Quashed

Mariyamma Joseph v. Insurance Ombudsman

Kerala HC8 Aug 2022WP(C)/23037/2021

Case brief

AI extract

What is this about?

This writ petition challenges an award by the Insurance Ombudsman rejecting a complaint against SBI Life Insurance. The High Court of Kerala set aside the award because it was rendered based on documents not served on the petitioner, violating fair procedure.

What did the court decide?

Ext.P1 award is set aside. The Ombudsman is directed to reconsider the complaint within three months with a fresh hearing.

Mariyamma Joseph Vs Insurance Ombudsman — Consumer Protection | Kerala HC (2022)

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IN THE HIGH COURT OF KERALA AT ERNAKULAM

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PRESENT

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THE HONOURABLE MR.JUSTICE V.G.ARUN

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MONDAY, THE 8TH DAY OF AUGUST 2022 / 17TH SRAVANA, 1944

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WP(C) NO. 23037 OF 2021

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PETITIONER/S:

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MARIYAMMA JOSEPH
AGED 68 YEARS
W/O. JOSEPH M.V. 286/6, MANAPARAMBIL HOUSE, M.G.ROAD,
EDAVANAKKADU VYPIN, ERNAKULAM-682 502

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BY ADVS.
V.RAJENDRAN (PERUMBAVOOR)
N.RAJESH
GOPAKUMAR P.

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RESPONDENT/S:

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1 INSURANCE OMBUDSMAN

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KOCHI ULINATTU BUILDINGS, 2ND FLOOR, M.G.ROAD, KOCHI682 015.

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2 FEDERAL BANK LIMITED NJARAKKAL BRANCH, PIN-682 505 REPRESENTED BY ITS MANAGER.

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3 SBI LIFE INSURANCE CO. PVT. LTD. 8TH LEVEL, SEAWOOD GRAND CENTRAL TOWER-2, PLOT NO.R-1, SECTOR-40, SEAWOODS, NERUL NODE, NAVI MUMBAI-400 706 REPRESENTED BY MANAGING DIRECTOR.

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4 SBI LIFE INSURANCE KADAVANTHRA BRANCH, 4TH FLOOR, MUSCAT TOWER, S.A.ROAD, KADAVANTHRA, ERNAKULAM, PIN-682 020 REPRESENTED BY ITS MANAGER.

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BY ADVS.
LEO GEORGE
T.G.SUNIL (PRANAVAM)

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THIS WRIT PETITION (CIVIL) HAVING COME UP FOR ADMISSION ON
08.08.2022, THE COURT ON THE SAME DAY DELIVERED THE FOLLOWING:

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WP(C) NO. 23037 OF 2021

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JUDGMENT Dated this the 8^th day of August, 2022

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The peititioner’s son, Binu Joseph, had availed a

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housing loan of Rs.8,40,000/- from the second respondent. Binu Joseph had secured his loan by availing a credit insurance from the third respondent. The sum assured was equivalent to the loan amount outstanding in the account along with the bank with interest, as per the original EMI schedule. The loan was to be repaid in 180 instalments and the petitioner’s son repaid 140 instalments. Unfortunately, Binu Joseph died on 07.06.2019. As per Clause No.5 of Ext.P2 certificate of insurance, in the event of death of the insured borrower due to any cause, the sum assured would become payable

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to the group administrator. The sum assured will be equivalent to the outstanding loan amount including interest as per the original EMI schedule. The petitioner calculated the amount in terms of the above Clause as Rs.4,08,909/-. On the other hand, the insurer/third

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WP(C) NO. 23037 OF 2021

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3

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respondent sanctioned only Rs.1,53,826/-. The petitioner disputed the payment and approached the Insurance Ombudsman with Ext.P5 complaint. The complaint stands rejected under Ext.P1 award. Hence, the writ petition.

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Learned Counsel for the petitioner submits that the complainant was heard online and the award passed, without providing the petitioner with copies of the documents produced by the respondents. It is also contended that the reasons that had prompted the Insurance Ombudsman to accept the contentions put forth by the insurer is not discernible from the award.

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I heard the learned Counsel for the second respondent Bank also.

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The third respondent insurer, though served with notice, has not entered apperance.

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Having gone through the documents and having carefully scrutinised Ext.P1 award, I find substantial merit in the challenge raised. The decision is seen rendered on the basis of documents produced by the insurer, copies of

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WP(C) NO. 23037 OF 2021

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which are not served on the complainant. For that reason alone, I find the procedure adopted and the decision rendered to be illegal.

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Consequently, Ext.P1 award is set aside. The Insurance Ombudsman shall reconsider Ext.P5 complaint and take a fresh decision thereon, after affording sufficient opportunity for the parties to put forth their contentions and to let in evidence. The decision, as directed above, shall be rendered within three months of receipt of a copy of this judgment.

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The Writ Petition is disposed of accordingly.

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Sd/-
V.G.ARUN
JUDGE

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RK

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WP(C) NO. 23037 OF 2021

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APPENDIX OF WP(C) 23037/2021

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PETITIONER EXHIBITS

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Exhibit P1TRUE COPY OF AWARD OF IST RESPONDENT
BEARING NO.10/KOC/A/LI/0121/2020-2021
DATED 30.11.20.
Exhibit P2TRUE COPY OF CERTIFICATE OF INSURANCE
ISSUED BY THE 3RD RESPONDENT BEARING
SERIAL NO.FBHL/6542 DATED 1.1.08 IN
FAVOUR OF LATE BINU JOSEPH.
Exhibit P3TRUE COPY OF AMORTISATION CHART
REGARDING THE HOUSING LOAN ISSUED BY
2ND RESPONDENT TO LATE MR. BINU JOSEPH.
Exhibit P4TRUE COPY OF LETTER SENT BY 4TH
RESPONDENT TO THE 2ND RESPONDENT ON
3.9.19.
Exhibit P5TRUE COPY OF COMPLAINT FILED BY THE
PETITIONER BEFORE IST RESPONDENT ON
19.8.20.

Mariyamma Joseph v. Insurance Ombudsman

Case brief

What is this about?

What did the court decide?

Mariyamma Joseph v. Insurance Ombudsman

Case brief

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What did the court decide?

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