2025 (12) TMI 1140 - SC - Indian Laws

Fire insurance claim after burglary-linked blaze: theft not an exclusion, insurer's repudiation overturned; loss assessment remitted.

The dominant issue was whether the insurer could repudiate a fire-policy claim on the ground that a prior burglary/theft was the proximate cause of loss. ... Denial of reimbursement/claim from the Respondent-Insurance Company - main cause of damage is fire - theft which took place on the premises in the factory preceded the fire - theft was the proximate cause of damage - HELD THAT:- A fire insurance policy is essentially a contract entered between the insurer and the insured for indemnification of the loss caused to the insured goods by fire. The High Court of Madras in its judgment in Sri. Balaji Traders vs. United India Insurance Co. Ltd. [2004 (12) TMI 740 - MADRAS HIGH COURT], which was later confirmed by this Court, while dealing with a case where a fire took place in a godown which resulted in loss of stock to the petitioner, held that, the cause of fire is immaterial unless it is specifically pleaded that the fire was occasioned by the wilful act of foul play or fraud by the insured himself. The principles governing “Fire Insurance” have been very succinctly laid down by this Court in the case of Orion Conmerx Pvt. Ltd. vs. National insurance Co. Ltd. [2025 (10) TMI 1334 - SUPREME COURT], wherein it was held that if there was a fire and something was on fire which ought not to be on fire and such a fire was not caused by the wilful act of the insured, then any loss attributable to fire would be covered under the policy - thus, it is a settled position that if the damage is caused by fire, then the reason by which the fire took place becomes irrelevant. In the current scenario, the fire took place in the factory of the Appellant which caused a huge loss to the Appellant. The loss occurred on account of the transformer being set ablaze and the fire could not be controlled for about 6 hours. It is also an admitted position that, on the intervening night of 01.11.2006, some miscreants entered the factory and committed burglary. It was reported in the FIR that flames were coming out of the transformer and at no stage any defense was taken that the insured caused the fire. Thus, it is now established that the loss caused to the Appellant was due to fire only and the incident of theft/ burglary merely preceded the incident of fire. In the case at hand, in terms of the policy, the burglary/theft is not an exclusion under the specified peril “Fire”. Even, the general exclusions to the policy do not cover theft which precedes the insured peril as an exclusion and the said exclusion is only provided under the RSMD clause. It is a trite law that the exclusions in the contract for insurance must be read strictly and, therefore, the exclusion provided under the RSMD clause would not oust the liability of the insurer when the loss or damage is attributable to the peril of fire which has its independent exclusions - there is no justification for the Respondent to repudiate the claim of the Appellant and the NCDRC had erred in not rectifying the mistake and to reject the claim. Thus, the letter dated 04.01.2008, sent by the Respondent repudiating the claim of the Appellant and impugned judgment, are set aside and matter is remitted back to the NCDRC to assess the loss pursuant to the claim filed by the Appellant - appeal allowed by way of remand. 1. ISSUES PRESENTED AND CONSIDERED (i) Whether, under a 'Standard Fire and Special Perils Insurance Policy' (a named peril policy), the insurer could repudiate a claim for loss admittedly caused by fire on the ground that the fire was triggered by an attempted burglary/theft, by invoking an exclusion located in the 'Riot, Strike, Malicious and Damage (RSMD)' clause. (ii) Whether, on a strict construction of exclusions and in light of the policy's structure (peril-specific exclusions for 'Fire' and separate exclusions under 'RSMD'), burglary/theft could be treated as excluding liability for damage attributable to fire where the 'Fire' peril's exclusions did not include burglary/theft and the general exclusions did not expressly exclude theft preceding an insured peril. 2. ISSUE-WISE DETAILED ANALYSIS Issue (i): Repudiation of fire loss on the basis that attempted burglary/theft was the proximate cause Legal framework (as discussed by the Court): The policy was a named peril policy which indemnified loss if property was damaged by any of the specified perils. 'Fire' was one such specified peril and contained its own expressly stated exclusions. The Court also considered the governing principle for fire insurance that, once loss is established to be due to fire, the cause of the fire is generally immaterial unless the policy provides a relevant exclusion or there is allegation/defence that the insured instigated the fire (fraud/wilful act). Interpretation and reasoning: The Court treated it as undisputed that the damage to insured property occurred due to a fire incident. It held that, in such circumstances, the 'cause igniting the fire becomes immaterial' for coverage under the 'Fire' peril, unless the policy itself excludes such causation under the 'Fire' peril exclusions or the case involves a defence that the insured caused/instigated the fire. Here, the 'Fire' peril exclusions were limited (fermentation/natural heating/spontaneous combustion/heating or drying process; burning by public authority) and did not include burglary/theft. The Court further noted there was no defence taken that the insured caused the fire. Accordingly, repudiation on the basis that burglary/theft was the 'proximate cause' was held unjustified, because the policy promised indemnity for loss by the specified peril of fire and did not carve out an exclusion for fire triggered by theft/burglary. Conclusions: The insurer could not deny indemnification for fire damage by treating attempted burglary/theft as the operative basis for repudiation when the loss was caused by fire and the 'Fire' peril exclusions did not exclude such circumstances and there was no case that the insured instigated the fire. Issue (ii): Whether RSMD/general exclusions could be used to oust liability for loss attributable to fire; strict construction of exclusions and policy silence on theft preceding an insured peril Legal framework (as discussed by the Court): The Court applied the principle that exclusion clauses in insurance contracts must be construed strictly, and where ambiguity exists, interpretation should favour the insured. The Court also examined the policy's internal structure: each specified peril had its own exclusions; additionally, the policy contained general exclusions, including an exclusion for loss by theft during or after the occurrence of an insured peril (except as provided under RSMD cover). The Court noted the policy was silent on whether theft/burglary preceding an insured peril was excluded by the general exclusions. Interpretation and reasoning: The Court held that burglary/theft was not an exclusion within the 'Fire' peril's exclusions. It further observed that the general exclusion regarding theft addressed theft 'during or after' the insured peril, but the policy was silent on theft/burglary that precedes the insured peril. The insurer's repudiation was anchored to the RSMD exclusion, but the Court reasoned that an exclusion provided under the RSMD clause could not be used to 'oust the liability' where the loss/damage is attributable to fire, a specified peril which has its own independent exclusions and does not include burglary/theft. On strict construction, and given the absence of an express exclusion for fire loss caused by antecedent burglary/theft within the fire coverage, the RSMD exclusion could not be extended to defeat the main fire cover. Conclusions: Strict reading of the policy meant the RSMD exclusion did not exclude liability for damage attributable to fire; neither the fire-peril exclusions nor the general exclusions expressly excluded theft/burglary preceding the insured peril. The insurer's repudiation and the consumer tribunal's acceptance of that repudiation were therefore erroneous. The Court set aside the repudiation and the dismissal order, and remitted the matter for assessment of loss on the claim.