Summary
The Court held that an insurer could not defend repudiation before the consumer forum on delayed intimation when its repudiation letter relied solely on another ground. Appointment of a surveyor did not itself waive policy conditions, but that distinct proposition did not permit later addition of grounds absent from the letter. The insured was awarded the surveyor-assessed loss with interest.
Issues
- Whether appointing a surveyor itself waived the condition requiring timely intimation.
- Whether delayed intimation could be raised for the first time in defending the consumer complaint.
Held
- Appointment of a surveyor does not, by itself, estop an insurer from relying on breached policy conditions. Waiver depends on the totality of circumstances; the contrary automatic-waiver argument failed under Sonell Clocks. (¶¶ 16, 17, 18)
- The insurer could not travel beyond the grounds in its repudiation letter. Sonell Clocks concerned a letter that expressly relied on delay and did not displace Galada on the distinct question of adding a new ground before the consumer forum. (¶¶ 19, 20, 21, 22)
- Since the repudiation letter contained no ground concerning delayed intimation or lodging of the claim, the National Commission erred in dismissing the complaint on that subsequently raised defence. Other policy grounds rejected below were not in issue in this appeal. (¶¶ 6, 23, 24)
Result
Appeal allowed without costs; the National Commission’s order was set aside. The insurer must pay Rs.63,43,679, as assessed by the surveyor, with 8% interest from filing of the claim petition until payment, within eight weeks.