Ruling that lunch break will be included in business hours unless specifically stated otherwise in the policy, the National Consumer Disputes Redressal Commission (NCDRC) has directed an insurance company to pay Rs 10.5 lakh to a Bhayander-based jeweller.
Panchsheel Jewellers had bought an insurance policy from the New India Assurance Company for Rs 21.51 lakh. The policy covered all the jewellery and cash in the shop.
According to the complaint, a theft occurred in the shop on the afternoon of May 8, 2003. The owner, as well as all the employees, were out on lunch-break between 1.30 and 4pm, when the incident happened. The owner lodged a police complaint, saying that jewellery worth almost Rs 23 lakh was robbed.
The jeweller filed a claim with the insurance company for the full insurance amount i.e. Rs 21.51 lakh. Later, police arrested the accused and managed to recover jewellery worth around Rs 12.5 lakh from them. However, the insurance company rejected the claim, citing an exclusion clause in the policy.
According to the reply affidavit filed by the insurer, jewellery displayed in the showcase was kept as it is and was not in a locker. It further stated that the claim was rejected since as per the policy, all property including cash currency notes while at the premises, shall be secured in the locked safe of standard make at all time, out of business hours
The NCDRC, however, observed that neither the insurer nor their advocates was able to point to any provision in the policy which would permit this interpretation they canvassed. In its absence, the argument amounts to bringing a stipulation into the policy which is not expressly contained in it, observed the Commission while deciding the case in the jeweller’s favour.
http://www.mumbaimirror.com/article/2/2012122620121226023026753da046a37/Insurance-company-asked-to-pay-Rs-105-L-to-jeweller.html
