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Court rejects insurer’s contention to avoid liability

Mohamed Imranullah S.

Directs the public sector company to pay the entire insurance amount to the nominee under accident policy


Company claimed it was not an accident as the nominee’s mother fell down due to giddiness

Court: it was a result of injuries sustained during the fall as pointed out by post-mortem report


MADURAI: “If you don’t want to do something, one excuse is as good as another,” goes a Yiddish proverb and it came true in the case of M. Parameswari (26) of Madurai, who was denied a part of the life insurance amount due to her deceased mother.

Parameswari’s mother, who was in her fifties, fell down from the terrace of her house while attempting to pick up a piece of cloth from the sunshade and died of injuries.

She had taken a policy with a public sector life insurance company and nominated her daughter to receive the amount in case of any exigency.

To the shock of the nominee, the insurer refused to disburse the entire amount on the ground that the policy holder did not die owing to “a bodily injury resulted solely and directly from an accident caused by outward, violent and visible means” as stated in clause 10.2(b) of the policy conditions.

The company claimed that the incident was not an accident as the policy holder fell down following giddiness caused due to her ill-health.

Further, it said the nominee was entitled to an additional amount equal to the sum insured only if the death had occurred as contemplated in the policy conditions and not otherwise.

The incident took place in November 2003 and an autopsy conducted at the Government Rajaji Hospital here confirmed that the death was due to multiple injuries sustained by the deceased. But the corporation issued a written order rejecting the claim only on December 30, 2004, forcing her to file a writ petition before the Madras High Court Bench here in 2005.

Allowing the petition pending before the court for the last three years, Justice K. Mohan Ram said: “It may be true that the assured (mother) was suffering from giddiness, but the death was not due to that… It was a result of the injuries sustained during the fall as pointed in the post mortem certificate.”

Not excluded under policy

Further, agreeing with petitioner’s counsel D. Saravanan, the Judge said: “Even assuming that the assured fell down due to giddiness, the respondents cannot avoid their liability when death due to such accidents has not been excluded under any one of the clauses of the policy conditions.”

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