Page 58 - Insurance Times January 2023

Insurance Caselaws

Whether there is any strait jacket formula for language of the question which is asked, and the answer
given will be similarly construed; (b) carelessness is no
awarding compensation under the heads, pain
excuse, unless the error is so obvious that no one could be
and suffering and loss of amenities and
regarded as misled; (c) an answer which is literally accurate,
happiness? so far as it extends, will not suffice if it is misleading by reason
Sri. Benson George of what is not stated; (d) where the space for an answer is
vs. left blank, leaving the question un-answered, the reasonable
Reliance General Insurance Co. Ltd inference may be that there is nothing to enter as an
Civil Appeal No. 1540 of 2022 answer; (e) where an answer is unsatisfactory, as being on
the face of it incomplete or inconsistent the insurers may,
Policy type- Third Party Insurance as reasonable men, be regarded as put on inquiry, so that if
they issue a policy without any further enquiry they are
The Supreme Court examined its previous decisions in Raj
assumed to have waived any further information; (f) a
Kumar v. Ajay Kumar and Anr. (2011)1SCC 343 and Lalan D.
proposer may find it convenient to bracket together two or
v. Oriental Insurance Company Limited (2020)9SCC 805, and
more questions and give a composite answer; (g) any answer
observed that the amount of compensation to be awarded
given, however accurate and honest at the time it was
under the heads, pain and suffering and loss of amenities
written down, must be corrected if, up to the time of
and happiness cannot be based on a straight jacket formula.
acceptance of the proposal, any event or circumstance
It depends upon the facts and circumstances of each case
supervenes to make it inaccurate or misleading.
and varies from person to person who has suffered due to
the accident. So far as awarding compensation under the
head pain, shock, and suffering is concerned, multiple factors Effect of delayed notification regarding theft
are required to be considered namely, prolonged of vehicle?
hospitalization, the grievous injuries sustained, the
operations underwent and the consequent pain, discomfort
Jaina Construction Company
and suffering. Similarly, loss of amenities and happiness
vs.
suffered by the claimant and his family members also depend
The Oriental Insurance Company Limited and Ors.
upon various factors, including the position of the claimant
I(2022)CPJ119(SC)
post accident, and whether, he is in a position to enjoy life
and/or happiness which he was enjoying prior to the Policy type- Motor Insurance Policy
accident. The Court accordingly enhanced the compensation The insurer repudiated the insured’s claim in toto on the
awarded to the claimant under the head loss of amenities ground that there was a delay in informing the insurance
and happiness. company regarding the theft of the vehicle. The condition
in question mandated the insured to give immediate notice
What are the rules to be observed for making to the insurer of the accidental loss/damage but was given
by the insured after a lapse of 5 months from the loss.
a proposal for insurance?
Relying on Gurshinder Singh v. Shriram General Insurance
Manmohan Nanda Co. Ltd. and Anr. 2020 (11) SCC 612, the Supreme Court
vs. United India Assurance Co. Ltd. and Ors. observed since the FIR was lodged immediately on the next
I(2022)CPJ20(SC) day of the occurrence of theft of the vehicle by the insured
and the vehicle could not be traced out, a delay of about
Policy type- Overseas Mediclaim Policy-B five months in informing and lodging the claim with the
The Supreme Court while allowing an insurance claim of the insurer would not be fatal. The Court held that when the
insured under a mediclaim policy summarized the rules to insurer has repudiated the claim only on the ground of delay,
be observed in making a proposal for insurance, namely, (a) and the claim of the insured was not found to be not
a fair and reasonable construction must be put upon the genuine, the insurer’s repudiation could not be sustained.

50 January 2023 The Insurance Times