Page 60 - Insurance Times April 2023

Effect of delayed notification regarding theft crucial with advancing age; the policy holder is more likely
to need cover; therefore, if there are freshly introduced
of vehicle?
limitations of liability, the insured may, if advised properly,
Jaina Construction Company and in a position to afford it, seek greater coverage, or seek
v. a different kind of policy. Further, most policies - health and
The Oriental Insurance Company Limited and Ors. medical insurance policies being no exception, are in
I(2022)CPJ119(SC) standard form. One who seeks coverage of a life policy/a
personal risk, such as accident or health policy has little
Policy type- Motor Insurance Policy
choice but to accept the offer of certain standard term
contracts. Therefore, relying on the IRDA (Health Insurance)
The insurer repudiated the insured’s claim in toto on the
Regulations, 2016, the Court observed that it is the insurer's
ground that there was a delay in informing the insurance
obligation to inform every policy holder, about any important
company regarding the theft of the vehicle. The condition
changes that would affect her or his choice of product.
in question mandated the insured to give immediate notice
to the insurer of the accidental loss/damage but was given
Can the Court adopt liberal interpretation
by the insured after a lapse of 5 months from the loss.
Relying on Gurshinder Singh v. Shriram General Insurance while interpreting terms of the insurance
Co. Ltd. and Anr. 2020 (11) SCC 612, the Supreme Court policy?
observed since the FIR was lodged immediately on the next
Life Insurance Corporation of India and Ors.
day of the occurrence of theft of the vehicle by the insured
v.
and the vehicle could not be traced out, a delay of about
Sunita Life Insurance Corporation of India and Ors.
five months in informing and lodging the claim with the
(2022)1SCC68
insurer would not be fatal. The Court held that when the
insurer has repudiated the claim only on the ground of delay, Policy type- Life Insurance Policy under the Jeevan
and the claim of the insured was not found to be not Suraksha Yojana
genuine, the insurer’s repudiation could not be sustained.
The accident claim benefit as per the terms of the insurance
policy was payable only if the policy was in force on the date
Duties of an insurer, when a policy holder
of the accident. In this case, the policy had lapsed at the
seeks renewal of an existing policy?
time of accident and the premium was sought to be paid
Jacob Punnen and Ors. three days after occurrence of accident. However, the
v. complainant contended that the premium was paid along
United India Insurance Co. Ltd. with late fee charges and therefore, the policy had stood
I(2022)CPJ87(SC) revived before the death of the complainant's husband. In
rejecting the claim of the complainant, the Supreme Court
Policy type- Medical Insurance Policy
relied upon its own decision in Vikram Greentech (I) Ltd. v.
New India Assurance Co. Ltd. (2009) 5 SCC 599. In that case,
The Supreme Court rejected the insurer’s argument that the
the Court had observed that in a contract of insurance, there
consumer was under an obligation to inquire about the
is requirement of uberrima fides i.e. good faith on the part
terms of the policy, and any changes that might have been
of the insured. The four essentials of a contract of insurance
introduced, in the standard terms. The state of the law as
are: (I) the definition of the risk, (ii) the duration of the risk,
observed was that an insurer was under a duty to disclose (iii) the premium, and (iv) the amount of insurance. Upon
any alteration in the terms of the contract of insurance, at issuance of the insurance policy, the insurer undertakes to
the formation stage or as in this case, at the stage of indemnify the loss suffered by the insured on account of the
renewal. The insurer cannot be heard to say that the insured risks covered by the insurance policy. Accordingly, the Court
was under an obligation to satisfy itself, if a new term had held that terms of insurance policy have to be strictly
been introduced. In the facts of the case, the Court construed, and it is not permissible to rewrite the contract
observed that medical or health insurance cover becomes while interpreting the terms of the Policy.

52 April 2023 The Insurance Times