IN THE HIGH COURT OF ALLAHABAD
ASHWANI KUMAR MISHRA, SYED QAMAR HASAN RIZVI, JJ.
Smt. Parul Agrawal – Appellant
Versus
Life Insurance Corporation of India and others - Respondents
Special Appeal Defective No. 782 of 2023
Decided on : 25-01-2024
Insurance - Special Appeal - Chapter VIII Rule 5 of the Allahabad High Court Rules, 1952; Insurance Regulatory and Development Authority (Protection of Policyholders' Interests) Regulation-2002 - The court interpreted the maintainability of special appeals against orders of the Insurance Ombudsman, emphasizing the duty of disclosure in insurance contracts and the implications of non-disclosure on claims.
Fact of the Case:
The appellant's husband held three insurance policies and died. The claim for two policies was rejected by LIC due to non-disclosure of a previous policy. The appellant contested the rejection, leading to a writ petition that was dismissed.
Finding of the Court:
The court upheld the dismissal of the writ petition, affirming that the non-disclosure of previous policies constituted a breach of the duty of utmost good faith required in insurance contracts.
Issues: Whether the special appeal against the Insurance Ombudsman's order was maintainable and whether the non-disclosure of previous insurance policies justified the rejection of the claim.
Ratio Decidendi: The court concluded that the special appeal was maintainable as it arose from an order of a Single Judge, and the non-disclosure of material facts in the proposal forms justified the rejection of the insurance claims.
Result: The Special Appeal is dismissed.
JUDGMENT :
Syed Qamar Hasan Rizvi, J.
In Re: Order on the Application for condonation of delay:
Registry has reported that the present Special Appeal is filed beyond time by 14 days. Sufficient reason is disclosed for the delay, so occasioned.
2. A feeble attempt has been made by the learned Counsel for the respondents to oppose the said Appeal on the ground of delay.
3. This application for condonation of delay is duly supported by an affidavit.
4. Cause of delay in filing of the Appeal has been explained to the satisfaction of the Court. Accordingly, the Application for the condonation of delay in filing of appeal is allowed. Delay is condoned. Special Appeal is treated to have been filed within time.
In Re: On the Special Appeal
1. We have heard Sri Rajendra Pratap Singh, learned counsel for the appellant and Sri Udai Shanker Mishra, learned counsel for respondents-Life Insurance Corporation of India (LIC) and perused the materials available on record.
2. With the consent of the learned counsel for the parties, this Court proceeds to decide the present Special Appeal at the admission stage itself.
3. This intra-Court appeal is directed against the judgment and order dated 3.4.2023 passed by the learned Single Judge in Writ-C No. 3149 of 2016 whereby the Writ petition filed by the Appellant has been dismissed. The Writ Court found no good ground to interfere with the impugned order dated 10.9.2015, passed by the Insurance Ombudsman (respondent No. 4), whereby the complaint filed by the appellant against rejection of her claim against the insurance policies Nos. 256487214 and 256487400 were rejected vide order dated 14.3.2014, passed by the authorities of the Life Insurance Corporation (hereinafter referred to as ''LIC'').
4. At the very outset, a preliminary objection has been raised by the learned Counsel for the respondent regarding the maintainability of the present Special Appeal on the ground that adjudication made by the Insurance Ombudsman would be akin of an award, and therefore, a special appeal would not lie against such order.
5. On the issue of the maintainability of the present Special Appeal, it has thus to be seen as to whether the impugned judgment and order passed by learned Single Judge arising out of such order passed by the Insurance Ombudsman could be assailed in special appeal. Before proceeding further it is imperative to briefly elucidate the law relating to the Special Appeal.
6. Chapter VIII Rule 5 of the Allahabad High Court Rules, 1952 (hereinafter referred to as 'Rules of 1952') provides for the remedy of filing Special Appeal. For a ready reference the same is reproduced hereinafter :
7. A perusal of Chapter VIII Rule 5 of the Rules of 1952 would indicate that the first part of the Rule provides for Special Appeal to be maintainable from a judgment passed by a Single Judge of this Court. The subsequent part of the Rule then provides the circumstances and exigencies in wh
Satwant Kaur Sandhu v. New India Assurance Company Limited
The duty of utmost good faith in insurance requires full disclosure of all material facts, and non-disclosure can lead to claim rejection.
Point of Law : There is no good ground to interfere in the orders impugned.
The duty of the proposer to disclose all material facts in the proposal form and the materiality of the non-disclosed information for the assessment of risk in insurance contracts.
The insurer cannot repudiate a life insurance claim based on non-disclosure of a previous policy if it failed to verify existing records, as this does not constitute material suppression.
1) Per Sec. 45 of Insurance Act, claim can be repudiated, if it is proved that the assured knowingly and fraudulently suppressed the material facts.2) Contractual duty so imposed on the Insured is su....
1) Non-disclosure of 3 policies obtained from Pvt. insurance co. not a material fact to repudiate the claim of the Respondents.2) Impugned policies are not the mediclaim policies nor the death of the....
Insurance – Materiality of a certain fact is to be determined on a case-to-case basis – However, burden of proving fact which excludes liability of Insurer to pay compensation lies on Insurer alone a....
Insurers can reject life insurance claims for non-disclosure of previous policies, highlighting the necessity for utmost good faith in insurance contracts.
The duty of the insured to disclose all material facts at the time of obtaining an insurance policy, the significance of material facts in influencing the decision of a prudent insurer, and the conse....
Point of Law : No fault can be found with the repudiation and the order of Ombudsman affirming the said repudiation and disallowing the claim. [Para 13]
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