Ramesh, a senior executive working in Delhi, purchased a Tata Sumo vehicle from Prime Motors on 27 th September, 2014 for a sum of ₹7,80,000. After getting the vehicle registered, Ramesh on 29 th September, 2014 got the
CS Professional · Insurance - Law and Practice · PYQS · December 2015
Ramesh, a senior executive working in Delhi, purchased a Tata Sumo vehicle from Prime Motors on 27 th September, 2014 for a sum of ₹7,80,000. After getting the vehicle registered, Ramesh on 29 th September, 2014 got the vehicle bearing no. DL2C-J-7250 insured comprehensively with Bright Insurance Co. for the period from 29 th September, 2014 to 28 th September, 2015. On 8 th November, 2014, Ramesh paid a visit to Noida for official work. He parked and locked the car on the side road adjoining the office and went for work at around 10:30 AM. After finishing his work around 3:30 PM, he came out to return to Delhi. To his surprise, he found the vehicle missing. He searched for the car frantically and on not finding it, lodged an FIR with the Noida police station for the missing car. Next day, he also informed Bright Insurance Co., the insurer in writing about the said theft of the vehicle. Despite vigorous efforts of the police, the vehicle could not be traced. Hence, after 90 days, the Noida police gave a non-traceable certificate/report to Ramesh, the complainant. Ramesh, thereafter, again pursued the matter of settlement of claim with the insurance company and submitted a copy of the purchase invoice of the vehicle alongwith driving license, proof of road tax payment and other relevant documents including the final report in support. Despite passage of over 21 days, the insurance company did not respond positively and kept delaying the matter on one pretext or the other. Aggrieved by this inaction on the part of the insurer, Ramesh after five weeks, filed a complaint with the District Forum. During the pendency of the complaint, the insurance company repudiated the claim on the ground that the vehicle was being used as a Taxi by Ramesh. The District Forum, after hearing both sides on 29 th March, 2015 allowed the complainant and directed the insurance company to pay Ramesh, the insured declared value of the vehicle, i.e., ₹7,80,000 alongwith interest @ 6% p.a. from four months after the date of lodging of claim till realisation. The District Forum also awarded ₹7,000 as costs. The insurance company, being aggrieved with this decision, filed an appeal before the State Commission. The plea highlighted the fact that the insurer was not liable to reimburse the loss of stolen vehicle as the same was being used as a taxi. This plea was rejected by the State Commission by observing that theft of the vehicle had nothing to do with the use of the vehicle. The appeal, therefore, was dismissed and the awarded amount was ordered to be released by Bright Insurance Co. to Ramesh. The insurance company being still not satisfied filed a revision petition before the National Forum. During arguments, both sides vehemently advocated their views. Finally, it was pointed out by the counsel of the insured that in the decided case of 'National Insurance Company Ltd. vs. Nitin Khandelwal' in 2008 (CPJ ISC 2008-SEC-259), the Supreme Court had held that, "in a case where the vehicle had been snatched or stolen, the breach of condition is not germane and the insurance company is liable to indemnify the owner of the vehicle where the insured owner has obtained a comprehensive policy for the vehicle in question." In view of the aforesaid judgment of the apex court in the earlier order of the State Commission in the 'Nitin Khandelwal case of 2008', the counsel for the insurance company did not press the point that insurer was not liable to reimburse for the stolen vehicle because it was being used as a taxi. Hence, the claim of Ramesh was finalised at 75% on 'non-standard basis' as upheld earlier by the Supreme Court in 2008 plus cost. In light of the above, answer the following questions: In the case cited above of the apex court in 2008, the claim was finalised at 75% being 'non-standard basis'. On consideration of the totality of the facts and circumstances in such cases, the law seems to be well settled that in case of theft of a vehicle, the nature of use of the vehicle cannot be looked into and the insurance company cannot repudiate the claim on this basis. If that be the case, should such claim be settled only on 'non-standard basis'? Comment.
Answer & Explanation:
The Supreme Court has held in "Nitin Khandelwal Case" in 2008 that "where the vehicle is snatched or stolen, the breach of condition of policy is not germane; that the insurance company is liable to indemnify the owner of the vehicle when the insurer has obtained comprehensive policy for the loss caused to the insurer". If the Supreme Court's decision is viewed in totally, it becomes clear that in case of theft of a vehicle the nature of use of the vehicle cannot be looked into and the breach of such a condition is not germane and hence the Insurance Company is liable to indemnify the owner for the loss suffered by him. However, in the present case, since there is no evidence of breach of usage condition, the claim will have to be paid. Further, as per rules, even if is presumed that there is a breach of any condition, a claim cannot be rejected for breach of a policy condition unless such breach is the cause of the loss. When there is no nexus between the breach and the loss, the claim has to be settled on a non-standard basis. Therefore, in the present case, as there is no evidence of misuse of vehicle as taxi, the claimant is liable for total loss payment and not only the total loss suffered by him as a result of theft and not merely settlement on 75% "Non-Standard basis", as the present facts of the case do not qualify under the guidelines for non-standard claims as mentioned below: Where a breach of warranty or policy condition arises and where such breach is of a technical nature or is evidently beyond the control or knowledge of the insured or is considered after rectifying the policy and collecting additional premium where due. In settling the claim, a deduction may be made from the assessed claim amount equivalent to the extra premium due for three years or three times the additional premium due for voyage which would have been charged had correct information been available originally.
Topics: Motor Insurance
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