Consumer Protection Act, 1986 – ss. 2(1)(g), 2(1)(r), 3 & 14
– Consumer Protection Regulations, 2005 – Consumer Protection
Act, 2019 – ss. 2(46), 2(47), 47, 49 & 59 – Insurance Regulatory
and Development Authority (Protection of Policy Holders Interests)
Regulations, 2002 – Insurance Claim – Repudiation of – Exclusion
Clause – Appellant secured a Standard Fire and Special Perils policy
from the respondent on 28.07.2012 – Policy was effective from
28.07.2012 to 27.07.2013 and it was meant to cover a shop situated
in the basement of the building – However, the exclusion clause of
the contract specified that it did not cover the basement – Shop met
with a fire accident for which the appellant raised a claim – Claim
was repudiated by the respondent, taking umbrage under the
exclusion clause – On challenge, State Consumer held that there
was no adequate disclosure and the insurer was deficient in service
and indulged in unfair trade practice – National Commission
overturned the order passed by the State Commission by placing
reliance upon the exclusion clause – Whether an exclusion clause
destroying the very contract knowingly entered, can be permitted
to be used by a party who introduced it, becomes a beneficiary and
then to avoid its liability–Held: An exclusion clause has to be
understood on the touch-stone of the doctrine of reading down in
the light of the underlining object and intendment of the contract –
It can never be understood to mean to be in conflict with the main
purpose for which the contract is entered – It is the foremost duty of
the insurer to give effect to a due disclosure and notice in its true
letter and spirit – Once, the State Commission or the National
Commission, as the case may be, comes to the conclusion that the
term of a contract is unfair, particularly by adopting an unfair trade
practice, the aggrieved party has to be extended the resultant relief
– Once it is proved that there is a deficiency in service and that
respondent knowingly entered into a contract, notwithstanding the exclusion clause, the consequence would flow out of it – As per the
common law principle of acquiescence and estoppel, respondent
cannot be allowed to take advantage of its own wrong.
Contract Act, 1872 – ss. 2, 10, 17, 18 & 19 – Adhesion
contracts/Standard Form of Contract – Insurance Contract – These
contracts are prepared by the insurer having a standard format
upon which a consumer is made to sign – The insurer who, being
the dominant party dictates its own terms, leaving it upon the
consumer, either to take it or leave it - Such contracts are obviously
one sided, grossly in favour of the insurer due to the weak bargaining
power of the consumer.
Doctrine of Blue Pencil – Discussed.