Asheesh had taken an insurance policy from Cobord Insurance Company Ltd. (Cobord), for insuring his office building. The term of the insurance was for a period of 4 years and Asheesh paid the premium regularly. In the 3r

CS Professional · Multidisciplinary Case Studies · PYQS · December 2024
Asheesh had taken an insurance policy from Cobord Insurance Company Ltd. (Cobord), for insuring his office building. The term of the insurance was for a period of 4 years and Asheesh paid the premium regularly. In the 3rd year of the insurance term, a fire accident took place in the insured building, causing huge damage to the property. Asheesh was too disturbed with this accident and there was a delay of 4 months 16 days in intimating Cobord about the accident. Thereafter, Cobord appointed a surveyor to assess the loss caused due to the fire. The surveyor after detailed inspection submitted his report to Cobord, stating that the claim is not payable on account of Asheesh's failure to comply with the primary condition of the policy, which is timely reporting of the incident to the insurance company. Acting upon the said report, Cobord repudiated the claim. Asheesh challenged the repudiation on the ground that the delay in intimation should be condoned, since a surveyor was appointed by Cobord. With support of a relevant case law, comment whether Asheesh's contention is valid.

Answer & Explanation:

Answer 3(a) The facts of the given situation are similar to the case Sonell Clocks And Gifts Ltd. (Appellant) Vs. New India Assurance Co. Ltd. (Respondent) . In this case, it was common ground that the letter of repudiation elucidates that the claim of the appellant was rejected on the ground that neither the intimation of the loss had been given to the Insurance Company immediately after the loss nor were the requisite particulars of the loss conveyed within stipulated period and there was breach of terms and conditions of Clause 6 of the general conditions of the policy. Additionally, the surveyor report predicates that it was very difficult to estimate the damages for the reasons mentioned therein and that the claim of the appellant was not payable on account of breach of Clause 6 of the general conditions of the policy. The event occurred on 4th August, 2004 but intimation was given to the insurer only on 30th November, 2004 after a gap of around 3 months 25 days. No explanation was offered for such a long gap much less plausible and satisfactory explanation. The stipulation in condition No.6 of the policy to forthwith give notice to the insurer is to facilitate the insurer to make a meaningful investigation into the cause of damage and nature of loss, if any. Thus, the appointment of a surveyor by the respondent after receipt of intimation of the loss from the appellant, in the context of the present insurance policy, coupled with the 2000 Regulations and in particular an express stand taken in the repudiation letter sent by the respondent to the appellant after consideration of the surveyor's report, it cannot be construed to be a case of waiver on the part of the respondent. In view of the above, we uphold the conclusion of the Commission that the respondent (insurer) had not waived the condition relating to delay stipulated in Clause 6 of the general 6 conditions of the policy, by appointing a surveyor. Accordingly, these appeals must fail. In view of the above case law, it can be concluded that the Insurance Company can reject the claim for delay in intimation. Therefore, contention of Asheesh is invalid as appointment of surveyor does not mean any kind of waiver for delay in intimation.

Topics: Insurance Law

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