Allowed

Mrs Jaya Elizabeth Mathew v. the Insurance Ombudsman for the State of Karnataka

Karnataka HC26 Jul 2024WA/1311/2022

Case brief

AI extract

What is this about?

Writ appeal over repudiation of a critical illness insurance claim citing pre-existing multiple sclerosis diagnosed before policy issuance. Relying on Manmohan Nanda, the Division held that leaving proposal form columns unanswered followed by policy issuance bars later repudiation, set aside the repudiation and Ombudsman decisions, and allowed the appeal.

What did the court decide?

Repudiation letter dated 14.12.2020, Ombudsman order dated 29.03.2021 and Single Judge verdict set aside; insurer directed to decide claim within two months and pay with 6% p.a. interest from 14.12.20

Mrs Jaya Elizabeth Mathew Vs the Insurance Ombudsman for the… — Insurance | Karnataka HC (2024)

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WA 1311/2022

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IN THE HIGH COURT OF KARNATAKA AT BENGALURU

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DATED THIS THE 26^TH DAY OF JULY, 2024

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PRESENT

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THE HON'BLE MR JUSTICE V KAMESWAR RAO

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AND

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THE HON'BLE MR JUSTICE C M JOSHI

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WA NO. 1311 OF 2022 (GM-RES)

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BETWEEN:

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1 . MRS. JAYA ELIZABETH MATHEW, AGED ABOUT 39 YEARS, (DOB: 19/10/1983), W/O MR. PRENEESH OMMEN,

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R/AT #54, BETHLEHEM, 3^RD CROSS, KAVERI ENCLAVE, 9^TH CROSS,

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KANSHIRAMNAGAR, LAKSHMIPURA,

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VIDYARANYAPURA P.O,

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BENGALURU - 560 097.

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2 . PRENEESH OMMEN,

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AGED ABOUT 41 YEARS (DOB: 24/07/1981), S/O MR. DAVID OMMEN, R/AT #54, BETHLEHEM,

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3^RD CROSS, KAVERI ENCLAVE, 9^TH CROSS, VIDYARANYAPURA P.O,

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BENGALURU - 560 097.

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…APPELLANTS

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(BY SMT. JAYNA KOTHARI, SENIOR COUNSEL FOR

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SRI. NAVEEN CHANDRA V, ADV.)

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AND:

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1 . THE INSURANCE OMBUDSMAN FOR

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THE STATE OF KARNATAKA,

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OFFICE OF THE INSURANCE OMBUDSMAN (KARNATAKA), 19/19, JEEVAN SOUDHA BUILDING, GROUND FLOOR, 24^TH MAIN, JP NAGAR, I PHASE, BENGALURU, KARNATAKA-560 078, REPRESENTED BY ITS SECRETARY

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2 . HDFC ERGO GENERAL INSURANCE COMPANY LTD., 1^ST FLOOR, 165, BACKBAY RECLAMATION H.T. PAREKH MAARG, CHURCHGATE, MUMBAI - 400 059, REPRESENTED BY THE MANAGER.

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…RESPONDENTS

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(BY SRI. KRISHNA KISHORE S., ADV. FOR R2; R1 IS SERVED AND UNREPRESENTED)

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THIS APPEAL IS FILED UNDER SECTION 4 OF THE KARNATAKA HIGH COURT ACT PRAYING TO SET ASIDE THE IMPUGNED ORDERS PASSED BY THE HON’BLE HIGH COURT OF KARNATAKA IN WRIT PETITION No.14346 OF 2021, DISPOSED OF ON 21/10/2022 AND ETC.

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THIS APPEAL HAVING BEEN HEARD AND RESERVED ON 03.07.2024, COMING ON FOR PRONOUNCEMENT OF JUDGMENT THIS DAY, THE COURT DELIVERED THE FOLLOWING:

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CORAM: THE HON'BLE MR JUSTICE V KAMESWAR RAO AND

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THE HON'BLE MR JUSTICE C M JOSHI

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CAV JUDGMENT

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(PER: THE HON'BLE MR JUSTICE V KAMESWAR RAO)

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This appeal has been filed by the appellants challenging

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the order dated 21.10.2022 of the learned Single Judge in W.P.No.14346/2021 (GM-RES), whereby the learned Single

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Judge has dismissed the writ petition.

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The challenge of the appellants in the aforesaid

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writ petition was to the order dated 29.03.2021 passed by

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WA 1311/2022

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respondent No.1/Insurance Ombudsman declining to accept the insurance claim of the appellants. They had also sought quashing of letter of repudiation dated 14.12.2020 of respondent No.2/Insurance Company and sought a consequential direction for issuance of writ in the nature of mandamus for release of an amount of Rs.28,43,684/- being their claim.

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Some of the facts that require to be noted for a decision in the appeal are, the appellants are wife and husband. They with intent to build a house, opted for a home loan from respondent No.2-Company. The said loan came with ‘Home Suraksha Plus’ dated 29.04.2014 and was to be for a period of 5 years till 28.04.2022. The policy covered major medical illness and procedures to an amount of Rs.56,87,368/- jointly for both the appellants.

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It was the case of the appellants that on 10.08.2020, the Doctors at Vikram Hospital have diagnosed appellant No.1 to be suffering from Multiple Sclerosis and started the treatment. After the treatment, the insurance

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claim was made on the strength of the insurance coverage that was given by respondent No.2-Company in its policy dated 29.04.2017.

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The claim was repudiated by respondent No.2Company vide its letter dated 14.12.2020 on the ground that appellant No.1 was diagnosed to be suffering from Multiple Sclerosis from 27.03.2017 and the ailment was a preexisting ailment.

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On rejection of their claim by respondent No.2Company, the appellants approached respondent No.1Insurance Ombudsman, who vide its order dated 29.03.2021, affirmed the repudiation of claim of the appellants by holding that the appellants were guilty of nondisclosure of information about serious illness despite it being in their knowledge.

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The case of the appellants before the learned

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Single Judge was that, on 27.03.2017, appellant No.1 had only developed giddiness and vomiting and was diagnosed as

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vertigo and the further diagnosis of the appellant No.1 was multiple sclerosis with a question mark. According to them, for the first time the Doctors at Vikram Hospital on 10.08.2020, opined that appellant No.1 is suffering from multiple sclerosis . Therefore, there was no occasion to mention a problem that would occur in future when the insurance policy was taken.

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On the other hand, the case of respondent No.2Company was that the appellants were guilty of suppression of pre-existing illness, notwithstanding the policy making it clear that if any pre-existing illness of any kind particularly mentioned in the policy, ought to have been mentioned. Since pre-existing illness clearly relates to multiple sclerosis , the appellants being guilty of such suppression, the claim cannot be accepted and the order of the Insurance Company repudiating the claim is in consonance with law, so is the order passed by the Insurance Ombudsman.

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Suffice to state that the counsel for the parties

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had relied upon many judgments in support of their respective stand before the Learned Single Judge.

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Learned Single Judge has dismissed the writ petition by stating in paragraph No.11 of the judgment as under:

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“11. On a coalesce of the judgments rendered by the Apex Court and that of the Bombay High Court the unmistakable inference would be that mediclaim policy being a non-life insurance policy, is a contract of insurance falling in the category of a contract uberrimae fidei which would mean, the contract of utmost good faith on the part of the assured. Divulging pre-existing illness was a duty of the insured. Having not done so, the repudiation of the claim cannot be found fault with in the teeth of the preceding analysis.”

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So, from the above, it is noted that the learned Single Judge has dismissed the writ petition by holding that as the appellants have not divulged pre-existing illness of multiple sclerosis , the repudiation of the claim cannot be faulted.

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Challenging the judgment of the learned Single

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Judge, the submission of Smt. Jayna Kothari learned Senior Counsel appearing for the appellant is primarily that the disease of multiple sclerosis has been confirmed for the first time only on 10.08.2020 and not on 27.03.2017. This, according to her, is by drawing our attention to the discharge summary of Baptist Hospital, wherein the Doctors have put a question mark which depicts that the said ailment is not a confirmed diagnosis “(? multiple sclerosis)”. So, according

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to her, multiple sclerosis is not a pre-existing ailment for which the claim can be repudiated. Even otherwise, it is her submission that the respondent no.2 having issued the policy on the basis of the information given by appellants and had made no attempt to seek any clarification on the information given by the appellant, even in respect of those columns which have not been filled by the appellants, cannot now take a stand that the appellants having concealed the preexisting ailment, they are not entitled to the claim. In support of her submissions, Smt. Jayna Kothari has relied upon the judgment of the Supreme Court in Manmohan

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Nanda -Vs.- United India Assurance Co. Ltd. and

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Another [(2022) 4 SCC 582] .

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On the other hand, learned counsel for

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respondent No.2 has primarily reiterated the stand taken by respondent No.2 before the learned Single Judge, which we have already reproduced above. He has relied upon the following judgments in support of his submissions :

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i) Branch Manager, Bajaj Allianz Life Insurance Co. Ltd. and Others -Vs.- Dalbir Kaur [C.A.No.3397/2020 , decided on 09.10.2020 ] ;

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ii) Oriental Insurance Co. Ltd. -Vs.- Mahendra Construction [AIR 2019 SC 2182] ;

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iii) Reliance Industries Co. Ltd. -Vs.- Rekhaben Naresh Bai Rathod [(2019) 6 SCC 175] ;

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iv) Satwant Kaur Sandu -Vs.New India Assurance Co. ltd. [2010 ACJ 265] .

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ANALYSIS

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Having heard the learned counsel for the parties and perused the record, the short issue that arises for

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consideration is, whether the learned Single Judge is justified

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in upholding the repudiation of claim of the appellants?

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At the outset we may state, the Respondent No.1-

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Ombudsman has sent a letter dated 07.02.2024 to the Assistant Registrar of this Court stating that Insurance Ombudsman is not an interested party in the case. It had carried out its duties as per the rules and sought for its deletion from the array of parties. Suffice to state, the stand of the Ombudsman has been noted. No need is felt at this stage to delete the Ombudsman.

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Before we deal with the submissions made by counsel for the parties, it is necessary to reproduce the finding of the learned Single Judge in paragraphs No.8 and 9 of the impugned judgment in the following manner:

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“8. On 27-03-2017 the 1 petitioner developed giddiness and Vomiting. She is initially taken to Baptist Hospital who undergo MRI on her. A team of medical experts at Baptist hospital on going through the results of MRI and other medical examination had opined as follows:

WA 1311/2022

"DIAGNOSIS:

ACUTE VERTIGO WHITE MATTER DISEASE OF CNS”

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What could be gathered from the report is that the diagnosis was acute vertigo white matter disease of CNS ('Central Nervous System'). The course in the hospital as described was 'symptomatic treatment with beta histines'. MRI done outside showed T2 hyper intense lesion in the dorso medial aspect of upper pons (multiple sclerosis). Neurology opinion was advised at discharge. It was seen that the 1st petitioner was symptomatically better. Regular monitoring was also advised. The review was to be with the Neurology Department on 10-04-2017. Therefore, the 1st petitioner was thus diagnosed with a symptomatic attached to multiple sclerosis. Even in terms of the opinion, though it is bracketed, nonetheless it was found. Therefore, there was a doubt in the minds of the doctors that it could be multiple sclerosis as it was attached to Central Nervous System. This discharge was made on 30-03-2017 after about 3 days of the 1st petitioner being an inpatient. Barely after 30 days of getting discharged, the petitioners were offered the insurance policy and it was accepted by them on 29-042017. Now the policy is required to be noticed. The policy does, contain coverage of major medical illness and procedures. The policy directed the petitioners to tick appropriate condition in case the person proposed for insurance has been diagnosed or is suffering from any symptoms or has undergone any of the below

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medical condition. The clauses of the policy which are relevant are as follows:

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"Kindly tick the appropriate condition Incase the person proposed for insurance (i) Has been diagnosed or is suffering from any symptoms or (ii) Has undergone treatment for any for the below mentioned conditions.

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	Hypert ension	Dia bet es	Cancer	Strok e	*Multiple* *Sclerosis*	Coronary Artery Bypass Surgery	Paral ysis	Kidney failure	Heart Valve Replace ment	Myocardial Infraction (Heart attack)	Major Organ Transpla nt	Oth ers
Insu red I
Insu red II

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“

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One of the afore-mentioned columns related to multiple sclerosis .

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The afore-quoted were the conditions in the policy.

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9. The 1^st petitioner on 10-08-2020 developed symptoms that were again became a problem with the Central Nervous System and got admitted to Vikram Hospital. The Doctors at Vikram Hospital diagnosed the problem to be multiple sclerosis. The discharge summary would read as follows:

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After the diagnosis and for the period the petitioner was inpatient medical reimbursement claim was made by the petitioners. The claim comes to be repudiated by an

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electronic communication dated 14-12-2020 which reads as follows:

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"Dear MR OMMEN PRENEESH,

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We refer the captioned claim intimation on 18/09/2020 and have carefully reviewed the documents submitted by you to validate the eligibility of claim basis policy terms and condition.

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We regret to inform you that the claim for Critical Illness does not meet the requirement for its eligibility as per the Policy terms and conditions. Since the claim is not admissible and losses not payable, we are constrained to close the claim as "No claim" in our records.

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We would like to draw your attention. Your claim has been declined due to below mentioned reason which is the basis for disallowing the claim, an extract of which is mentioned below for your ready reference.

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As per the documents received and verification, Insured was diagnosed to be suffering from Multiple Sclerosis since 27/03/2017. As the date of Inception of policy is 29/04/2017; the ailment is pre-existing in nature. Hence this claim is being repudiated as per Section 3 C 1 of policy terms conditions as per which no payment will be made by the Company for any claim directly or indirectly caused by, based on arising out of or howsoever attributable to any Critical illness for which care, treatment or advice was recommended by or received from a Physician, or which first manifested itself or was contracted before the start of the Policy Period or for which a claim has or could have been made under any earlier policy.

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We sincerely express our inability to serve you, given the circumstances. However, we look forward to service your requirements in future.

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Thanking you in anticipation

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HDFC ERGO General Insurance Company Limited 6th Floor, Leela Business Park, Andheri Kurla Road, Andheri (East), Mumbai-400059"

(Emphasis added)

WA 1311/2022

The claim is declined on the ground that the patient had been diagnosed with multiple sclerosis since 27-032017, the policy coming into effect from 29-04-2017 and, therefore, the illness was a pre-existing illness and the claim cannot be allowed. This was called in question before the 1st respondent/Insurance Ombudsman. The Insurance Ombudsman by his order dated 29-03-2021 disallowed the claim, affirmed repudiation by the Insurance Company, after granting opportunity of personal hearing also to the petitioners. The reasons so rendered by the Insurance Ombudsman are as follows:

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"21. Result of personal hearing with both the parties (Observations & Conclusions):

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The dispute is with regard to repudiation of hospitalisation claim by RI.

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Personal hearing by the way of online Videoconferencing through Goto Meet was conducted in the said case. Mrs. Jaya (Complainant) along with her husband and Ms. Amala along with Dr. Ravi (Representative of RI) presented their case. Confirmation from all the participants about the clarity of audio and video was taken and to which the participants responded positively. This Forum has perused the documentary evidence available on record and the submissions made by both the parties during the personal hearing.

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Medical records of 2012 of Columbia Asia Hospital reveal that she has history of Vertigo since pre pregnancy. The MRI report of Columbia Asia Hospital dt 27.03.2017 reveals that doctor on the basis of the symptoms experienced by IP suggested that she might be suffering from MS. T2/Flair hyperintense ovoid lesion was seen in dorsomedial aspect of upper pons. Hyperintense-T2 lesions are defined as sharply demarcated regions of high signal intensity

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compared with surrounding brain tissue. The report suggested features could be possible of demyelinating etiology like MS and less likely of infective etiology. Thereafter she was hospitalised Bangalore Baptist Hospital from 27.03.2017 to 30.03.2017. The Discharge Summary of Bangalore Baptist Hospital records the final diagnosis as Acute Vertigo and White Matter Disease of the CNS.

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Internet Study reveals that White matter disease or leukoaraiosis is a disease that affects the nerves that link various parts of the brain to each other and to the spinal cord. White matter is tissue that includes nerve fibers (axons), which connect nerve cells. A fatty tissue called myelin covers the axons. These axons connect the neurons of the brain and spinal cord and signal nerve cells to communicate with one another. Degeneration of the white matter -specifically, the myelin sheaths can affect a person's mood, focus, muscle strength, vision, and balance. White matter disease may develop with conditions associated with aging, such as stroke, but it can also affect young people due to conditions such as cerebral adrenoleukodystrophy and multiple sclerosis (MS).

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The condition that results in damage to the protective covering (myelin sheath) that surrounds nerve fibers in the brain, optic nerves and spinal cord is called demyelination. MRI is the imaging modality of choice to assess demyelinating disorders of the brain and the cord and, together with the clinical and laboratory findings, can accurately classify them in most cases.

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Forum notes that IP took the policy immediately after being diagnosed with above conditions. Perusal of proposal form reveals that IP was required to disclose any signs and symptoms of MS along with an option to disclose any other medical condition in the proposal form.

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Forum notes that column for MS was left blank even though MRI report of Columbia Asia Hospital suspected signs of MS. Further, neither the preexisting medical condition of vertigo nor the

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diagnosis of white matter disease of CNS was disclosed in the "Others" column in proposal form dt 22.04.2017. Relevant excerpt from proposal form is shared below:

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In Satwant Kaur Sandu Vs New India Assurance on July 10 , 2009, Hon'ble Supreme Court has held that:

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"A mediclaim policy is a non-life insurance policy meant to assure the policy holder in respect of certain expenses pertaining to injury, accidents or hospitalizations. Nonetheless, it is a contract of Insurance falling in the category of contract uberrimae fidei, meaning a contract of utmost good faith on the part of the assured. Thus, it needs little emphasis that when an information on a specific aspect is asked for in the proposal form, an assured is under a solemn obligation to make a true and full disclosure of the information subject which is within his knowledge. It is not for the proposer to determine whether the information sought for is material for the purpose of the policy or not."

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Under the facts of the case, the Forum finds that IP has failed to disclose her pre-existing medical condition in the proposal thus depriving RI of the opportunity to assess the risk. Accordingly the Forum concurs with repudiation of RI. The complaint is Disallowed."

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The Insurance Ombudsman on looking at the medical records of the 1^st petitioner right from 2012 comes to conclude that the records would reveal history of Vertigo since pre-pregnancy and the suggestion at Columbia Asia Hospital or Baptist Hospital was that she

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might be suffering from MS and the discharge summary of the Baptist Hospital was 'White Matter Disease of the CNS". The research of the study is made and the claim is rejected.”

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Having noted the aforesaid paragraphs in the impugned Judgment, it is clear from perusal, the findings of the learned Single Judge can be summed up as under :

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i) on 27.03.2017, appellant No.1 developed giddiness and vomiting, she was taken to Baptist Hospital, where she was advised to undergo MRI. On going through the results of MRI and other medical examination, the diagnosis was: “acute vertigo white matter disease of CNS” ;

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ii) MRI done showed T2 hyper intense lesion in the dorso medial aspect of upper pons (multiple sclerosis) ;

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iii) even in terms of the opinion, though it is bracketed, nonetheless it was found. There was a doubt in the minds of Doctors that it could be multiple sclerosis as it was attached to Central Nervous System. The discharge was made on 30.03.2017;

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iv) barely after 30 days of getting discharged, the petitioners were offered insurance policy and it was accepted by them on 29.04.2017;

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v) the policy contains coverage of major medical illness and procedures. The policy directed the petitioners to tick appropriate condition in case the person proposed for insurance has been diagnosed or is suffering from any symptoms or any of the medical conditions.

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It is to be noted that the appellants had filled the form, but had not ticked the disease of multiple sclerosis. It appears despite appellants leaving the columns unfilled, the respondent no.2 did not seek any clarification from the appellants. The respondent no.2 issued the policy in favour of the appellants on 29.04.20217. The effect thereof has been considered and decided by the Supreme Court, in the case of Manmohan Nanda (supra), wherein the Supreme Court has, in paragraphs No.43 and 55, held as under:

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“43. The basic rules to be observed in making a proposal for insurance may be summarized as follows :

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43.1. A fair and reasonable construction must be put upon the language of the question which is asked, and

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the answer given will be similarly construed. This involves close attention to the language used in either case, as the question may be so framed that an unqualified answer amounts to an assertion by the proposer that he has knowledge of the facts and that the knowledge is being imparted. However, provided these canons are observed, accuracy in all matters of substance will suffice and misstatements or omissions in trifling and insubstantial respects will be ignored.

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43.2. Carelessness is no excuse, unless the error is so obvious that no one could be regarded as misled. If the proposer puts ‘no’ when he means ‘yes’ it will not avail him to say it was a slip of the pen; the answer is plainly the reverse of the truth.

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43.3. An answer which is literally accurate, so far as it extends, will not suffice if it is misleading by reason of what is not stated. It may be quite accurate for the proposer to state that he has made a claim previously on an insurance company, but the answer is untrue if in fact he has made more than one.

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43.4. Where the space for an answer is left blank, leaving the question unanswered, the reasonable inference may be that there is nothing to enter as an answer. If in fact there is something to enter as an answer, the insurers are misled in that their reasonable inference is belied. It will then be a matter of construction whether this is a mere nondisclosure, the

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proposer having made no positive statement at all, or whether in substance he is to be regarded as having asserted that there is in fact nothing to state.

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43.5. Where an answer is unsatisfactory, as being on the face of it incomplete or inconsistent the insurers may, as reasonable men, be regarded as put on inquiry, so that if they issue a policy without any further enquiry they are assumed to have waived any further information. However, having regard to the inference mentioned in head (4) above, the mere leaving of a blank space will not normally be regarded as sufficient to put the insurers on inquiry.

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43.6. A proposer may find it convenient to bracket together two or more questions and give a composite answer. There is no objection to his doing so, provided the insurers are given adequate and accurate information on all points covered by the questions.

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43.7. Any answer given, however accurate and honest at the time it was written down, must be corrected if, up to the time of acceptance of the proposal, any event or circumstance supervenes to make it inaccurate or misleading.

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[Source : Halsbury’s Laws of England, Fourth Edition, Para 375, Vol.25 : Insurance]

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xx xx xx xx xx xx xx xx xx xx xx xx

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xx xx xx xx xx xx xx xx xx xx xx xx

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55. On a consideration of the aforesaid judgments, the following principles would emerge:

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55.1. There is a duty or obligation of disclosure by the insured regarding any material fact at the time of making the proposal. What constitutes a material fact would depend upon the nature of the insurance policy to be taken, the risk to be covered, as well as the queries that are raised in the proposal form.

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55.2. What may be a material fact in a case would also depend upon the health and medical condition of the proposer.

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55.3. If specific queries are made in a proposal form then it is expected that specific answers are given by the insured who is bound by the duty to disclose all material facts.

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55.4. If any query or column in a proposal form is left blank then the insurance company must ask the insured to fill it up. If in spite of any column being left blank, the insurance company accepts the premium and issues a policy, it cannot at a later stage, when a claim is made under the policy, say that there was a suppression or nondisclosure of a material fact, and seek to repudiate the claim.

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55.5. The insurance company has the right to seek details regarding medical condition, if any, of the proposer by getting the proposer examined by one of its empanelled doctors. If, on the consideration of the

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medical report, the insurance company is satisfied about the medical condition of the proposer and that there is no risk of preexisting illness, and on such satisfaction it has issued the policy, it cannot thereafter, contend that there was a possible preexisting illness or sickness which has led to the claim being made by the insured and for that reason repudiate the claim.

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55.6. The insurer must be able to assess the likely risks that may arise from the status of health and existing disease, if any, disclosed by the insured in the proposal form before issuing the insurance policy. Once the policy has been issued after assessing the medical condition of the insured, the insurer cannot repudiate the claim by citing an existing medical condition which was disclosed by the insured in the proposal form, which condition has led to a particular risk in respect of which the claim has been made by the insured.

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55.7. In other words, a prudent insurer has to gauge the possible risk that the policy would have to cover and accordingly decide to either accept the proposal form and issue a policy or decline to do so. Such an exercise is dependant on the queries made in the proposal form and the answer to the said queries given by the proposer. “

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(emphasis supplied)

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From the above position of law laid down by the Supreme Court, it is clear when the insured has not filled a column and left the question(s) unanswered and the Insurance Company accepts the premium and issues a policy, it cannot at later stage, say that there is a suppression or non-disclosure of a material fact, and seek to repudiate the claim.

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It is precisely this situation which has arisen in the present case in as much as despite there being a diagnosis of multiple sclerosis , the appellants having not ticked the said ailment in the form, respondent No.2Company without making enquiries, went ahead to issue the policy to the appellants. It follows the Company could not have repudiated the claim in view of the law laid down by the Supreme Court.

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It is noticed the judgment of the Supreme Court is dated 06.12.2021. It appears that the said judgment was not brought to the notice of the learned Single Judge, resulting in the impugned order. It must be held the issue

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which arose for consideration before the learned Single Judge is covered in favour of the appellants by the judgment of the Supreme Court in Manmohan Nanda (supra).

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Though, learned counsel for the respondent no.2 has relied upon many judgments in support of his stand of which reference has been made above, in view of the latest opinion of the Supreme Court in Manmohan Nanda (supra), we do not feel any necessity to refer to those judgments.

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In view of our above discussion, it is held that the repudiation of the claim of the appellants by respondents No.1 and 2 is illegal. The communications dated 29.03.2021 and 14.12.2020 are set aside. Consequently the judgment of the learned Single Judge dated 21.10.2022 in W.P.No.14346/2021 upholding the said decisions is also set aside.

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We direct respondent No.2 shall consider the

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claim of the appellants and decide the same within a period of two months.

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The amount to be paid shall be released to the appellants within a period of three weeks thereafter with interest at the rate of 6% p.a. from the date of repudiation of claim by respondent No.2 i.e., on 14.12.2020, till the date

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of payment.

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The appeal is disposed of as allowed .

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Sd/(V KAMESWAR RAO) JUDGE

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Sd/(C M JOSHI) JUDGE

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Mrs Jaya Elizabeth Mathew v. the Insurance Ombudsman for the State of Karnataka

Case brief

What is this about?

What did the court decide?

Mrs Jaya Elizabeth Mathew v. the Insurance Ombudsman for the State of Karnataka

Case brief

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What the court decided

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