Nilesh, a businessman took a fire insurance policy to cover stocks of oil seeds, oil cakes, etc., in a godown of Class I construction located behind Vile Parle Market, Mumbai for a sum insured of ₹7 lakh against fire wit

CS Professional · Insurance - Law and Practice · PYQS · June 2015
Nilesh, a businessman took a fire insurance policy to cover stocks of oil seeds, oil cakes, etc., in a godown of Class I construction located behind Vile Parle Market, Mumbai for a sum insured of ₹7 lakh against fire with riot and strike cover with ABC Insurance Company Ltd. for the period 15th May, 2014 to 16th May, 2015. The insured remitted ₹1,255 through account payee cheque to the insurer as premium for the coverage. The cheque was acknowledged by the insurer and a cover note for the sum insured of ₹7 lakh was issued against fire with riot and strike coverage on 19th May, 2014 (17th and 18th May, 2014 being Saturday and Sunday). The cover note covering the risk in question was duly delivered to Nilesh on 20th May, 2014 by an authorised representative of the insurer. The cover note whilst describing the property in brief also indicated "Subject to terms, conditions and exceptions of the standard fire policy." The policy however was not released by the insurer. Unfortunately, on 22nd June, 2014, a fire occurred in the godown and resulted in damage to a part of the oil seeds and oil cakes. The fire brigade was summoned and the fire was put out after considerable effort. But by that time, a substantial portion of the insured's stocks had suffered damages. The insurance company upon receipt of intimation, deputed a senior fire surveyor to carry out inspection and assessment of damages. The surveyor after detailed inspection and verification of records assessed the damages to the tune of ₹3.40 lakh on account of 'spontaneous combustion'. The report was submitted to the insurer on 25th July, 2014. The insured, Nilesh, took-up the matter with the insurance company for compensation. The ABC Insurance Company Ltd. however on the basis of surveyors findings informed the insured that spontaneous combustion was an excluded peril under the standard fire policy and hence the insurance company could not admit its liability under the claim. This decision of the insurance company was conveyed to the insured in writing on 6th August, 2014. Being not satisfied with the decision of the insurance company, the insured, Nilesh took-up the matter with the 'consumer forum' for redressal stating that the cover note issued to him did not have a stipulation that 'spontaneous combustion' was an excluded peril under the standard fire policy and in the absence of such a condition, his rightful claim for compensation cannot be rejected by the insurer. Moreover, the policy too had not been released by the insurer even after a month and hence the claimant was completely in the dark with regard to terms, conditions and exclusions of a standard fire policy. The insured, therefore, cannot be penalised for 'no fault of his own'. The insured further contended that there was 'deficiency in service' on the part of the insurer in not releasing the policy document in time and in keeping the insured fully informed of the coverage. The consumer forum heard arguments from both the parties including those advanced by the respective advocates on both sides. They also questioned the surveyor at length who had carried out loss assessment of the damages sustained by the insured. The consumer forum after due deliberation amongst its members, directed the insurance company to pay the claim to the insured to the tune of ₹3.40 lakh as assessed by the surveyor. The consumer forum further directed the insurance company to pay an additional amount of ₹30,000 for 'deficiency in service' in not releasing the fire policy within a reasonable period of 30 days. What do you understand by 'condition of average' in a fire insurance contract?

Answer & Explanation:

Fire insurance contracts are strict contracts of indemnity. In other words, the insurer is supposed to indemnify the insured to the extent of loss suffered by him and not more than the loss. Indemnity implies making good of actual loss. The aim of the principle of indemnity is to place the insured in his pre-loss financial position and not to make a gain out of a loss. For example, if a property is insured for a certain amount and later on it transpired that the market value of the property was much on the higher side and in case an accidental fire occurs, then the insured will be his own insurer for the accidental partial loss suffered by him. This is also called as underinsurance or self-insurance. The formula that will be applicable would be as under: Sum insured / Market value x loss For example, if sum insured is ₹2 lakh and the value of the property on the day of loss was ₹2.75 lakh. If the loss assessed for partial damages is ₹1.25 lakh, then the liability of the insurance company would be as under: (₹2,00,000 / ₹2,75,000) x ₹1,25,000 = ₹90,909 The insured would be his own insurer for the balance amount of loss. In other words, he has to bear a loss of ₹34,091 out of his pocket.

Topics: Fire Insurance

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