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10 (i) The complainant has tried to explain the time taken in filing the claim with OP 1 (rather, the first information report with the NSE with copy to OP 1, because no separate claim application is on record) on two grounds. First, it took time upto 01.06.1996 to crystallise the loss due to deception and secondly, the Certificate of Insurance (CoI) issued by OP 1 to the complainant (and available with it right from the start) did not give sufficient details of the procedure for filing claims. Therefore, the complainant had to obtain those details from the NSE, which too took time after 01.06.1996. As a result, the complainant was able to file the claim with OP 1 on 30.06.1996, which was within 30 days of crystallisation of the loss.

(iii) We may also notice that the CoI issued by OP 1 (as produced by the complainant) states, inter alia, the following:

IMPORTANT CONDITIONS

1. In the event that the Insured becomes aware of any loss sustained, or any circumstances which may give rise to a claim, or any reasonable cause for suspicion of fraud, dishonesty or forgery on the part of any Employee, the Insured must notify the Oriental Insurance Co. Ltd. at the address given below in writing as soon as possible and in any event, not later than 30 days after discovery. FAILURE TO DO SO WOULD AFFECT THE INSUREDS RIGHTS UNDER THE POLICY.

2. The Insured must not make any admission of any liability, in respect of, nor offer to settle, any claim for which Indemnity may be sought under this policy, without the prior written consent of the Oriental Insurance Co. Ltd. [Emphasis supplied]   11 (i) On the tenability of the grounds advanced by the complainant to explain the delay, some observations are in order. The word crystallisation of the loss, repeatedly used in the complaint and the rejoinder, is a semantic invention of the complainant. The CoI or the master policy document does not even once mention this word. The CoI is absolutely clear that when the insured becomes aware of any loss having been sustained; it must notify the insurer as soon as possible and in any event, not later than 30 days after discovery (of the loss).

14. Apart from mentioning, inter alia, the sections insured, which were covered by the policy, the CoI does not indeed spell out the details of the insured perils nor does it give a summary of the claims procedure. It merely records, for example, Section 1 Legal Liability for inability to complete transactions for specified perils COVERED. Clearly, therefore, the complainant, having availed of the insurance policy at the directive of the NSE and received only the CoI was expected to obtain, as soon as possible, a copy of the detailed policy document that also included the claims procedure. In fact, that would be the immediate response of an average stockbroker of ordinary prudence because, as it stood, the CoI did not ex facie disclose these crucial details. The NSE circular, which detailed the rationale for obtaining a single master policy compulsorily covering all members of the NSE, also advised its Members, The insurance indemnity cover will be provided on a Master Policy basis issued to the National Stock Exchange of India Ltd. but the cover would be in respect of each Trading Member who will be issued individual certificate of insurance by the OIC. The copy of Master Policy will be available for inspection with the National Stock Exchange of India Ltd. once the same has been issued by the OIC.