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IN THE HIGH COURT OF JUDICATURE AT PATNA
A. ABHISHEK REDDY
Veena Devi W/o Late Amod Ra – Appellant
Versus
Bharat Sanchar Nigam Ltd through Chief General Manager Telcom – Respondent
| Table of Content |
|---|
| 1. petitioner's claim for insurance compensation (Para 2 , 3) |
| 2. responses regarding policy premium payment (Para 4 , 5) |
| 3. analysis of the premium payment issue (Para 6 , 7) |
| 4. court's verdict favoring the petitioner (Para 8 , 9) |
JUDGMENT :
A. ABHISHEK REDDY, J.
Heard the learned counsel for the parties.
2. This writ petition has been filed for the following relief(s):-
“That this is an application for issuance of a writ in the nature of Mandamus, commanding and directing the respondents to make payment of remaining insurance claim in the case of late husband of the petitioner namely, late Amod Rai to the tune of Rs. 2,80,109/- (Two Lakh, Eighty Thousand, Once Hundred and Eight only), which has been paid Rs. 19,892/- only (Nineteen Thousand, Eight Hundred and Ninety-two Only) against the full claim of Rs. 3 Lakhs only and/or may pass such any other order/orders for which the petitioner may be found legally entitled to.”
3. It is the case of the petitioner that during the life time of her husband, namely, late Amod Rai the respondent BSNL had taken a Group Insurance Scheme for a claim amount of Rs. 3 lakhs. That husband of the petitioner late Amod Rai had died on 11.02.2019
An insurer cannot deny a claim based on the late payment of premium by the employer if the premium was later accepted without objection.
The validity of an insurance claim is contingent upon the existence and operation of the insurance coverage at the time of the insured event, as per the terms of the insurance agreement.
Interpretation of Group Insurance Policy rule regarding coverage for LIC agents based on termination and reinstatement.
The need for documented proof establishing a direct nexus between the accident/injury and the death of the insured employee in insurance claim cases.
The employer is obligated to ensure employee insurance coverage, and non-deduction of premiums does not negate compensation claims under the Group Personal Accident Insurance Scheme.
Insurers must honor claims when prior medical examinations show no pre-existing conditions, upholding principles of good faith and fair dealing.
An insurance policy lapses if the premium is not paid within the grace period; revivals after the insured's death are impermissible under contract terms.
A lapsed insurance policy cannot be revived post-death, and the Insurance Ombudsman lacks authority to bypass contract terms based on equity.
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