The Supreme Court of India upheld the State Commission’s award of the entire Insured Declared Value (IDV) of Rs. 5,02,285/- with 9% interest to the appellant. The Court held that the National Consumer Disputes Redressal Commission (National Commission) exceeded its revisional jurisdiction by interfering with concurrent factual findings. The Supreme Court also clarified the application of exclusionary clauses in insurance policies, emphasizing the insured’s reasonable conduct under compelling circumstances.

• Revisional Jurisdiction Misused: The National Commission transgressed its revisional powers by interfering with concurrent findings without demonstrating jurisdictional error or material irregularity (Para 13).
• Reasonable Conduct Under Compelling Circumstances: The Court held that the insured acted reasonably by prioritizing the co-passenger's medical needs, and thus, the exclusionary clause in Condition No. 4 of the policy did not apply (Paras 17-18).
• Delay in Intimation Explained: The Supreme Court condoned the delay in intimation to the insurer as it was justified due to the appellant's preoccupation with rescuing the co-passenger (Para 19).

1. Introduction and Leave Granted (Paras 1-2)

The appellant challenged the National Commission's order, which reduced the insurance amount payable.

2. Insurance Policy and Accident (Paras 3-4)

The appellant held a Private Car Insurance Policy for Rs. 5,02,285/-. On 25.03.2013, the car capsized in a ditch while avoiding a cow, and subsequent short-circuiting caused significant damage.

3. Insurer’s Denial of Claim (Para 4)

The insurer denied the claim, citing delay in intimation and the appellant’s alleged failure to safeguard the vehicle.

4. Proceedings Before Lower Commissions (Paras 5-7)

• District Commission: Awarded 75% of the IDV, considering the delay justified (Para 5).
• State Commission: Granted the entire IDV with 9% interest (Para 6).
• National Commission: Reduced the award to Rs. 53,543/- relying on Condition No. 4 of the policy (Para 7).

5. Arguments by Counsel (Paras 8-10)

The appellant argued that the National Commission exceeded its jurisdiction and disregarded factual findings. The respondent justified the reliance on Condition No. 4 and the surveyor’s report.

6. Analysis by Supreme Court (Paras 11-19)

• Scope of Revisional Jurisdiction: National Commission’s interference was unjustified as there was no jurisdictional error or material irregularity (Paras 13-15).
• Exclusionary Clause: Condition No. 4 did not apply as the appellant acted reasonably under exigent circumstances (Paras 17-18).
• Delay Condoned: The delay in intimation was explained and condonable (Para 19).

7. Conclusion and Order (Paras 20-21)

The Supreme Court restored the State Commission’s award, directing the insurer to pay Rs. 5,02,285/- with 9% interest.

Acts and Sections Discussed:

1. Consumer Protection Act, 1986:

   • Section 21(b): Revisional jurisdiction of the National Commission.

2. Insurance Policy Conditions:

   • Condition No. 4 on safeguarding the vehicle.

Ratio Decidendi:

1. Revisional Jurisdiction: Revisional powers must not disturb concurrent factual findings unless jurisdictional errors, illegality, or gross miscarriage of justice are evident.
2. Interpretation of Exclusion Clauses: Exclusionary conditions must be applied contextually, considering the insured’s reasonable actions under compelling circumstances.
3. Delay in Intimation: Delays in reporting an insurance claim are excusable if justified and do not prejudice the insurer.

Subjects:

Insurance Law, Consumer Protection
Insurance claim, Consumer dispute, Revisional jurisdiction, Exclusion clause, Delay in intimation, Motor vehicle insurance.