BRIJENDRA BHUSAN Vs. INSURANCE OMBUDSMAN

JUDGEMENT

(1.) Instant writ petition under Article(s) 226 and 227 of the Constitution of India, 1950 has been filed by the Petitioner for quashing of the rejection of the insurance claim by the insurer, namely, HDFC Standard Life Insurance Co. Ltd. (OP No.2) and intimation thereof by letter dtd. 17/5/2010 (Annexure-2); the decision of the Grievance Committee informed by letter dtd. 2/7/2010 (Anenxure-3); and the order of the Insurance Ombudsman (OP No.1) dtd. 4/10/2011 (Annexure-1) in Complaint No.21-005-1343 on the grounds inter alia that the same is not sustainable in law, inasmuch as, there has been no suppression of any material fact by the insured regarding her medical condition while applying for the insurance policy.

(2.) The Petitioner's wife was issued with a life insurance policy on payment of annual premium of Rs.20,000.00 for a sum assured of Rs.1,00,000.00 towards death benefit acceptance of which was intimated by OP No.2 to her by letter dtd. 2/9/2008 under Anenxure-4, however, the insurer, after the death of the insured, declined to honour the insurance claim on the ground of suppression of fact that she was suffering from diabetes and was receiving regular treatment prior to the issuance of the policy. Aggrieved by the rejection and informed under Annexure-2, the Petitioner approached the Grievance Committee but the same was rejected, whereafter, a complaint under Rule 12(1)(b) of the Redressal of Public Grievances Rules, 1998 (in short 'the Rules') was filed before OP No.1 but the same yielded no result. Thereafter, the Petitioner approached this Court for quashing of Annexures- 1,2&3 with a direction to OP No.2 to pay the sum assured with interest and compensation.

(3.) Heard Mr. A.K.Dalai, learned counsel for the Petitioner and Mr. B.M.Pattanaik, learned counsel for O.P.No.2.