Madras HC comes to rescue of widow who was denied home loan insurance claim.

Source – thehindu.com

The Madras High Court has come to the rescue of a young widow who was denied home loan insurance by a private firm despite having lost her 39-year-old husband due to a cardiac arrest when he was behind the wheels of his car on his way to office in Abu Dhabi in 2015.

A Bench of Chief Justice Amreshwar Pratap Sahi and Justice Subramonium Prasad dismissed a writ appeal preferred by HDFC ERGO General Insurance Company and confirmed an order passed by Justice Pushpa Sathyanarayana on June 6 directing the company to honour the claim.

Authoring the verdict for the Bench, Justice Prasad pointed out that Jasmine Ebenezer Arthur and her husband Thanasekar Samuel Chellam had obtained a home loan for ₹35 lakh from HDFC Bank Limited in 2013 for purchasing a property at Kolathur here and had to repay the money in 120 monthly instalments of ₹47,522 each.

They also availed an insurance policy for the home loan under the Home Suraksha policy offered by HDFC ERGO. Under the policy, the insurers were covered for major medical issues such as cancer, kidney failure, major organ transplant, stroke, paralysis and myocardial infarction.

However, when the widow, also a mother of two minor children, made a claim for the insurance amount after her husband’s death, the company rejected it on the ground that her husband had died due to ventricular fibrillation as per a case summary issued by Mafraq Hospital in Abu Dhabi.

It was the contention of the insurance company that death due to ventricular fibrillation and acute coronary syndrome could not be considered as a death due to myocardial infarction. Though the widow approached the Insurance Ombudsman, the latter dismissed her complaint on May 6, 2016.

Expert opinion

Thereafter, she filed a writ petition seeking a direction to the insurance firm to honour her claim for ₹36.45 lakh. On February 18, Justice Sathyarayana requested the Dean of Rajiv Gandhi Government General Hospital here to obtain an expert opinion regarding the cause of death of the petitioner’s husband. The opinion was called for with the consent of the counsel for both sides and accordingly M. Nandakumaran, Professor of Cardiology, Madras Medical College, stated that if a patient died due to acute coronary syndrome and ventricular fibrillation, the cause of death could be considered as myocardial infarction.

Challenging the reliance placed upon such opinion by the single judge to allow the writ petition, the firm claimed that it had obtained a contrary opinion from another cardiologist. However, the Bench refused to go by the second opinion.