When an insurance policy is ambiguous regarding exclusions for listed perils, the principle of contra proferentem applies, obligating the insurer to indemnify losses where specific exclusion columns for those events are left blank.

SIMARJOT KAUR, MEMBER :

The Appellant/Opposite Party No.1 has filed the present Appeal to challenge the impugned order dated 09.04.2024 passed by the District Consumer Disputes Redressal Commission, Moga (in short, “the District Commission”), whereby the Complaint filed by the Complainant had been allowed.

2. It would be apposite to mention here that hereinafter the parties will be referred, as were arrayed before the District Commission.

3. Briefly, the facts of the case as made out by the Complainant in the Complaint filed before the District Commission are that Mr.Balwinder Singh, the proprietor of the Complainant Firm is running the business of readymade garments since 01.04.2019 in the name and style of M/s Bru Readymade Garments for the purpose of earning his livelihood. For smooth running of the business, the Complainant Firm had taken a cash credit facility for an amount of Rs.5,00,000/- as loan from the OP No.2. It was obtained against the hypothecation of stock of readymade garments lying in the shop/business premises. To secure the loan amount, the OP No.2 had advised the Complainant Firm to take an Insurance Policy from OP No.1 to cover the risk of stock lying in his shop/business premises. Therefore, the Complainant Firm had purchased an Insurance Policy namely ‘Bharat Sookshma Udyam Suraksha Policy’ from OP No.1 through OP No.2. It was issued vide policy No.OG-24-1225-4056-00000002 which was valid w.e.f. 10.09.2022 to 09.09.2023 for sum insured of Rs.8,00,000/-. As per the terms and conditions of the policy, it had covered the risk of damage caused by storm, cyclone, Typhoon, Tempest, Hurricane, Tornado, Tsunami, Flood and Inundation. In the month of April, 2023, there were heavy storms and rain. Due to a heavy storm and rain the rain water had entered into the shop through roof on 17.04.2023. Resultantly, it had damaged the roof as well as ceiling of the shop. It had also damaged entire stock of readymade garments lying in the shop/business premises. The Complainant Firm had informed the OPs on 18.04.2023 regarding the loss & damage and requested them to appoint surveyor. Pursuant to his request a Surveyor was appointed by OP No.1 on 03.05.2023. The Surveyor had visited the insured business premises for spot inspection to assess the loss. All the relevant documents as required by the Surveyor had been supplied to him. The Surveyor had given its assessment report of the loss to OP No.1 and had also submitted that Complainant Firm was a genuine Firm. It was Income Tax Payee and had filed ITR every year. The stock was damaged due to seepage of water from roof and inundation. It could be evaluated through the purchase bills, balance sheet of financial year 2022-23, provisional balance sheet of month of April 2023. As per the estimate of the Complainant, a loss of more than Rs.9,00,000/- had occurred due to the damaged to the stock during the heavy rain. It was surprising that the OP No.1 vide letter dated 22.07.2023 had repudiated the genuine claim of Complainant Firm on the ground that the loss caused to Complainant Firm was not covered within the ambit of the policy. The claim was denied on the ground that the loss had occurred due to leakage of rain water from the roof and not "flood or inundation". Thereafter, the Complainant had made several requests to the OPs for the redressal of grievances, but till date OPs did not pay any heed to his request. Hence, the Complaint was filed by the Complainant with the prayer to issue following directions to the OPs:-

i. OP No.1 be