Allahabad High Court Orders Rs 5 Lakh Accident Benefit For Farmer’s Sister

A woman whose brother died in a road accident in 2019 will receive Rs 5 lakh under the Mukhyamantri Kisan Evam Sarvahit Bima Yojana, after the Allahabad High Court set aside Oriental Insurance Company’s rejection of her claim.

The division bench of Justices Garima Prashad and Prakash Padia ruled that the woman could not be denied the death benefit solely because “sister” was absent from the scheme’s list of covered family members.

Insurer Rejected The Claim

The woman told the court that her brother cultivated their family’s agricultural land, headed the household, and served as the breadwinner. She was unmarried and dependent on him. Their parents had died, and she said she was the only surviving member of the household, according to a recent report by The Indian Express.

After her brother’s death, she claimed the insured amount. Oriental Insurance rejected the claim, arguing that the scheme's governing agreement did not include a sister in its definition of family.

The matter went before the Basti district committee. Based on a report from the sub-divisional magistrate in Harraiya, which recorded that the deceased was the family’s head, the committee directed the insurer to accept the claim and make payment. The insurer maintained its rejection in a communication dated April 16, 2021. The woman then challenged that decision in the High Court.

Court Separates Cover From Who Receives The Benefit

The court said the dispute was about who could receive the benefit after the insured person’s accidental death—not whether the woman herself was covered for an accident or medical treatment. Under the scheme, the accidental death benefit related to the head or breadwinner; the agreement also referred to a nominee or legal heir as the recipient. These provisions had to be read alongside the separate list of family members covered for benefits such as medical treatment.

The bench held that leaving sisters out of the list of covered family members did not, by itself, prevent one from receiving a death benefit as a legal heir. The insurer’s interpretation would effectively add a condition that a legal heir must also be a covered family member, though the agreement did not say that.

The court also noted that there was no dispute between competing heirs. It said a succession certificate was required under the scheme only where succession was disputed. Since no rival claimant had come forward, the insurer could not rely on the absence of the claimant’s relationship from the family list to defeat her claim.

The High Court set aside the rejection and directed Oriental Insurance to pay Rs 5 lakh within four weeks of production of a certified copy of the judgment.

The ruling is limited to the facts and wording before the court. It does not make every sister eligible for a benefit under every insurance policy, nor does it add sisters to the scheme’s insured-family list. The court clarified that its finding concerns receipt of the death benefit; it does not expand who is covered for their own accidental injury or medical treatment.

For families, the distinction matters: the person insured against an accident and the person entitled to receive a payout after that person’s death can be governed by different clauses. A claim still turns on the applicable policy or scheme wording and whether the claimant qualifies as a nominee or legal heir.

FAQs

Could the woman claim the Rs 5 lakh death benefit even though the scheme did not list sisters as covered family members?
Yes. The High Court held that her status as a legal heir could make her eligible to receive the benefit; she did not also have to be a covered family member.

Does this ruling make sisters eligible for cover under the scheme?
No. The court clarified that it concerned who could receive the death benefit, not who was covered for their own accidental injury or medical treatment.

Was a succession certificate required?
The court said the scheme required one only if succession was disputed. No competing heir had come forward in this case.