C.P.Ravindranath Menon vs United India Insurance Company Limited.

2026:BHC-OS:10420-DB
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Salgaonkar
IN THE HIGH COURT OF JUDICATURE AT BOMBAY
MANDIRA
MILIND
SALGAONKAR
Digitally signed by
MANDIRA MILIND
SALGAONKAR
Date: 2026.04.23 17:53:40
+0530
ORDINARY ORIGINAL CIVIL JURISDICTION
WRIT PETITION NO.2474 OF 2023
C.P.Ravindranath Menon .. Petitioner
Versus
United India Insurance Company .. Respondents
Limited & Anr.
…
Mr.Subit Chakrabarti with Ms.Khushnumah Banerjee i/b
Vidhii Partners for the Petitioner.
Ms.Varsha Chavan for the Respondent No.1.
CORAM: BHARATI DANGRE &
MANJUSHA DESHPANDE, JJ.
th
DATE : 20 APRIL, 2026
...
ORAL JUDGMENT [PER BHARATI DANGRE, J.]
1. In availing the benefit of Group Health Insurance, the
Petitioner placed his claim before his employer i.e. Export
Import Bank of India through his communication dated
24/05/2022.
The four claims for distinct period on behalf of the
Petitioner himself and in respect of his spouse, aggregated to
Rs.1,13,487.49/-.The communication also requested processing
by the TPA/Insurance Company. Since this claim is turned
down by United India Insurance Co. Ltd., by relying upon the
time-lines set out in the insurance policy, the Petitioner is
before us, seeking the relief of quashing and setting aside of
the decision of the Insurance Company, rejecting the claim of
the Petitioner on the ground that it is time barred.
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2. By consent of the parties, we issue Rule, which is made
returnable forthwith.
The Petitioner purchased a Group Health Policy from
United India Insurance Co. Ltd. for a period covering from
01/04/2021 and ending in the midnight of 31/03/2022. The
insurance policy, with the type ‘family floater basis’, stipulated
the terms and conditions and the policy stipulated various
expenses to be covered, by setting out the eligibility criteria as
well as the claim procedure.
Clause 7.2 of the said policy under the caption,
‘procedure for reimbursement of claims’, made it imperative
for the insured person to submit necessary documents to
TPA/the company within the prescribed time-limit as specified
thereunder and the relevant portion of the said policy reads
thus :-

3. Clause 7.4 of the policy provided for the documents to be
submitted by the insured in support of the claim, which
included the documents like the medical history of the patient;
bills and payment receipts duly supported by the prescription
from attending medical practitioner/hospital; discharge
certificate/ summary from the hospital; cash-memo/bills/
invoices from the diagnostic centre/hospital/chemist; payment
receipt from Doctors, Surgeons, Anaesthetist etc. The note
appended to clause 7.4 also clearly stipulated thus :-
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“(iii) Any delay in notification or submission may be condoned
on merit where delay is proved to be for reasons beyond the
control of the Insured Person”.
Similarly, in clause 8 of the policy, under caption “General
terms and conditions”, clause 8.2 clearly stipulated thus :-
“The terms and conditions of the policy must be fulfilled by the
Insured Person for the Company to make any payment for
claim (s) arising under the policy.”
4. The claim set out by the insured on 24/05/2022 is
summarized below :-

5. The Insurance Company refused to consider the claim
and vide its e-mail, declined the claim to be entertained,
apparently since it was beyond the period of limitation
prescribed in the policy.
6. When the Insurance Company communicated with the
Petitioner/insured, that the claim was beyond the prescribed
period as set out in the policy, the Petitioner relied upon the
decision of the Apex Court in the case of The Oriental
1
Insurance Company Ltd. Vs. Sanjesh & Anr. , where the
imposition of a condition of time-line in lodging of a claim in a
policy was held to be contrary to Section 28(b) of the Indian
Contract Act, 1872 and was declared to be void.
1 2022 SCC Online SC 806
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However, the Insurance Company, by submitting that the
decision of the Apex Court was based on factual aspect and the
case being of a contract entered between the parties, stuck up
to its stand by asserting that the time-line is specified for
submission of the claim and since the insurance policy clearly
contemplated that bills more than 90 days old will not be
paid/reimbursed, refused to entertain the claim of the
Petitioner.
7. Ms.Chavan, the learned counsel representing the
Insurance Company, would invite our attention to the policy
which the Petitioner had availed and she would submit that
since it is a contract between the parties and the Petitioner
agreed to all the stipulations therein, which clearly
contemplated that bill more than 90 days will not be
paid/reimbursed, he is bound by the same and since the
reimbursement is claimed beyond the said period, the
Insurance Company has rightly refused the claim.
8. The learned counsel for the Petitioner has placed heavy
reliance upon the decision of the Apex Court in the case of
Sanjesh (supra) and we have perused the said decision, which
is placed before us.
On 11/03/2022, the Apex Court, considered the same
argument advanced on behalf of the Insurance Company and
in the said case, by the Oriental Insurance Company Limited,
that the claim was not filed within a period of one month or
extending condonable period of one month. Dealing with the
said submission, the Apex Court observed thus :-
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“We do not find any merit in the said arguments in view of Section
28 of the Indian Contract Act, 1872 (for short, ‘the Act’) which
reads as under:-
“28. Agreements in restraint of legal proceedings, void.- [Every
agreement,-
(a) by which any party thereto is restricted absolutely from enforcing
his rights under or in respect of any contract, by the usual legal
proceedings in the ordinary tribunals, or which limits the time within
which he may thus enforce his rights;
or
(b) which extinguishes the rights of any party thereto, or discharges
any party thereto, from any liability, under or in respect of any
contract on the expiry of a specified period so as to restrict any party
from enforcing his rights, is void to the extent.
In view of the aforesaid section, the condition of lodging claim
within a period of one month, extendable by another one month is
contrary to Section 28 of the Act and thus void.
In view of the said fact, we do not find any ground to interfere
with the order passed by the High Court.”
By relying upon sub-clause (b) of Section 28, the Apex
Court thus ruled that the condition of lodging claim within a
period of one month, extendable by another one month is
contrary to Section 28 and this condition was held to be void.
9. In the wake of the aforesaid authoritative
pronouncement, when we perused the insurance policy, which
the Petitioner had availed the benefit of, with a specific
stipulation to the effect that no claim shall be entertained after
more than 90 days and when the policy provide that for the
claim of reimbursement in respect of hospitalisation, day care
and pre-hospitalisation expenses, the time-limit prescribed
was within 30 days from discharge from the hospital and in
case of reimbursement of post-hospitalisation expenses, the
time-limit for setting up the claim was within 15 days from
completion of post-hospitalisation treatment, with a specific
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clause that no claim shall be entertained beyond 90 days, we
find that the said clause imposing a limitation on invocation of
right under the policy only on the ground that it was beyond
the specified period, therefore, clearly attract clause (b) of
Section 28 of the Indian Contract Act.
Section 28 of the Indian Contract Act prescribe that any
agreement, which extinguishes the rights of any party thereto,
or discharges any party thereto, from any liability, under or in
respect of any contract on the ground of expiry of a specified
period, so as to restrict any party from enforcing his right, is
void to that extent, and in our view, such an inhibition in
insurance policy restricting the period of availing the benefit
under the policy, which the insured is otherwise entitled to
avail, cannot be sustained and has to be declared as void and
non-est in the wake of the decision of the Apex Court.
10. The learned counsel for the Insurance Company, has
placed reliance on the decision of the Apex Court in the case of
United India Insurance Co. Ltd. Vs. Harchand Rai Chandan
2
Lal , in support of her submission that, the insurance policy is
a contract between the parties, where the insurer undertakes
to compensate the loss suffered by the insured on account of
risk covered by the insurance policy, and therefore, the terms
of the agreement have to be strictly construed to determine
the extent of the liability of the insurance and the insured
cannot claim anything more than what is covered by the
insurance policy.
We have no difficulty in accepting the said proposition in
law, and definitely the insurance policy is a contract and,
2 (2004) 8 SCC 644
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therefore, strictly governed by the Indian Contract Act and if
there is an embargo, which is created under Section 28, in the
form of any restraint being imposed on any agreement, and the
one which is specified in clauses (a) and (b) of Section 28, the
policy being a contract, will strictly be enforceable.
She would also rely upon the the proposition laid down in
the said decision that the terms of contract have to be strictly
read and natural meaning be given to it and no outside aid
should be sought. The argument is reproduced only to be
rejected, since the contracts are governed by the Indian
Contract Act and if Section 28 is the facet of this contract, then
it must come into operation with full force.
11. The Writ Petition is, therefore, allowed in terms of prayer
clauses (a) and (b).
Respondent No.1-Insurance Company shall reimburse
the amount under the policy within a period of eight (8) weeks
from today, with interest at the rate of 6% p.a, when it become
due and payable.
(MANJUSHA DESHPANDE, J.) (BHARATI DANGRE, J.)
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