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2007 (1) CPR 365
PUNJAB STATE CONSUMER DISPUTES REDRESSAL COMMISSION, CHANDIGARH
R.S. Mongia, President; C.P. Budhiraja and Mrs. Jasbir Kapoor, Members
United India Insurance Company
Ltd.—Appellant
versus
Ashwani Kumar —Respondent
Appeal No. 649 of 2001
Decided on 18-1-2007
Counsel for the Parties:
For the Appellant:Sh. Pradeep Bedi, Advocate with Sh. Munish Goel, Advocate
For the Respondent:Sh. Rohit Sapra, Advocate.
IMPORTANT POINT
Contract of Insurance is a bilateral contract and parties could not be left to interpret words used in the contract in the way they liked.
Headnote:Consumer Protection Act, 1986—Sections 12 and 17—Insurance claim—Contract of Insurance is bilateral between parties and parties cannot be left to interpret the words used in contract in a way they like—Respondent complainant got his two wheeler scooter insured under comprehensive policy—Scooter was damaged when due to heavy rain a signboard and a wall fell on scooter—Claim was repudiated on ground that it was covered by exclusion clause damage due to ‘earthquake etc.’—District Forum allowed complaint—Appeal—Insurance Company could not be allowed to use word etc. in the word “earthquake” to include storm/heavy rain—Exclusion clause could not be said to be direct cause of damage—Impugned order called for no interference. (Paras 5 & 6)
Result: Appeal dismissed.
R. S. Mongia, President—This is an appeal by the Insurance Company against the judgment and order of the District Forum by which the complaint of the complainant was allowed in the following terms:
“As stated above, the ground of repudiation is that the scooter was not covered against certain perils including storm. The scooter which no doubt was comprehensively insured, was damaged because of storm as admitted by the complainant himself. Unless the complainant got his scooter specially insured against this perils, his claim cannot be entertained and was rightly repudiated. Mr. Gurmit Singh, Assistant Divisional Manager in his affidavit Ex R1 has nowhere stated that whether the complainant was informed at the time of getting the policy that he is required to pay extra amount for the peril such as storm earthquake etc. The copy of the policy Ex. C2 is also silent on this aspect. When a person who gets a vehicle insured comprehensively generally feels that it covers all the eventualities. If something is not included and for that extra charges are required, it is the duty of the opposite party to explain the complainant whether he wants to get the policy for that special eventuality and asked him to pay more. The complainant in his affidavit has also stated that while paying for the insurance premium, he understood that since he is paying an enhance amount, as such, his scooter is insured of all possible losses which may rise out in the body of the vehicle and not because of his wrong doing and we find that he is justified in taking this stand. The main question is that how the complainant was to know that he is required to pay etc. for the perils such as earthquake, storm etc. unless the same is explained to him and the same is mentioned in the first terms and conditions laid down in the policy. The policy is absolutely silent in this respect. We find that the opposite party is not justified in repudiating the claim of the complainant that the accident had been caused by storm which was not included in the policy. Unless the same has been mentioned in the terms and conditions of the policy, this defence cannot be entertained. As such, we reject the repudiation done by the opposite party and pass an order to pay Rs. 13,500 as assessed by the investigator in his report Ex. R3 and accepted by the complainant in this letter photostat copy of which is Ex. R 4. Costs assessed at Rs.2,000. Compliance of the order be made within one month from the receipt of copy of this order. Copy be supplied under the rules. Record be consigned.”
2. Facts are in a narrow-compass. The complainant got his two-wheeler scooter comprehensively insured with the appellant-Insurance Company which was valid from 6.9.1999 to 5.9.2000. In the policy it was mentioned that some premium out of a comprehensive insurance was being excluded i.e. for any damage to the scooter by riot and strike, 0.15% on the total IEV was reduced. Further, there was exclusion of damage due to ‘earthquake etc.’ @ 0.10% on total IEV. Then there was exclusion due to damage by flood etc. to the tune of 0.15% on total IEV. The scooter got damaged and according to the complainant it was a case of total loss. Surveyor was appointed by the Insurance Company and it was stated by the complainant that “I had gone to take Newspaper shop to enquire about examination result (Bank result). At once heavy storm followed by rain came. The shop signboard along with wall build at the top of the floor fall on my scooter and damaged it.”
3. The claim was repudiated by the Insurance Company on the ground that the damage in the aforesaid circumstances, as stated by the complainant, was not covered under the policy inasmuch as the damage due to ‘earthquake etc.’ was excluded from insurance contract.
4. The District Forum was of the view that it was not specifically provided that if the damage was due to storm/heavy rain, the same would be excluded.
5. Learned counsel for the appellant argued that th
