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IN THE HIGH COURT OF DELHI AT NEW DELHI
Sanjeev Narula, J.
Smt. Nuraisha khatoon - Petitioner
Versus
Iffco Tokio General Insurance Co. Ltd. And Ors. - Respondents
W.P.(C) 7516/2022, W.P.(C) 7552/2022, W.P.(C) 11074/2023, W.P.(C) 14529/2023, W.P.(C) 14533/2023 & W.P.(C) 14863/2023
Decided On : 22-11-2024
(A) Pravasi Bharatiya Bima Yojana, 2017 - The scheme mandates insurance for Indian emigrants, ensuring coverage for accidental death or disability. The Court emphasized the welfare-oriented nature of the scheme, allowing claims despite delays due to circumstances beyond control. (Paras 10, 20, 39)
(B) Writ Jurisdiction - The Court held that the writ jurisdiction is maintainable in cases involving public welfare schemes, even if the parties are private entities. (Paras 4, 14)
Facts of the case:
The Petitioner sought to enforce an insurance claim under the PBBY, 2017 after the death of her husband in a road accident abroad, which was repudiated due to delayed claim intimation.
Findings of Court:
The Court set aside the repudiation of claims, directing the insurance company to process the claims expeditiously.
Issues: The main issues included the maintainability of the writ petition and the implications of delay in claim intimation.
Ratio Decidendi: The Court ruled that the insurance scheme is a statutory mechanism aimed at protecting emigrant workers, thus justifying judicial review despite the contractual nature of the dispute.
Result: Writ petitions allowed.
JUDGMENT :
SANJEEV NARULA, J.
1. The present writ petitions raise common grounds of challenge and emerge from similar set of facts. Accordingly, the same are being disposed of by way of a common order.
2. Notwithstanding the commonalities, the specific details of each case warrant individual attention, as the claims of each Petitioner arise from separate insurance policies and involve distinct facts, such as the duration of the policy, the date of the accident and the date of claim intimation. These specific facts, are tabulated below as follows:
| Relevant Facts | W.P. (C) No. 7552 of 2022 Aisha Khatoon v. ITGI & Ors. | W.P. (C) No. 7516 of 2022 Nuraisha Khatoon v. ITGI & Ors. | W.P. (C) 11074 of 2023 Smt. Lutfa Bibi v. ITGI & Ors. |
| PBBY Policy No. | 1431648 | 30165210 | 30134291 |
| Duration of Policy | 27.11.2013 to 26.11.2015 | 08.01.2015 to 07.01.2017 | 30.12.2014 to 29.12.2016 |
| Date of Accident | 11.06.2015 | 29.01.2016 | 29.02.2016 |
| Date of Claim Intimation | 07.04.2018 | 12.12.2018 | 10.09.2018 |
| Delay in Claim Intimation | 2 years 10 months | 2 years 11 months | 2 years 7 months |
| Date of Claim Repudiation | 15.06.2018 | 28.03.2019 | 17.09.2018 |
| Date of institution of Writ Petition | 06.05.2022 | 06.05.2022 | 16.08.2023 |
| Delay in Petition institution | 4 years | 3 years | 5 years |
| Date of condonation of delay by Embassy / Union | 22.06.2022 | 21.06.2022 | – |
| Relevant Facts | W.P. (C) No. 14863/2023 Sh. Mohmmad Husen v. ITGI & Ors. | W.P. (C) No. 14529/2023 Smt. Rashida Begum v. ITGI & Ors. | W.P. (C) No. 14533/2023 Smt. Hashnehar Bibi @ Hosnehara Bibi v. ITGI & Ors. |
| PBBY Policy No. | 30107646 | 1496190 | 1427526 |
| Duration of Policy | 20.12.2014 to 19.12.2016 | 26.02.2014 to 25.02.2016 | 22.11.2013 to 21.11.2015 |
| Date of Accident | 17.11.2016 | 08.07.2015 | 23.05.2015 |
| Date of Claim Intimation | 09.01.2019 | 11.07.2019 | 10.09.2018 |
| Delay in Claim Intimation | 2 years and 2 months | 4 years | 3 years 4 months |
| Date of Claim Repudiation | 22.01.2019 | 31.07.2019 | 17.09.2018 |
| Date of institution of Writ Petition | 2.11.2023 | 02.11.2023 | 02.11.203 |
| Delay in Petition institution | Almost 5 years (4 years and 10 months) | 4 years 3 months | 5 years 2 months |
3. To contextualize the controversy, the facts narrated in W.P.(C) 7552/2022 — Aisha Khatoon v. Iffco Tokio General Insurance Co. Ltd. & Ors. — are being extensively noted and discussed below.
3.1 The Petitioner – Ms. Aisha Khatoon, is a citizen of India represented through a Special Power Attorney holder, Mr. Sandeep Kumar Srivastava.
3.2 Respondent No. 1 – IFFCO-TOKIO General Insurance Co. Ltd., is a general insurance company duly registered with Respondent No. 2 – Insurance Regulatory and Development Authority of India[“IRDAI”] . Respondent No. 3 is the Protector of Emigrants, Ministry of External Affairs[“MEA”] , Government of India. Respondent No. 1 provides insurance benefits to persons under the policy issued by the MEA, Government of India, named - Pravasi Bharatiya Bima Yojana, 2017, which is an insurance scheme for Indian emigrants going abroad for employment.
3.3 Respondents No. 2 and 3 are ‘State’ within the meaning of Article 12 of the Constitution of India, 1950.
3.4 On 27th November, 2013, M/s. Al-Babtain Recruitment Office, Riyadh (employer), purchased an insurance policy bearing No. 1431648 (P400 Policy No. 61469590) from Respondent No. 1 under the Pravasi Bharatiya Bima Yojana, 2017 [“PBBY, 2017”] , for the husband of the Petitioner - Mr. Shahid Alam (emigrant) for the period covering 27th November, 2013 to 26th November, 2015. The applicable premium for the policy was duly paid by the employer. This policy cove
The Pravasi Bharatiya Bima Yojana, 2017, is a statutory welfare scheme, allowing judicial review of insurance claims despite delays in intimation, emphasizing the protection of emigrant workers' righ....
Writ petitions related to insurance claims involving factual disputes are not maintainable under Article 226 of the Constitution, mandating civil adjudication instead.
The court ruled that an insurance claim cannot be repudiated on misinterpretations of theft and abandonment, emphasizing the need for valid grounds for repudiation.
The payment of prior premium is a Sine qua non of coming into force of any contract of insurance between the insured and insurer, and the State Government's insistence on making payment to the farmer....
Point of law: While dealing with the present appeal, one has to bear in mind that a intra-Court appeal is really not a statutory appeal preferred against the judgment and order of an inferior to the ....
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.
The court affirmed that an insurance company cannot contest a claim based on the insured's status after significant delay and emphasized the need for timely processing of claims.
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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