Supreme Court Rules Insurance Claim Cannot Be Totally Repudiated Due to Delay in Intimation
In a significant ruling, the Hon’ble Bench of Justices J.K. Maheshwari and K.V. Viswanathan delivered a landmark judgment on July 31, 2023, addressing the contentious issue of insurance claim repudiation. The case involved an insurance claim dispute where the insurance company rejected the claim on the grounds of the insured’s delay in intimating them about the theft and alleged negligence in leaving the key in the ignition during the incident.
The court, while analyzing the relevant conditions of the insurance policy, observed, “When an insured has lodged the FIR immediately after the theft of a vehicle occurred and when the police after investigation have lodged a final report after the vehicle was not traced, the insured would be in a position to lodge his claim for compensation. Mere delay in intimating the insurance company about the occurrence of the theft cannot be a ground to deny the claim of the insured.” (Para 12)
The Bench highlighted the principles laid down in previous judgments, particularly the cases of Nitin Khandelwal and Amalendu Sahoo, which emphasized that any violation of the policy condition should be considered a fundamental breach to deny the claimant the entire amount. (Para 15)
Relying on the precedents, the court concluded that “in the present case, on facts, completely different, as there is no breach of Condition No.1 because the intimation to the police was immediate… Even if there was some carelessness, on the peculiar facts of this case, it was not a fundamental breach of Condition No.5 warranting total repudiation.” (Para 16)
The court further noted that the insurance company’s own guidelines for settling claims on a non-standard basis, such as in the case of negligence, should be followed. Consequently, the court awarded 75% of the admissible claim to the appellant, upholding the District Forum and State Commission’s decision. (Para 20)
This ruling sets a crucial precedent, affirming that mere delay in intimation cannot result in total repudiation of an insurance claim. The judgment emphasizes the need to assess the breach of conditions on a proportionate basis, safeguarding the rights of policyholders while ensuring insurers can address genuine concerns.
Insurance companies will now be required to consider each claim on its merits, taking into account contributory factors, before repudiating claims entirely. This judgment ensures a fair and balanced approach to insurance claims, providing policyholders with greater protection and strengthening the foundation of insurance law in the country.
Date of Decision: July 31, 2023
Ashok Kumar vs New India Assurance Co. Ltd.
