• Requirement to implead Insurance Co. in case of Medico-legal claims

Dear Expert, 
I am currently working for a leading healthcare provider company. We have obtained Error and Ommission policy from a General Insurance Company. My query is the following:
In case of any medico legal claim / case , do we need to implead the Insurance Company as a party in the case or simple intimation of case / claim to insurance company is sufficient? Secondly, if not impleaded , can the Insurance co. deny to pay for the claims. At what stage the Insurance co should be added as a party?
Asked 4 years ago in Civil Law

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14 Answers

you have to implead insurance company as party to the case

2) no reliefs can be claimed against insurance company in court if it is not made party to the case

3) as and when legal proceedings are instituted insurance company should be made a party defendant

Ajay Sethi
Advocate, Mumbai
87947 Answers
6207 Consultations

5.0 on 5.0

The insurance company should be impleded as party from point of intiation of proceeding if case is filed and it is not impleded as party than application for impleading necessary party can be moved in court. Without making them party they are not party to proceeding and they cannot be asked to pay claim.

Shubham Jhajharia
Advocate, Ahmedabad
25516 Answers
179 Consultations

5.0 on 5.0

In already decided cases you cannot implead them as party where the order is already given by the court.

In ongoing case you can put an application before court to add necessary party and court can decide on application accordingly and add them as party.

Shubham Jhajharia
Advocate, Ahmedabad
25516 Answers
179 Consultations

5.0 on 5.0

where order has already been passed and case disposed of you cannot add insurance company as party

2) in pending consumer cases make application for amendment of complaint to add insurance company as party

3) consumer forum would allow amendment application

Ajay Sethi
Advocate, Mumbai
87947 Answers
6207 Consultations

5.0 on 5.0

Yes the insurance company has to be made the party, it has to be made the party at the starting of the case only, since the company has to bear the payment.

Anilesh Tewari
Advocate, New Delhi
17940 Answers
377 Consultations

5.0 on 5.0

If they have not been made the party then an impleadment application may be moved and the notice be served upon them after the permission from the court.

Also, if the cases have been decided then there is no requirement of making them a party to the case.

Regards

Anilesh Tewari
Advocate, New Delhi
17940 Answers
377 Consultations

5.0 on 5.0

You need to add the company as a party if you have claim from the said company. You can add the insurance company party later after filing complaint also.

Prashant Nayak
Advocate, Mumbai
27275 Answers
88 Consultations

4.4 on 5.0

Dear Client,

Without making the insurance company as party in the case, how court will order against the company.

IT`s fatal for case and suffering of non joinder of parties, Without further lapse, implead company as necessary.

File application under Order 1 Rule 10 of Code of Civil Procedure.-

10. Suit in name of wrong plaintiff.- (1) Where a suit has been instituted in the name of the wrong person as plaintiff or where it is doubtful whether it has been instituted in the name of the right plaintiff, the court may at any stage of the suit, if satisfied that the Suit has been instituted through a bone fide mistake, and that it is necessary for the determination of the real matter in dispute so to do, order any other person to be substituted or added as plaintiff upon such terms as the court thinks just.

Yogendra Singh Rajawat
Advocate, Jaipur
21481 Answers
31 Consultations

4.4 on 5.0

Dear Sir,

Without a party before no judgment can be passed against it. So you have to implead the insurance company.

Secondly, in case of already decided cases, go to appellate court and get it remanded to Tribunal and then file application for impleadment or file impleadment petition there itself and get it remanded. The following link is useful.

IMPLEADMENT OF THIRD PARTIES

http://ecourts.gov.in/sites/default/files/Impleadment%20of%20third%20parties%20by%20Sri%20Atheeque%20Ahamad.pdf

Kishan Dutt Kalaskar
Advocate, Bangalore
6050 Answers
381 Consultations

4.8 on 5.0

1. Insurance Company is not involved in the offence committed by the Hospital or doctor against which you intend to file Medico Legal case for their negligence before the Consumer Forum.

2. Insurance companies can be sued if they refuse to pay the genuine claim forwarded for reimbursement by or for the insured before the local District Consumer Dispute Redressal Forum.

3. You can only make the Insurance Company a party if they refuse to reimburse the insured amount where as from the medical establishment, you can claim an amount which you feel reasonable even above the insured amount.

Krishna Kishore Ganguly
Advocate, Kolkata
26603 Answers
726 Consultations

5.0 on 5.0

1. What orders were passed in those old medico legal cases which have already been disposed of?

2. It is a fact that where the order has already been passed and the case has been disposed of there is no scope for your adding any further party or anything since the mater has already been disposed of.

3. If the Insurance Company has refused any claim filed by the insured or his legal heirs for the loss incurred by him, either limb or life, then consumer case can be filed against the Insurance Company alleging deficiency in service and unfair busyness practice claiming the insured amount with interest, damage and cost.

Krishna Kishore Ganguly
Advocate, Kolkata
26603 Answers
726 Consultations

5.0 on 5.0

Hi, as the case is pending, you are suggested to add insurance company as the party.

Ganesh Singh
Advocate, New Delhi
6646 Answers
16 Consultations

4.5 on 5.0

An MLC is a case of injury/illness where the attending doctor, after eliciting history and examining the patient, thinks that some investigation by law enforcement agencies is essential to establish and fix responsibility for the case in accordance with the law of the land. It can also be defined as a case of injury or ailment, etc., in which investigations by the law-enforcing agencies are essential to fix the responsibility regarding the causation of the said injury or ailment.

The insurance company cannot settle claim in medico legal cases at the behest or on behalf of the medical health institution/hospital.

The insurance obtained for the institution is a general coverage for its insurance claim and not for medico legal cases.

Therefore there is no necessity for impleading the insurance company in medico legal claims.

T Kalaiselvan
Advocate, Vellore
78104 Answers
1543 Consultations

5.0 on 5.0

We have many pending consumer cases where the insurance company has not been made party. please let me know the exact procedure to implead them now. We were told that In old cases , where any order has already been passed , we cannot add the insurance company as a party now. Please calrify the legal position on this.

In the consumer cases in respect of medico legal claims, the insurance company has nothing to compensate.

Hence they cannot be impleaded as a party.

T Kalaiselvan
Advocate, Vellore
78104 Answers
1543 Consultations

5.0 on 5.0

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