Mr. Vikrant, as a sole proprietor of rice mill running under the head and style of "M/s. Vikrant Enterprises", at village H in Tehsil B, District S, which was financed by PBZ Bank. Mr. Vikrant is also a depot holder and
CS Professional · Insurance - Law and Practice · PYQS · December 2021
Mr. Vikrant, as a sole proprietor of rice mill running under the head and style of "M/s. Vikrant Enterprises", at village H in Tehsil B, District S, which was financed by PBZ Bank. Mr. Vikrant is also a depot holder and authorised to distribute kerosene oil (highly flammable) in the nearby areas to poor villagers as per requirement. Sometimes, the excess stock of oil is also stored in the premises of rice mill. As per the terms and conditions of the financial assistance, M/s. Vikrant Enterprises got the building, plant, machinery and stock insured with the ULP Insurance Company Limited, covering the risk of earthquake, fire and floods, for which two separate insurance policies were taken, one in respect of the building, plant and machinery and another in respect of stocks of paddy, rice, rice bran, rice husk and bardana etc., lying in the factory premises. The total risk covered was for ₹500 lakh. The terms and conditions of the policy were explained to Mr. Vikrant and he agreed in totality. The period of validity of such insurance policies was w.e.f. 24th September, 2019 to 23rd September, 2020. During the intervening night of 16th/17th January, 2020, the factory premises gutted into fire. On account of devastation of fire, stock to the tune of ₹150 lakh got destroyed. Its information was given to the Insurance Company and the necessary claim was lodged. After carrying out the survey, the company decided not to pay the claim. Mr. Vikrant filed an appeal with State Commission and lost it. In your opinion, what are the considerations which led the insurance company and the State Commission not to settle the claim? Also list some examples of such type under which insurance companies can take shelter to rebut a claim.
Answer & Explanation:
The principle of Uberrimae fidei applies to all types of insurance contracts and is a very basic and primary principle of insurance. According to this principle, the insurance contract must be signed by both parties (i.e. insurer and insured) in absolute good faith or belief or trust. The person getting insured must willingly disclose and surrender to the insurer all relevant complete true information regarding the subject matter of insurance. The insurer's liability is voidable (i.e. legally revoked or cancelled) if any facts, about the subject matter of insurance are either omitted, hidden, falsified or presented in a wrong manner by the insured The principle forbids either party to an insurance contract, by non-disclosure or misrepresentation of a material fact. Material fact is every circumstance or information, which would influence the judgment of a prudent insurer in assessing the risk. Facts, Which Must Be Disclosed: Facts, which show that a risk represents a greater exposure than would be expected from its nature e.g., the fact that a part of the building is being used for storage of inflammable materials. External factors that make the risk greater than normal e.g., the building is located next to a warehouse storing explosive material. Facts, which would make the amount of loss greater than that normally expected e.g., there is no segregation of hazardous goods from non-hazardous goods in the storage facility. History of Insurance (a) Details of previous losses and claims (b) if any other Insurance Company has earlier declined to insure the property and the special condition imposed by the other insurers; if any. The existence of other insurances. Full facts relating to the description of the subject matter of Insurance. Thus failure to disclose storage of hazardous substances along with non-hazardous substances has lead to non-disclosure of material fact in given case. Insurance company did not accept the claim.
Topics: Insurance Law and Practice
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