2025:KER:29529 W.P (C) No.13518 of 2025 1 IN THE HIGH COURT OF KERALA AT ERNAKULAM PRESENT THE HONOURABLE MR.JUSTICE C.S.DIAS FRIDAY, THE 4TH DAY OF APRIL 2025 / 14TH CHAITHRA, 1947 WP(C) NO. 13518 OF 2025 PETITIONER/1 st RESPONDENT: HDFC ERGO GENERAL INSURANCE CO LTD 1ST FLOOR, HDFC HOUSE, 163-166, 1 BACKBAY RECLAMATION, H.T PAREKH MARG, CHURCH GATE, MUMBAI, REPRESENTED BY ITS SENIOR MANAGER LEGAL AMAL JOSE VARGHESE, PIN – 400020. BY ADVS. K.J.SAJI ISAAC ELIZABETH VARKEY JITHIN SAJI ISAAC ABHISHEK S. KUMAR JOSHUA SEBASTIAN RESPONDENTS/PETITIONERS 1 TO 5 & RESPONDENT NO.2: 1 AMBILY G AGED 41 YEARS W/O LATE REJEESH R, 73 B, KRISHNA, VEMPALA PO, PATHANAMTHITTA, PIN – 689101. 2 YADHUKRISHNA R NAIR AGED 16 YEARS, S/O LATE REJEESH R, 73 B, KRISHNA, VEMPALA PO, PATHANAMTHITTA REPRESENTED BY 1ST RESPONDENT, AMBILY G, PIN – 689101. 3 VIDHU KRISHNA AGED 11 YEARS, S/O LATE REJEESH R, 73 B, KRISHNA, VEMPALA PO, PATHANAMTHITTA REPRESENTED BY 1ST RESPONDENT, AMBILY G, PIN - 689101 2025:KER:29529 W.P (C) No.13518 of 2025 2 4 DEVIKRISHNA R NAIR, AGED 8 YEARS, D/O LATE REJEESH R, 73 B, KRISHNA, VEMPALA PO, PATHANAMTHITTA REPRESENTED BY 1ST RESPONDENT, AMBILY G, PIN – 689101. 5 LEELAMANI, AGED 77 YEARS, M/O LATE REJEESH R, LEELA BHAVAN, PERUMPALAM PO, ALAPPUZHA, PIN – 688570. 6 HDFC HOME LOANS HDFC HOUSE, RAVIPURAM JUNCTION, M.G ROAD, KOCHI ERNAKULAM REP BY ITS MANAGER, PIN - 682015 THIS WRIT PETITION (CIVIL) HAVING COME UP FOR ADMISSION ON 04.04.2025, THE COURT ON THE SAME DAY DELIVERED THE FOLLOWING: 2025:KER:29529 W.P (C) No.13518 of 2025 3 C.S.DIAS, J. ============================= W.P (C)No.13518 of 2025 ============================= Dated this the 4th day of April, 2025 J U D G M E N T Respondents 1 to 5 filed O.P.No.73/2023 before the Permanent Lok Adalat, Thiruvananthapuram ('Adalat', in short) under Section 22C of the Legal Services Authorities Act, 1987, against the petitioner insurance company and the 6th respondent bank, to direct the petitioner to pay the home loan insurance amount to the 6th respondent. It was their case that the late Rajesh. R.(deceased) ― the husband of the 1st respondent, the father of respondents 2 to 4 and son of the 5th respondent ― had availed a housing loan from the 6th respondent. To secure the loan, the deceased had taken a home loan insurance from the petitioner. On 6.11.2022, the deceased lost his life due to a heart attack. However, the petitioner rejected the claim, stating that the deceased's illness was not covered under the policy. Aggrieved by the rejection of the claim, the respondents 1 to 5 filed the petition before the Adalat. By Ext.P6 Award, the Adalat 2025:KER:29529 W.P (C) No.13518 of 2025 4 allowed the petition, by directing the petitioner to pay the respondents 1 to 5 Rs.37,57,837/- with interest. Ext.P6 Award is erroneous and wrong. Hence, the writ petition. 2. Heard; the learned counsel for the petitioner. 3. The learned counsel for the petitioner argued that Ext.P2 policy covers only nine major illnesses, including myocardial infarction. As the deceased lost his life due to ‘acute coronary syndrome’, the petitioner was justified in repudiating the claim. Therefore, Ext.P6 Award is erroneous and liable to be set aside. 4. Section 22E of the Legal Services Authorities Act, 1987 (‘Act’, in short) states that an award passed by an Adalat, either on merits or in terms of a settlement, is final and binding on all parties, is deemed to be a decree of a civil court and shall not be called in question in any original suit, application or execution proceedings. 5. In Bar Council of India v. Union of India [(2012) 8 SCC 243], the Honourable Supreme Court has held that even though the Legal Services Authorities Act does not provide for an appeal against an award passed by the Permanent Lok Adalat, if 2025:KER:29529 W.P (C) No.13518 of 2025 5 a party has a grievance against the award, their remedy is to invoke the High Court’s extraordinary/supervisory jurisdiction under Articles 226/227 of the Constitution of India. 6. An analysis of the scheme of the Act, especially the conferment of adjudicatory powers on the Permanent Lok Adalat and the conscious exclusion of a remedy of appeal against the awards, demonstrates that the intention of the legislature is to ensure the speedy resolution of disputes. 7. It is trite that a writ of certiorari under Article 226 of the Constitution is issued to correct errors of jurisdiction where a Court or Tribunal acts with material irregularity or violates the principles of natural justice and not to re-appreciate the evidence or act like a Court of appeal. (Read the decision of the Hon’ble Supreme Court in Syed Yakub v K S Radhakrishnan and others (AIR 1964 SC 477). 8. While considering the analogous provisions under the industrial law, the Hon’ble Supreme Court has held that, unless the High Court finds that the award of a Labour Court or Industrial Tribunal is based on no evidence or is perverse, the 2025:KER:29529 W.P (C) No.13518 of 2025 6 High Court shall not proceed to reappreciate the evidence under Articles 226 or 227 of the Constitution of India. (Read the decisions in Indian Overseas Bank v IOB Staff Canteen Workers Union and Another (2000) 4 SCC 245; Anoop Sharma v Executive Engineer, Public Health Division No.1, Panipat,Haryana, (2010) 5 SCC 497; and Pepsico India Holding (P) Ltd. v Krishna Kant Pandey, (2015) 4 SCC 270). 9. Now, coming back to the facts of the present case, on 6.11.2022, the deceased was taken to a laboratory for an ECG due to chest pain. However, he collapsed and lost consciousness in the laboratory and was rushed to the Thiruvalla Taluk Hospital. The deceased was referred to the Pushpagiri Medical College, where he breathed his last at 8.50 p.m. As per the treatment records, the deceased lost his life due to 'acute coronary syndrome'. 10. The petitioner’s principal defence was that, Ext.P2 policy covers only nine major illnesses, namely., (i) Cancer, (ii) End Stage Renal Failure, (iii) Multiple Sclerosis with persisting symptoms, (iv) Major Organ Transplant (v) Heart Valve Replacement (vi) Coronary Artery Bypass Graft (vii) Stroke (Viii) 2025:KER:29529 W.P (C) No.13518 of 2025 7 Paralysis and (ix) Myocardial Infarction. The deceased lost his life due to ‘probable acute coronary syndrome’ with ECG suggestive of ventricular fibrillation”. Ventricular fibrillation is a malfunction of the normal beating rhythm of the lower chambers of the heart. A heart attack is caused due to blockages in blood vessels that supply oxygen to the heart. Acute coronary syndrome is not myocardial infarction. Therefore, the petitioner was justified in repudiating the claim. 11. The first respondent and two Doctors were examined as PWs.1 to 3, and Exts.A1 to A11 were marked in evidence. The respondents marked Exts.B1 to B4 in evidence. PW2, the Civil Surgeon, testified that ventricular fibrillation is the next stage of myocardial infarction, which would cause the death of a patient. Likewise, PW3, the Senior Consultant Cardiothoracic Surgeon, deposed that unstable angina occurs when the block becomes critical, and the next stage is acute coronary syndrome. If no proper treatment is given, it would turn out to be myocardial infarction, and the next stage is the death of the patient. Ext.A5 treatment certificate also proved that the deceased was in an unresponsive state and the initial rhythm 2025:KER:29529 W.P (C) No.13518 of 2025 8 was ventricular fibrillation when he was taken to the Medical College Hospital. 12. After evaluating the pleadings and materials on record, the Adalat concluded that the deceased lost his life due to a massive cardiac attack/myocardial infarction. The Adalat also relied on the decision of the Hon’ble Supreme Court in Gurmel Singh v. Branch Manager, National Insurance Co. Ltd [2022 KHC OnLine 6582], wherein it is held that an insurer should not be too technical and ask for the documents which the insured is not in a position to produce. Thus, the Adalat held that respondents 1 to 5 could not be expected to produce documents to prove the electrocardiogram changes and the elevation of enzymes, troponins, etc., in an emergency. Furthermore, the petitioner has not let in any contra evidence to discredit the materials produced by respondents 1 to 5, other than for producing the certain documents admitted by both sides. Accordingly, the Adalat allowed the petition and directed the petitioner to pay the respondents 1 to 5 the assured amount. 13. After bestowing my anxious consideration to the findings and reasonings in Ext.P6 Award, I find that the Adalat 2025:KER:29529 W.P (C) No.13518 of 2025 9 has properly appreciated the facts and materials on record and passed a reasoned order. I do not find any illegality, material irregularity or error of jurisdiction in the award warranting interference by this Court under Article 226 of the Constitution of India. The writ petition is meritless and does not deserve to be admitted. Resultantly, the writ petition is dismissed at the threshold. Sd/- C.S.DIAS, JUDGE ma/05.04.2025 2025:KER:29529 W.P (C) No.13518 of 2025 10 APPENDIX OF WP(C) 13518/2025 PETITIONER EXHIBITS Exhibit P1 TRUE COPY OF THE PATIENT TREATMENT SUMMARY OF THE INSURED MARKED AS EXHIBIT B3 IN THE AWARD OF THE PERMANENT LOK ADALAT Exhibit P2 TRUE COPY OF THE RELEVANT PAGES OF THE POLICY DOCUMENT Exhibit P3 TRUE COPY OF THE WRITTEN STATEMENT FILED BY THE PETITIONER HEREIN IN OP NO. 73 OF 2023 BEFORE THE PERMANENT LOK ADALAT, THIRUVANANTHAPURAM Exhibit P4 TRUE COPY OF THE DEPOSITION OF PW2 IN IN OP NO. 73 OF 2023 BEFORE THE PERMANENT LOK ADALAT, THIRUVANANTHAPURAM Exhibit P5 TRUE COPY OF THE DEPOSITION OF PW3 IN OP NO. 73 OF 2023 BEFORE THE PERMANENT LOK ADALAT, THIRUVANANTHAPURAM Exhibit P6 TRUE COPY OF THE AWARD IN OP NO. 73 OF 2023 DATED 18.01.2025 BEFORE THE PERMANENT LOK ADALAT, THIRUVANANTHAPURAM