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SUBHASH CHANDRA
Meta Industries – Appellant
Versus
New India Assurance Company Limited – Respondent
ORDER
Subhash Chandra, Presiding Member—This complaint is filed under section 21 of the Consumer Protection Act, 1986 (in short, ‘the Act’) alleging deficiency in service on account of repudiation of his claim under the Standard Fire and Special Perils Policy issued by the opposite party.
2. The facts, in brief, of the case are that the complainant which is a partnership firm had obtained Standard Fire and Special Perils Policy no.360300/11/11/01/00000205 for the period 29.07.2011 to 28.07.2012. It is contended that this policy had been initially obtained by it in 2008 as the complainant is engaged in the business of exporting stainless steel houseware and cookware products. The policy was categorised as Engineering Workshop including plant and machinery and stocks, furniture, fixtures and fittings uptill 2011. In 2011-2012 the complainant did not include the plant and machinery in the policy related to its trade. The word ‘Stainless Steel Kitchenware and Packing Material’ has been included in the description of risk. The policy was paid by way of premium for a sum of Rs.2,54,0
(1) Concealment of a material fact - It is apparent that the change in the coverage of risk had not been conveyed to the opposite party by the complainant. This was a concealment of a material fact s....
“Repudiation of insurance claim on ground of exclusion clause in the policy, since not expressly conveyed to the insured, amounts to deficiency in service.”
The court enforced the principle that ambiguities in insurance policies favor the insured, ruling against the insurer for failing to adequately disclose exclusions.
The duty to disclose material facts runs throughout the continuance of the contract of insurance and it is binding on both parties to the contract.
Insurance Policy, viz; Standard Fire & Special Peril Insurance Policy – Repudiation of claim not justified – Complainant is Consumer as he filed claim for recovery of amount assessed by surveyor.
(1) Voidable policy – when the complainant himself, by his own acts, rendered the Policy absolutely voidable, cannot be allowed to succeed on the ground of delay in repudiation having regard to the s....
Absence of valid license on the date of incident as a sole ground cannot justify repudiation of insurance claim when there is no evidence of positive suspension of license or of positive embargo on p....
The insurer must settle valid insurance claims timely, and failure to substantiate claims can lead to repudiation; however, claimants must provide adequate documentation to support their claims.
An insurance claim can be repudiated if the loss is caused by a peril explicitly excluded in the insurance policy; the burden of proof rests on the insured to demonstrate coverage.
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