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UTTARANCHAL STATE CONSUMER DISPUTES
REDRESSAL COMMISSION, DEHRADUN
Hon’ble Mr. Justice K.D. Shahi, President &
Mr. Surendra Kumar, Member
MOHD. NAFEES—Appellant
versus
NEW INDIA ASSURANCE CO. LTD.—Respondent
Appeal No. 303 of 2004—Decided on 22.3.2005
Counsel for the Parties :
For the Appellant :Mr. Deepak Ahluwalia, Advocate.
For the Respondent:Mrs. Anjali Gusain, Advocate.
The exclusion clauses in an insurance policy should be interpreted clearly and unambiguously, and any ambiguity should benefit the insured.
Headnote:
Insurance - Vehicle Insurance - Exclusion of Flood and Earthquake - Interpretation of Insurance Policy
Fact of the Case:
The complainant's insured jeep met with an accident and was washed away in a river due to flood, causing total loss. The insurance company contended that the policy excluded coverage for flood and earthquake, and a sum was deducted from the premium for this exclusion.
Finding of the Court:
The court found that the vehicle was damaged due to flood, which was excluded from the insurance policy. It also noted a calculation mistake in the premium deduction but held that it did not affect the exclusion of flood and earthquake from the policy.
Issues: The main issue was whether the complainant was entitled to claim for the damage caused by flood, which was excluded from the insurance policy.
Ratio Decidendi: The court interpreted the insurance policy and held that the exclusion of flood and earthquake was clear and unambiguous. It also emphasized that any ambiguity in the insurance policy should benefit the insured, but in this case, there was no ambiguity regarding the exclusion.
Final Decision: The court dismissed the appeal, upholding the rejection of the complaint due to the vehicle not being covered for flood. The complainant's argument regarding the calculation mistake in the premium deduction was not accepted.
Mr. Justice K.D. Shahi, President—This is an appeal against the order dated 31.10.2003 passed by the District Forum, Nainital, whereby the complaint of the complainant was dismissed.
2. According to the complainant he had a jeep, which was insured. During the insurance period, it met with an accident and it fell in a river, which caused total loss to the vehicle. According to the Insurance Company, it did not fell in the river but it was washed away in the river by flood and the insurance policy, which was issued, excluded flood and earthquake. It is why a sum of Rs. 200/- has been deducted from the payable premium by the complainant.
3. After taking the evidence of the parties and hearing them the learned Forum rejected the complaint, against which order the present appeal has been filed.
4. We have heard the learned Counsel for the parties and gone through the records. The first question is whether there was accident or whether the vehicle was washed away in the flood. The complainant should have come before the learned Forum with true case. In the complaint, it is written (“Hindi matter omitted”), while in the FIR lodged by the complainant, it has been specifically written (“Hindi matter omitted”). Subsequently it appears that the words (“Hindi matter omitted”) and (“Hindi matter omitted”) have been interpolated in the FIR. However, the chik report of the FIR has not been produced before us. In the claim form itself the complainant has written and it is perhaps in his own handwriting, in the column short description of the accident (“Hindi matter omitted”). Thus the cause of damage is flood and not by falling from the road in the river. By rolling of the vehicle in the flood, there may be extensive damages but still if this damage is caused due to flood, the complainant according to the Insurance Company is not entitled to claim.
5. Now it is admitted fact that flood and earthquake have not been covered in the policy. The learned Counsel for the complainant advanced a very able argument that if there is any ambiguity and confusion in the insurance, benefit shall go to the insured. We agree to this argument. On the strength of this argument, the learned Counsel for the complainant produced before us, the proposal form. In this proposal form, it is written basic premium Rs. 1,953/-. Then flood and earthquake have been written and for this a sum of Rs. 200/- has been deducted. The amount becomes Rs. 1,753/-. Then 20% has been deducted, which is Rs. 390/- for no claim. Here is calculation mistake. After deducting Rs. 390/- from Rs. 1,753/-, the amount comes to Rs. 1,363/- but it is written Rs. 1,563/-. According to the learned Counsel for the complainant, this mistake in calculation shall be read in the benefit of the consumer that the Insurance Company has charged a sum of Rs. 200/- for flood and earthquake as well. This argument is fallacious on the face of it because flood and earthquake have been exclusively excluded in the proposal form as well as in the policy. There is no ambiguity in this that flood and earthquake have been excluded. This is crystal clear. Now the calculation mistake is from Rs. 1,753/-, not from Rs. 1,953/-. From Rs. 1,953/-, Rs. 200/- have been made minus and then Rs. 1,753/- has come. Thereafter calculation mistake is there. If there is calculation mistake, then the complainant should not have paid Rs. 1,563/-, but should have paid only Rs. 1,363/-. He should have claimed Rs. 200/- from the Insurance Company, which is mistake in the deduction of no claim amount and not of deduction in premium. If in the rebate of no claim there is any mistake and the complainant has paid extra money, he should claim this Rs. 200/- of no claim, it cannot be extended to the earlier deduction of Rs. 200/- for the non premium charge for flood and earthquake. In view of specific endorsement and specific case of the parties that earthquake and flood have been excluded, it cannot be argued that there has been any confusion
