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2013 DIGILAW 650 (JK)

National Insurance Co. Ltd. v. Mohammad Shafi Bhat & Others

2013-11-12

MUZAFFAR HUSSAIN ATTAR, VIRENDER SINGH

body2013
Muzaffar Hussain Attar, J.:-- 1. These Appeals, filed u/S. 17 of Jammu and Kashmir State Consumers Protection Act, 1987, arise from a common order passed by the Jammu and Kashmir State Consumer Dispute Redressal Commission, Srinagar (Commission for short), impugned herein. Since identical question of law is involved in all these cases, they are taken up together and are disposed of along with connected CMPs by this common order. 2. The admitted facts, which are taken from the impugned order of the Commission, annexed with CIMA 162/2012 are summarized below: “The parties have admitted that the valid Insurance Policies were issued. It is also admitted that the properties of the respondents” complainants got damaged during the subsistence of these policies. It is also admitted that on receipt of information, the Appellants ‘Insurance Companies appointed surveyors, who, after conducting survey, submitted their reports about the loss and damages suffered by the respondents-complainants. It is also admitted that the damage was caused to the properties of the respondents-complainants on account of cross fire/shelling by or between the armed forces and militants. It is also admitted that separate amounts were paid by the respondents-complainants for coverage of risk on account of terrorism. It is also admitted that in all cases, police has opined about the non-involvement whatsoever of the respondents-complainants with the militancy related activities.” 3. Despite all these admitted facts, the Appellants repudiated claims of the respondents-complainants, constraining them to approach the Commission. The Commission, by its order dated 18-5-2012, allowed the complaints of the respondents and directed the Appellants to pay the amount in the manner directed by the Commission hi the aforesaid order. 4. It may not be out of place to mention here that New India Insurance Company Limited, Srinagar, against which Complaint No. 37/2009 was filed before the Commission, which was decided by the Commission along with other complaints in terms of the aforesaid order, has been implemented by the said Insurance Company and has not, thus, challenged the same by filing Appeal as has been done by Appellants herein. 5. 5. The Appellants had taken objection before the Commission about grant of reliefs in the complaints on the basis of the Exclusion Clause of the Insurance Policy, which provides “notwithstanding any provision to the contrary within this insurance, it is agreed that this insurance excludes loss, damage, cost or expense of whatsoever nature, directly or indirectly caused by, resulting from, or in connection with any act of terrorism regardless of any other cause or event contributing concurrently or any in other sequence to the loss.” It is further provided that “for the purpose of aforementioned endorsement, an act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons whether acting alone or on behalf of or in connection with any organization(s) or Government(s) committed for political, religious, ideological or similar purpose including the intention to influence any Government and/or to put the public, or any section of public in fear. The warranty also excludes loss, damage cost or expenses of whatsoever nature, directly or indirectly caused by resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to action taken in respect of any act of terrorism.” It is further provided that “if the Company alleges that by reason of this exclusion, any loss, damage, cost or expenses is not covered by this insurance, the burden of proving the contrary shall be upon the insured. In the event any portion of this endorsement is found to be invalid or unenforceable, the remainder shall remain in full force and effect.” The aforesaid quoted terms and conditions form part of ‘Guidelines for coverage of terrorism risk with effect from 1-4-2002 under Standard Fire and Special Perils Policy.’ 6. The Commission in Complaint No. 28/2004, titled Ghulam Hassan Mir v. New India Assurance Company Limited, Srinagar, which complaint was decided in the year 2008, considered almost the similar question in respect of the same Exclusion Clause contained in the Circular, which clause became operative from 1-4-2002. The Commission in this case found that the Exclusion Clause was not made part of the insurance policy and same was communicated to the complainant after the period of 02 years, 02 months and 05 days after the issuance of Insurance Policy. The Commission in this case found that the Exclusion Clause was not made part of the insurance policy and same was communicated to the complainant after the period of 02 years, 02 months and 05 days after the issuance of Insurance Policy. It is in this backdrop, the Commission ruled that the terms and conditions of the Circular will not bind the complainant. The order of the Commission was challenged before this Court in CEVIA 106/2008. The Division Bench of this Court dis­missed the Appeal of the Insurance Company on the ground that it has not informed the complainant about the terms and conditions, which were contained in the revised Circular No. FT/1/2002 dated 13-3-2002 to the extent which related to the loss on account of terrorist activities. It also held that the Appellant-Company, in the circumstances, cannot wriggle out of its liability under the insurance Contract to indemnify the loss to the insured property as assessed by its Surveyor and Loss Assessor on the ground of change in the terms and conditions of the insurance Contract, which were neither incorporated in the said Contract nor communicated or conveyed to the complainant therein. The Appeal of the Insurance Company, accordingly, failed before this Court. 7. A similar question arose in CIMA 118/2010, titled National Insurance Company Limited v. Ghulam Hassan Lone, which was disposed of by the Division Bench of this Court on 10-5-2011 by observing that the issue was directly covered by the earlier Di­vision Bench judgment of the Court. SLP (C) No. 24738/2011 titled National Insurance Company Limited v. Ghulam Hassan Lone, filed against the aforesaid order of the Division Bench was dismissed by the Hon’ble Supreme Court. The Commission, in Complaint No. 54/2008, in case titled M/s. A.R. Enterprises v. National Insurance Company Limited, considered the effect of Circular on the rights of the insured. The Commission, in the aforesaid case, after considering the effect of the Circular, declared the same to be unconscionable and opposite to public policy. CIMA 181/2009, against the aforesaid order of the Commission, was dismissed by this Court by a common judgment passed in CIMA 106/2008. As already stated, another CIMA 118/2010 was also dismissed by this Court by following aforementioned judgment and the SLP filed against the said judgment was also dismissed by the Hon’ble Supreme Court. 8. CIMA 181/2009, against the aforesaid order of the Commission, was dismissed by this Court by a common judgment passed in CIMA 106/2008. As already stated, another CIMA 118/2010 was also dismissed by this Court by following aforementioned judgment and the SLP filed against the said judgment was also dismissed by the Hon’ble Supreme Court. 8. Learned counsel for the Appellants made an effort to distinguish the earlier decisions of this Court on the ground that in those cases, the Exclusion Clause was not part of the insurance Contract but in the cases on hand, the Exclusion Clause is part of the insurance Contract, thus, binds the respondents-complainants. Learned counsel also referred to the judgments of this Court passed in the aforesaid Appeals in order to elucidate the points urged by them at bar and to highlight the distinguishing factors in the facts of the decided cases and in the present cases. Besides this, Mr. Kawoosa, learned counsel appearing for some of the Appellants, vehemently submitted that the Exclusion Clause incorporated in the insurance Contact has to be given effect in the manner, which exists in the said Contract. He submitted that the said Exclusion Clause cannot be interpreted in the manner which would literally have the effect of substituting it by the interpretation which may be placed on it. Learned counsel, accordingly, prayed for allowing the Appeals and dismissal of the Complainants filed by the respondents-complainants before the Commission. 9. Learned counsel for the respondents submitted that the issue raised in these Appeals stands already settled by this Court in the judgments referred to hereinabove. Learned counsel submitted that the Appellants are precluded and estopped from raising the issues in the Appeals, which have already been decided by this Court. They also submitted that the Commission, by one single order, allowed as many as 8 Complaints but one of the Insurance Companies, viz. New India Insurance Company Limited, implemented the same order in Complaint No. 37/2009. Learned counsel submitted that the Insurance Companies are creature of same Statute and they cannot discriminate the respondents-complainants in the matter of implementation of the order of the Commission when in one Complaint, order has already been implemented and no Appeal filed. Learned counsel, while referring to the earlier Division Bench judgment of this Court, prayed for dismissal of these Appeals. 10. Learned counsel, while referring to the earlier Division Bench judgment of this Court, prayed for dismissal of these Appeals. 10. A gist of complaints filed by the respondents - complainants before the Commission, which have been taken notice of by the Commission, is reproduced as under: “I........In complaint No. 4/2010, the complainant insured his house situated at Samlar Bandipora under policy No. 421806/48/08/3600000509 effective from 19-7-2008 to 18-7-2009 for an amount of Rs. 9 lacs and paid premium of Rs. 683/- with an additionality of Rs. 90/- specifically to cover terrorist risk. During currency of insurance cover at night intervening 27/28th November, 2008, the insured house gutted in cross-fire, intimation whereof was given by complainant to the insurance company who relying on the above said circular repudiated his claim. Aggrieved, he filed this complaint, giving full details of the insurance cover, occurrence and other features of the matter to claim Rs. 12 lacs by way of indemnification on different counts mentioned therein. In reply, respondent company have mainly based their defense on the plea that loss alleged to have been caused to insured property was not cover red under the ‘Tariff Committee’s’ Circular/condition which excluded loss or damage caused directly, or indirectly, or indirectly by any action taken to control, prevent or suppress a terrorist activity or resulting therefrom or connected therewith. Other grounds taken are only ancillary thereto. While pleading exclusion of alleged loss from the insurance cover, the Company has however, admitted that surveyor appointed by them namely one Nayeem Khan estimated loss caused to the house of insured at Rs. 6.50 lacs. Regarding receipt of premium specifically to cover the risk of terrorism, the company pleads that it refers to terrorist activities committed by militants directly independent of any action on behalf of armed forces. In support of their respective contentions, the complainant and office bearer of respondent insurance company as also surveyor have filed their affidavits which are on file. II. In complaint No. 37/2009, the complainant alleges that his residential house situated at Patipora Salora, Ganderbal duly insured with respondent insurance company under policy No. 48-08812 dated 14-8-2006 for an amount of Rs. 6.25 lacs was gutted in a militancy related activity on 4-7-2007 during currency of insurance cover, in respect whereof FIR was also lodged. On intimation, respondent-insurance company did not at all act to indemnify the loss, putting complainant to undue harassment. 6.25 lacs was gutted in a militancy related activity on 4-7-2007 during currency of insurance cover, in respect whereof FIR was also lodged. On intimation, respondent-insurance company did not at all act to indemnify the loss, putting complainant to undue harassment. Photo copy of insurance policy on file reveals that in addition to other premia, the complainant has paid Rs. 63/- as additional premium on account of terrorist risk cover to the property. In their reply, respondent company have exactly as in the foregoing case stated that the loss was excluded from insurance cover in terms of the circular/condition mentioned in the foregoing complaint and as such claim could not be considered. They have, however, admitted the surveyor appointed by them assessed loss caused to the complainants house at Rs. 4,31,212/-. No evidence has yet been recorded in the matter, nor would perhaps any be required in view of the nature of controversy and admitted factual position of the case. III. In complaint No. 35/2011, the complainant pleads that he had his hotel namely “Punjab Hotel and Restaurant” situated at Lal Chowk Srinagar insured with respondent company under a valid policy No. 421001/11/09/3100000461, effective from 12-9-2009 to 11-9-2010; second and third storey whereof got gutted in fire during night intervening 6/7th of June, 2010 whereupon, FIR was registered by him with concerned police and matter reported to respondent company. M/s. Alak Consultants Pvt. Ltd. were appointed as surveyors who assessed the loss at Rs. 18,97,112/-. Despite that insurance company repudiated their claim vide communication dated 15-4-2011. The complain­ant has appended photocopy of the insurance cover note, according to which additional premium appears to have been paid to cover loss by terrorism. In the reply precisely on the lines of foregoing two cases, the respondent company have pleaded that despite assessment loss by the surveyor as alleged by the complainant, the same could not be paid because the loss caused was not covered under the specific circular/condition which excluded such loss. Party in this case too have furnished evidence affidavits of their respective witnesses which are on record and would be discussed in due course if necessary. IV. In complaint No. 30/2011, the complainant pleads that his residential house situated at Krankshavan Colony Sopore duly insured with respondent-insurance company for Rs. Party in this case too have furnished evidence affidavits of their respective witnesses which are on record and would be discussed in due course if necessary. IV. In complaint No. 30/2011, the complainant pleads that his residential house situated at Krankshavan Colony Sopore duly insured with respondent-insurance company for Rs. 16.87/- lacs under policy No. 4210014/41809/360000226 was gutted in an encounter between militants and armed forces on 26-6-2010 an had to be dismantled resulting in loss of Rs. 12,35,500/- to them. On intimation, respondent company appointed surveyor who assessed the loss Rs. 2,45,4443/- but despite that the claim was repudiated on the ground that same was not covered under insurance policy. In the reply the respondents have like in other cases pleaded that the loss having been caused due to antiterrorist activity was not covered under the policy as such not indemnifiable. Photocopy of the insurance cover note in this case also shows payment of extra Rs. 168/- on account of premium to cover the terrorist risk specifically. V. In complaint No. 1/2011, the house of the complainant insured for Rs. 25 lacs with respondent company under policy No. 4836120333138, effective from 3-11-2009 to 2-11-2010 was gutted on 30-1-2010. On intimation, respondent-insurance company appointed a surveyor in the matter who assessed loss at Rs. 14,75,310/- but despite that his claim was repudiated. In their reply, while admitting assessment of loss by surveyor, respondent-insurance company taking refuge under the abovesaid circular/condition have denied their liability to indemnify complainant on the ground that loss allegedly caused to him was not covered under the policy. VI. In complaint No. 45/2007, the residential building of complainant insured with respondent insurance company for an amount of Rs. 20,50,000/- under policy No. 11100001/56/1805/2005 suffered damage due to cross fire between armed forces and militants on 1-6-2006 which was reported to concerned police and FIR registered in the matter but claim was declined by insurance company on the ground that same was not covered under the policy. In their reply, respondent company have inter alia pleaded that the risk on account where loss is reported to have occurred was excluded under the particular policy clause mentioned in foregoing complaints and as such the claim could not be allowed. In this case also like others, the complainant has paid extra premium to cover the terrorist risk. In their reply, respondent company have inter alia pleaded that the risk on account where loss is reported to have occurred was excluded under the particular policy clause mentioned in foregoing complaints and as such the claim could not be allowed. In this case also like others, the complainant has paid extra premium to cover the terrorist risk. Evidence affidavits of complainant are already on record while as respondents have not filed any, presumptively because vide interim order dated 13-12-2007, their right to file the reply has been closed which they have sought to file later through a miscellaneous application lying undisposed on the record. The reply appended therewith has been quoted only for the sake reference despite its inadmissibility in view of foregoing interim order. VII. In complaint No. 80/2011, the residential house of complainant duly insured with respondent insurance company for Rs. 10,17,900/- under policy No. 421004/48/09/36000000246 was gutted on 24-6-2010 during currency of policy covering terrorism risk also by payment of extra premium by Rs. 100/- which besides being reported to police was intimated to respondent-insurance company also who appointed surveyor and loss was assessed Rs. 1,33,848/-. Despite that, he was not indemnified on the pretext the loss caused to the insured property was not covered due to the exclusion of terrorist risk as mentioned in the following complaint. VIII. In complaint No. 66/2011, the complainants residential house situated at Haigam Sopore insured with respondent insurance company under a valid policy No. 111404/48/09/3200000853 for Rs. 32 lacs was seriously damaged on 20-7-2010 in cross firing between armed forces and militants whereupon case was registered in the police station concerned and loss intimated to respondent company. Photocopy of the policy cover note in this case also indicates payment of extra premium of Rs. 320/- on account of terrorist risk cover but despite that he was not indemnified. In their reply, respondent company has pleaded that even though they appointed surveyor in the matter, M/s. Alak Consultants Pvt. Ltd. who while assessing loss at Rs. 23,44,289/- opined that the loss was not payable because of having been caused by FIR between militants and armed forces as the same was excluded from risk cover due to the exclusion clause in aforesaid policy directive. IX. In complaint No. 03/2010, the insured property, a Hotel situated at Chota Bazar, main chowk Sopore covered under respondents policy No. 111/404/01/1/205/2007 for Rs. IX. In complaint No. 03/2010, the insured property, a Hotel situated at Chota Bazar, main chowk Sopore covered under respondents policy No. 111/404/01/1/205/2007 for Rs. 12,00,000/- got gutted in fire on 8-11-2007. Case was registered in police concerned and incident reported to respondent insurance company. Photocopy of policy cover note in this case also reveals payment of extra premium to cover the terrorism risk but despite that indemnification has been denied by the respondent who in their written reply while admitting appointment of surveyor who assessed the loss Rs. 8,93,450/- plead that the same was not payable in view of the exclusion clause referred to hereinabove.” 11. The fate of the Complaints of the respondents hinges on the interpretation of the Exclusion Clause. 12. Section 2(g) of the Jammu and Kashmir Contract Act, 1977 (1920 AD), for short Act of 1977, provides that an Agreement not enforceable by law is said to be void. Section 2(h) of the Act of 1977 provides that an Agreement enforceable by law is a Contract Section 23 of the Act of 1977 provides that the consideration or object of an Agreement is lawful, unless the Court regards it as immoral or opposite to public policy. 13. The Exclusion Clause shall have to be considered in the peculiar and special background, in which the State of Jammu and Kashmir and some other States of the country have ushered into, because of terrorist activities. The Exclusion Clause, in view of Circular dated 1-4-2002, does cover all the insurance Policies through out length and breadth of the country. The impact of this Exclusion Clause, if to be understood in the manner, the Appellants want this Court to understand, it would segregate those of the areas/States of the country, which are affected by terrorist activities and would not get benefit of the insurance policy from those parts/States of the country, which are not experiencing the terrorist activities and would not suffer the same consequences as the people of the State of J.&K. and like States would suffer. 14. India comprises of union of States. Ours is a country governed by Constitution, and thereby, by rule of law. The Exclusion Clause, though part of the insurance Contract, nevertheless, is to be understood and interpreted in the manner which would satisfy the conscience of the Constitution and would not be immoral, unconscionable and/or opposite to public policy. 15. 14. India comprises of union of States. Ours is a country governed by Constitution, and thereby, by rule of law. The Exclusion Clause, though part of the insurance Contract, nevertheless, is to be understood and interpreted in the manner which would satisfy the conscience of the Constitution and would not be immoral, unconscionable and/or opposite to public policy. 15. It is admitted that separate amount has been received by the Insurance Companies to cover the terrorist risks. It would mean that if the property of insured is damages because of the act/actions of the terrorists, then the insured would be indemnified. The Exclusion Clause, as interpreted by the Appellants and as argued before us, would mean that in case property of the insured suffers damage and consequent loss is caused to the insured, he/she will not be indemnified for the same by the insurer if, besides militants, the security forces are involved in the action. The State and/or its instrumentalities, which include the Appellants Insurance Companies, which are covered by the definition of Article 12 of the Constitution of India, in our constitutional scheme, cannot draw a battle line between itself and its citizens and de­feat their legitimate legal or contractual rights. 16. The Exclusion Clause has few limbs. A citizen takes out an insurance Policy with the expectation that in the event the property, for which he/she has taken the policy, suffers damage, will be indemnified by the insurer for the loss, assessed by it. In the State of J.&K., the properties are damaged in controlling/suppressing the terrorist activities by the security forces. On an overall consideration of the Exclusion Clause, it appears that the insurer can repudiate claim of the insured and will not indemnify the loss suffered by him/her, in case, on the basis of material and evidence available, the insurer comes to a conclusion that the insured was himself/herself involved in the militant activity. The insured, in such circumstance, even on the principles of equity and good conscience, cannot seek any benefit from the insurer as the insured is himself/herself violator of laws of the land. The Contract Act cannot permit the insurer to enter into a Contract with a citizen who is involved in militant activities, consequently, if his property suffers damage, he will not be indemnified. 17. Take another situation. The Contract Act cannot permit the insurer to enter into a Contract with a citizen who is involved in militant activities, consequently, if his property suffers damage, he will not be indemnified. 17. Take another situation. The security forces, in their attempt to suppress or control the terrorist activities, enter into the house of an insured person. The militants are passing by that house, least knowing that the security forces are hiding there to nab them. The militants, when they come to know about the presence of security forces in the house, open fire and face retaliatory action on the part of the security forces. The insured house suffers huge damage in the process. In such eventuality, can it be said, on the basis of Exclusion Clause, that the insured would not be indemnified by the insurer. Such instances have happened in the past and will take place in the future also. 18. This point can be explained by citing another example. The militants force their way into a house (A). The security forces get information about the same, who, in order to neutralize them (militants) and flush them out, occupy another house (B) located at a strategic place in the same location. Both houses, A & B, are insured with same Insurance Company. The militants open fire on the house (B). The security forces, in retaliation, attack house (A). Both the houses get damaged in the process. On the basis of interpretation placed by learned counsel for the Appellants on the Exclusion Clause, owner of house (B) would be indemnified but claim of indemnification of loss suffered by owner of house (A) would be repudiated by the insurance Company. In this fact situation, can owner of house (A), were the militants took shelter forceably, be discriminated and his claim for indemnification be repudiated. Such action would not only be unconstitutional but would be against the cannons of Law of Contracts. The insurer, in such circumstances, shall have to indemnify the loss suffered by owners of both the houses (A&B). If the Exclusion Clause is interpreted in the manner as suggested by the Appellants, then it would become unconscionable and against public policy and cannot be enforced, being void. 19. Another similar situation can be conceived. Suppose militants attack security forces on a road and thereafter run away and take refuge in a near by house, which is insured. If the Exclusion Clause is interpreted in the manner as suggested by the Appellants, then it would become unconscionable and against public policy and cannot be enforced, being void. 19. Another similar situation can be conceived. Suppose militants attack security forces on a road and thereafter run away and take refuge in a near by house, which is insured. The security forces shell the said house to kill or force out the militants, resultantly, the house suffers huge damage. Can, in such circumstance also, claim of the insured be repudiated on the basis of Exclusion Clause. 20. Let us consider Exclusion Clause on yet another premises. If there is no terrorist or terrorist activity. Obviously, there will be no operation by the security forces. What will be the position of the Exclusion Clause in such circumstance. That will simply be otiose. The very presence of militants, at any place, involves action by security forces. The Exclusion Clause cannot be read to exclude all the claims of the insured. As already stated, it is only that claim of the insured which can be repudiated, that too on the basis of material/evidence with the Insurer, where the insured himself/herself is involved in the militant activity. In all other cases of such activity, the insurer would be responsible for indemnifying the loss suffered by the insured. The Exclusion Clause, on the interpretation of the Appellants would be; a. Rendered immoral, unconscionable and against public policy and cannot be enforced rendering it void; b. The Exclusion Clause would be rendered and has to be declared unjust. And an unjust agreement or unjust clause of it cannot be enforced being against public policy in terms of Section 23 of Contract Act. 21. For the above stated reasons, these Appeals, being meritless, are dismissed along with connected CMPs. Appeals dismissed.