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Issues: (i) whether the IRDA had jurisdiction under section 64UM of the Insurance Act, 1938 to entertain a claim even after repudiation by the insurer and to call for an independent survey report; (ii) whether the Appellate Authority under section 110H of the Insurance Act, 1938 had co-terminus powers to direct fresh survey and settlement of the claim; (iii) whether the impugned order directing payment on the basis of the later survey report suffered from legal infirmity.
Issue (i): Whether the IRDA had jurisdiction under section 64UM of the Insurance Act, 1938 to entertain a claim even after repudiation by the insurer and to call for an independent survey report.
Analysis: Section 64UM(2) applies to every claim in respect of a loss requiring to be paid or settled in India, and the expression is wide enough to cover even a claim repudiated by the insurer. The statutory role of the IRDA under section 14(2)(b) of the IRDA Act includes protection of policyholders in matters concerning settlement of insurance claims. The insurer's appointment of surveyors does not make the survey report binding or final, but the IRDA can intervene, seek an independent report, and examine whether repudiation is justified. The Authority therefore acted within jurisdiction in entertaining the claim and in obtaining a fresh survey report.
Conclusion: The IRDA had jurisdiction to proceed notwithstanding repudiation, and its direction for an independent survey was valid.
Issue (ii): Whether the Appellate Authority under section 110H of the Insurance Act, 1938 had co-terminus powers to direct fresh survey and settlement of the claim.
Analysis: The Appellate Authority's powers were held to be co-terminus with those of the IRDA for purposes of section 64UM. Once the regulatory authority could seek an independent assessment and act on it, the appellate forum could also direct a fresh survey where one of the earlier assessors was found to be interested. The exercise of that power was treated as within the statutory framework and not ultra vires.
Conclusion: The Appellate Authority was competent to direct a fresh survey and to act upon the resulting assessment.
Issue (iii): Whether the impugned order directing payment on the basis of the later survey report suffered from legal infirmity.
Analysis: The impugned order was consequential to the earlier appellate directions and rested on a detailed consideration of the fresh survey material. The Court declined to sit as a further appellate authority over the factual assessment of loss, and found no legal infirmity, perversity, or jurisdictional error in the reasoning or conclusion of the impugned order.
Conclusion: The impugned order was upheld.
Final Conclusion: The writ petition failed in its entirety, the challenged orders were sustained, and the insurer's liability as determined by the appellate process remained undisturbed.
Ratio Decidendi: In a claim falling within section 64UM, repudiation by the insurer does not oust the regulatory authority's power to seek an independent survey and oversee settlement, and the appellate authority may exercise co-terminus powers within that statutory scheme.
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