Kerala High Court
Lakshmipriya vs New India Assurance Company Ltd on 26 March, 2026
Author: Anil K. Narendran
Bench: Anil K. Narendran
WA NO. 1155 OF 2025 1 2026:KER:26265
IN THE HIGH COURT OF KERALA AT ERNAKULAM
PRESENT
THE HONOURABLE MR. JUSTICE ANIL K. NARENDRAN
&
THE HONOURABLE MR. JUSTICE MURALEE KRISHNA S.
THURSDAY, THE 26TH DAY OF MARCH 2026 / 5TH CHAITHRA, 1948
WA NO. 1155 OF 2025
AGAINST THE JUDGMENT DATED 05.03.2025 IN WP(C) NO.29393 OF
2019 OF HIGH COURT OF KERALA
APPELLANT(S)/RESPONDENT:
LAKSHMIPRIYA
D/O JAYASREE K G, MINOR, REPRESENTED BY HER MOTHER AND
GUARDIAN JAYASREE K G, AGED 50, D/O GOPALAKRISHNAN,
RESIDING IN THE ADDRESS MULLAPPILLY HOUSE,
KORATTY SOUTH P O, THRISSUR DISTRICT, PIN-680308
BY ADV SHRI.G.SREEKUMAR (CHELUR)
RESPONDENT(S)/PETIITONER:
NEW INDIA ASSURANCE COMPANY LTD
KALAMASSERY BRANCH REPRESENTED BY ITS ASSISTANT
MANAGER, REGIONAL OFFICE, M G ROAD,
ERNAKULAM DISTRICT, PIN-682016
OTHER PRESENT:
SMT. LATHA SUSAN CHERIAN FOR NEW INDIA ASSURANCE
COMPANY
THIS WRIT APPEAL HAVING COME UP FOR ADMISSION ON 16.03.2026,
THE COURT ON 26.03.2026 DELIVERED THE FOLLOWING:
WA NO. 1155 OF 2025 2 2026:KER:26265
JUDGMENT C.R.
Muralee Krishna S., J.
This writ appeal is filed by the respondent in W.P.(C)No.29393 of 2019, invoking the provisions under Section 5(i) of the Kerala High Court Act, 1958, challenging the judgment dated 05.03.2025 passed by the learned Single Judge in that writ petition.
2. The facts which led to the filing of this writ appeal are as follows:
The appellant, a minor girl represented by her mother, is a group medi-claim policy holder, with the respondent New India Assurance Company Limited from 2015 onwards, namely Asha Kiran Policy. The appellant was consulted with the eye department of L.F. Hospital on 13.05.2018 due to recurrent attacks of severe headache and eye pain associated with vomiting, which started in the year 2017. According to the appellant, several eye tests were conducted at the eye department of L.F. Hospital, and thereafter, the doctors advised her to consult a paediatrician. Therefore, the appellant decided to consult an expert Ayurvedic physician since the illness was not cured, and accordingly, the appellant was taken to Sreedhareeyam Eye Hospital, Koothattukulam, for expert WA NO. 1155 OF 2025 3 2026:KER:26265 treatment. She was admitted therein from 11.08.2018 to 24.08.2018. A claim was made for Rs.46,752/- by the appellant's mother with the respondent insurance company. The said claim was rejected by the respondent on 24.09.2018 on the ground that the treatment undergone was for the correction of eyesight, which is excluded as per Clause 4.4.2 of the policy conditions.
Thereafter, the appellant, through her mother, filed O.P.No.69 of 2019 before the Permanent Lok Adalath, Ernakulam. In that original petition, the respondent filed a written statement contending that expenses incurred for change of life or cosmetic treatment of any description, such as correction of eyesight, are excluded under the policy. By Ext.P6 award dated 09.08.2019, the Permanent Lok Adalath passed the award directing the respondent to process the claim of the appellant and to pay the amount with 9% interest per annum from the date of petition till the date of payment/realisation along with litigation expenses of Rs.10,000/. It was further directed in the award that if the respondent fails to comply with the directions mentioned in the award, the same can be executed through a Civil Court having jurisdiction over the area as provided under Section 22E(5) of the Legal Services Authorities Act.
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3. Being aggrieved by Ext.P6 award of the Permanent Lok Adalath, the respondent approached this Court by filing W.P.(C)No.29393 of 2019 under Article 226 of the Constitution of India, seeking an order to set aside that award.
4. After considering the rival contentions raised by the parties, the learned Single Judge, by the impugned judgment dated 05.03.2025, allowed the writ petition and set aside Ext.P6 award of the Permanent Lok Adalath, which resulted in the filing of the present writ appeal.
5. Heard Sri.G.Sreekumar, the learned counsel for the appellant and Smt.Latha Susan Cheriyan, the learned Standing Counsel for the respondent.
6. The learned counsel for the appellant would submit that the treatment availed by the appellant in Sreedhareeyam Ayurvedic Eye Hospital and Research Centre ('Sreedhareeyam' for short) is not for the correction of eyesight, and for the correction of eyesight, she had already availed the treatment from L.F. Hospital. She is still wearing power glasses as advised from L.F. hospital. The treatment availed by the appellant from Sreedhareeyam is for headache and vomiting, which may have a connection with her vision impairment. By relying on the judgment WA NO. 1155 OF 2025 5 2026:KER:26265 of the Apex Court in Skandia Insurance Company Limited v. Kokilaben Chandravadan [(1987) 2 SCC 654], the learned counsel submitted that if two views are possible, the one that is beneficial to the claimant has to be adopted. According to the learned counsel, there is no incorrectness in Ext.P6 award of the Permanent Lok Adalath and therefore the judgment of the learned Single Judge has to be set aside by restoring Ext.P6 award.
7. On the other hand, the learned counsel for the respondent Insurance Company would submit that as per Clause 4.4.2 of the policy discernable from Ext.P5 letter dated 24.09.2018 issued by the respondent Insurance Company, it is clear that the treatment for change of life or cosmetic or aesthetic treatment of any description such as correction of eyesight, etc., is excluded from the coverage under the policy. From Ext.P4 certificate issued by Sreedhareeyam, it is evident that the treatment obtained by the appellant is for myopic astigmatism, which is a complaint of distance vision, that will fall under the category of correction of eyesight. Therefore, the impugned judgment of the learned Single Judge is not liable to be interfered with.
8. There is no dispute on the point that, as per Clause WA NO. 1155 OF 2025 6 2026:KER:26265 4.4.2 of the policy, treatment for change of life or cosmetic or aesthetic treatment of any description, such as correction of eyesight, etc., is excluded from the coverage. It is also not in dispute that the headache and vomiting suffered by the appellant are due to the complaint of distant vision. It is for the complaint of 'Hruswadrushti' (Myopic Astigmatism), the appellant, obtained treatment from Sreedhareeyam after obtaining initial treatment from L.F. Hospital. The appellant contends that the aforesaid treatment obtained by her from Sreedhareeyam cannot be termed as for the correction of eyesight.
9. To understand the treatment obtained by the appellant from Sreedhareeyam, we have referred Taber's Cyclopedic Medical Dictionary, 21st Edition, to ascertain the actual meaning of myopic astigmatism. As per the said dictionary, 'Myopia' means an error in refraction in which light rays are focused in front of the retina, enabling the person to see distinctly for only a short distance. A negative (concave) lens of proper strength will correct this condition. Similarly, 'Astigmatism' means a form of ametropia in which the refraction of a ray of light is spread over a diffuse area rather than sharply focused on the retina. It is due to differences in the curvature in various meridians of the cornea and WA NO. 1155 OF 2025 7 2026:KER:26265 lens of the eye. The exact cause is unknown. Some types show a familial pattern.
10. A reading of the definition of 'Myopia' and 'Astigmatism' given in Taber's Cyclopedic Medical Dictionary, as mentioned above, it can be gathered that it is a treatment for long distance vision, which can be corrected by using a concave lens of proper strength. The symptoms, such as headache and vomiting, suffered by the appellant are an aftereffect of the aforesaid error in eyesight.
11. During the course of arguments, the learned standing Counsel for the respondent produced a copy of the deposition of RW1, who is an Ayurvedic Doctor with BAMS qualification, examined before the Permanent Lok Adalath, for our perusal. In his deposition, he stated that the claim of the appellant was rejected since the treatment undergone by her at Sreedhareeyam is for the correction of eyesight, and there is nothing in Ext.P4 certificate to show that the treatment given was for any other illness. There is no evidence or material placed on record from the side of the appellant to arrive at a finding that the treatment availed by the appellant at Sreedhareeyam is not for correcting the eyesight, but for some other diseases unconnected with the WA NO. 1155 OF 2025 8 2026:KER:26265 said error in eyesight. Therefore, it can be concluded that the treatment availed by the appellant is excluded from the policy as per Clause 4.4.2. The learned Single Judge considered these aspects in its proper perspective. The judgment in Skandia Insurance Company Limited [(1987) 2 SCC 654], relied on by the learned counsel for the appellant, does not apply to the facts of the present case, since there is no question of the availability of two views in the instant case, one favouring and the other against the appellant.
12. Having considered the pleadings and materials on record and the submissions made at the Bar, we find no illegality or impropriety in the impugned judgment of the learned Single Judge, which warrants interference by exercising appellate jurisdiction.
In the result, this writ appeal stands dismissed.
Sd/-
ANIL K. NARENDRAN, JUDGE Sd/-
MURALEE KRISHNA S., JUDGE nak