ASMA QAMAR vs JUBILEE LIFE INSURANCE Ss — 2023 CLD 1283 INSURANCE-TRIBUNAL-LAHORE

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ASMA QAMAR VS JUBILEE LIFE INSURANCE Ss. 75, 76, 77, 118 & 122---Insurance claim---Utmost good faith---Deceptive marketing conduct---Language used in the policy documents---Interpretation of the contract (policy documents) executed between the policy-holder and Insurance Company---Claim of the petitioner (policy-holder) was that she was entitled for recovery of assured amount/sum on attaining maturity of her insurance policy as per the policy documents---Contention of the respondent (insurance company) was that the petitioner was entitled for surrendered value only in light of nature of insurance policy being Unit link policy---Validity---Respondent/company, submitted that there was a schedule annexed with policy, and that the policy proceeds were to be paid according to the said schedule---Said schedule only spoke about different amounts which were to be paid in different years to the policy holder on surrendering the policy, whereas in the present case, the petitioner was claiming the policy proceeds on the maturity of the policy which was mentioned in the policy schedule---Business of insurance was based on the principle of "utmost good-faith" and the law required each party to act towards other party in respect of any matter arising in relation to the insurance with utmost good-faith---Policy documents, in the present case, although were signed by the petitioner/policy-holder but the same, on the face of it, were deceptive and mis-leading because the technicalities used in said documents had neither been explained nor disclosed to the policy-holder---Besides, in the written statement respondent/company had nowhere claimed/mentioned that the respondent/company or its agent had fulfilled the responsibilities as required by the law, therefore, respondent/company had failed to discharge its obligations as enshrined in S. 75 of the Insurance Ordinance, 2000---Section 77 of the Insurance Ordinance, 2000 required that while constructing or drafting the policy documents (proposal form and claim forms etc.) a reasonable effort should be made to use plain and simple language---Contract (policy documents) was to be construed and interpreted objectively and the policy-holder was entitled to take benefits of the ambiguities created by the respondent/company in light of principle of contra-proferentem---Petitioner on the maturity of the policy had, admittedly, duly applied to the respondent/company for payment of policy proceeds on printed forms, namely "Request Form for Policy Maturity Proceeds"---It was nowhere mentioned in said printed forms, having been provided by the respondent/company, that on maturity of the policy, the policy holder would receive surrender value instead of the sum assured---Payment of total premium by the petitioner was proved from the contents of the policy and she had applied on the printed forms of the company after eight days of attaining maturity of term of policy, therefore, the petitioner was entitled to receive total sum assured amount of Rs.800,000/- along with liquidated damages under S. 118 of the Insurance Ordinance, 2000---Respondent/company knowing that the petitioner was entitled to the sum assured as per terms of the policy documents unnecessarily delayed the matter for a long time and dragged the petitioner into litigation, therefore, petitioner was also entitled for the costs---Insurance petition was allowed with costs of Rs.50,000.

ASMA QAMAR vs JUBILEE LIFE INSURANCE Ss — 2023 CLD 1283 INSURANCE-TRIBUNAL-LAHORE

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