Law: Insurance Ordinance, 2000

Section: XXXIX,122,127,2(xlv)

Law: Federal Ombudsmen Institutional Reform Act, 2013

Section: XIV,14

Law: Constitution of Pakistan, 1973

Section: 199

(a)    Insurance Ordinance (XXXIX of 2000)--- ----Ss. 122 & 127---'Insurance Tribunal' and 'Federal Insurance Ombudsman'--Jurisdiction---Distinction---Tribunal under S. 122 of Insurance Ordinance, 2000 is empowered to adjudicate claims by policyholders against insurance companies in respect of or arising out of insurance contracts---Jurisdiction on Federal Insurance Ombudsman conferred under S. 127 of Insurance Ordinance, is to entertain complaints from any aggrieved person alleging maladministration by an insurance company. (b)    Insurance Ordinance (XXXIX of 2000)--- ----S. 127---Federal Ombudsman Institutional Reforms Act (XIV of 2013), S. 14--Constitution of Pakistan, Art. 199---Constitutional petition---Maladministration--Insurance claim, denial of---Pre-existing conditions---Petitioner / insurance company was aggrieved of orders passed by Federal Insurance Ombudsman and Appellate Authority to pay insurance claim to respondents / insured persons---Plea raised by petitioner / insurance company was that respondents were suffering from ailments prior to their insurance which were covered under pre-existing conditions ---Validity---Merely incorporating pre-existing conditions are not covered in the exclusion term of the Policy did not allow petitioner / insurance company to repudiate the claim---Where a stipulation was not merely unreasonable but impossible, in the sense that from the outset it never could be performed, it was a nullity, and was simply disregarded---Respondents / insured persons alleged mala fide conduct, delay in claim settlement, arbitrary repudiation, misrepresentation of policy terms and repudiation contrary to law---Federal Insurance Ombudsman rightly found maladministration and directed payment of reasonable compensation for the medical expenses incurred by respondents---Federal Insurance Ombudsman rightly assumed its jurisdiction while deciding complaints filed by respondents as their grievances fell squarely within the Ombudsman s jurisdiction under S.127 of the Insurance Ordinance, 2000---High Court declined to interfere in the orders passed by two fora below---Constitutional petition…