises on 8th
August, 1995. At that time also the insured have claimed that the machines and
dies/moulds on the ground floor of the factory have been damaged by water used
by fire brigade to extinguish the said fire which seeped from wooden floorings.
During
the visit, the entire first floor roof and contents therein were found to have
been severely burnt/damaged. The insured had suspected their
machinery/accessories on the ground floor to have been damaged by water used
for extinguishing the fire.
They were also informed that factory compound
had already been surrounded by water accumulated due to excessive rain as a
result of which the machinery, tools and accessories remained submerged under
water.
They
have assessed the loss only for electric motors at Rs.20,203/-.
Ld. counsel appearing on behalf of the
Insurance Company submitted that claim for the mould or die is not covered in
view of specific Exclusion Clause. The
aforesaid survey report would also establish that the Surveyor has assessed the
loss by not taking into account the loss suffered by the Complainant for the
moulds, on the ground that moulds are excluded as per the insurance policy.
Therefore, the first question which
would require consideration is whether in view of the clarification made by the
Tariff Advisory Committee on 30th June, 1998, the insured is
entitled to get its benefit ?
Firstly, it is settled law that opinion given by the Tariff Advisory
Committee is binding to all the
Insurance Companies.
The opinion dated 30th June, 1998 given by the Tariff
Advisory Committee qua the moulds used by the plastic manufacturers is as
under:
Sub: Moulds for Plastics Goods
Manufacturing-
Clarification
Fire Policy ‘C’ excludes
loss or damage to manuscripts, plan, drawings or designs, patterns, models or moulds
unless otherwise expressly stated in the policy.
In this connection we
have received a representation from Indian Plastic Federation, Calcutta,
OPIPET, GSPMA, IPI, OPPI, AIPMA – various Associations representing Plastic
manufacturers with a specific query as to whether plastic injection moulds
are covered under the heading plant and machinery or not. They have further contended with supporting
arguments that moulds should be treated on par with machinery as it is an
integral part of the machine.
Secretariat’s views:
Moulds are usually
required to be made to customer specifications and have intrinsic value. Very often, moulds are replaced depending
upon the end product. Hence all moulds
other than one used in the machine are kept separately. Unless otherwise these are specifically included,
the loss or damage to the mould is not covered.
In our opinion the intention of this
condition is not to exclude loss or damage to the mould which is in the
machine as an integral part.
A clarification may, however, be made
that the condition will not apply for the moulds which form an integral part of
the machine.
Submitted for consideration.”
Thereafter, on 30.6.1998, the Tariff Committee informed the insurance companies to amend the Exclusion Clause in fire policies A, B and C by deleting the words “patterns, models or moulds” appearing therein. The insurance companies were further requested to advise their operating offices suitably in that regard pending reprinting of relevant sheets of All India Fire Tariff.
The next question which requires
consideration is whether the said clarification or meaning would apply to the
policy which was taken in July, 1995.
The
Exclusion Clause, in the policy, at the relevant time was:
“This insurance does not cover
i)
unless otherwise expressly stated in the
policy, loss or damage to
iv)
manuscripts, plans, drawing or design,
patterns, models or MOULDS.”
Learned counsel appearing on behalf of the complainant highlighted the opinion expressed by the Secretariat of the Tariff Board, which is as under :
“In our opinion the intention of this condition is not to exclude
loss or damage to the mould which is in the machine as an integral part.
A clarification may, however, be made that the condition will not
apply for the moulds which form an integral part of the machine.”
The
learned Counsel for the Complainant, therefore, submitted that the direction by
the Tariff Advisory Committee to amend the Exclusion Clause made it clear by
deleting certain words would not mean that deletion has taken place after 30th
June 1998 and MOULDS were not covered prior to that date. It is his contention that the intent and
purpose of clarification would be defeated if it is meant for giving only
prospective effect.
It is true that the Tariff Advisory
Committee has advised to suitably amend the Exclusion Clause by its order dated
30.6.1998. At the same time, the
Secretariat has specifically clarified that for the plastic industries, MOULDS
were covered by the insurance policy because they are integral part of the
machinery.
In our view, the said opinion of the Tariff Advisory Committee only clarifies the existing position and, therefore, there is no question of any retrospective or prospective operation of the said clarification. The reason is that MOULDS used in industries for manufacturing plastic goods are all-throughout covered by the insurance policies, as it is integral part of machinery. Because, the Tariff Advisory Committee has specifically stated that in plastic industries moulds are the integral part of the machinery. Thereafter, they have issued a clarification to the effect that “the condition will not apply for the moulds which form an integral part of the machine”. The existing contract of the insurance is required to be understood accordingly. In view of the aforesaid clarification by the Tariff Committee it hardly lies in the mouth of the Insurance Company that moulds are not covered in the present case.
At this stage, we would state that even with regard to the statutory provision, clarification would have retrospective effect because it clarifies the position which already exists. Therefore, by the Tariff Committee’s clarification it is made clear that qua plastic industries moulds are integral part of the machine and hence not to be equated with the moulds which are used in other industries. The exclusion clause may be applicable to other industries, but for plastic industries, it is part and parcel of the machinery and/or is usually required to be made as per customer’s specification.
Further, clarification may require consideration, whether it is retrospective or prospective. But, stating meaning of a word does not require any further consideration, i.e. whether it is retrospective or prospective, because that is the meaning which is understood all throughout.
In
the present case, the Tariff Advisory Committee held that ‘mould’ is an
integral part of the ‘machinery’ in the plastic industry. That means, it is
machinery and hence insurance cover which is applicable to the machinery would
be applicable.
Hence, it is highly improper on the part of the Insurance Company, after Tariff Committee’s clarification, to contend that moulds are not part and parcel of the machinery.
The law with regard to clarification:
It is settled law that even amendment of the law if it is clarificatory or declaratory in nature it would have retrospective effect.
The Court in Shri Chaman Singh & Anr. Vs. Srimathi Jaikaur, (1969) 2 SCC 429 observed:
“… It is well settled that if a statute is curative or merely declares the previous law retroactive operation would be more rightly ascribed to it than the legislation which may prejudicially affect past rights and transactions”.
Dealing with the contention that the ‘Acetic Anhydride’ manufactured by the assessee sold to drug manufacturers for using it for manufacturing drugs can be considered to be drug intermediate in exemption notification, the Apex Court in the case of Collector of Central Excise, Guntur Vs. Andhra Sugar Ltd., Venkata Rayapuram, (1989) Supp 1 SCC 144, referred to the Government’s view that this requirement of end-use though not built into the exemption notification is not only implied but also becomes imperative in a situation where the produce has uses other than a drug intermediate whereas the exemption is limited only to drug intermediate that is when the produce is used as a drug intermediate. And held in para 5 as under:
“5. It appears that the same principle
was reiterated in the case of In re Shasun Chemicals (Madras) P. Ltd. (1982)
ELT 786. It is well settled that the
meaning ascribed by the authority issuing the notification, is a good guide of
a contemporaneous exposition of the position of law. Reference may be made
to the observations of this Court in K. P. Varghese v. ITO (1981) 4 SCC 173. It
is a well settled principle of interpretation that courts in construing a
statute will give much weight to the interpretation put upon it at the time of
its enactment and since, by those whose duty has been to construe, execute and
apply the same enactment.”
The same would be
the position in the present case, because the clarification or the directions
issued by the Tariff Advisory Committee
are binding to the insurance companies. Therefore, while interpreting
the term of the policy weight has to be given to the Tariff Advisory
committee’s clarification that moulds in plastic industries were/are part and
parcel of machinery.
Similar
is the direction the case of State of Tamil Nadu Vs. Mahi Traders & Ors.
(1989) 1 SCC 724, dealing with interpretation of Central Sales Tax Act, 1956,
the Court observed that opinion rendered on meaning of statutory expressions by
the concerned department at the initial stage when the statute came into force
can be given effect to in interpreting the provision s of the statute if not
shown to be clearly wrong. While discussing this aspect, in para 8 it is held
as under:
“8. It has been pointed out by this
Court in Desh Bandhu Gupta v. Delhi Stock Exchange Association Ltd. (1979) 4
SCC 565 and K.P. Varghese v. ITO (1981) 4 SCC 173 that a contemporaneous exposition by the
administrative authorities is a very useful and relevant guide to the interpretation
of the expressions used in a statute. Considering that the above
clarification was sought for at the earliest point of time when a doubt arose
as to the scope of the expression used by the statute and given after
considering the technicalities of the processes employed in the manufacture of
finished leather by the department fully conversant with this branch of
trade and in the context of the provisions of this very statute, the terms
of the statute can well be construed by reference to such exposition, in the
absence of anything in the statute to indicate the contrary. Indeed, “such
interpretation should be shown to be clearly wrong before it is overturned”.
Similarly,
in Union of India & Ors. Vs. S. Muthyam Reddy, (1999) 7 SCC 545, the Court
observed that declaratory amendment would have retrospective operation.
Further, an amending Act may be purely declaratory to clear a meaning of a
provision of the principal Act which was already implicit. A clarificatory
amendment of this nature will have retrospective effect. [Re. Zile Singh Vs.
State of Haryana, (2004) 8 SCC 1].
Considering
the aforesaid settled law, in our view, clarification given by the Tariff
Advisory Committee that molds in the plastic industries are integral part of
machinery, no question of excluding the moulds while giving the insurance cover
would arise. In these set of circumstances, it is to be held that the
clarification given by the Tariff Advisory Committee is binding even the insurance
policy which was taken in the year 1995 and the fire took place in August,
1996, as it merely clarifies the existing position that moulds are part and
parcel of the machinery.
In
this view of the matter, the contention of the learned Counsel Mr.Mehra, that
the terms of the contract are to be interpreted on the basis of the words used
therein deserves no further consideration and the judgment cited by him in
support of thereof does not require any further consideration. As there was
doubt as to whether the moulds used by the plastic industries would be covered
by the exclusion clause, the Tariff Advisory Committee clarified that in an
insurance cover by the plastic industry ‘moulds are integral part of the
machinery’ and to be treated as such. This clarification was sought by the
plastic industries from the Tariff Advisory Committee and that clarification is
binding to the insurance companies.
Insurance
premium on the basis that moulds are part of machinery:
Further, in
support of this claim, insured has stated that one Mr.H.K.Shah acting as an
agent of the Insurance Company approached him for effecting fire insurance of
Plant and Machinery and accessories worth about a Crore of Rupees safe guarding
them from the risk of fire. After
discussion, the valuation of the machinery tools and accessories was made as
under:
”Tools & Accessories Rs.30,00,000.00
Machinery & Accessories Rs.50,00,000.00
Stocks Rs.5,00,000.00
Total Rs.85,00,000.00
The above break-up also included the cost
of Moulds, which amounts to almost 90% of the total value of the Tools,
Machinery and Accessories insured under the policy. The opposite Insurance Company accepted this
valuation and the break-up and the same have been incorporated in the policy
issued by them and only thereupon was the premium payable calculated and
charged from the Complainant Company.
I say that therefore the Complainant had
insured its assets consisting of Tools and Accessories and machinery and
accessories and stocks with the Opposite Party no. 1, through the Opposite
Party no. 2 having its office at Mumbai.
The O.P. No.2, issued the Insurance Policy bearing No.
250800/II/Complainant3115376/95, for the period from 31.7.95 to 30.7.96, which
pertains to the relevant period of loss.
The said insurance policy was delivered to the Complainant Company only
on 27/11/95 after more than four months of the execution of the cover note
covering all risks from 31.7.95 to 30.7.96.
The Complainants are the consumers of the services rendered by the
Opposite Parties under the Insurance Policy.
I say that the Insurance Company charged
the premium on all the items at Rs.36,713/-.
If it was the intention of the Insurance Company to exclude the Moulds
from the scope of the coverage then the sum Insured would have reduced to
Rs.8,50,000/- only and premium would have been merely Rs.3,671/-. It is therefore clear that the Insurance
Company accepted the understanding reached between their Agent Shri H. K. Shah
and the Complainant Company”.
The Insurance Company had
not filed any affidavit of H.K.Shah, the agent of the Insurance Company,
denying the aforesaid statement. In any case, denial by some other persons
subsequent to the occurrence of peril caused to the premises would have no effect because, in the present case, 90% of
the machinery in the factory of the insured consist of moulds. The insurance
cover is mainly for tools and accessories, machinery and accessories for a sum
of Rs.80 lakhs. This would establish that if moulds are not covered by the
insurance policy there was no question of paying premium for such a large
amount. Therefore, the subsequent assertion of the Insurance Company cannot be
relied.
Further, it is to be stated that if
moulds are not covered then, the Insurance Company ought to have repudiated the
claim in the year 1996 itself or the surveyor ought to have submitted the
report in the year 1996. But, the surveyor delayed it for years together and
thereafter, on one pretext or the other, he avoided submission of the report
despite the warning given by the Manager and the Chief Manager
of the Insurance Company. He submitted the report when the
Insurance Company pointed out that a complaint was filed before the Consumer
Fora, he hesitantly submitted the report stating that the insured was not
entitled to any compensation for the loss suffered on account of moulds, by
ignoring the Tariff Advisory Committee clarification.
In this view
of the matter, in our view, the insured is entitled to reimbursement for loss
suffered by him for the moulds.
Delay in submitting the claim form:
Next, it is contended by Mr.Mehra, learned Counsel for the Insurance Company that there was delay on the part of the Complainant in lodging the claim. This submission is without any substance because immediately after the fire, the Insurance Company appointed the Surveyor who visited the site on the 8th August, 1995. Therefore, it cannot be said that the insured has not lodged the claim within the prescribed time limit. It is true that exact amount was not claimed by the insured by insisting that the surveyor has to assess the loss. That was not done by the surveyors. Therefore, only in March 1996, he lodged a formal claim. But, that would not mean that his claim is not required to be entertained even though it is genuine, because information was given at the earliest to the insurance company; the Insurance Company appointed surveyor on 7th August, 1995; and, he visited the site on 8th August, 1995. At that time also the insured has informed the surveyor that he has suffered loss to his tools and machinery.
Relevant documents not produced by the insured:
Further, the contention of the Insurance Company or the Surveyor that the insured has not produced the relevant documents is baseless. In the letter dated 27.1.2000 written by the Manager of the Insurance Company to the surveyor it has been specifically stated that to sort out the matter amicably a meeting between the insured along with the officers of the Insurance Company was organized. In that letter it has been specifically stated that the insured produced as documentary evidence copies of several letters sent to the surveyor with the information such as:
.1. Loss of
tools/machinery, accessories as shown under the heading “Gross Block”in their
balance sheet as on 31.3.1995;
.2. List of
tools/machinery accessories damaged;
.3. List of
tools/machinery accessories not damaged;
.4. List of
repairs carried out by them.
On
the basis of the said information the Manager informed the surveyor that there
was no reason why the assessment was not computed. He specifically asked the
surveyor to let them know why the assessment was pending in spite of all the
information submitted by the insured to him as per the insured’s submission. The Divisional Manager also wrote a similar
letter dated 1.2.2000 wherein it has been specifically averred that the insured
has already submitted the documents to the office of the surveyor long back.
Therefore, the contention of
the learned counsel that the insured has not submitted the relevant documents
to the surveyor is without any substance and is apparently an after thought
contention.
Admittedly,
in the present case, the Insurance Company has not repudiated the claim.
However, in the written version it has been pointed out that by letter dated 8th
December, 1997 written to the complainant that the Insurance Company stated
that it would be constrained to treat the claim as ‘no claim’ if the
complainant fails to submit various documents required by the surveyor.
However, as stated above, in order to
sort out the matter amicably, a meeting between the insured along with the
officers of the Insurance Company and officials from RO was organized on
21.1.2000. The Manager as well as the Chief Manager and the persons who were
sitting in the meeting were satisfied that the
insured had submitted the relevant documents and the surveyor was required to
assess the loss. Therefore, there is no question of disentitling the insured to
recover any amount from the Insurance Company on the ground that the insured
has not submitted the relevant documents.
No loss suffered by the complainant:
Lastly,
the learned Counsel for the Insurance Company submitted that the insured has
not suffered any loss. In our view, this submission is without any basis. The
insured has produced the documentary evidence to establish that the moulds were
affected by water would be of no consequence
in plastic industries.
Conclusion:
For
the reasons stated, it is apparent that the complainant is entitled to have
reimbursement for the loss suffered by him to the moulds, when loss admittedly
not assessed by the surveyor.
In
this set of circumstance, it is difficult for us, in this complaint, to assess
the loss suffered by the complainant. Hence, the Insurance Company is directed
to appoint another competent surveyor for assessing the loss on the basis of
the documents which are produced on record.
Meantime, the Insurance
Company is directed to reimburse the complainant the sum of Rs.20,203/- with
interest at the rate of 12% p.a. from 1.8.1996, i.e. after one year from the
date of the incident till its payment.
The Insurance Company is
directed to submit the assessment report within a period three months from
today.
……………………………..J.
( M.B. SHAH )
PRESIDENT
……………………………..J.
( K.S. GUPTA)
MEMBER