Law: Insurance Ordinance, 2000

Section: 129

Insurance Ordinance (XXXIX of 2000)---Ss. 129 & 130(1)(2)---Denial of payment on the claim made under the Insurance Policy---Complaint---Appeal against order passed by Insurance Ombudsman---Issue essentially involved in the case was, whether the loss of vision of the insured persons (appellant) had been caused by the fall he had while discending the stairs as claimed, or it was the eventual result of some ailment, the appellant had contracted and suffered much before entering into insurance contract with the insurance company---Approach to discern fact from the fiction via medical tests had already been tried and exhausted without leading to conclusion; it was assumed, in circumstances, that it would be better, if both parties try to reach on amicable settlement on their own---Appellant side offered that, if the Insurance Company would undertake the treatment of the blinding disease of the appellant, then there would be no more dues on the company---Other offer of appellant side was that Insurance Company refund the entire premium already paid, and the main Life Policy be continued---Other options discussed were the waiver of the premium in the respective future term period, and the Policy to continue as such and that compensation be paid to the appellant under the policy in a fairway with main Policy of life remain intact---Counsel for Insurance Company had submitted that company was willing to refund the whole premium with no deduction at all to the appellant plus Rs.50,000---Appellant accepted the final settlement offer, with Proviso that no deduction be made from the premium refund---Insurance Company, on that point had already expressed their approval---Parties having arrived at the settlement on their own quite agreeably, it was ordered that Insurance Company would refund the premium already paid, to the appellant with no deduction under any head plus the payment of Rs.50,000 on compassionate ground---Policy along with all auxiliary benefits thereafter would stand terminated. ORDER TARIQ HUSSAIN, DIRECTOR---This Order shall dispose of the Appeal No.9 of 2012 under section 130(2) of the Insurance Ordinance, 2000 (the Ordinance) which was filed with…

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