NYIRAGANZA_v.Sonarwa_kinya_419529_kn

NYIRAGANZA_v.Sonarwa_kinya_419529_kn

SONARWA's failure to respond to the insured's request for medical board approval did not absolve it of liability for necessary medical expenses incurred abroad. The standard form signed by the insured upon payment did not constitute a full and final settlement barring further claims. However, the applicant failed to prove entitlement to higher lost earnings damages due to insufficient evidence of commercial activity.

Citation
RLR V.2-2019
Parties
Appellant/respondent: SONARWA General Insurance Company Ltd; Respondent/applicant: Nyiraganza Ramu
Court
Supreme Court
Jurisdiction
Rwanda
Judgment Date
23 September 2018
Case Number
RS/INJUST/RC 00047/2017/SC
Procedural Posture
Civil Appeal (insurance Claim) / Supreme Court Review on Grounds of Injustice
Outcome
Partially allowed; applicant's claim for reimbursement of medical expenses abroad and certain damages granted; other claims dismissed.
Legal Topics
Motor Vehicle Accident Compensation, Medical Expenses Abroad, Standard Form Contracts, Damages for Bodily Injury, Procedural Review for Injustice
Source Language
en, rw
Insurance Law Tort Law Civil Procedure Motor Vehicle Accident Compensation Medical Expenses Abroad Standard Form Contracts Damages for Bodily Injury Procedural Review for Injustice

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Parties

SONARWA General Insurance Company Ltd

Appellant/respondent

Nyiraganza Ramu

Respondent/applicant

Procedural Posture

Civil Appeal (insurance Claim) / Supreme Court Review on Grounds of Injustice

Legal Issues

  1. 1 Whether SONARWA is liable to reimburse medical expenses incurred abroad when it failed to respond to the insured's request for approval.
  2. 2 Whether the acceptance and signing of a standard form receipt by the insured constitutes a full and final settlement barring further claims.
  3. 3 Whether the applicant is entitled to additional damages for lost earnings and other heads of damages not previously awarded.

Ratio Decidendi

SONARWA's failure to respond to the insured's request for medical board approval did not absolve it of liability for necessary medical expenses incurred abroad. The standard form signed by the insured upon payment did not constitute a full and final settlement barring further claims. However, the applicant failed to prove entitlement to higher lost earnings damages due to insufficient evidence of commercial activity.

Court Disposition

Partially allowed; applicant's claim for reimbursement of medical expenses abroad and certain damages granted; other claims dismissed.

Orders

  • SONARWA to reimburse Nyiraganza Ramu 10,129,924 Frw for medical expenses incurred in India.
  • SONARWA to pay Nyiraganza Ramu 3,000,000 Frw in damages for wrongful denial and 1,300,000 Frw for legal costs and attorney fees.