{"id":286612,"date":"2023-03-09T12:00:22","date_gmt":"2023-03-09T06:30:22","guid":{"rendered":"https:\/\/www.scconline.com\/blog\/?p=286612"},"modified":"2023-03-10T17:55:29","modified_gmt":"2023-03-10T12:25:29","slug":"newborn-baby-includes-full-term-or-pre-term-babies-bombay-high-court-legal-research-legal-news-updates","status":"publish","type":"post","link":"https:\/\/www.scconline.com\/blog\/post\/2023\/03\/09\/newborn-baby-includes-full-term-or-pre-term-babies-bombay-high-court-legal-research-legal-news-updates\/","title":{"rendered":"\u201cNewborn baby includes both \u2018full term\u2019 or \u2018pre-term\u2019\u201d; Bombay High Court directs payment of insurance claim"},"content":{"rendered":"<p><script type=\"text\/javascript\">\n\tdocument.title = 'Newborn baby includes full term or pre-term babies: Bombay HC | SCC Blog'\n\tdocument.querySelector('meta[name=\"description\"]').setAttribute(\"content\", \"Bombay High Court rejected the insurance company's exclusion of premature babies from newborn babies and directed payment of claim to the petitioner.\");\n<\/script><\/p>\n<div style=\"text-align: justify; line-height: 150%;\">\n<p style=\"margin-bottom: 3%;\"><b>Bombay High Court:<\/b> In a writ petition seeking declaration of entitlement to recovery of all expenses incurred for treatment of newborn twin babies under the insurance policy, seeking mandamus to the insurance company for disbursing the amount, the Division Bench of G.S. Patel and Neela Gokhale, JJ. held the distinction between a &#8216;new-born&#8217; and a &#8216;premature baby&#8217; or a baby born &#8216;pre-term&#8217; unreasonable and unjust, and directed the insurance company to pay the claim of Rs 11,05,953 to the petitioner.<\/p>\n<p style=\"margin-bottom: 3%;\">Facts of the matter reveal that the petitioner took two medical policies in 2007 covering a claim for Rs 20 lakhs, which were renewed periodically. On 3-09-2018, the petitioner delivered premature twin babies in an Emergency Lower Segment Caesarean Section (LSCS), who were admitted to Neo-Natal Intensive Care Unit (NICU) for life-saving treatment. The petitioner submitted a claim to the insurance company claiming the expenses incurred at the NICU under the insurance policies for Rs 11,05,953 for twin babies, which was repudiated by the insurance company citing Clause 3.11 of the policy saying that expenses incurred towards post-natal care, pre-term or pre-mature care or any such expense incurred in connection with delivery of such newborn baby, or the Congenital Eternal Anomaly of the newborn baby were not covered. Petitioner claims that such exclusion by the insurance company violates her as well as the newborn twin babies&#8217; fundamental rights under Article <a href=\"https:\/\/www.scconline.com\/DocumentLink.aspx?q=JTXT-0001574870\">14<\/a> and <a href=\"https:\/\/www.scconline.com\/DocumentLink.aspx?q=JTXT-0001574949\">21<\/a> of the <a href=\"https:\/\/www.scconline.com\/DocumentLink.aspx?q=JTXT-0002726967\">Constitution of India<\/a>.<\/p>\n<p style=\"margin-bottom: 3%;\">Analysing the maintainability of the petition, the Court referred to <i>LIC of India<\/i> v. <i>Asha Goel<\/i>, <a href=\"http:\/\/www.scconline.com\/DocumentLink\/m4KVkcn6\">(2001) 2 SCC 160<\/a> wherein, the Court allowed the writ petition and clarified the extraordinary and expansive jurisdiction under Article <a href=\"https:\/\/www.scconline.com\/DocumentLink.aspx?q=JTXT-0001574969\">226<\/a> of the <a href=\"https:\/\/www.scconline.com\/DocumentLink.aspx?q=JTXT-0002726967\">Constitution<\/a> for considering the question of contractual dispute in insurance policy. The Court also mentioned the case of <i>Biman Krishna Bose<\/i> v. <i>United India Insurance Co. Ltd.<\/i>, <a href=\"http:\/\/www.scconline.com\/DocumentLink\/sLj1dXN4\">(2001) 6 SCC 477<\/a>, wherein, it washeld insurance companies acquiring the trappings of &#8216;State&#8217; as other authorities under Article <a href=\"https:\/\/www.scconline.com\/DocumentLink.aspx?q=JTXT-0001574842\">12<\/a> of the <a href=\"https:\/\/www.scconline.com\/DocumentLink.aspx?q=JTXT-0002726967\">Constitution<\/a> and ought toactreasonably and fairly while dealing with customers.<\/p>\n<p style=\"margin-bottom: 3%;\">The Court observed that the present matter surrounds interpretation of Clause 3.11 of the insurance policy and none of the other facts. Thus, the Court refused to dismiss the present petition on the grounds of maintainability.<\/p>\n<p style=\"margin-bottom: 3%;\">The Court noted that coverage for newborn babies was introduced in the same year when the petitioner&#8217;s twins were born and extended the benefit to all policy holders without additional premium and held irrelevant the insurance company&#8217;s contention that the newborn babies were not covered under the policy. The Court also scrutinised Clause 3.11 of the policy and observed that the same covers a newborn baby for &#8216;any illness or injury&#8217;. The Court clarified that the expenses related to illness or injury are construed to be the same as expenses of post-natal care, pre-term or premature babies.<\/p>\n<p style=\"margin-bottom: 3%;\">The Court found the distinction of newborn and premature babies unreasonable and commented that &#8220;the distinction between a &#8216;new-born&#8217; and a &#8216;premature baby&#8217; or a baby born &#8216;pre-term&#8217; is also baseless as a new-born baby can be one which is born &#8216;full term&#8217; or &#8216;pre-term&#8217;. A full-term baby does not become more &#8216;newer&#8217; any more than a &#8216;pre-term&#8217; baby becomes an &#8216;earlier born&#8217; or, to make it even more pointed, &#8216;old born&#8217;.&#8221; The Court supported these lines with Clause 29 of circular dated 22-07-2022 issued by the Insurance Regulatory and Development Authority of India (&#8216;IRDAI&#8217;) defining the term &#8216;new-born baby&#8217; as &#8220;a baby born during the policy period and aged up to 90 days.&#8221;, further clarified through circular dated 12-10-2022.<\/p>\n<p style=\"margin-bottom: 3%;\">The Court held the insurance company&#8217;s rejection of petitioner&#8217;s claim contrary to law, unreasonable, arbitrary and liable to be set aside. Thus, the Court directed the insurance company to honour the petitioner&#8217;s collective claim of Rs.11,05,953 with an interest @9% p.a. from the date of claim till actual payment.<\/p>\n<p style=\"margin-bottom: 3%;\">The Court also directed the insurance company to pay Rs 5 lakhs as costs of litigation, additionally prompted by its defiance in obeying IRDAI&#8217;s directives and commented that &#8220;the aim of reposing faith in the insurance company, is pre-eminently to guard\/provide against dangers which beset human life and dealings, by agreeing to pay the consideration in the form of premiums, as per the terms of the policy&#8221;.<\/p>\n<p style=\"margin-bottom: 3%;\">[<span style=\"font-weight: bold; color: #632423;\">Rita Kirit Joshi v. New India Assurance Company, <a href=\"http:\/\/www.scconline.com\/DocumentLink\/z41vvG1h\">2023 SCC OnLine Bom 511<\/a>, judgment dated 1-03-2023<\/span>]<\/p>\n<p style=\"text-indent: 18pt;\"><strong><span style=\"color: #000080;\">*Judgment authored by: Justice Neela Gokhale.<\/span><\/strong><\/p>\n<hr\/>\n<p>Advocates who appeared in this case:<\/p>\n<p style=\"margin-left: 18pt;\">For Petitioner: Advocate Ashok Shetty, Advocate Swapnil P. Kamble;<\/p>\n<p style=\"margin-left: 18pt;\">For Respondents: Advocate D.S. Joshi, Advocate Komal B. Shah.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p><i>Bombay High Court rejected the insurance company&#8217;s contentions and directed them to pay the claim of Rs 11,05,953 to the petitioner with interest and Rs 5 lakhs as costs of litigation.<\/i><\/p>\n","protected":false},"author":67513,"featured_media":285808,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[3,10],"tags":[2518,31265,55849,55850,55851],"class_list":["post-286612","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-casebriefs","category-highcourts","tag-Bombay_High_Court","tag-insurance-policy","tag-new-india-assurance-company","tag-newborn-babies","tag-premature-babies"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.4 (Yoast SEO v26.4) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>\u201cNewborn baby includes both \u2018full term\u2019 or \u2018pre-term\u2019\u201d; 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Karnik J., granted bail to the petitioner on furnishing P.R. bond in the sum of Rs 10,000\/- with one or more sureties\u2026","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2022\/11\/Bombay-High-Court-1.png?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":320373,"url":"https:\/\/www.scconline.com\/blog\/post\/2024\/04\/19\/bombay-high-court-grants-no-bail-to-man-who-allegedly-murdered-neighbor-to-fake-own-death-to-obtain-insurance-money-legal-news\/","url_meta":{"origin":286612,"position":1},"title":"Man fakes own death to claim insurance after allegedly murdering neighbor : Bombay HC refuses to grant bail","author":"Editor","date":"April 19, 2024","format":false,"excerpt":"To avail the benefit of insurance policy of Rs.1,50,00,000\/-, an innocent person was killed to portray that the accused had met with an accident and in the said accident, the car in which the accused was travelling caught fire and got burnt.","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"Bombay High Court","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/02\/Bombay-High-Court.webp?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/02\/Bombay-High-Court.webp?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/02\/Bombay-High-Court.webp?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/02\/Bombay-High-Court.webp?resize=700%2C400&ssl=1 2x"},"classes":[]},{"id":180274,"url":"https:\/\/www.scconline.com\/blog\/post\/2018\/01\/08\/bombay-hc-allows-withdrawal-part-compensation-amount-insurance-company-companys-failure-file-reply\/","url_meta":{"origin":286612,"position":2},"title":"Bombay HC allows withdrawal of a part of compensation amount from insurance company on Company\u2019s failure to file reply","author":"Saba","date":"January 8, 2018","format":false,"excerpt":"Bombay High Court: A Single Judge Bench comprising of NM Jamdar, J. heard a miscellaneous civil application whereby the applicants had requested to grant them the permission to withdraw an amount of Rs. 3,00,000\/- so that it may be utilized for medical expenses that they had incurred. The applicants had\u2026","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":359647,"url":"https:\/\/www.scconline.com\/blog\/post\/2025\/09\/10\/bom-hc-on-insurance-claim-by-tata-aig-to-widow\/","url_meta":{"origin":286612,"position":3},"title":"\u2018Conduct far from bona fide\u2019: Bombay HC upholds award of Insurance Ombudsman directing Tata AIG to pay insurance claim of Rs. 27 lakh to widow","author":"Editor","date":"September 10, 2025","format":false,"excerpt":"The Court stated that IIFL and TATA AIG entered into internal business arrangement where IIFL, virtually acted as an insurance agent of TATA AIG while selling the policy to its borrower. The present case does not involve voluntary application by the insured for insurance policy.","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"insurance claim by TATA AIG to widow","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2025\/09\/insurance-claim-by-TATA-AIG-to-widow.webp?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2025\/09\/insurance-claim-by-TATA-AIG-to-widow.webp?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2025\/09\/insurance-claim-by-TATA-AIG-to-widow.webp?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2025\/09\/insurance-claim-by-TATA-AIG-to-widow.webp?resize=700%2C400&ssl=1 2x"},"classes":[]},{"id":236154,"url":"https:\/\/www.scconline.com\/blog\/post\/2020\/09\/23\/bom-hc-if-there-is-breach-of-policy-condition-is-the-insurance-company-still-liable-to-pay-compensation-hc-explains-in-a-motor-accident-case\/","url_meta":{"origin":286612,"position":4},"title":"Bom HC | If there is breach of policy condition, is the Insurance company still liable to pay compensation? HC explains in a motor accident case","author":"Bhumika Indulia","date":"September 23, 2020","format":false,"excerpt":"Bombay High Court:\u00a0Anil S. Kilor, J., decided an appeal wherein the claim petition was rejected by the Motor Accident Tribunal on certain grounds. FACTS Deceased Baby was traveling in a jeep owned by respondent 1. It has been stated that the vehicles' driver was driving at a high speed and\u2026","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":323753,"url":"https:\/\/www.scconline.com\/blog\/post\/2024\/06\/06\/dhc-directs-state-to-file-atr-after-death-of-7-newborn-babies-at-hospital-scc-times\/","url_meta":{"origin":286612,"position":5},"title":"Delhi HC directs State to file an Action Taken Report after seven new-born babies die in a fire at Baby Care New Born Hospital","author":"Editor","date":"June 6, 2024","format":false,"excerpt":"A news report dated 28-05-2024, stated that out of almost 1000 hospitals registered with the Delhi Government, only 196 have fire NOC, i.e., roughly 20% of the total hospitals have fire NOCs while the rest are at risk of a fire hazard.","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"Delhi High Court","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/02\/Delhi-High-Court.webp?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/02\/Delhi-High-Court.webp?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/02\/Delhi-High-Court.webp?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/02\/Delhi-High-Court.webp?resize=700%2C400&ssl=1 2x"},"classes":[]}],"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/posts\/286612","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/users\/67513"}],"replies":[{"embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/comments?post=286612"}],"version-history":[{"count":0,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/posts\/286612\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/media\/285808"}],"wp:attachment":[{"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/media?parent=286612"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/categories?post=286612"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/tags?post=286612"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}