Three friends, Mr. Ashok, Mr. Lalit, and Mr. Hari-teamed up to start a lobster export business. Mr. Ashok owned a boat which was used in the business for fishing as well as for transporting the processed lobsters to fore

CS Professional · Banking and Insurance - Laws and Practice · PYQS · June 2025
Three friends, Mr. Ashok, Mr. Lalit, and Mr. Hari-teamed up to start a lobster export business. Mr. Ashok owned a boat which was used in the business for fishing as well as for transporting the processed lobsters to foreign shores. They insured their ship, the cargo, freight, profits and commission, for a total of ₹ 80 lakh. Expecting to obtain enormous profits on their cargo, it was overvalued by the insured. A few months later, the boat sank in mid-ocean as it had a hole. Consequently, the cargo was also lost. The insured approached the insurance company to file a claim for compensation for the lost boat and cargo. However, the insurance company refused payment of the entire claim amount. It only made partial payment of the claim stating that the cargo was insured for an amount more than its actual market value. Moreover, investigation by the insurance company surveyor revealed that the insured had intentions to sink the boat. The vessel was retrieved by the insurance company and was offered for sale as salvage. The insured approached the court to prevent the sale of the ship. Answer the following: Was the insurance company violating the insurance contract by refusing payment to the insured? Justify your answer.

Answer & Explanation:

No, the insurance company was not violating the insurance contract by refusing payment to the insured in this scenario. An insurance contract legally binds an insurer to pay the policyholder for the damages or losses caused by the perils against which the policyholder has insured himself. However, this obligation is contingent upon the principle of utmost good faith and the absence of fraudulent acts by the insured. In the given case, the sinking of the boat and the loss incurred by the insured was due to a willful or fraudulent act of the insured (the intention to sink the boat) and not solely by the perils against which the ship was insured. Furthermore, the cargo was overvalued, indicating a potential attempt to gain financially beyond the actual loss, which violates the principle of indemnity. An insurer is not liable for refusing to accept a claim pertaining to a loss caused by the fraudulent act of the insured. Such losses are not covered by insurance policies, as insurance is meant to cover fortuitous events, not intentionally caused losses. Therefore, the insurance company was justified in refusing the full payment and making only a partial payment for the cargo based on its actual market value, and could potentially repudiate the entire claim due to fraud.

Topics: Insurance Claims

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