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.

JUDGMENT :

Heard learned counsel for the parties through V.C.

2. The instant writ application has been preferred praying by the petitioner praying for a direction upon the respondents to settle the claim of the petitioner under the Group Personal Accident Insurance Scheme of Oriental Insurance Company.

3. The brief facts of the case is that the husband of the petitioner, namely Birsa Munda was employed under Respondent No.1 to 4 and was insured with Respondent No.5 under Group Personal Accident Insurance Scheme of Oriental Insurance Company as the employer entered into an agreement with the Insurance Company. A premium of Rs. 266/-was also deducted per month from the salary of the husband of the petitioner for Group Personal Accident Insurance Scheme. The husband of the petitioner unfortunately met with an accident and thereafter, he was admitted in Central Hospital at Gandhinagar, Ranchi and died in the hospital in course of treatment on 19.4.2004.

The petitioner being the legal heir filed an application with all relevant documents to the Respondent No. 2 to settle the claim under Group Personal Accident Insurance Scheme. However, her claim was rejected by the insurance company due to late submission of the documents. As a result, the petitioner approached this Court.

4. Mr. Yogendra Prasad, learned counsel for the petitioner submits that the ground of rejection as stated by the respondent Insurance company is non est in the eye of law as this Court in various judgments has stated that without any clause in the agreement the claim cannot be rejected on the ground of late submission of claim papers.

He further submits that the petitioner is running from pillar to post and even approached Jharkhand Legal Services Authority and ultimately approached this Court, as such since the ground of rejection is non-est in the eye of law the respondents be directed to release the amount of Rs.5,00,000/- being the insurance claim amount.

5. Mr. A.K. Das, learned counsel for the respondent C.C.L., relying upon its counter affidavit submits that no delay has been caused by this respondent. He further submits that an M.O.U. was signed between the Respondent C.C.L. and the Insurance Company on 28.3.2003 for a period from 31.3.2003 to 30.3.2004 and as per the MOU Rs.266/-was required to be deducted from the salary of the employee per month as per the Scheme.

He further submits that after the expiry of the above agreement; a new M.O.U was signed between the Management of C.C.L. and the Insurance Company on 19.7.2004 for Group Accident Insurance Policy for the Executives and Non-Executives employed in C.C.L. which includes Rs.5,00,000/-in case of accidental death and other benefits as mentioned in the said MOU.

He lastly submits that though the claim of the petitioner was duly forwarded to the Insurance Company for making payment of Rs.5,00,000/-, however, the fact remains that since the petitioner died on 19.4.2004 as such he was not covered by Group Insurance Policy as the same was not in existence between 31.3.2004 to 05.5.2004. Even otherwise, since there are no latches on the part of Respondent C.C.L. no relief can be granted to the petitioner as against this respondent.

6. Mr. G.C. Jha, learned counsel for the respondent Insurance Company, though did not contended the stand made in the counter affidavit with regard to late submission of claim but he fairly submits that after filing of this writ application the matter was again verified and it was found that the petitioner’s husband died on 19.4.2004. The first MOU was effective from 31.3.2003 to 30.03.2004 and the subsequent MOU was from 06.5.2004 to 05.5.2005 as such it is evident that at the time of accident and/or death; none of the MOU was effective or was in operation and as such; Insurance Company is not liable to pay any sum as it is a settled law that the insurer is liable to pay the benefit to the beneficiary only when there is an existence of an agreement.

7. Having heard learned counsel for