Supreme Court Dismisses Appeal Against NCDRC Order Rejecting Insurance Claim for Road Damage Due to Normal Wear and Tear Exclusion. The appellant failed to prove that the damage was caused by abnormal rainfall and not normal wear and tear under Section 1 of the insurance policy.

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Case Note & Summary

The appellant, Mahavir Road and Infrastructure Pvt Ltd., was undertaking road resurfacing and asphalting in Nashik and obtained an insurance policy from IFFCO Tokio General Insurance Co Ltd. The policy covered 'material damage' under Section 1, which included loss or damage from any cause except those specifically excluded. The exclusions included normal wear and tear and gradual deterioration due to atmospheric conditions. The appellant submitted a claim alleging that between 25 June 2007 and 5 July 2007, the roads suffered loss and damage due to abnormal rainfall and water logging, specifically heavy rains on 29 June 2007 causing inundation and washing out of the top layer. The insurer rejected the claim on 28 March 2008, citing defective workmanship and failure to provide an alternative route, and later on 13 May 2008, relying on the exclusion for normal wear and tear and gradual deterioration due to atmospheric conditions. The surveyor's report dated 21 March 2008 found only surface damage, no evidence of flood water, and attributed the damage to movement of traffic on wet roads and normal wear and tear. The NCDRC dismissed the consumer complaint, noting inconsistencies in the appellant's dates of damage, delay in intimation, lack of expert evidence, and meteorological data showing minimal or no rainfall on the alleged dates. The Supreme Court upheld the NCDRC's decision, holding that the appellant failed to prove that the damage was not due to normal wear and tear, as the surveyor's report and meteorological data contradicted the claim of abnormal rainfall. The appeal was dismissed.

Headnote

A) Insurance Law - Material Damage Policy - Exclusion Clause - Normal Wear and Tear - The appellant claimed insurance for road damage due to abnormal rainfall and water logging. The policy excluded normal wear and tear and gradual deterioration due to atmospheric conditions. The Supreme Court held that the appellant failed to prove that the damage was not due to normal wear and tear, as the surveyor found only surface damage and meteorological data showed no excessive rainfall on the alleged dates. (Paras 1-8)

B) Consumer Protection - Deficiency of Service - Burden of Proof - The appellant alleged deficiency of service by the insurer in rejecting the claim. The NCDRC and Supreme Court held that the appellant did not discharge the burden of proving that the damage fell within the policy coverage, as no expert evidence was adduced and the surveyor's report contradicted the claim. (Paras 4-8)

C) Insurance Law - Surveyor's Report - Evidentiary Value - The surveyor's report indicated that the damage was due to movement of traffic on wet roads and normal wear and tear, not flood or inundation. The Supreme Court upheld the NCDRC's reliance on the surveyor's report and meteorological data to reject the claim. (Paras 3-8)

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Issue of Consideration

Whether the NCDRC erred in rejecting the appellant's claim for insurance coverage for road damage allegedly caused by abnormal rainfall and water logging, given the policy's exclusion for normal wear and tear and gradual deterioration due to atmospheric conditions.

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Final Decision

The Supreme Court dismissed the appeal, upholding the NCDRC's order rejecting the consumer complaint. The Court held that the appellant failed to prove that the damage was not due to normal wear and tear, as the surveyor's report and meteorological data contradicted the claim of abnormal rainfall. The appeal was dismissed with no order as to costs.

Law Points

  • Insurance law
  • Consumer protection
  • Burden of proof
  • Exclusion clauses
  • Surveyor's report
  • Meteorological data
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Case Details

2019 LawText (SC) (3) 71

Civil Appeal No.7315 of 2016

2019-03-25

Dr. Dhananjaya Y Chandrachud, Hemant Gupta

Mr. Anirudha Joshi, Mr. Abhishek Singh, Mr. Onkar Singh, Mr. Saurabh Mishra (for appellant); Mr. Abhishek Mishra, Mr. Rajat Khattry, Mr. Vivek Kishore (for respondent)

Mahavir Road and Infrastructure Pvt Ltd.

IFFCO Tokio General Insurance Co Ltd

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Nature of Litigation

Civil appeal against order of National Consumer Disputes Redressal Commission (NCDRC) rejecting consumer complaint alleging deficiency of service in rejection of insurance claim.

Remedy Sought

Appellant sought reversal of NCDRC order and direction to insurer to pay the insurance claim for damage to roads.

Filing Reason

Appellant's insurance claim for road damage due to alleged abnormal rainfall and water logging was rejected by the insurer, and the NCDRC dismissed the consumer complaint.

Previous Decisions

NCDRC rejected the consumer complaint on grounds of inconsistency in dates of damage, delay in intimation, lack of expert evidence, and surveyor's report indicating normal wear and tear.

Issues

Whether the NCDRC erred in rejecting the appellant's claim for insurance coverage for road damage allegedly caused by abnormal rainfall and water logging, given the policy's exclusion for normal wear and tear and gradual deterioration due to atmospheric conditions. Whether the appellant discharged the burden of proving that the damage fell within the policy coverage and not under the exclusion.

Submissions/Arguments

Appellant argued that the insurance policy covered damage due to 'any cause whatsoever' under Section 1, and the exclusion for normal wear and tear did not apply because the damage was due to abnormal rainfall and water logging. The notice of claim was within 14 days as per Clause 5. Respondent argued that the claim was specifically based on flood/inundation, but the surveyor found no evidence of flood damage, only surface damage due to traffic and normal wear and tear. Meteorological data showed no excessive rainfall on the alleged dates.

Ratio Decidendi

The burden of proof lies on the insured to show that the loss falls within the policy coverage and not under any exclusion. Where the policy excludes normal wear and tear, the insured must adduce evidence to establish that the damage was caused by a covered peril. In this case, the appellant failed to provide expert evidence or credible meteorological data to support its claim of abnormal rainfall, and the surveyor's report indicated normal wear and tear. Therefore, the claim was rightly rejected.

Judgment Excerpts

The insurance policy specifically excluded normal wear and tear. In order to establish that this was not a case involving normal wear and tear, the appellant sought to rely upon what it described as abnormal rainfall and water logging. The evidence on the record did not sustain the basis of such a claim. The failure of the appellant to examine any expert in regard to the cause of the damage is a significant omission which has been correctly relied upon by the NCDRC.

Procedural History

The appellant filed a consumer complaint before the National Consumer Disputes Redressal Commission (NCDRC) alleging deficiency of service by the insurer in rejecting the insurance claim. The NCDRC dismissed the complaint on 23 February 2016. The appellant then appealed to the Supreme Court of India, which dismissed the appeal on 25 March 2019.

Acts & Sections

  • Insurance Policy (Contract): Section 1 (Material Damage), Exclusions to Section 1(c), Memo 8 (Flood/Inundation), General Conditions Clause 5
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