Dispute Resolution & Arbitration Monthly Update | December 2021

Jacob Punnen & Anr v. United India Insurance Co Ltd

Civil Appeal No. 6778 of 2013

Background facts

• In 1982, Mr. Jacob Punnen & his wife (Appellants), both senior citizens, availed a medical insurance policy (referred as Mediclaim), from United India Insurance Co Ltd (the Insurer), which was renewed annually. Thereafter, the existing insurance policy was renewed by the Appellants for the period of 2008-2009 with a coverage of INR 8 lakh. However, at the time of renewal, the Insurer failed to disclose that the terms of the new policy would be different from those of the earlier, lapsed policy. In 2008, the 2^nd Appellant had to undergo angioplasty surgery and a claim of INR 3.82 lakh was submitted by her to the Insurer. However, the Insurer partially accepted the claim by paying only INR 2 lakh to the Appellants. It was the case of the Insurer that the renewed policy had a new clause which limited the liability with respect to surgeries like angioplasty to an