Page 3 - Jehangir B Gai

Suppression of key facts can lead to claim rejection

The National Commission concluded the claim had been rightly rejected on grounds of misrepresentation in the proposal form and breach of duty to maintain good faith

Businesses can claim cover under consumer rules

The National Commission overruled the maintainability objection on the interpretation of the law laid down by the Supreme Court that insurance is for indemnification, not for commercial purpose

Uncontested facts can't be disputed in appeal

The State Commission noted that the supporting documents had not been disputed as being false, and so the surveyor had erred in questioning the theft

Banks can't withhold loan on flimsy ground

The District Commission concluded that raising a doubt about the validity of the NOC at such a belated stage could not be permitted

Consent must for fixed to floating loan shift

When the loan agreement was submitted in the revision proceedings, it revealed the interest rate column, which should have mentioned fixed or floating, had been left blank

Hospital held liable for acting without consent

Dilip filed a complaint before the Delhi State Commission, alleging that the RFA procedure was carried out without his knowledge or consent, and also without considering the findings of the EPS

Builder paid for breach of contract by buyer

The National Commission noted that the agreement provided for a refund of money, along with interest, but the purchasers had never sought refund

No sub-limits in policy? Avg clause can't apply

According to the National Commission, the average clause couldn't apply since the policy didn't have individual coverage limits for building, stock, and packaging material

Buyer is liable if builder fails to pay his EMI

The National Commission observed that the loan agreement entitled the bank to recover the EMI from the purchaser if the builder failed to pay on his behalf

Insurer liable to reimburse genuine cash payments

All payments were supported by TDS and GST. Hence, the National Commission concluded that the insurer would have to reimburse these legitimate cash expenses

Delay in permissions can't be termed force majeure

The National Commission found that delay was caused due to submission of plans which were not in consonance with the statutory rules and regulations

Magazine held liable for delayed delivery, made to pay Rs 1.5 lakh

The National Commission observed the term "guarantee of satisfaction" would not be limited to the magazine's contents, but would also include other aspects like timely delivery

Insurer needn't pay for VAT on unsold goods

The National Commission said VAT is payable only on sale. If goods are damaged before sale, VAT is not payable, so to claim it is incorrect

Valuation claim must be backed by evidence

The National Commission observed that even though the builder had disputed Naik's valuation, the latter had failed to produce any evidence to support his valuation claim

Insurer must pay heed to surveyor's findings

The National Commission observed that failure to carry out the impossible task of closing the road couldn't be considered a failure to take reasonable precautions

Insurer must pay for specified OPD treatments

The policy specifically mentioned treatment for oesophageal manometry as one of the exceptions for which the claim would be covered even if taken as an outpatient

Mere alcohol presence isn't intoxication

The National Commission decided a person can be said to be intoxicated only when blood alcohol level is 100 mg per 100 ml or more

Fake invoices can lead to insurance claim repudiation, shows a recent order

Aristo Texcon, a private limited company, had its factory in Kolkata's Tangra Industrial Estate. A massive fire occurred on February 19, 2012. Here's what happened when they approached their insurer.

Hotel liable to pay for death caused by fire

A fire broke out on the night between August 3 and 4, 2012, at Hotel Lucky India

Surveyor cannot apply deductions arbitrarily

The National Commission held the insurer liable to settle the claim in accordance with the original computation of loss jointly signed by the surveyor and insured