The Madras High Court has directed ICICI Lombard Insurance Company to pay the insured amount to a claimant, ruling that cardiac arrest caused by Covid-19 qualifies as a heart attack. The court was addressing a writ petition filed by a woman whose insurance claim was denied by the company.
Case Background
The petitioner’s husband had taken out two loans from DCB Bank Ltd., which required life insurance. His life was insured with ICICI Lombard General Insurance Company Ltd. He died of cardiac arrest during the COVID-19 pandemic, with the cause of death recorded as cardiac arrest without a postmortem. The insurance claim filed by his widow, N. Lakshmi, was rejected by the bank due to the unverified cause of death and lack of a postmortem. She was advised to seek redress from the Insurance Ombudsman, leading to the current petition.
Court’s Observation
Justice G.K. Ilanthiraiyan noted that the insurance policy covered the first occurrence of a heart attack of a specified severity. The court highlighted that insurance companies should not be overly technical or arbitrary, referencing a Supreme Court ruling on the matter. The court highlighted the imbalance between individuals and large insurance corporations, noting that policy language often aims to evade liability.
Insurance Company Responsibilities
The court criticized insurance companies for neglecting to reimburse insured individuals, forcing them to seek legal action to enforce their rights. The court quashed the denial order and ruled in favour of the petitioner, directing the insurance company to disburse the insured amount.
The court cited the case Jasmine Ebenezer Arthur vs. HDFC ERGO General Insurance Company Ltd., illustrating the legal principle that insurance companies should not exploit technicalities to deny claims.
The Madras High Court’s decision strengthens the protection of insured individuals’ rights and clarifies the interpretation of policy terms in the context of Covid-19-related deaths. The ruling highlights the need for insurance companies to act fairly and avoid arbitrary decisions that disadvantage policyholders.