UII had rejected the claims saying Sreesanth had a pre-existing toe injury which was not disclosed by Rajasthan Royals
New Delhi: State owned United India Insurance has appealed to the Supreme Court challenging an order of the National Consumer Disputes Redressal Commission (NCDRC )on paying a claim of Rs 82 lakh to its insured Rajasthan Royals, one of the owners for the IPL Cricket Tournament of 2012.
A bench of Justices Vikram Nath and Sandeep Mehta is currently hearing the case.
Rajasthan Royals had lodged a claim with UII on account of S. Sreesanth’s injury at the time, which rendered him incapable of playing in the tournament.
UII had rejected the claims saying . Sreesanth had a pre-existing toe injury which was not disclosed by Rajasthan Royals.
For the 2012 IPL season, Rajasthan Royals had obtained a ‘Special Contingency Insurance for Player Loss of Fees Cover’ (policy) for a total sum of Rs.8,70,75,000/- from UII. In terms coverage , UII was liable to pay Rajasthan Royals for any loss of monies paid/payable to the contracted players due to their non-appearance in the tournament.
The policy was enforced from 28.03.2012. On that day itself, one of the insured players – S Sreesanth – suffered a knee injury in a practice match at Jaipur. After treatment and analysis, he was found unfit to play in the IPL 2012 tournament due to the knee injury.
A surveyor was appointed by the appellant, who reported that the injury was on account of a ‘sudden unforeseen and unexpected event’ and the claim was within the scope of the policy.
However, claim by Rajasthan Royals was repudiated by UII on the ground that an existing injury to the insured player (Sreesanth) was not disclosed by it to the insurer.
UII had rejected the claims saying “undeniably, the player was suffering from a career threatening toe injury in both legs and was out of action Mace August 2011. Such injury was known to Rajasthan Royals , despite which he appears to have been selected…it clearly appears that it was not a fit player who was fortuitously or accidently injured after been contracted by the team & after insurance which resulted in his unavailability for the season, but a preexisting injury/condition from which the player had never fully recovered notwithstanding expectations. The unavailability of the player is not attributable entirely to an insured peril, but greatly due to the excluded cause of pre existing injury”.
Aggrieved, Rajasthan Royals approached the NCDRC which had directed UII to settle the claim.
“When the fact of a knee injury is established through evidence such a X-Rays, MRI reports and expert opinion of doctors, the repudiation on the basis of a pre-existing toe injury, that has not been established to have occurred/recurred during the period of insurance cover, makes the repudiation a deficiency in service”, the Commission had said in its order.