Insurance Claim Approved Despite Lack of "Forcible Entry" in Theft Case; Consumer Commission Orders Payment.


14 October 2024 Civil Revision >> Civil & Consumer Law   |   Insurance >> Personal Law  

The Oriental Insurance Company's revision petition against concurrent orders from lower consumer forums was dismissed. The case involved a theft at the complainant's insured shop, where thieves used keys stolen from his home to gain entry. The insurance company repudiated the claim, citing the policy's definition of "burglary and housebreaking" which required "forcible and violent means" of entry.

Both the District Consumer Disputes Redressal Forum and the State Consumer Disputes Redressal Commission ruled in favor of the complainant, finding the repudiation unjustified. The National Consumer Disputes 


 

 

Redressal Commission (NCDRC), while acknowledging the policy's strict definition, recognized the unique circumstances of the case. They noted the theft was acknowledged by the police and the surveyor had assessed the full insured value of Rs. 650,000. Additionally, the NCDRC found no evidence of fraud.

The NCDRC dismissed the revision petition, modifying the lower forum's orders. They directed the insurance company to pay the complainant Rs. 650,000 within six weeks, with a 9% annual interest penalty for any delay. The commission concluded that, given the specific situation, a strict interpretation of the policy's "forcible entry" clause would be inequitable, and the complainant deserved the benefit of the doubt.