'Insurance Company Can't Be Blamed For Agent's Bluff’

Can an insurance company be held responsible for the alleged promises given by its agent to anyone who avails a policy while purchasing a vehicle?

The Madras High Court has ruled in the negative, dismissing a petition seeking to direct the National Insurance Company to provide medical reimbursement following an accident. The Court held that vehicle insurance was not mediclaim policy.

The case pertains to one R Ayyanar of Kilambakkam who was lured by an agent of the Taramani branch of the National Insurance Company to take a policy for the purchase of a Hero-Honda motor-bike in April, 2006.
The agent allegedly promised Ayyanar that he was eligible for reimbursement of medical expenses in case of accidents, theft and third party insurance. 

Ayyanar met with an accident on May 15, 2008, when the policy was in force. He hit against a stray cattle, fell down and sustained fractures. He was admitted in two hospitals as in-patient and had undergone surgeries spending about `1.5 lakh. When Ayyanar approached the insurance company seeking reimbursement of the medical expenses, the company by an order dated September 9, 2008 rejected the claim. Hence, the present writ petition.

Petitioner’s advocate Suresh contended that his client had simply believed the promises of the agent. He was not aware of the terms and conditions of the policy as, they were in English and he didn’t know the foreign language. In this connection, he had also filed a writ petition for a direction to the Insurance company to print the terms and conditions in regional languages in a readable manner and to settle the claim. 

And the HC disposed of the petition on August 14, 2008 with a direction to the insurance company to consider petitioner’s plea on merit in accordance with law. And by the September 9, 2008 order, the company rejected all his claims on unreasonable grounds, Suresh contended.

When the matter came up on January 13 last, the First Bench of SK Kaul and Justice MM Sundresh asked Suresh as to whether his client Ayyanar was in the habit of signing documents in a language which he does not understand. But, Suresh could not say yes. It was also not the case of the petitioner that, at any stage, he had approached the insurance company for a copy of the policy in the vernacular language, the Bench pointed out.

The insurance policy does not cover medical treatment as it is not a mediclaim policy. “Thus, in any case, the petitioner would not be entitled to reimbursement of the medical expenses,” the Bench said and upheld the rejection order of the insurance company.