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K. V. ARAVIND
TOYOTA KIRLOSKAR MOTOR PVT. LTD. – Appellant
Versus
INSURANCE OMBUDSMAN FOR THE STATE OF KARNATAKA – Respondent
ORDER :
1. This writ petition seeking the following prayers:
(b) Further issue a writ in the nature of certiorari or any other writ or order and quash the Award bearing No. 10/BNG/A/G1/0314/2018-19 dated 02.01.2019 passed by the first respondent at Annexure 'F' to this writ petition; and
(c) Pass such other appropriate order as deemed fit to grant in the facts and circumstances of the case, in the interest of justice.”
2. The petitioner is a company engaged in manufacture of motor vehicles. The petitioner has contracted “Group Personal Accident Tailor Made Policy” with respondent No. 2- United India Insurance Company Limited to cover all the employees of the company when they suffer bodily injuries. The benefit is available even in case of death of an employee. It is stated that the policy would cover injuries suffered even beyond working place and hours. The benefit is available even to death cases outside working place.
3. The premium is negotiated by the petition
The court established that the principles of natural justice require that an employer, as a stakeholder in insurance claims, must be given an opportunity to be heard in proceedings before the Insuran....
The Insurance Ombudsman acted within jurisdiction, and the Insurance Company must comply with the award, emphasizing accountability for delays and suppression of documents.
The court clarified that the monetary limit in the Insurance Ombudsman Rules applies to compensation, not to the claims themselves, allowing for broader jurisdiction.
A lapsed insurance policy cannot be revived post-death, and the Insurance Ombudsman lacks authority to bypass contract terms based on equity.
The Insurance Ombudsman can only award compensation under regulatory rules and lacks authority to mandate policy issuance at prior premiums.
The Insurance Ombudsman lacks jurisdiction to adjudicate complaints concerning policies from proprietorships or commercial lines, as these do not fall under personal lines as defined by relevant rule....
Natural justice is flexible, requiring context-specific application, with emphasis on actual prejudice caused to uphold procedural fairness in administrative decisions.
Natural justice is context-dependent; its violation must demonstrate actual prejudice to affect the legality of administrative actions like environmental compensation assessment.
An Insurance Ombudsman must not rely on inadmissible evidence; doing so undermines the principle of fair adjudication required in quasi-judicial proceedings.
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