A luxury car owner in Chhattisgarh has successfully won a ₹2.02 lakh insurance payout after a consumer commission ruled against his insurer for denying a claim related to rainwater damage. The incident occurred when rainwater entered the vehicle through a slightly open driver-side window, damaging its infotainment system and other components.
Insurer Denied Claim Citing Negligence and Exclusions
The car owner had an active private car insurance policy from November 2020 to November 2021. In August 2021, the vehicle sustained damage after its window was inadvertently left open during rain. An appointed surveyor assessed the repair costs at ₹1.98 lakh, though the owner claimed expenses totaling ₹2.73 lakh.
The insurer rejected the claim in February 2022, arguing that rainwater damage was not covered under the policy and that leaving the window open constituted gross negligence, violating policy conditions.
Commission Rules Insurer Failed to Provide Full Policy Terms
Challenging the rejection, the owner approached the Chhattisgarh District Consumer Commission, alleging deficiency in service and unfair trade practices. His primary argument was that the insurer had not provided him with the complete policy terms and conditions at the time of issuance.
The commission, comprising president Dakeshwar Prasad Sharma and members Nirupma Pradhan and Anil Kumar Agnihotri, found merit in the complainant's argument. It noted that the insurer had failed to supply the full terms, conditions, and exclusions along with the insurance policy document. Consequently, the commission stated that the insurer could not rely on these undisclosed exclusions to reject the claim.
“Since the opposite party had not provided the complainant with a copy of the policy’s terms, conditions, and exclusions along with the insurance policy, those terms and conditions were not binding on the complainant.”
The commission also scrutinized the policy documents provided by the insurer, observing discrepancies in the number of pages submitted versus the stated length of the original policy. This further reinforced the finding that complete documentation had not been furnished to the policyholder.
Payout Includes Compensation for Mental Agony
As a result of its findings, the commission directed the insurer to pay ₹1.75 lakh towards the claim amount, an additional ₹20,000 for mental agony, and ₹7,000 to cover litigation costs, totaling ₹2.02 lakh. This ruling underscores the importance of transparency and full disclosure of policy terms by insurance providers to their customers.