Exclusionary Clause Interpretation in Insurance Claim Repudiation Case

Rajarhat, District 24- Paraganas, (South) of West Bengal had obtained two insurance policies from the appellant-Insurance Company, one being Policy No 100900/11 / 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.

Also Read: https://newslaw.in/case-type/civil/c-a-no-003957-003957-2023/

Rajarhat 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 2 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.

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.

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. 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.

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.

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.

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 7 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. 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. .

Case Title: NATIONAL INSURANCE COMPANY LTD. Vs. VEDIC RESORTS AND HOTELS PVT. LTD. (2023 INSC 545)

Case Number: C.A. No.-004979 / 2019

Click here to read/download original judgement

Leave a Reply

Your email address will not be published. Required fields are marked *