IMPORTANT POINT
Insurance claim cannot be repudiated on basis of un-communicated terms of exclusions.

JUDGMENT :

DHANANJAYA Y. CHANDRACHUD, J.

1. Leave granted.

2. The National Consumer Disputes Redressal Commission [“NCDRC”] by its judgment dated 16 April 2015 reversed the concurrent findings arrived at by the District Consumer Disputes Redressal Forum, Solapur [“District Forum”] and by the Consumer Disputes Redressal Commission, Maharashtra [“SCDRC”].

3. The appellant has a showroom at Solapur in which watches are sold. The appellant had insured its stock of watches with the respondent. During the course of the night on 3 August 2001, after the shop had closed for the day, a theft occurred in the premises. The theft was detected at about 9 A.M. on the next day after the shop opened for business.

4. A First Information Report was lodged with the Police and a claim under the insurance policy was made. The surveyor submitted a preliminary report on 4 September 2001 indicating a loss of approximately Rs 3,86,395. The surveyor recorded that they were informed by the partner of the firm that the theft may have taken place by utilising duplicate keys. The surveyor, however, found empty watch stands on which the strips of the model numbers were lying behind the counters. There was no sign of forcible entry. This was followed by a surveyor’s report dated 30 November 2001.

5. After the claim was repudiated by the insurer, the appellant filed a consumer complaint. By an order dated 26 April 2007, the District Forum allowed the claim in the amount of Rs. 3,04,000. The decision of the District Forum was affirmed, in appeal, by the SCDRC on 19 April 2010.

6. The NCDRC reversed the above decisions in its revisional order dated 16 April 2015, relying upon a decision of this Court in United India Insurance Co. Ltd. vs. Harchand Rai Chandan Lal., (2004) 8 SCC 644 Construing the terms of the exclusion in a policy of insurance against burglary and/or house breaking, this Court had held that where the loss or damage was caused without forcible and violent entry to and/or exit from the premises, the claim could not be maintained. The terms of the policy in the above decision of this Court read as follows:

“’Burglary and/or housebreaking’ shall mean theft involving entry to or exit from the premises stated therein by forcible and violent means or following assault or violence or threat thereof to the insured or to his employees or to the members of his family.”

Construing the above condition, this Court held:

“15….we are of the opinion that theft should have been preceded with force or violence as per the terms of insurance policy. In order to substantiate a claim an insurer has to establish that theft or burglary took place preceding with force or violence and if it is not, then the insurance company will be well within their right to repudiate the claim of the insurer.”

7. In the present case, the NCDRC in the course of its decision adverted to “clause 8” of the insurance policy which was in the following terms:-

“Loss of money and/or other property abstracted from safe following the use of the key to said safe or any duplicate thereof belonging to the insured unless such key has been obtained by assault or any threat”

8. This was in any event not applicable, since the loss was not from a safe.

9. Clause (a) of the policy as extracted in the above judgment reads thus:

“Any loss of or damage to the property or any part thereof whilst contained in the premises described in the schedule hereto due to Burglary or Housebreaking (theft following upon an actual forcible and violent entry to and/or exit from the premises and hold-up”

10. Since clause (a) was pari materia with the clause which was construed by this Court in the above decision of this Court in United India Insurance (supra), the NCDRC reversed the decisions of the District Forum and the SCDRC.

11. The basic issue which has been canvassed on behalf of the appellant before this Court is that the conditions of exclusion under the policy document were not handed over to the appellant by the insurer and in the