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2022 Supreme(Ker) 970

V. G. ARUN
Star Health and Allied Insurance Company Ltd. – Appellant
Versus
Avinash T. – Respondent


Advocates:
Advocate Appeared:
For the Petitioner: R.S.Kalkura, M.S.Kalesh, Harish Gopinath
For the Respondent: Nirmal.S, GP, Justine Jacob

JUDGMENT :

The petitioner Company is engaged in the business of Health and Allied Insurance. The first respondent had taken a Corona Rakshak Insurance Policy from the petitioner with a coverage of Rs.1,00,000/- for the period 25.07.2020 to 06.05.2021. As per the terms of the policy, lump sum benefit equivalent to 100% of the sum assured was payable to the policy holder on positive diagnosis of COVID requiring hospitalisation for a minimum continuous period of 72 hours.

2. The first respondent tested positive for COVID-19 on 29.09.2020 from the Government Medical College hospital, Kozhikode and was referred to a COVID First Line Treatment Centre (IFLTC). He was admitted at the CFLT Centre from 29.09.2020 to 08.10.2020. After his discharge, the first respondent claimed the insurance amount. The claim was repudiated on the ground that the insurance amount was payable only in case of hospitalisation and the first respondent had only been under institutional quarantine is frivolous. Aggrieved by the rejection of his claim, the first respondent preferred Ext.P2 original petition before the permanent Lok Adalat, Kozhikode. The petitioner defended the repudiation, contending that the CFLTC t

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