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Madras High Court Allows Reimbursement Claim Under NHIS 2021 for Aorto Bi-Iliac Bypass Surgery Despite Cashless Denial — Insurance Company and TPA Directed to Pay Rs.2,72,406/- with Interest. Court Held That Denial of Cashless Facility Does Not Extinguish Reimbursement Entitlement Under the Scheme.

The petitioner, P. Ravi, a Head Constable serving in the Tamil Nadu Police Department, filed a writ petition under Article 226 of the Constitution of ...

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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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Supreme Court Allows Appeal of Complainant in Life Insurance Claim Repudiation Case — Insurer Failed to Prove Suppression of Material Facts. Non-disclosure of existing policies not established by documentary evidence; burden of proof under Section 45 Insurance Act, 1938 not discharged.

The present civil appeal arises from the repudiation of life insurance claims by Future Generali India Life Insurance Company Limited. The appellant, ...

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Bombay High Court Enhances Compensation in Motor Accident Claim Case Due to Negligence of Driver and Owner. Apportionment of Liability Between Owner and Driver Under Motor Vehicles Act, 1988.

The case involves two appeals arising from a motor accident claim petition filed by the legal heirs of deceased Prasad Sarodaya, who died in a road ac...

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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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Supreme Court Allows Appeal in Mediclaim Policy Renewal Dispute — Insurer Must Disclose Material Changes in Coverage at Renewal. Renewal of Insurance Policy is Not a Fresh Contract; Insurer Owed Duty to Inform Insured of Restrictive Terms Under Principle of Utmost Good Faith.

The appellants, Jacob Punnen and his wife, held a Mediclaim policy with United India Insurance Co. Ltd. since 1982, renewed annually. In March 2008, t...

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Supreme Court Allows Appeal in Insurance Claim Dispute — Repudiation of Overseas Mediclaim Policy for Non-Disclosure of Pre-existing Condition Set Aside. Insurer Failed to Prove That Insured Had Knowledge of Hyperlipidaemia at Time of Proposal.

The appellant, Manmohan Nanda, sought an overseas mediclaim policy from United India Assurance Co. Ltd. to travel to the USA for a family wedding. He ...

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High Court of Karnataka Enhances Compensation for Accident Victim and Fixes Liability on Insurance Company in Motor Vehicle Accident Case. Claimant sustained grievous injuries due to driver's negligence; Insurance Company held liable as no evidence of invalid license.

The case involves an appeal filed by the claimant under Section 173(1) of the Motor Vehicles Act, 1988, challenging the judgment and award dated 27.06...