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2023 Supreme(Gau) 324

THE GAUHATI HIGH COURT (HIGH COURT OF ASSAM, NAGALAND, MIZORAM AND ARUNACHAL PRADESH)
Sanjay Kumar Medhi, J.
Joyanta Maibangsa @ Joyanta Hojai R/o. Choto Narainpur Kachari - Appellant
Vs.
The Kotak Mahindra Life Insurance Company Limited And Ors. - Respondent
WP(C) No. 6542 of 2021
Decided On : 25-01-2023

Advocates:
Advocate Appeared:
For the Appellant : Mr B D Das
For the Respondent: SC, Irdai

Headnote:

Insurance Ombudsmen Rules 2017 - Rule 13 - Indian Penal Code,1860 - Section 365 - claim was repudiated - Insurance Policy - victim of extremist violence - grievance regarding - Ombudsmen - Accident Death - pecuniary jurisdiction - Whether to accept or decline to undertake risk and in event of acceptance of risk to determine rates terms and conditions of a cover to be granted - Held, There is no dispute to proposal advanced by counsel for Insurance Company that a Policy of Insurance is a contract of utmost good faith where parties are required to disclose all materials - Keeping that principle in mind let us examine present dispute - None of documents or contents thereof would even indicate that there has been any suppression of material while opening policy by husband of petitioner - Policy was renewed from time to time which presumes a re-verification is also a relevant factor in favour of policy holder - In unfortunate episode of abduction and subsequent elimination of husband of petitioner there is not even a semblance of any contributory negligence on part of the husband of petitioner - Order Accordingly.

JUDGMENT :

An unfortunate and helpless widow is before the Court with the grievance regarding non-payment of the amount covered by the Insurance Policy of her deceased husband. The husband was a victim of extremist violence and he had passed away on 28.04.2020. The life of the husband was insured with the respondent No. 1 which, however, was repudiated on 10.12.2020 on the alleged ground of suppression of facts. The efforts of the petitioner to redress her grievance by approaching the Insurance Ombudsmen having failed to yield any result, the writ court has been approached.

2. I have heard Shri B. D. Das, learned Senior Counsel assisted by Ms R. Deka, learned counsel for the petitioner whereas the respondent-Insurance Company is represented by Shri M. Sharma, learned counsel.

3. The brief facts of the case may be narrated as follows.

4. The petitioner is a widow, who has instituted the present writ petition. It is the case of the petitioner that her husband Late Sontosh Hojai, during his life-time, had obtained a Life Insurance Policy with the Kotak Mahindra Life Insurance Company Ltd. on 30.03.2018 bearing Policy No. 09870477. The name of the policy was Kotak Assured Savings Plan (Basic Plan) along with Accident Death Benefit (Rider). The term of the policy was for a period of 20 years with guaranteed maturity benefit of Rs.25,42,929.40 and the basic sum assured for the policy was Rs.15,46,191/-. The petitioner was the nominee of the said policy. The premium amount was Rs. 2,53,216/-.

5. On 24.04.2020, the husband of the petitioner was abducted from the residence by some miscreants and having failed to trace him out, an FIR was lodged on 25.04.2020 which was registered as Harangajao PS Case No. 3/2020. Ultimately, on 30.04.2020, the body of the husband of the petitioner was found. In this connection, the petitioner had also written a letter to the High Court based upon which a suo moto Habeas Corpus case was registered as WP(Crl.) (suo moto) 1/2020.

6. Subsequently, the claim was made by the petitioner who was the legal heir and nominee. Such claim was made on 17.09.2020 in the local office of the respondent. However, the said claim was repudiated vide an order dated 10.12.2020. Against the aforesaid repudiation, an appeal was preferred by furnishing all relevant documents and information. Unfortunately, there was nothing to show that the appeal was even considered. Accordingly, by invoking the provisions of Rule 13 of the Insurance Ombudsmen Rules 2017, the complaint was, however, closed by the Ombudsmen holding that there was lack of pecuniary jurisdiction.

7. Shri Das, the learned Senior Counsel for the petitioner has submitted that reason put forward in rejecting the claim of the petitioner is absolutely unreasonable and arbitrary and would rather, reflect the high handedness. The policy was opened on 21.03.2018 and it is not in dispute that the premiums were paid regularly. The incident occurred on 24.04.2020 when the husband of the petitioner was kidnapped from their residence by some unknown militants. An FIR was immediately lodged before the Harangajao Police Station in the district of Dima Hasao which was registered as Harangajao PS Case No. 3/2020 under Section 365 IPC. Since the husband of the petitioner could not be traced out, the petitioner addressed a letter dated 28.04.2020 to this Court which was, in turned, converted to a suo moto proceedings and registered as WP(Crl) (suo moto) No.1/2020. During the pendency of the aforesaid writ petition, the husband of the petitioner was found dead at Lailing village and under the Langting Police Station. The writ petition was, accordingly disposed of vide order dated 04.10.2021 as investigation was concluded and Charge-Sheet submitted.

8. By drawing the attention of this Court to the policy document, the learned Senior Counsel has submitted that all information, as sought for, was given by filling up the prescribed form. Against the “occupation” category the deceased had mention

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