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SANGITA DHINGRA SEHGAL, PINKI, J. P. AGRAWAL
In the matter of the Oriental Insurance Co. Ltd. – Appellant
Versus
Orient Resins Ltd. – Respondent
JUDGMENT
Sangita Dhingra Sehgal, President—The facts of the case as per the District Commission record are:—
“The complaint pertains to repudiation of claim by OP on theft of vehicle. The complainant’s vehicle Tata Sumo, bearing No.HR-26G 8735 was insured with OP vide policy No.2002/1863. The vehicle was stolen by two unidentified persons who drugged the driver in the intervening night of 7-8 April, 2002, near Kanpur.
The driver on recovering his senses, returned to Delhi and narrated the incident to complainant’s Director and thereafter FIR was lodged on 14.4.2002 in Achhalada Police Station which is duly annexed with complainant. Claim was filed and untraceable report was made on 13.4.2002.
On 25.2.2003, the Magistrate gave a finding that the road between Achhalanda to Phahphund does not exist and thereafter claim was repudiated. Complainant has also annexed photographs revealing Achhalanda Police Station, elementary school building, Achhalaanda Distt. and Phuphand Milestone. A revised report was made by concerned magistrate on 14.3.2005 that FIR by police is liable to be accepted.”
2. The District Commission after taking into consideration the material available on record p
Theft – The Insurance Company cannot repudiate the claim in toto in case of loss of vehicle due to theft.
Exclusion Clause – Complainant/Respondent is at no fault and the contention of the Appellant that the Complainant/Respondent left the money unattended which falls under the Exclusion Clause hold no w....
(1) Non-Standard Settlement – In cases of theft where there is a contributory factor or breach of warranty (like limitation as to use) that is not fundamental to the loss, the claim should be settled....
1. Delay in filing FIR and insurance claim to be condoned if reasonable explanation given, especially in case of theft of vehicle.2. Mere delay cannot be a reason for not providing claim as per Apex....
Inordinate Delay – The appellant/insurance company has committed deficiency in service in not deciding the claim of the respondent No.1/ complainant for an inordinate delay even after having sufficie....
(1) Definition of Fundamental Breach – An insurance company can only deny a claim in its entirety if there is a “fundamental breach” of policy conditions. A delay in reporting is generally considered....
(1) Insurance Policy between Insurer and insured has to be strictly construed to determine extent of liability of Insurer.(2) Insured cannot claim anything more than what is covered by Insurance Poli....
(1) Transparency and Exclusion Clauses – The Commission emphasized that if an insurance company intends to exclude certain liabilities based on specific interpretations, they must be transparently di....
Motor Insurance Policy – Any violation of condition should be in nature of a fundamental breach so as to deny claimant any amount.
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