Insurance appeal dismissed due to failure to prove loss exclusion & reject surveyor's report.

The appeal was dismissed as the Insurance Company failed to prove that the loss fell within the exclusion clause V(d) of the policy and did not provide sufficient grounds to reject the surveyor's report.

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Issues involved: Appeal under Section 23 of the Consumer Protection Act challenging a judgment and order passed by the National Consumer Disputes Redressal Commission.

Summary:

Issue 1: Insurance claim repudiation based on exclusion clause V(d) of the policy.
The respondent-complainant, operating a Resort, suffered property damage due to a mob incident. The Insurance Company repudiated the claim citing Clause V(d) of the policy, alleging the loss was due to a malicious act by the respondent. The appellant argued that the loss was a result of the respondent harboring criminals, falling under the exclusion clause. However, the Court found insufficient evidence to link the damage to the respondent's actions. The Court emphasized that in cases of ambiguity, the insurance contract should favor the insured. Citing past judgments, the Court held that the burden of proof lay with the insurer to establish the applicability of the exclusionary clause. As the Insurance Company failed to provide compelling reasons to reject the surveyor's report, the Court dismissed the appeal.

Decision: The appeal was dismissed as the Insurance Company failed to prove that the loss fell within the exclusion clause V(d) of the policy and did not provide sufficient grounds to reject the surveyor's report.

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