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Bombay High Court Sets Aside Insurance Ombudsman Award for Non-Compliance with Rule 17 and Ignoring Policy Terms. Ombudsman directed insurer to process claim without determining compensation or considering policy exclusions for medical expenses incurred in India.

The petitioner, Tata AIG General Insurance Co. Ltd., challenged an award dated 4 March 2024 passed by the Insurance Ombudsman for Mumbai. The responde...

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High Court of Karnataka Quashes Insurance Ombudsman Award for Violation of Natural Justice — Employer Not Heard Before Award. Group Personal Accident Policy Claim Decided Without Notice to Employer, Award Set Aside and Remitted for Fresh Hearing.

The petitioner, M/s. Toyota Kirloskar Motor Pvt. Ltd., is a company engaged in the manufacture of motor vehicles. It had contracted a 'Group Personal ...

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Bombay High Court Reviews Insurance Ombudsman Award Upholding Health Insurance Claim. Court Examines Applicability of Two-Year Exclusion for Disc Prolapse Under Clause 3(a) of Family Floater Policy.

The dispute arose from a health insurance claim under a Star Comprehensive Insurance Policy issued by Star Health and Allied Insurance Co. Ltd. to Res...

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Bombay High Court Dismisses Insurance Company's Petition Challenging Ombudsman Award in Favor of Widow in Housing Loan Insurance Claim. Non-Disclosure of Pre-Existing Conditions Not Material to Risk, Ombudsman's Award Upheld.

This case involves a widow, Gauri V. Raut (Respondent No. 2), whose husband, along with her father-in-law and brother-in-law, passed away within a spa...

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Bombay High Court Dismisses Insurer's Writ Petition Against Insurance Ombudsman Award in Life Insurance Claim. Non-Disclosure of Pre-Existing Ailments Not Proven to be Material Under Section 45 of Insurance Act, 1938.

The petitioner, Aditya Birla Sun Life Insurance Co. Ltd., challenged an award dated 31 December 2020 passed by the Insurance Ombudsman, Goa/Mumbai Met...

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Madras High Court Dismisses Insurance Company's Writ Against Ombudsman Award in PMFBY Crop Insurance Dispute. Error in Village Name by Cooperative Society Does Not Shift Liability to Insurer; Ombudsman's Award Upheld.

The case involves a dispute under the Pradhan Mantri Fasal Bima Yojana (PMFBY) scheme. The first respondent, a non-loanee farmer, insured her crops th...

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Bombay High Court Dismisses Insurer's Challenge to Insurance Ombudsman Award in Health Insurance Claim Dispute. Court upheld the Ombudsman's jurisdiction and award of Rs.27,13,582/- for medical expenses, rejecting the insurer's arguments on partial repudiation and policy validity.

The case involves a dispute between Bharat Hirji Dedhia (the insured) and Oriental Insurance Company Ltd. (the insurer) regarding a health insurance p...

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Bombay High Court Allows Writ Petition in Cyber Fraud Case — Directs Bank to Refund Rs. 76.9 Lakhs Under RBI Circular. Unauthorized Addition of Beneficiaries and Absence of OTP Constitute Deficiency in Service Under RBI Circular Dated 6 July 2017.

The petitioners, a director and a closely held family company, maintained a bank account with Respondent No. 2 for 15-20 years. On 1 October 2022, unk...