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MUNNURI LAXMAN
S. B. I. General Insurance Co. Ltd. – Appellant
Versus
Kuldeep S/o Lala Ram – Respondent
Question 1? What is the proximate causal relationship required between accident and death for coverage under a Group Personal Accident Insurance Policy? Question 2? What constitutes an "accident" under the policy, and must death occur within 180 days due to that accident to qualify? Question 3? What is the standard of evidence and reliance (e.g., police reports, postmortem) applicable to establish a claim for accidental death under the policy?
ORDER :
1) The present writ petition assails the award dated 31.10.2023 passed by the Permanent Lok Adalat, Pali on the file of Case No.07/2021, wherein and whereby the claim made by the respondent No.1 herein for grant of compensation for the personal accident was allowed and assured sum of Rs.10,000/- was granted with interest.
2) The petitioners herein are the Insurance Company, which is the respondent Nos. 1 & 2 before the Permanent Lok Adalat. For convenience, the claimant is referred to as the claimant and non-claimant Nos.1 & 2 as the Insurance Company.
3) The sum and substance of the case of the claimant is that on 14.10.2019 at about 11:00 a.m., Lala Ram (deceased) while on foot on the road, fell down and sustained fatal injury and immediately, he was shifted to hospital. On account of injury resulting in Hemorrhage, the deceased succumbed to the injury on 16.10.2019 at 4:00 a.m. Thereafter, a report under Section 174 of Cr.P.C. was filed. Basing on the said report, an enquiry was conducted by the police and the statements of nephew, two sons and wife of the deceased were recorded. The scene of offence, inquest and postmortem was also conducted on the body of the deceased. Th
The claimant must establish a direct causal link between the accident and the injury for compensation under the accident policy.
The main legal point established is that the insurance company is not liable to compensate if the deceased was under the influence of alcohol at the time of the accident, as per the terms of the poli....
Point of Law : Plea of limitation taken up in the present case on the strength of clause 20 of the agreement read with Article 44 of the Schedule appended to the Limitation Act, would not defeat the ....
Medical Practitioner – In the absence of Medico Legal Certificate and Post Mortem Report issued by Medical Practitioner, the certificate issued by the Pradhan, Gram Panchayat, who is admittedly not a....
Personal accident coverage under a Motor Vehicle policy is limited to the registered owner; non-owners cannot claim coverage.
Personal Accident Coverage under Motor Vehicle Policy is applicable to the insured, with the court affirming prior judgments supporting the claimants’ position.
Insurance claims for accidents must be evaluated considering all aspects of disability, emphasizing strict adherence to policy terms when determining entitlements.
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