Supreme Court says insurance
companies use 'ambiguous' and 'sloppy' policy terms to evade liability
The Supreme Court on Monday (July 20,
2026) observed that the practice of insurers drafting ambiguous and sloppy
insurance policies to escape liabilities they ought to bear had caused ordinary
policyholders to suffer. The court said such uncertainty was also creating
hurdles in the timely disposal of motor accident compensation claims.
A Bench of Justices Sanjay Karol and N
Kotiswar Singh observed that insurance companies must use clear and precise
language while drafting standard-form insurance contracts to avoid multiple
interpretations. When the party with all the drafting power writes an
ambiguous policy, it is the ordinary policyholder who suffers. Insurers have,
in many cases, exploited this ambiguity, either to escape liability which they
should rightfully bear, or, conversely, found themselves burdened with
liability they never intended to assume simply because their policy language
was sloppy, the Bench observed.
The observations came while the court
was hearing an appeal filed by the Oriental Insurance Company against a
February 4, 2025 judgment of the Chhattisgarh High Court directing it to pay
₹32.67 lakh as compensation in a motor accident claim.
The case arose from an accident
involving a vehicle insured with the company, which was carrying passengers on
a religious tour to various destinations in Nepal. The vehicle collided with a
hill, killing three persons, including the driver, Riaz Khan, and passenger
Harish Yadav. Following the accident, Yadav's wife, children and mother filed a
claim petition before the Motor Accident Claims Tribunal (MACT) seeking
compensation of ₹48.99 lakh.
The Tribunal directed the owner of the
vehicle to pay the compensation along with interest at 6 per cent per annum
from October 22, 2011, the date of institution of the claim petition. However,
the High Court modified the award and held the insurer liable to satisfy the
claim instead of the vehicle owner.
MACT orders devoid of 'clear
reasoning'
The Bench also expressed reservations
about the manner in which orders were being passed by MACTs, observing that
many were devoid of adequate and clear reasoning . It said that unless this
was addressed, claim petitions would continue to be delayed and appeals would
continue to rise.
In certain cases that have come up
before this Court, including the present one, the tone, tenor and extent of the
orders passed by the concerned Tribunals has caused us considerable
disturbance. In this case, for example, the Tribunal elaborately recorded the
submissions and evidence. However, their correlation with the facts of the
case, and the effect of this correlation on the ultimate outcome, was lacking,
the judgment authored by Justice Karol said.
The insurance company had contended that
since the accident had occurred outside the territory of India, the policy did
not cover the claim. The Bench, however, rejected the contention, holding that
if the insurer intended to exclude coverage for accidents occurring outside
India, it ought to have expressly mentioned so in the policy. It noted that
the offending vehicle had been lawfully permitted to travel into Nepal only
after the authorities at the international border post were satisfied that all
legal requirements had been complied with.
It should have effectively and clearly
communicated the terms of the contract, as the terms are unilaterally drafted
by the insurer only. Essentially, Cover what you want. Exclude what you want.
But make sure you do it clearly. Sloppy drafting could cost you something, the
Bench said.
It added that where the terms of an
insurance policy are capable of more than one interpretation, courts should
adopt the interpretation that best advances the beneficial object of the Motor
Vehicles Act, 1988.
Accordingly, the top court directed that
if cross-border coverage is excluded, insurance policies must expressly state
so and inform policyholders that they would be required to obtain a separate
endorsement before undertaking inter-country travel.
The language adopted in the policy
should be clear and unambiguous, and every policy, if it is meant to cover any
extra-territorial jurisdiction, must be clearly mentioned. The insurer should
communicate this requirement of extending coverage, as in the case of separate
health insurance policies undertaken while travelling abroad, as it is possible
that an average consumer may be unaware of the rigours of law, the Bench said.
'No regulatory clarification'
The court also pointed to a regulatory
vacuum governing cross-border insurance coverage. It observed that while the
Inter-Country Transport Vehicles Rules, 2021 provide a legal framework for
Indian vehicles to travel abroad under valid inter-country permits, they do not
clarify whether a domestic insurance policy extends to the country where the
vehicle is permitted to operate.
It appears that there is, as of today,
no clear statute, binding precedent or regulatory clarification in force that
clarifies the extension of insurance policies for cross-border travel. This
uncertainty causes hurdles in deciding motor accident claims in a timely and
efficient manner, thereby affecting the claimants the most, the Bench said.
To address this lacuna, the Bench
advised the Insurance Regulatory and Development Authority of India (IRDAI),
the regulatory authority for the insurance sector, to consider issuing a master
circular standardising cross-border coverage clauses across all motor insurance
policies.
The court accordingly directed the
insurance company to deposit the claim amount within four weeks and disposed of
the appeal.
www.thehindubusinessline.com,
dt. 21-07-2026