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1992 DIGILAW 216 (RAJ)

Girjesh Kumari v. L. I. C. Of India

1992-02-26

S.N.BHARGAVA

body1992
JUDGMENT 1. - This writ petition has been filed for quashing the letter dated 20.2.1987 (Annexure 2). 2. As per the facts stated in the memo of writ petition, Chaturbhuj Pal Yadav (since deceased), husband of the petitioner, who was serving as Station House Officer, on 13.11.1983 made a proposal to insure his life. The proposal for a sum of Rs. 50,000/-was accepted by the Life Insurance Corporation of India and a policy bearing No. 5096281 was issued mentioning the petitioner Girjesh Kumari (wife) as the nominee, under Section 39 of the Insurance Act. Late Chaturbhuj Pal Yadav made payments of the premium regularly till his death on 26.4.1986 when he died a natural death. The petitioner submitted an application to the respondent No. 1 to which a reply was received by her on 25.11.1986 wherein she was assured that the claim was under active consideration. Thereafter, the petitioner received another letter dated 20.2.1987 informing that her claim had been rejected on account of the deceased having withheld material information regarding his health at the time of effecting the insurance with the Corporation. The petitioner then submitted an application to review but with no result in spite of the fact that she was informed vide letters dated 8.8.1987 and 18.8.1987 that the matter was receiving consideration and ultimately, the petitioner filed the present writ petition on 2.2.1988. Notices were issued to show cause as to why this writ petition should not be admitted. Reply has been filed on behalf of the respondents wherein it has been admitted that the last quarterly premium due on 28.2.1986 was paid on 22.2.1986 and it has not been disputed that the deceased died on 26.4.1986, i.e., after 2 years 4 months of the issuance of the policy. An enquiry was conducted from the pension office and the office in which the deceased was employed. It was revealed that deceased was sick from 1980 and he used to remain on leave on medical grounds from January, 1980 to 24th May, 1980, again from 16.6.1980 to 25.11.1980 for diabetes, asthma, eczema and ulcer. In support of the above, the respondents have annexed along with the reply copies of letters addressed by the deceased to the Supdt. of Police, Jaipur, Exhs. R-2 to R-6. In support of the above, the respondents have annexed along with the reply copies of letters addressed by the deceased to the Supdt. of Police, Jaipur, Exhs. R-2 to R-6. Along with the reply, the respondents have also annexed a copy of the proposal form wherein the petitioner did not disclose about his earlier ailments and deliberately concealed these facts which were within his knowledge and answered in negative the columns like 18,19,20,21. Arguments have been heard. 3. Learned counsel for the petitioner has placed reliance on Section 45 of the Insurance Act which provides that policy cannot be called in question on ground of misstatement after two years and has also cited Daulat Ram v. Bharat Insurance Co. AIR 1973 Delhi 180 . He has further submitted that the respondents have utterly failed to discharge the burden of proving that the deceased was guilty of making false representation and suppressing material facts and has drawn my attention to Life Insurance Corporation of India v. G.M. Channabasamma 1991 ACJ 303 (SC) . 4. He has further brought to my notice Dipashri v. Life Insurance Corporation of India 1985 ACJ 416 (Bombay) , wherein it has been held that the expression 'fraudulently' connotes deliberate and intentional falsehood and some strong material is required before concluding that the policy-holder played a fraud on the Corporation. Mere failure to describe in the form trivial ailments like influenza, bleeding piles, fever, etc., cannot be construed as fraudulent suppression of material facts so as to repudiate the contract of insurance. 5. Learned counsel for the petitioner also placed reliance on Rameswar Singh v. Life Insurance Corporation of India 1991 ACJ 813 (Calcutta) , wherein also it has been held that policy is issued after full and proper medical examination, therefore, burden of proof is on the Life Insurance Corporation to show that the policyholder suppressed material facts like suffering from asthma. 6. On the other hand, learned counsel for the respondents has brought to my notice Kiran Sinha v. Life Insurance Corporation of India 1983 ACJ 669 (Patna) , against which the appeal filed by the Life Insurance Corporation was allowed by the Supreme Court in Life Insurance Corporation of India v. Kiran Sinha 1985 ACJ 657 (SC) . 7. He has further submitted that the disputed fact as to whether the insured suppressed material facts or not, cannot be decided in writ petition. 8. 7. He has further submitted that the disputed fact as to whether the insured suppressed material facts or not, cannot be decided in writ petition. 8. He has further submitted that Section 45 of the Insurance Act has been held to be intra vires by the court in Vijay Laxmi Gaur v. State Writ Petition No. 2006 of 1982; decided on 10.10.1983 . 9. I have given by thoughtful consideration to the whole matter and have also gone through the record of the case as well as the authorities cited by the learned counsel for the parties. 10. The proposal made on 13.11.1983 by Chaturbhuj Pal Yadav (deceased) was accepted by the Life Insurance Corporation and premiums were regularly paid and the policy was in force till he died on 26.4.1986. Before accepting the proposal Mr. Yadav must have also been medically examined thoroughly. Policy is issued only after full and proper medical examination of the insured. It is true that the policyholder in the present case also has not furnished full information correctly as he ought to have done as a straightforward man but the illness, if any, could have been discovered at the time of medical check-up by the doctor before the proposal was accepted. Heavy burden lies on the Life Insurance Corporation to prove that the policyholder suppressed material facts in his declaration form at the time of effecting life insurance policy and the Life Insurance Corporation, in the present case, has not been able to discharge that burden. Merely submitting in reply to the writ petition that certain columns were not correctly filled in, as per the investigations made after the death of the insured, is not sufficient. The expression 'fraudulently' connotes deliberate and intentional falsehood and some strong material is required before concluding that the policy-holder played a fraud on the Life Insurance Corporation. Mere failure to mention some minor ailments cannot be construed as fraudulent suppression of material facts so as to repudiate the contract of insurance. It is admitted that the deceased died after two years of the policy coming into operation and, therefore, Section 45 of the Insurance Act comes into play which is a beneficial legislation in favour of the insured. 11. It is admitted that the deceased died after two years of the policy coming into operation and, therefore, Section 45 of the Insurance Act comes into play which is a beneficial legislation in favour of the insured. 11. In this view of the matter, this writ petition is allowed and the respondents are directed to make payment of the petitioner's claim towards insurance policy of her husband in accordance with law, within six months from today. Parties are left to bear their own costs.Petition Allowed. *******