LIFE INSURANCE CORPORATION OF INDIA v. NARMADA AGARWALLA
1996-01-29
D.P.MOHAPATRA, R.K.DASH
body1996
DigiLaw.ai
JUDGMENT : R.K. Dash, J. - The aforementioned two Letters Patent Appeals arise out of common judgment passed by a learned Single Judge in First Appeal Nos. 1 and 2 of 1986 confirming the judgment and decree of the Subordinate Judge, Karanjia, in Money Suit Nos. 9 and 10 of 1983. Therefore, this judgment is passed which shall govern both the above appeals. 2. Undisputed facts leading to these appeals lie in a narrow compass: One Devakilal Agarwala of Karanjia during his life time had taken two Life Insurance Policies, one for Rs. 80,000/- on 4.2.1971 and the other for Rs. 40,000/- on 13.9.1978. While both the policies were in force, the insured suffered from diabetes for which he was brought to S.C.B. Medica 1 College & Hospital and from there he was taken to Jaslok Hospital, Bombay for treatment. While undergoing treatment in Jaslok Hospital, he expired on 23.6.1982 on account of cardiorespiratory arrest due to infraction following coronary by-pass surgery for triple vessel coronary disease as revealed from the certificate granted by the hospital authority, Ext. E. his dead body was brought to Karanjia where it was cremated. Intimation regarding his death was given to the insurer, namely, Life Insurance Corporation of India (for short, the Corporation'). Claims were advanced by the successors of the assured (hereinafter referred to as 'plaintiffs') but the same were repudiated by the Corporation on the ground that the policies had become void because an untrue and incorrect statement about his state of health had been made by the assured when he submitted the proposal to insure his life. This led the plaintiffs to file two suits in the Court.of the learned Subordinate Judge, Karanjia. The case of the Corporation was that the deceased-assured when offered proposals to insure his life was quite aware that he was suffering from diabetes. In the proposal statement he gave a false answer, inasmuch as with regard to question No. 7 that whether he had ever passed blood, pus, albumen or sugar in the urine, his answer was emphatic 'no'. Had he given true statement, the Corporation would not have accepted the proposal and insured his life. Since he fraudulently suppressed the material fact, the Corporation rightly repudiated the contract. The Trial Court upon hearing, negatived the stand taken by the Corporation and decree both the suits against which the Corporation preferred appeals.
Had he given true statement, the Corporation would not have accepted the proposal and insured his life. Since he fraudulently suppressed the material fact, the Corporation rightly repudiated the contract. The Trial Court upon hearing, negatived the stand taken by the Corporation and decree both the suits against which the Corporation preferred appeals. The learned Single Judge having taken into consideration the law involved and the submissions made, confirmed the Trial Court's judgment and dismissed the appeals. 3. One of the contentions of the Corporation before the learned Single Judge was that the assured when was admitted in the Jaslok Hospital had made a statements Dr. Thomas, marked Ext. F, that he was suffering from disbetes since 15 years and this document having been brought in evidence on admission, its content as aforesaid should have been taken as correct to come to a finding that the insured had withheld material facts at the time of giving proposal to insure his life with the Corporation. This contention was repelled by the plaintiffs bom on facts and law. Learned Single Judge on consideration of the submissions observed: Once a document is marked on admission, contents thereof are also treated to be admitted. Mr. Das, however, is correct in his submission that contents may have been admitted, not its truth. Truth or correctness is to be ascertained from the evidence. A party admitting a document has right to explain that though the document contains such a statement, it is not correct. The learned Judge on discussion of the evidence of PW 1, son of the deceased-insured that his father when taken to Bombay for treatment was not in a condition to make any statement, nor did any doctor take down the history of his aliment, came to hold that the deceased did not make any statement to Dr. Thomas that he was suffering from diabetes since 15 years. In these Letters Patent Appeals it has been urged on behalf of the Corporation that statement of the deceased-insured having been reduced into writing by the attending physician in Ext. F in regular course of business, should have been treated as an admission of a dead person and on the basis thereof appeals should have been allowed upsetting the findings of the Trial Court. 4. Insurance is a contract upon speculation, the legal concept of which is a contingent contract.
F in regular course of business, should have been treated as an admission of a dead person and on the basis thereof appeals should have been allowed upsetting the findings of the Trial Court. 4. Insurance is a contract upon speculation, the legal concept of which is a contingent contract. The special facts upon which the contingent chance is to be computed lie most commonly in the knowledge of the assured only; the underwriter trusts on his representation and proceeds upon confidence that he does not keep back any circumstance in his knowledge to mislead the underwriter into a belief that the circumstance does not exist. To keep back such circumstance is fraud, and therefore, the policy is void. Chity on contract states: An insurance contract is a contract "uberrimae fidei'. It is a contract based on the utmost good faith and if the utmost good faith is not observed by either party the contract may be avoided by the other party. The reason for this principle of insurance law is that contracts of insurance are founded on facts which are nearly always in the exclusive knowledge of one party (usually the assured) and, the risk insured against may be different from that intended to be covered by the party in ignorance. The duty which arises is three-fold: a duty to disclose material facts; a duty not to misrepresent material facts; and a duty not to make fraudulent claims. 5. The Supreme Court in the case of Life Insurance Corporation of India Vs. Smt. G.M. Channabasemma, has observed that the assured is under a solemn obligation to make full disclosure of material facts which may be relevant for the insurer to take into account while deciding whether the proposal should be accepted or not. While making a disclosure of the relevant facts, the duty of the insured to state them correctly cannot be diluted. The sameis also the view of the High Courts of Madras/Allahabad, Andhra Pradesh and Karnataka. (See All India General Insurance Co. Ltd. and Another Vs. S.P. Maheswari Smt. Kamla Wanti Vs. L.I.C. of India The Life Insurance Corporation of India South Zone, Madras and Another Vs. Bhogadi Chandravathamma, and Prabhavati Gangadhar Shanbhag Vs. Life Insurance Corporation of India and another.
The sameis also the view of the High Courts of Madras/Allahabad, Andhra Pradesh and Karnataka. (See All India General Insurance Co. Ltd. and Another Vs. S.P. Maheswari Smt. Kamla Wanti Vs. L.I.C. of India The Life Insurance Corporation of India South Zone, Madras and Another Vs. Bhogadi Chandravathamma, and Prabhavati Gangadhar Shanbhag Vs. Life Insurance Corporation of India and another. On are adding of the books on Insurance Lawand various judicial pronouncements what is deducible is that both the insurer and me assured act on the basis of mutual trust and confidence. The insurer trusts to the representation of the assured and proceeds upon the confidence that he does not keep back any circumstance in his knowledge so as to mislead the insurer into a belief that the circumstances does not exist or to induce him to estimate the risk as if it did not. Usually when a person makes a proposal to the insurer to insure his life, no information is available with the insurer either to accept the proposal and enter into the contract or to refuse the same. The insurer's sources of information are (i) the insured himself; (ii) the information of persons to whom the latter may consent to refer the insurer; and (iii) lastly, the opinion formed by the Medical Examiner appointed by the insurer and to whose inspection the 'life' must submit himself. These are the only avenues of information which affect the contract by the doctrine of disclosure and the rule of good faith. So when questions are put by the insurer it is executed of the assured to answer every question with complete honesty which implies truthfulness. But if he gives false statement and suppress facts fraudulently intending to induce the insurer to a accept the proposal and insure his life, ultimately the policy of insurance is vitiated. Therefore, the insurer as of right can avoid the contract. 6. Now coming to the case in hand, we shall first see whether the assured made any false statement or suppressed any fact in the Personal Statement, marked Ext. K. All kinds of diseases find mention in Clauses (a) to (k)of Column 6, but diabetes is conspicuous by its absence. It may be that in the opinion of the Corporation diabetes is not a so serious disease which can be taken note of.
K. All kinds of diseases find mention in Clauses (a) to (k)of Column 6, but diabetes is conspicuous by its absence. It may be that in the opinion of the Corporation diabetes is not a so serious disease which can be taken note of. The case of the Corporation in the written statement is that the assured gave false answer to question No. 7 which amounts to suppression of material fact. In view of such stand, reference may be made to the said question which relates to passing of blood, pus, albumen or sugar in the urine. When asked, the answer of the assured to the said question was 'No.' We can take note of the fact that all diabetic patients do not pass sugar in the urine and even if one does so pass, he cannot be said to be aware of the same unless there is pathological examination of the urine by the doctor. Added to it, the confidential report of the medical examiner of the Corporation reveals that there was no sugar in the urine of the assured. This being the factual position, the Corporation could not be said to have been misled for entering into the contract with the assured by any misrepresentation or suppression of truth. 7. Now coming the validity and genuineness of the Personal Statement of the insured, Ext. F, it may be stated that the learned Single Judge repelling the submission of the learned Counsel for the plaintiffs not to treat Ext. F as a piece of evidence, observed that the same having been marked on admission, contents thereof are also to be treated as admitted. However, with regard to the truth or correctness of the contents thereof, he observed that the same has to be ascertained from the available evidence. Accordingly he relying upon the evidence of PW l that his father namely, the insured, was not in a condition to give any statement to the doctor, came to hold that the insured did not make any statement to Dr. Thomas about his having suffered from diabetes since 15 years. In view of such finding, no fault can be found with the learned Single Judge to say that he has not considered Ext. F in its true perspective to arrive at a conclusion on the question involved. 8.
Thomas about his having suffered from diabetes since 15 years. In view of such finding, no fault can be found with the learned Single Judge to say that he has not considered Ext. F in its true perspective to arrive at a conclusion on the question involved. 8. On a consideration of the facts and law as directed above, we find no reason to interfere with the findings of the learned Single Judge and to upset the judgment passed in the aforementioned First Appeals. Consequently, both the Letters Patent Appeals are dismissed. No costs.