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2021 MarsdenLR 2106

HIGH COURT MALAYA KUALA LUMPUR
SHIVA KUMAR DAY – Appellant
Versus
ALLIANZ LIFE INSURANCE MALAYSIA SDN BHD & ANOR – Respondent
[Suit No: WA-22NCC-415-09-2020]



Petitioner Advocates:Harvindar Singh Saran Singh ,Respondent Advocate: Christopher Foo,Chong Juen Quan,M/s Raja, Darryl & Loh

The cause of action under an indemnity insurance policy arises at the occurrence of the insurable event, not upon the insurer's repudiation, reinforcing strict adherence to limitation periods.

Headnote:(A) Limitation Act 1953 – Section 6(1)(a) – The cause of action in an indemnity insurance policy arises from the date of loss, not from repudiation by the insurer – Plaintiff's claim for Total and Permanent Disability (TPD) benefits rejected as time-barred as filed beyond the 6-year limitation period – Court finds that the claims against the Defendants are wholly unsustainable and affirms the necessity for precision in pleadings. (Paras 6, 60, 62)

(B) Indemnity Insurance – The insured's right to indemnity exists upon the occurrence of the insured event, establishing the time when the cause of action arises – Claim filed beyond prescribed limitation fails to satisfy the actionable requirement. (Paras 10, 24, 45)

(C) Fraud Allegations – Court emphasizes the requirement for corroborative evidence, such as a police report, when making serious allegations like fraud or forgery – Mere unsupported allegations do not warrant proceeding to trial. (Paras 49, 61)

JUDGMENT

Liza Chan Sow Keng JC:

Introduction

[1] This suit raised a question on when an insured's cause of action in an indemnity insurance policy against his insurer arise.

[2] There are two applications before the Court - enclosure (encl) 15 made by the 1st Defendant pursuant to O 18 r 19 (1) (b) and/or (d) of the Rules of 2012 ("ROC 2012") and/or under the O 92 r 4 ROC 2012 and Enc. 17 made by the 2nd Defendant pursuant to O 18 r 19 (1) (b) and/or (d) of ROC 2012 and/or under the O 92 r 4 ROC 2012 for striking out the Plaintiff's Writ dated 2 September 2020 and Statement of Claim ("SOC") dated 1 September 2020.

[3] On 18 February 2021, I heard both enclosures together as there were common questions of fact and law, reserved decision to 16 March 2021 and allowed both enclosures with costs. These are the reasons in amplification of the grounds delivered on 16 March 2021.

Background Facts

[4] Between July 2013 to January 2014, the Plaintiff applied for 5 life insurance policies from the 1st Defendant and was issued policies as follows:

[5] The Plaintiff claimed that that he was involved in an accident at work sometime in March 2013 and due to the injuries suffered and the existing "joint pain", he was subsequently diagnosed to be totally and permanently disabled sometime in 2014.

[6] The Plaintiff submitted his claim for the Total and Permanent Disability ("TPD") benefits under the 5 policies on 24 July 2014. The 1st Defendant vide a letter dated 3 September 2014, declined the Plaintiff's claims on the basis of a 'Conditional Coverage Letter' executed by the Plaintiff before the policy purchase (which had expressly excluded TPD coverage, following the Plaintiff's pre-medical examination outcome) and later proceeded to exercise its right to avoid the 5 policies.

[7] The Plaintiff alleged that the 'Conditional Coverage Letter under the Insurance Policies which formed the basis of his claim rejection was fabricated by the 1st and the 2nd Defendant - see: para 17 of the Statement of Claim and that he discovered this only at the end of 2014.

[8] As such, this Action was filed by the Plaintiff to seek the following reliefs:

(a) a declaration that the termination of the 5 policies by the 1st Defendant is void and invalid;

(b) a declaration that the rejection of the Plaintiff's permanent disability claim by the 1st Defendant is void and invalid;

(c) an order that the 1st Defendant to deliver to the Plaintiff's solicitors a statement explaining and detailing the amount of compensation (including interest, dividend and etc) which should be paid by the Defendant to the Plaintiff in accordance with the 5 policies, at a time stipulated by this Honourable Court;

(d) an order that the 1st Defendant to pay to the Plaintiff or the Plaintiff's solicitors, compensation for his Total and Permanent Disability at a time stipulated by this Honourable Court;

(e) an order that the Defendants jointly and severally pay the Plaintiff special damages and general damages to be assessed;

(f) an order that the Defendants pay the Plaintiff interest at a rate of 5% per annum on the amounts awarded by this Honourable Court from 24 July 2014 to full realisation thereof; and

(g) costs.

Enclosure 15 - 1st Defendant's Case For Striking Out

[9] The 1st Defendant in essence contended that the Plaintiff's Writ and Amended Statement of Claim against the 1st Defendant is time-barred as the Plaintiff's cause of action accrued:

(i) by 24 January 2014, that is the date by which the Plaintiff must have suffered his alleged TPD; or

(ii) alternatively, by 24 July 2014, that is the date the Plaintiff submitted the Plaintiff's claim for the TPD benefits under the 5 policies.

[10] In contending that the Plaintiff's cause of action accrued on 24 January 2014, the 1st Defendant's counsel, Mr Christopher Foo, drew attention that:

(a) under the definition of "Total and Permanent Disability" under the 5 policies, the Plaintiff must have sustained a disability for a continuous period of not less than 6 mont


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