Research › Search › Judgment

Kerala High Court · body

2025 DIGILAW 1633 (KER)

Deepa S. W/o. Late Rahul Chandran v. Permanent Lok Adalat(For Public Utilities)

2025-06-10

HARISANKAR V.MENON

body2025
JUDGMENT : The petitioner has filed the captioned writ petition seeking to challenge Ext.P4 award passed by the 1 st respondent herein by which certain insurance benefits claimed by her with respect to the death of her husband were rejected. 2. The short facts necessary for the disposal of this writ petition are as follows: - The petitioner’s deceased husband had obtained two housing loans from the 5 th respondent and on the insistence of the said respondent, insurance was obtained from respondents 2 to 4, by including the cost of the premium in the loan amount. The first disbursement of the insurance is stated to have taken place on 29.06.2015, inclusive of the premium payable to respondents 2 to 4. It is stated that the 5 th respondent paid the premium directly to respondents 2 to 4 on 29.06.2015. However, Ext.R2(a) insurance policy is issued starting the coverage from 14.07.2015 alone. The petitioner’s husband, in the meantime, was hospitalised on 21.09.2015 and passed away after a Cardiac Arrest on 10.10.2015. The petitioner sought for the insurance benefit based on the policy referred to above, and she was informed that the claims are inadmissible since the deceased was suffering from a pre-existing disease and since three months had not expired from the policy date when her husband passed away. In such circumstances, the petitioner filed the claim petition before the 1 st respondent authority under Section 22C (1) and 22A of the Legal Services Authorities Act, 1987 (for short, the “Act”). The Insurance Company sought to justify the repudiation of the claim on account of the two reasons noticed above. 3. The 1 st respondent authority issued Ext.P4 award dated 20.02.2018 finding that: - i. The stand of the Insurance Company that there was a pre- existing disease is not correct. ii. The death of the petitioner’s husband was on 10.10.2015, i.e., within a period of three months from the date of commencement of the insurance policy-14.07.2015. iii. The stand of the petitioner that the relevant date for calculation of the 90 days should be 29.06.2015/30.06.2015 (date of payment of premium), cannot be accepted. 4. It is in such circumstances that the captioned writ petition has been filed by the petitioner seeking to challenge Ext.P4. 5. iii. The stand of the petitioner that the relevant date for calculation of the 90 days should be 29.06.2015/30.06.2015 (date of payment of premium), cannot be accepted. 4. It is in such circumstances that the captioned writ petition has been filed by the petitioner seeking to challenge Ext.P4. 5. A counter affidavit has been filed by the 2 nd respondent, dated 15.11.2018, contending that the petitioner’s husband had a pre-existing illness- Pemphigus Vulgaris, and that an irregular finding by the 1 st respondent authority cannot be used by the petitioner. It is further pointed out that the calculation of 90 days was made properly, and hence, the death having occurred within the period of 90 days, the petitioner is not entitled to the benefits. 6. I have heard Sri. Thomas T. Varghese, the learned counsel for the petitioner and Sri.Latheesh Sebastian, the learned counsel for respondents 2 to 4 and Sri.P.Paulochan Antony, the learned counsel for the 5 th respondent. 7. The challenge before the 1 st respondent authority at the instance of the petitioner was with respect to the two reasons for repudiation as noticed earlier and the first reason having been found against the Insurance Company, the petitioner has challenged the second reason, which is found in favour of the Insurance Company by the 1 st respondent. 8. The petitioner’s deceased husband had availed the insurance policy from respondents 2 to 4 based on the premium being paid on 29.06.2015. However, the policy is seen issued only from 14.07.2015. The question arising for consideration is as to whether the insurance policy obtained by the petitioner’s husband is valid with reference to the date of payment of the premium or the date of commencement as shown in the policy. 9. Straight away, it may be noticed that this Court, noticing the rival contentions, on 19.03.2025, had directed the Insurance Company to come on record with reference to the date of receipt of the insurance premium. The Insurance Company has, therefore, filed an additional affidavit dated 14.05.2025 stating that the cheques towards the premium from the 5 th respondent Bank were encashed on 30.06.2015. However, it is further pointed out that some “clarification” is required, and they were obtained through “telephonic confirmation,” and the policies were issued on 13.07.2015. Thus, according to the Insurer, it was for want of the afore clarifications that the policy was delayed up to 13.07.2015. However, it is further pointed out that some “clarification” is required, and they were obtained through “telephonic confirmation,” and the policies were issued on 13.07.2015. Thus, according to the Insurer, it was for want of the afore clarifications that the policy was delayed up to 13.07.2015. The Insurance Company further states that the insured, having never raised any dispute on the delay, the petitioner is not entitled to take a different stand. 10. Thus, the fact that the insurance premium was received on 30.06.2015 is admitted by the respondents 2 to 4, and the delay in issuing the insurance policy, even thereafter, is sought to be justified on account of the “clarifications” required, which were obtained through “telephonic confirmation”. The affidavit is silent as regards what the “telephonic confirmation” was obtained. Therefore, the above explanation can only be considered as an afterthought, when the respondents 2 to 4 were called upon to explain the delay by this Court. 11. It is with reference to the afore that the ultimate claim made by the petitioner is to be considered. As already noticed, the premium being paid on 30.06.2015, admittedly, there is no justification on the part of the Insurance Company for delaying the issue of the policy till 13.07.2015. True, the insured did not raise a dispute then. However, that by itself does not curtail the right of the petitioner to seek refuge under the provisions of the Act. 12. The 1 st respondent authority in the impugned order had sought to rely on the judgment of the Apex Court in Life Insurance Corporation of India v. Raja Vasireddy Komalavalli Kamba and Others [ (1984) 2 SCC 719 ] to reject the case of the petitioner. The afore judgment considered an almost similar issue where the proposed insured died on the very next day after payment of the premium and before the issuance of the actual policy. The Apex Court in the afore circumstances found that mere filing of the proposal for insurance and the deposit of the first premium do not create a binding contract. But in my opinion, the afore judgment cannot be an authority for consideration of the dispute raised by the petitioner herein with reference to the provisions of the Act. The Apex Court in the afore circumstances found that mere filing of the proposal for insurance and the deposit of the first premium do not create a binding contract. But in my opinion, the afore judgment cannot be an authority for consideration of the dispute raised by the petitioner herein with reference to the provisions of the Act. Further, this Court notices the judgment of the Division Bench of this Court in Life Insurance Corporation of India, Trivandrum V. Kamalamma [1986 SCC OnLine Ker 22] which also took note of the judgment of the Apex Court in Raja Vasireddy (supra), holding as under:- “5. No policy has admittedly been issued in the present case. The question, however, is not whether a policy of insurance has been issued - a contract of insurance can come into existence even without a policy - but whether a binding contract has come into existence. "....Indeed there is no legal necessity, in non-marine insurance, to have a policy at all, writing is necessary in marine insurance, but, in other forms of insurance writing is not, it seems, necessary, even if the period of the insurance extends beyond a year. Any positive act therefore indicative of an intention to create a contract may be sufficient acceptance; for example receipt of the premium without demur or qualification or conduct precluding the insurers from disputing receipt of the premium. Even a demand for the premium may be sufficient. An acceptance may, however, be conditional (unless the form of a prior acceptance precludes the imposition of a new condition), and in such a case performance of the condition operates as the initiation of the contract." (emphasis supplied) (Halsbury’s Laws of England, Vol. 22, 3rd Edn., page 206). Finding thus, the Division Bench of this Court held that the existence of the contract is proved in the matter. 13. This Court also notices the judgment of the Patna High Court in Life Insurance Corporation of India, Mumbai and Others v. Krishna Devi [ AIR 2017 Pat. 75 ] , wherein also the principles laid down in the judgment of the Apex Court in Raja Vasireddy (supra) and by this Court in Kamalamma (supra were referred, reiterating the same principles. This Court also notices the judgment of the Patna High Court in Life Insurance Corporation of India, Mumbai and Others v. Krishna Devi [ AIR 2017 Pat. 75 ] , wherein also the principles laid down in the judgment of the Apex Court in Raja Vasireddy (supra) and by this Court in Kamalamma (supra were referred, reiterating the same principles. Therefore, I am of the opinion that the insurance policy in the case at hand is to be considered with reference to the date of receipt of premium - 30.06.2015, in which event the death of the insured on 10.10.2015 is after the period of 90 days on account of which the petitioner is entitled to succeed. To the above extent, there was a deficiency on the part of the Insurance Company, for no fault of the deceased. Resultantly, this writ petition would stand allowed by setting aside Ext.P4 award of the 1 st respondent authority. It is declared that the petitioner is entitled to the benefits of the policy obtained by her deceased husband. The Insurance Company to act accordingly, as expeditiously as possible, at any rate, within a period of six weeks from the date of receipt of a certified copy of this judgment.