Dr. M.K Sharma, J.:— This Letters Patent Appeal arises out of the judgment and order dated 9-5-1995 passed by the learned Single Judge in Civil Writ Petition No. 3115/1994 dismissing the writ petition. The appellant association filed the aforesaid writ petition seeking a direction to the respondents to strictly adhere to and comply with the provisions of Section 64 UM of the Insurance Act, 1938 (hereinafter referred to as the Act.) and to quash all appointments of unqualified persons acting and/or performing duties of surveyors in contravention of Section 64 UM of the Act and to substitute them with only licenced surveyors in terms of the Insurance Act.
2. In the writ petition the appellant, as the writ petitioner, challenged the legality and validity of the statement of the Chairman-cum-Managing Director of the Oriental Insurance Company, which appeared in the Issue of ‘Economic Times’ dated 21st April, 1994, wherein it was stated that the company would not employ licenced surveyors or loss assessors in respect of small claims of the value of less than Rs. 20,000 and that such claims would be settled by the Insurance Company through its own sources. It appears that a decision was taken by the aforesaid Insurance Company that in case of claims of value of less than Rs. 20,000/-, the Insurance Company will have in-house assessments made by its own staff and they would not seek returns in case of such claims from licenced surveyors or loss assessors. According to the respondents the said decision was taken so as to simplify the procedure and also to cut down delays in settling the claims against the Insurance Companies. The appellant appears to have been aggrieved by the aforesaid decision and policy of the respondents and challenged the same through the aforesaid writ petition alleging that the said policy is in violation of the provisions of section 64 UM of the Act and also is in violation of Article 14, 19(1) (g) and 21 of the Constitution of India. The respondents contested the aforesaid writ petition by filing the counter affidavit stating inter alia, that claims, the value of which is less than Rs. 20,000 could be setlled by the Insurance Company itself, without reference to the approved assessors or surveyors as the provision of section 64 UM of the Act do not in house assessments or settlement of claim in such cases.
3. On the analysis of the pleadings of the parties in the writ petition the question that arose for consideration of the learned Single Judge appeared to be as to whether Under Section 64 UM of the Act any survey by an approved surveyor or loss assessor is necessary in respect of a claim of less than Rs. 20,000 and whether or not such a claim could be settled by the Insurance Company itself without intervention of an approved surveyor or loss assessor. Therefore, the answer to the aforesaid question appears to be rested upon a true and correct interprotation of Section 64 UM of the Act which was brought into effect by an Amendment Act, 1968 w.e.f 1st January, 1969.
4. The learned Single Judge after considering the entire provisions of section 64 UM of the Act and also on considering the entire scheme of the Act came to the conclusion that the legislature did not require that all claims should be surveyed by an approved surveyor and loss assessor and finally held that so far as in-house assessment is concerned, Section 64 UM of the Act does not place any restriction on the settlement of the claims where the value of the claim is less than Rs. 20,000 and that the policy to have such claims settled by an insurer without seeking a report from a surveyor or loss assessor could not be said to be arbitrary or violative of Article 14 of the Constitution of India and accordingly dismissed the writ petition.
5. Mr. Vishwajit Bhattacharya, learned counsel appearing for the appellant submitted before us that on a proper and correct interpretation of the provision of section 64 UM of the Act the insurer has no power to settle even a claim below Rs. 20,000 by itself without the same being reported upon by a qualified assessor by valuer and that under such circumstances the policy of the respondents in deciding to settle the claims of the value of less than Rs. 20,000 without the intervention of the approved surveyors or loss assessors is arbitrary and in violation of the provisions of section 64 UM of the Act and also of Article 14, 19 (1) (g) and 21 of the Constitution of India. His further submission was that the policy of having an in-house assessment for the claim of value of less than Rs. 20,000 is also against the objects and reasons of the Amendment Act by which the aforesaid amendment of Section 64 UM of the Act was brought in by the legislature. The further submission of the learned counsel for appellant was that the source of power for settlement of claim below Rs. 20,000 is the provision of sub-section (6) of Section, 64 UM of the Act according to which an in-house assessment is clearly barred and therefore the learned Single Judge erred in law and on facts in holding that a power is vested in the Insurance Company under Section 64 UM of the Act to have an in-house assessment. According to him the learned Single Judge further erred in law in not holding that either sub-section (6) or sub-section (9) of the Section 64 UM of the Act does not empower the Insurer to do away with the services of such surveyors or to vest the Insurer with the power to perform the role and/or to act as surveyor. He also submitted that obtaining a report from approves surveyor or loss assessor before settling any claim by the Insurer is a mandatory requirement of the provision of section 64 UM. irrespective of the amount of the claim involved, whether Rs. 20,000/-, below, or above.
6. Mr. Milon K. Banerjee, Attorney General appearing on behalf of respondent took us through different provisions of section 64 UM of the Act and submitted that on a true and correct interpretation of the aforesaid provisions read with the objects and reasons of the Amendment Act the conclusion arrived at by the learned Single Judge is the correct and true conclusions that could be arrived at in the present case. He also placed before us the report of the Committee of Reforms in the Insurance sector, a copy of which was placed before us by him, as a pursuasive value for the construction of the enactment. On careful reading of the said recommendations of the Committee it was also noticed by the learned Single Judge that no other conclusion could be arrived at than what was arrived at by the learned Single Judge. The learned counsel further submitted before us that a conjoint reading of the entire provision of section 64 of the Act will explicitly make it clear that an Insurance Company is permitted to settle a claim of the value of less than Rs. 20,000 by assessment of the case by its own in house staff.
7. For a proper and correct appreciation of the rival contentions of the parties, it is necessary for us to consider the relevant provisions of section 64 UM of the Act. The aforesaid provision of section 64 UM is a relatively new provision which came to be inserted in the insurance Act by the Insurance (Amendment) Act, 1968 which was brought into effect on 1st January, 1969. Clause A Sub-Section (1) of Section 64 UM deals with the grant of licence to a surveyor or loss assessor in respect of general insurance business whereas Clauses (B) and (C) of Sub-Section (1) of Section 64 UM deals with the mode and procedure for acquiring such licence. Sub-section (1) (D) lays down the qualifications required by a person to enable him to acquire a licence for acting as a surveyor or loss assessor. The aforesaid sub-section 1 (D) of Section 64 UM reads thus:--
64 UM:—(1)
(A) XXXXXXXXX
(B) XXXXXXXXX
(C) XXXXXXXXX
(D) No licence to act as a surveyor or less assessor shall be issued unless:—
(i) the applicant, where he is an individual, satisfies the Controller that he:—
(a) has been in practice as a surveyor or loss assessor on the 26th day of October, 1968, or
(b) holds a degree of a recognised University in any Branch of engineering, or
(c) is a fellow or associate member of the Institute of Chartered Accountants of India or the Institute of Cost and Works Accountants of India, or
(d) possesses actuarial qualifications or holds a degree or diploma of any recognised University or institute in relation to insurance, or
(e) holds a diploma in insurance granted or recognized by the Government, or
(f) possesses such other technical qualification as may be prescribed, and
(g) does not suffer from any of the disqualifications mentioned in sub-section (4) of Section 42;
(ii) the applicant, where he is a company or firm, satisfies the Controller that all his directors or partners, as the case may be, possess one or more of the qualifications specified in clause (i) and none of such directors or partners suffer from any of the disqualifications mentioned in sub-section (4) of Section 42”.
8. The remaining clauses of Sub-Section (1) of Section 64 UM need not be referred to as they have no relevance to the present case.
9. On the other hand sub-section (2) reads as follows:—
“(2) No claim in respect of a loss which has occurred in India and requiring to be paid or settled in India equal to or exceeding twenty thousand rupees in value on any policy of insurance, arising or intimated to an insurer at any time after the expiry of a period of one year from the commencement of the Insurance (Amendment) Act, 1968, shall, unless otherwise directed by the Controller, be admitted for payment or settled by the insurer unless he has obtained a report, on the loss that has occurred, from a person who holds a licence issued under this section to act as a surveyor or loss assessor (hereinafter referred to as “approved surveyor or loss assessor”);
Provided that nothing in this sub-section shall be deemed to take away or abridge the right of the insurer to pay or settle any claim at any amount different from the amount assessed by the approved surveyor or loss assessor.”
10. The said sub-section provides that settlement and/or payment of a claim of Rs. 20,000 or above would not be done by the insurer so long a report on the quantum of loss in respect thereof is not obtained from an approved surveyor or loss assessor. This sub-section also provides us with the meaning of an approved surveyor or loss assessor which means a person who holds a licence issued under this Section as a surveyor and loss assessor.
11. In view of the aforesaid definition of approved surveyor or loss assessor given in sub-section (2) of Section 64 UM of the Act defining him as a person who holds a licence issued under Section 64 UM of the Act to act as a surveyor or loss assessor the submission of the learned counsel for the appellant that there is a distinction between the expression ‘approved surveyor’ and ‘licenced surveyor’ cannot be accepted. As is apparent from the aforesaid definition given in sub-section (2) of Section 64 UM an approved surveyor is a licensed surveyor and that no distinction is envisaged is this section in the aforesaid two expressions.
12. The provisions of sub-section (3) and sub-section (4), in our opinion, are not of much relevance to the facts of the present case. However, we feel that we should look into the said provisions also for a better appreciation of the issues raised before us by the counsel for the rival parties. Sub section, (3) authorises the Controller to call for an independent report from any other approved surveyor or loss assessor specified by him in respect of any claim of the nature referred to in sub-section (2). The expression any other approved surveyor or loss assessor used us this sub section refers to an approved surveyor or loss assessor other than the one employed by the Insurance Company for the purpose of determining the claim made in a particular case. Such other approved surveyor or loss assessor from whom an independent report is called for is to submit his report to the Controller. Sub-section (4) authorises the Controller, on receipt of the report to issue such direction as be may consider necessary with regard to the settlement of claim which could be a direction to settle a claim at a figure less than or more than that of the quantum proposed by the other surveyor or loss assessor for settlement of the said claim and in such case the Insurance Company would be bound to comply with such directions.
13. Sub-section (5), on the other hand is, in the nature of a mandate or direction to the Insurer As it opens by a non obstante clause, therefore, is a mandate that after the expiry of the period of one year from the commencement of the Amendment Act no fee shall be paid to any person for surveying or verifying or reporting on a claim of loss under the policy of Insurance unless the person making such survey or verification is an approved surveyor or loss assessor. Now coming down to sub-section (6) we feel and consider that a detailed analysis of the said provision is necessary for deciding the present case, therefore the said provision is quoted herein for ready reference:—
“Where, in the case of a claim of less than twenty thousand rupees in value on any policy of insurance it is not practicable for an insurer to employ an approved surveyor or loss assessor without incurring expenses disproportionate to the amount of the claim, the insurer may employ any other person (not being a person disqualified for the time being employed as a surveyor or loss assessor) for surveying such loss and may pay such reasonable fee or remuneration to the person so employed as he may think fit”.
14. This subsection provides that where the claim is less than the value of Rs. 20,000 and where the insurer does not want to employ an approved surveyor or loss assessor on the ground that expenses for obtaining the report from an approved surveyor and loss assessor would be disproportionate to the amount of the claim, the insurer can employ any other person for surveying such loss provided the said person is not disqualified for being employed as surveyor or loss assessor. This provision further enables the insurer to pay a reasonable fee to the person so employed as he may think fit. Subsection (9) and (10) also are relevant and have a bearing to the facts and circumstances and the issues raised in the present case, which read as follows:—
“9. The Controller may in respect of any claim of value of less than twenty thousand rupees on an insurance policy, if the claim has not been or is not proposed to be reported upon by a surveyor or loss assessor, direct that such claim shall be reported upon by an approved surveyor or loss assessor and where the Controller makes such direction, the provision of sub-section (3) and (4) shall apply in respect of such claim.
10. Where, in relation to any class of claims, the Central Government is satisfied that it is customary to entrust the work of survey or loss assessment to any person other than a licensed surveyor or loss assessor, or it is not practicable to make any survey or loss assessment, it may, by an order published in the Official Gazette, exempt such class of claims from the operation of this Section”.
15. From a reading of the aforesaid sub-section (9) it would appear that a power has been vested on the Controller to ask for a report from an approved surveyor or loss assessor in respect of a claim of a value of less than Rs. 20.000/-, if the claim is not reported upon or is not proposed to be reported by a surveyor or loss assessor. Under sub-section (10) a power has been vested in the Central Government to exempt any class of claims mentioned in the Schedule from the operation of the provision of section 64 UM.
16. On a careful reading of the aforesaid provisions of section 64 UM it appears to us that in any claim of value of Rs. 20,000 or more the same could be paid or settled by the insurer only upon receipt of a report on the loss occurred from a licenced/approved surveyor or loss assessor. It is, however, to be made clear at this stage that even in such type of claim where the value is Rs. 20,000.or more the Insurance Company is not bound to accept and/or act on the report of the said surveyor or loss assessor and a right is vested in the Insurer to pay or settle any claim at any amount different from the amount assessed and proposed by the approved surveyor or loss assessor. Therefore, when we give effect to the provisions of this Act, we are of the view, that the Insurer still possesses an inherent right to make payment and/or to settle a claim against it at an amount which it thinks to be reasonable on the facts and circumstances of each case. The aforesaid power also appears to be inherent to the Insurance Company in all types of claim whether it is above Rs. 20,000 or below the value of Rs. 20,000 and in certain cases the aforesaid inherent power of the Insurance Company has been abridged or barred to a limited extent that is to the extent that when the claim is of the value of Rs 20,00 or more obtaining a report from an approved surveyor or loss assessor is mandatory. But, even in such cases the Insurance Company is not bound to accept and/or act on such report and make payment as assessed or proposed by the approved surveyor or loss assessor.
17. Going by the said analogy we do not find any fetter or bar being put up by any of the provisions of section 64 UM relied upon and referred to by the counsel for parties before us that there is a prohibition or bar for settlement of a claim without obtaining a report from an approved/licenced surveyor or loss assessor when the claim is of value less than Rs. 20,000/-. Sub-section (6) of the section 64 UM deals with cases of claim of the value of less than Rs. 20,000 and under that provision a power is vested in the Insurance Company not to employ any approved surveyor or loss assessor, if according to the Insurance Company the expenses to be incurred for such appointment would be disproportionate to the amount of claim. In such cases the Insurance Company could employ any other person for surveying such loss. The only requirement to be possessed by such a person is that he is not disqualified to be employed as a surveyor or loss assessor. A controversy has been raised before us with regard to the qualifications to be possessed by such a person which we would like to deal with separately a little later. In our considered opinion, sub-section (6) cannot be said to have put any restriction on the right of the Insurer to settle the claim by itself through its own officers. When we read the provision of sub-section (6) and sub-section (9) together it becomes apparent to us that where the Insurer choses not to have a claim below Rs. 20.000 reported upon by any surveyor or loss assessor, whether approved or the one contemplated by sub-section (6), the Controller has been endowed with the power to get the claim reported upon by an approved surveyor or loss assessor. We have understood the meaning of the provision of different sub-sections contained in Section 64 UM in the aforesaid context and going by the said interpretation, in house assessment by the staff, in a case where the claim of value of less than Rs. 20,000 appear to be clearly permissible to us. After reading the entire provisions of the Act, we are left with no hesitation in cur mind to hold that when the law permits a person, who is otherwise not disqualified to be appointed as surveyor or loss assessor, to enquire and survey a loss and submit a report on it, there is no earthly reason as to why the Insurer could not get a claim examined and scrutinised through an in-house process of assessment of loss where the value of the claim is less than Rs. 20,000/-. This process of reasoning and findings arrived at by us tally with the findings arrived at by the learned Single Judge in respect of the aforesaid provisions and therefore we do not see any infirmity in the judgment and order impugned herein.
18. We may now examine the other aspect of the case dealt with by the learned Single Judge with regard to the qualification that is necessary to be possessed by a person as referred to in sub-section (6) of section 64 UM. The learned Attorney General appearing for the respondent drew our attention to section 42 (4) which provides for the nature of these disqualifications. The said provision alongwith sub-section (1) of Section 42 read as follows:—
“42 Licensing of insurance agents.—(1) The [Controller] or an officer authorized by him in this behalf shall, in the prescribed manner and on payment of the prescribed fee which shall not be more than [twenty fice rupees], issue, to any individual [making an application in the prescriber manner] and not suffering from any of the disqualifications hereinafter mentioned a licence to act as an insurance agent for the purpose of soliciting or procuring insurance business
(2) XXXXXXXXX
(3) XXXXXXXXX
(3-A) XXXXXXXXX
(4) The disqualifications above referred to shall be the following:—
(a) that the person is a miner;
(b) that he is found to be of unsound mind by a Court of competent jurisdiction.
(c) that he has been found guilty of criminal misappropriation or criminal breach of trust or cheating [or forgery or an abetment of or attempt to commit any such offence] by a Court of competent jurisdiction;
(Provided that, where at least five years have elapsed since the completion of the sentence imposed on any person in respect of any such offence, the (Controller) shall ordinarily declare in respect of such person that his conviction shall cease to operate as a disqualification under this clause,)
(d) that in the course of any judicial proceeding relating to any policy of insurance of the winding up of an insurance company or in the course of an investigation of the affairs of an insurer it has been found that he has been guilty of or has knowingly participated in or connived at any fraud dishonesty or mispresentation (against an insurer or an insured)”.
19. Now the question arises for our consideration in respect of which a controversy is being raised is with regard to the true meaning of the word not being a person disqualified”. The learned Single Judge has held that if a person does not fulfil the requisite qualifications in clause (a) to (g) cf sub-section 1 (D) of Section 64 UM, he is to be considered a person disqualified for being employed as surveyor or loss assessor. We, however, feel that the aforesaid conclusion arrived at by he learned Single Judge appear to us to be not correct and we express our pain for not being able to agree with him on this count. In our opinion, the word “disqualified” does not mean not being qualified. We also feel that while interpreting the provisions of a statute the plain meaning of the words or the expressions should be given effect to and in case the said word or expression is found to be already defined in the Act itself, then the said definition as enumerated in the Act itself should be held to be the guiding principle for giving true meaning to the expression. As we have stated earlier sub-section (4) of section 42 of the Act clearly lays down the criteria and/or grounds on which a person is said to be disqualified. In our opinion, while interpreting the provisions of sub-section (6) of section 64 UM the expression “any other person not being a person disqualified for the time being” should be given the same meaning as is given to the said expression appearing in section 42 (4) and nothing beyond it and thereby qualifying a person not suffering from any of the disqualifications' occurring in sub-section (1) of Section 42 and enumerate in sub-section (4) of Section 42 or the Act.
20. With the aforesaid modification in our conclusions from that of the conclusion reached by the learned Single Judge we dismiss this appeal but on the facts and circumstances we do not propose to impose any cost in the present appeal.
V. K. S. Appeal Dismissed
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