Beatrice Mururi Kamau v AIG Kenya Insurance Ltd [2020] eKLR Case Summary

Court
High Court of Kenya at Nairobi, Commercial & Tax Division
Category
Civil
Judge(s)
Justice Maureen A. Odero
Judgment Date
October 02, 2020
Country
Kenya
Document Type
PDF
Number of Pages
3
Explore the case summary of Beatrice Mururi Kamau v AIG Kenya Insurance Ltd [2020] eKLR. Discover key legal insights and rulings in this important insurance law case.

Case Brief: Beatrice Mururi Kamau v AIG Kenya Insurance Ltd [2020] eKLR

1. Case Information:
- Name of the Case: Beatrice Mururi Kamau v. AIG Kenya Insurance Ltd
- Case Number: Civil Case No. 421 of 2008
- Court: High Court of Kenya at Nairobi, Commercial & Tax Division
- Date Delivered: October 2, 2020
- Category of Law: Civil
- Judge(s): Justice Maureen A. Odero
- Country: Kenya

2. Questions Presented:
The court needed to resolve the following central legal issues:
- Did the Plaintiff fail to disclose a pre-existing medical condition?
- Was there a breach of the Contract of Insurance by either party?
- Is the Plaintiff entitled to the compensations sought?

3. Facts of the Case:
The Plaintiff, Beatrice Mururi Kamau, sought a declaration that AIG Kenya Insurance Ltd was liable under a medical insurance policy to cover her medical expenses incurred during her stay in the United States. The Plaintiff claimed special damages of US$ 476,573.65, general damages for breach of contract, and costs. The Defendant contested the claim, asserting that the Plaintiff had a pre-existing condition that was not disclosed when the insurance policy was obtained. The Plaintiff traveled to the U.S. for a graduation ceremony, during which she fell ill and required hospitalization.

4. Procedural History:
The case was initiated on July 15, 2008, and was consolidated with two other suits against AIG Kenya Insurance Ltd on September 30, 2009. The hearing commenced on October 13, 2014, with multiple judges presiding due to transfers. The Plaintiff called three witnesses, while the Defendant called one witness. Written submissions were filed by the Plaintiff, but the Defendant's submissions were disregarded due to a lack of filing evidence.

5. Analysis:
- Rules: The court considered the burden of proof as outlined in Section 107 of the Evidence Act, which states that the party asserting the existence of a fact must prove it. The court also referenced the principle of "uberrimae fidei," which applies to insurance contracts requiring utmost good faith in disclosures.
- Case Law: The court cited *Gichinga Kibutha v. Caroline Nduku* [2018] eKLR and *Sita Steel Rolling Mills Limited v. Jubilee Insurance Co. Ltd* [2007] eKLR, emphasizing the obligations of parties in insurance contracts regarding disclosure of material facts. The court also referenced *William Okoth Abatha v. Pioneer Assurance Company Limited* [2016] eKLR regarding the necessity of the proposal form in establishing good faith.
- Application: The court found that the Plaintiff did not have a pre-existing condition that was undisclosed, as medical experts testified that her illness in the U.S. was a complication arising from a recent surgery, not a pre-existing condition. However, the court noted that the Plaintiff and her family misrepresented their ages on the insurance application, which constituted a material misrepresentation, voiding the insurance contract.

6. Conclusion:
The court ruled against the Plaintiff, concluding that while there was no failure to disclose a pre-existing condition, the misrepresentations about ages in the insurance application constituted a breach of contract. The Plaintiff was therefore not entitled to any compensation, and the suit was dismissed in its entirety.

7. Dissent:
There were no dissenting opinions noted in the judgment.

8. Summary:
The High Court of Kenya dismissed the Plaintiff's suit against AIG Kenya Insurance Ltd, finding that although the Plaintiff did not fail to disclose a pre-existing condition, the material misrepresentation regarding the ages of the insured parties invalidated the insurance contract. Consequently, the Plaintiff was denied the sought compensation, highlighting the importance of honesty in insurance applications. The ruling underscores the legal principle that misrepresentation can nullify claims, even when the insured party has a legitimate basis for their claim.

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