Full Judgment Text
REPORTABLE
IN THE SUPREME COURT OF INDIA
CIVIL APPELLATE JURISDICTION
CIVIL APPEAL NO. 4979 OF 2019
NATIONAL INSURANCE COMPANY LTD. .....APPELLANT
VERSUS
VEDIC RESORTS AND HOTELS
PVT. LTD. .....RESPONDENT
J U D G M E N T
BELA M. TRIVEDI, J.
1. The aggrieved appellant-Insurance Company has filed the present
appeal under Section 23 of the Consumer Protection Act, 1986
(hereinafter referred to as the said Act) challenging the judgment
and order dated 07.01.2019 passed by the National Consumer
Disputes Redressal Commission, New Delhi (hereinafter referred
to as the “National Commission”) in Consumer Complaint No. 227
of 2012, whereby the Commission has allowed the complaint filed
Signature Not Verified
by the complainant (respondent herein), and directed the appellant
Digitally signed by
Ashwani Kumar
Date: 2023.05.17
16:48:17 IST
Reason:
to pay a sum of Rs. 202.216 lakhs to the complainant along with
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interest @ 9% per annum from six months from the date of
lodgment of the claim till the date on which the said payment is
made.
2. The respondent-complainant, running a Resort at Village
Shikharkpur, P.S. Rajarhat, District 24- Paraganas, (South) of
West Bengal had obtained two insurance policies from the
appellant-Insurance Company, one being Policy No. 100900/11 /
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08/3300000420 for the period from 16 September, 2008 to 15
September, 2009 in respect of the buildings of the said Resort
with plant and machineries accessories and furniture etc. and the
other being Policy No. 100900/11/09/3100000270 for the period
th th
from 13 July, 2009 to 12 July, 2010 in respect of two hotel
buildings at the said resort with stock.
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3. As per the case of the respondent-complainant on 23 August, 2009
at about 5.00 p.m., a mob of about 200-250 persons entered the
resort and damaged/destroyed the insured property resulting in loss
to the complainant. The incident was reported to the police and the
FIR being No. 144 of 2009 was registered on the written complaint
given by one Santanu Bhattacharjya, General Manager of Vedic
Village Resort, P.S. Rajarhat.
4. Another FIR being No. 143 of 2009 was registered at P.S. Rajarhat
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on 23 August, 2009 for the offence under Sections 302/34, 120B,
506, 212 IPC and Section 25 and 27 of the Arms Act against one
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Gaffar Molla and his associates, at the instance of a written
complaint given by one Monirul Sardar to the effect that when the
said complainant and his brother were returning home, they saw a
football match going on at Sekharpur Adarsha Sangha Ground.
When the said football match was going on, suddenly one Gaffar
Molla and his associates started firing and hurling bombs to
postpone the match. As a result, thereof, the brother of the
complainant, namely, Alam @ Amirul Sardar received gunshot injury
on his person causing his instant death. Several other spectators
also received injuries due to bomb explosion.
5. During the course of investigation, it was revealed that the accused-
Gaffar Molla and his associates after the firing and throwing bombs
at the football match venue, and upon being chased by the crowd,
took shelter in Vedic Resorts and Hotels Pvt. Ltd. of the respondent-
complainant. Since the said Gaffar Molla and his associates were
given shelter in the said Vedic Resort, the crowd chased them and
damaged the insured property of the respondent-complainant.
During the course of investigation, the police conducted a search of
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Vedic village on 24 August, 2009 and found that there were pipe
guns, live bombs in gunny bags and explosive substances found
and recovered from the housing material-cum-electrical store room
situated within the compound of the Vedic village of the respondent.
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6. On the surveyor being appointed, as per the Final Survey Report
dated 16.06.2011, the Surveyor assessed the loss to the buildings
and contents to the extent of Rs. 197.842 lakhs in Policy No. 420
and the loss to the crockery and cutlery to the extent of Rs. 4.274
lakhs in Policy No. 270, in aggregate assessed the loss to the tune
of Rs. 202.216 lakhs under both the policies.
7. The appellant-Insurance company repudiated the claim of the
respondent vide letter 06.07.2012 inter alia stating that loss in
respect of which the subject claim was made, was an outcome of
the malicious act and therefore fell within the exclusions under
Clause V(d) of the Subject policies; and that there had been a
breach of warranty on the part of the assured in respect of the
class of constructions covered under the subject policies.
8. The respondent therefore filed the Consumer Complaint being No.
227 of 2012 challenging the said repudiation of claim under
Section 21 of the said Act before the National Commission, which
by the impugned order dated 07.01.2019 partly allowed the same
as stated hereinabove.
9. The learned counsel Mr. Vishnu Mehra, appearing for the
appellant-Insurance Company vehemently submitted that the
respondent had harboured the hard-core criminal Gaffar Molla and
his associates who had killed one person and injured many others
at the football match venue, using illegal fire-arms and explosives
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stored at his own compound of Vedic village and had invited public
grudge which had caused damage to his insured property. Hence,
according to him, the loss suffered by the respondent was an
outcome of the malicious act on the part of the management of
Vedic village, which fell within the exclusions provided under
Clause V(d) of the Insurance Policy. He further submitted that the
words “or any omission or any kind or any person” occurring in
Clause V(d) of the Policy would cover the damage to the property
caused on account of omission of the management of the
respondent-complainant to abide by the law, and the respondent
had engaged Gaffar Molla and his associates for carrying out
illegal activities and terrorising the people having their lands
adjacent to the resort, to extend the area of his resort. He also
submitted that the Survey Report of the Surveyor opining that the
loss had occurred due to the insured peril and the claim was
admissible was highly erroneous and could not be treated as final.
10. However, the learned counsel Mr. Sukumar Pattjoshi, appearing
for the respondent supporting the findings recorded by the
National Commission submitted that the repudiation of his claim by
the appellant-Insurance Company was erroneous and the
Commission had rightly granted the same.
11. The appellant having relied upon the Clause V of the subject
policies, the relevant extract thereof is reproduced as under:
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| “V. Riot, Strike and Malicious Damage:<br>Loss of or visible physical damage or destruction by<br>external violent means directly caused to the<br>property insured but excluding those caused by: | “V. Riot, Strike and Malicious Damage: | |
|---|---|---|
| Loss of or visible physical damage or destruction by<br>external violent means directly caused to the<br>property insured but excluding those caused by: | ||
| (a) to (c)……………… | ||
| (d) burglary, housebreaking, theft, larceny or any<br>such attempt or any omission of any kind of any<br>person of any person (whether or not such act is<br>committed in the course of a disturbance of public<br>peace) in any malicious act. | ||
| If the Company alleges that the loss/damage is | ||
| not caused by any malicious act, the burden of | ||
| proving the contrary shall be upon the insured.” | ||
12. From the bare reading of the said clause, it is discernible that the
loss of or visible physical damage or destruction by external violent
means directly caused to the property insured was covered, but
the loss, damage or destruction to the property caused by
burglary, housebreaking, theft, larceny or any such attempt or any
omission of any kind of any person in any malicious act was not
covered. It further states that if the Insurance company alleges that
the loss/damage was not caused by any malicious act, the burden
of proving the contrary would be upon the insured. In the instant
case, the appellant-Insurance company had repudiated the claim
of the respondent taking recourse to the said Clause V(d) of the
subject policy on the ground that the loss caused to the
respondent was an outcome of the malicious act/acts on the part
of the respondent Vedic Village management and it fell within the
exclusions provided under Clause V(d) of the Insurance Policy. For
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the purpose of coming to the said conclusion, the appellant-
Insurance Company in its letter dated 02/05/2011 while
repudiating the claim of the respondent, had relied upon the
incident which had taken place at the football match ground, where
the accused Gaffar Molla and his associates had fired and caused
death of one person and injured others, and thereafter they had
taken shelter at the Vedic Village of the respondent.
13. Though, it is true that the said Gaffar Molla and his associates had
taken shelter at the Vedic Village when the mob became frenzied
and chased them, and though it is also true that during the course
of investigation the pipe guns and other explosive materials were
found lying in the compound of Vedic Village, nonetheless the
alleged incident of firing and causing death of a person appears to
have taken place on the spot during the football match being
played at the football ground. There is hardly any material to show
that the entire incident and the resultant damage to the insured
property was caused as a result of the malicious act of the
respondent-complainant. Even if, the allegations against the said
Gaffar Molla and his associates are taken at their face value, it is
difficult to accept the contention raised by the learned counsel for
the appellant that the damage caused by the frenzied mob which
had chased said Gaffar Molla and his associates, was caused due
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to the malicious act on the part of the respondent and therefore
was excluded from the coverage in view of Clause V(d) of the
subject Policy.
14. It is trite to say that wherever such an exclusionary clause is
contained in a policy, it would be for the insurer to show that the
case falls within the purview of such clause. In case of ambiguity,
the contract of insurance has to be construed in favour of the
insured.
15. Beneficial reference of the decision in National Insurance
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Company Limited vs. Ishar Das Madan Lal be made in this
regard, in which it has been held that: -
| “8. | However, there may be an express clause | ||
|---|---|---|---|
| excluding the applicability of insurance cover. | |||
| Wherever such exclusionary clause is contained in | |||
| a policy, it would be for the insurer to show that the | |||
| case falls within the purview thereof. In a case of | |||
| ambiguity, it is trite, the contract of insurance shall | |||
| be construed in favour of the insured. “ |
16. The Constitution Bench in case of General Assurance Society
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Ltd. Vs. Chandumull Jain and Another had also observed as
back as in 1966 that: -
| “11.…… | there is no difference between a contract | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| of insurance and any other contract except that in a | |||||||||
| contract of insurance there is a requirement | |||||||||
| of | uberrima fides | i.e. good faith on the part of the | |||||||
| assured and the contract is likely to be | |||||||||
| construed | contra proferentem | that is against the | |||||||
| company in case of ambiguity or doubt”. |
1 (2007) 4 SCC 105
2 AIR 1966 SC 1644
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17. In the instant case, the appellant-Insurance Company had failed to
discharge its burden of bringing the case within the exclusionary
clause V(d) of the policies in question. The surveyor in the Final
Survey Report dated 16.06.2011 had also opined that the loss had
occurred due to the insured peril and the claim was admissible.
Though it is true that the Surveyor’s Report is not the last and final
one nor is so sacrosanct as to the incapable of being departed
from, however, there has to be some cogent and satisfactory
reasons or grounds made out by the insurer for not accepting the
Report. We are afraid in the instant case, the appellant-Insurance
Company has failed to make out any such cogent reason for not
accepting the surveyor’s Report.
18. In that view of the matter, we do not find any merit in the present
appeal and the same is accordingly dismissed.
. .………………………. J.
[AJAY RASTOGI]
…..................................J.
[BELA M. TRIVEDI]
NEW DELHI;
17.05.2023
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