A is a horse-owner and races his horses. He has been racing horses, all of which are insured comprehensively by a general insurance company. One of the insured horses which has won many races for A in the past, had of la
CS Professional · Insurance - Law and Practice · PYQS · June 2018
A is a horse-owner and races his horses. He has been racing horses, all of which are insured comprehensively by a general insurance company. One of the insured horses which has won many races for A in the past, had of late, due to various factors including age, been on a losing streak and had lost at the recent three races and A had lost large amount of money because of this. Suddenly, this horse, which was insured for ₹25 lakhs, fell sick and died soon thereafter, the cause of death was indicated to be colic, a common killer disease of horses. A made a claim on the insurance company for ₹25 lakhs and incidental expenses. The insurer after due enquiry passed the claim and paid to A the amount of ₹25 lakhs as claim. One year after such payment was made, due to persistent newspapers reporting and on the basis of police investigation conducted in similar cases, it was noticed that some race horses which had become old and were losing races, were systematically killed by the owners through the help of a syndicate which had been retained by the owners. Y was arrested by the police in this regard as the main culprit who had poisoned the horses and enabled the owners to collect the insurance money. On examination, Y revealed the names of the horses that he had killed through poisoning and their respective owners. A was also included in the list. It was ascertained that death by electrocution could be disguised as death caused by colic. On the basis of this investigation and report, the insurer who had paid ₹25 lakhs to A wants to reopen the claim. Arising out of the above move, the following issues arise for consideration which you are required to deal: Can you estimate the damage compensation liability of A?
Answer & Explanation:
Financially A will be liable to repay to the insurance company: Amount of claim paid: ₹25,00,000 Incidental claims paid (if any) Incidental expenses incurred by the insurance company for the investigation and other such matters. Besides these financial liability the company can also take A to the court for fraud and misrepresentation where he could be convicted for manipulating the death of the horse under the relevant provisions of the procedure code.
Topics: Insurance Claims
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