Karnataka High Court
The Manager (Crm) vs A.V.Nagarajan on 6 August, 2024
Author: M.G.S. Kamal
Bench: M.G.S. Kamal
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NC: 2024:KHC:31292
WP No. 11564 of 2021
C/W WP No. 3257 of 2021
IN THE HIGH COURT OF KARNATAKA AT BENGALURU
DATED THIS THE 6TH DAY OF AUGUST, 2024
BEFORE
THE HON'BLE MR JUSTICE M.G.S. KAMAL
WRIT PETITION NO. 11564 OF 2021 (GM-RES)
C/W
WRIT PETITION NO. 3257 OF 2021 (GM-RES)
IN WRIT PETITION NO.11564/2021
BETWEEN:
THE MANAGER (CRM)
LIFE INSURANCE CORPORATION OF INDIA,
DIVISIONAL OFFICE-I
J.C. ROAD, BANGALORE - 560 002.
REPRESENTED BY ITS
AUTHORIZED SIGNATORY
SECRETARY (LEGAL)
LEGAL CELL, ZONAL OFFICE
JEEVAN MANGAL, HAYES ROAD
BANGALORE - 560 025.
...PETITIONER
Digitally (BY SRI. RAJESH SHETTY, ADVOCATE)
signed by
SUMA B N
Location: AND:
High Court
of Karnataka
DR T.C. JAIPRAKASH
S/O T.G. CHANDRASHEKHARIAH
AGED ABOUT 70 YEARS
R/A NO.108, 1ST FLOOR
6TH MAIN ROAD, JAYANAGAR 5TH BLOCK,
BANGALORE-560 041
...RESPONDENT
(BY SRI. JAGADISH G. KUMBAR, ADVOCATE FOR
SRI. JAGADEESH GUNDAPPA, ADVOCATE)
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NC: 2024:KHC:31292
WP No. 11564 of 2021
C/W WP No. 3257 of 2021
THIS WRIT PETITION IS FILED UNDER ARTICLES 226 AND
227 OF THE CONSTITUTION OF INDIA PRAYING TO CALL FOR THE
RECORDS LEADING TO PASSING OF THE IMPUGNED AWARD
DATED:28.01.2021 IN COMPLAINT BY THE INSURANCE OMBUDSMAN
VIDE ANNEXURE-F AND AFTER PERUSAL TO ISSUE A WRIT OF
CERIORARI QUASHING THE IMPUGNED AWARD DATED:28.01.2021
IN COMPLAINT PASSED BY THE INSURANCE OMBUDSMAN VIDE
ANNEXURE-F TO THE WRIT PETITION IN THE FACTS AND
CIRCUMSTANCES OF THE CASE.
IN WRIT PETITION NO. 3257 OF 2021 (GM-RES)
BETWEEN:
THE MANAGER (CRM)
LIFE INSURANCE CORPORATION OF INDIA,
DIVISIONAL OFFICE 1, J C ROAD,
BANGALORE - 560 002,
REPRESENTED BY ITS
AUTHORIZED SIGNATORY,
SECRETARY (LEGAL),
LEGAL CELL, ZONAL OFFICE,
JEEVAN MANGAL,
HAYES ROAD, BANGALORE - 560 025.
...PETITIONER
(BY SRI. RAJESH SHETTY, ADVOCATE)
AND:
A.V.NAGARAJAN
S/O LATE ANANTHA SASTRY,
AGED ABOUT 70 YEARS
R/A NO.42/28, 39TH 'A' CROSS,
11TH MAIN, 4TH T BLOCK,
JAYANAGAR, BANGALORE-560 041.
...RESPONDENT
(BY SRI. ADITYA NARAYAN, ADVOCATE)
THIS WRIT PETITION IS FILED UNDER ARTICLES 226 AND
227 OF THE CONSTITUTION OF INDIA PRAYING TO CALL FOR THE
RECORDS LEADING TO PASSING OF THE IMPUGNED AWARD
DTD.6.11.2020 IN COMPLAINT BY THE INSURANCE OMBUDSMAN
VIDE ANNEXURE-H AND AFTER PERUSAL TO ISSUE A WRIT OF
CERTIORARI QUASHING THE IMPUGNED AWARD DATED:06.11.2020
PASSED BY THE INSURANCE OMBUDSMAN VIDE ANNEXURE-H TO
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NC: 2024:KHC:31292
WP No. 11564 of 2021
C/W WP No. 3257 of 2021
THE WRIT PETITION IN THE FACTS AND CIRCUMSTANCES OF THE
CASE.
THESE PETITIONS, COMING ON FOR PRELIMINARY HEARING
IN 'B' GROUP, THIS DAY, ORDER WAS MADE THEREIN AS UNDER:
CORAM: HON'BLE MR JUSTICE M.G.S. KAMAL
ORAL ORDER
The Manager (CRM) Life Insurance Corporation of India, Bengaluru, (common petitioner in these two writ petitions) is before this Court aggrieved by the awards dated 28.01.2021 and 06.11.2020 respectively passed by the office of Insurance Ombudsman by which the petitioner insurance company has been directed to settle the maturity claim of the respondents in these writ petitions in a sum of Rs.10,00,000/- each together with loyalty addition if any along with policy conditions including penal interest.
2. It is the case of the petitioner that respondents submitted proposal on 31.03.2010 and 26.04.2010 respectively to the petitioner and have taken LIC's Jeevan Saral (with profits) policy with premium of Rs.48,040/- for a term of ten years. After maturity, the petitioner informed the respondents that maturity benefit payable under the above policy is Rs.1,74,362/-. Respondents being aggrieved lodged a -4- NC: 2024:KHC:31292 WP No. 11564 of 2021 C/W WP No. 3257 of 2021 complaint with the Insurance ombudsman under the provisions of Insurance Ombudsman Rules, 2017 claiming Rs.8,25,638/- in respect of their policies.
3. Insurance ombudsman by its awards dated 28.01.2021 and 06.11.2020 directed the petitioner to settle the maturity claim under the policies for maturity sum assured of Rs.10,00,000/- together with loyalty additions if any as per the policy terms and conditions. Aggrieved by the same, petitioners are before this Court.
4. Learned counsel for petitioners taking through the policy at Annexure -B submits that in the schedule provided thereunder there is a reference with regard to the sum assured in the event of death of insured which is a sum of Rs.10,00,000/- and also Rs.10,00,000/- in the event of any accident. He submits that there is no mention with regard to the assured sum payable to the insured in the event of he surviving both the events. Thus he submits non mentioning of the sum assured in the event of insured surviving in two instances shall not result in petitioner being compelled to pay Rs.10,00,000/- which is not even contemplated under the -5- NC: 2024:KHC:31292 WP No. 11564 of 2021 C/W WP No. 3257 of 2021 policy. He further submits respondents being well qualified and educated are expected to know the terms of the policy. Merely because of non mentioning of maturity amount in the event of the respondents surviving the instance of death and accident as the case may be, they cannot take undue advantage of the same. He submits that Insurance ombudsman has not appreciated the terms of policy bond and has come to wrong conclusion. Hence, seeks for allowing of the petition.
5. Learned counsel for the respondents on the other hand submits that column No.2 at the schedule of the policy reflects mentioning of the sum of Rs.10,00,000/- twice. He submits that the first of the mentioning of Rs.10,00,000/- represents the maturity amount and second mentioning of Rs.10,00,000/- represents the amount payable in the event of death or accident as the case may be. Thus, he submits that there is no ambiguity in the policy issued by the petitioner insurance company and that the office of insurance Ombudsman having taken into consideration all these aspects of the matter has passed the awards warranting no interference.
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NC: 2024:KHC:31292 WP No. 11564 of 2021 C/W WP No. 3257 of 2021
6. Heard and perused the records.
7. There is no dispute to the fact that the petitioner had issued Insurance Policy Bonds at Annexure-B in favour of the respondents and has been collecting the premium. It is also not in dispute that the total premium collected by the petitioner from the Respondents is in excess of Rs.48,040/-. Though it is contended that this is a unique policy in terms of which sum assured in Rs.10,00,000/- becomes payable only upon the death or on the insured meeting accident and if he survives either of the incidents he would be entitled receive only Rs.1,74,362/-, the aforesaid terms of the policy is admittedly not forthcoming in the policy document. There is not even whisper about the amount of Rs.1,74,362/- payable in the event the insured surviving death or the accident as the case may be. Merely because the respondents are well qualified, it cannot be expected that the same would obliviate the petitioner from discharging its obligation in accordance with law. The reasoning assigned by the office of insurance Ombudsman in the impugned awards is on taking into consideration all these aspects of the matter including the law laid down by the Apex Court in the case of United India Insurance Limited Vs -7- NC: 2024:KHC:31292 WP No. 11564 of 2021 C/W WP No. 3257 of 2021 M.K.J Corporation reported in 1996 (6) SCC 428 wherein the principles obligating the insurance company to disclose the terms of the policy has been reiterated. In that view of the matter no error or irregularity can be found with the order passed by the office of the insurance Ombudsman. Petitions lack merit, accordingly same are dismissed.
Petitioner- insurance company shall expedite the process of releasing the amounts to the respondents in these two writ petitions in terms of the awards, dated 28.01.2021 and 06.11.2020 passed by the office of the insurance ombudsman within an outer limit of eight weeks from the date of receipt of certified copy of this order.
Sd/-
(M.G.S. KAMAL) JUDGE SBN List No.: 1 Sl No.: 43