Life Insurance Corporation of India, Machilipatnam v. Vankadaru Koteswaramma
2002-03-16
body2002
DigiLaw.ai
L. NARASIMHA REDDY, J. ( 1 ) IN this appeal; the defendant in O. S. No, 16 of 1985 on the file learned Senior Civil Judge, Nuzlvld, challenges the judgment and decree dated 25-9-1989 passed therein. ( 2 ) THE respondent-plaintiff filed the suit claiming that her, husband by name venkadaru Panduranga Rap, insured his life with the appellant-defendant herein by taking a policy for a sum of Rs. 25,000. 00 through an authorised agent. The said panduranga Rao nominated the plaintiff as nominee and died on 2-4-1982. When she demanded the payment of the amount from the appellant, they informed her that they repudiated the claim on the allegation that late Panduranga Rao. during his lifetime, did not disclose the fact that he was suffering from Diabetes, while submitting the proposals for the policy. The respondent-plaintiff claimed that the plea taken by the appellant was not sustainable and that they were under obligation to pay the amount covered by the policy. ( 3 ) THE appellant filed the written statement disputing the entitlement of the respondent. Two principal contentions were raised. One was that there was no acceptance of the policy in the eye of law and as such, they are not under the obligation to pay the amount. The second contention was that the policyholder late Panduranga Rao has been suffering with Diabetes and the same was suppressed by him, while submitting the proposals for the policy. Taking shelter under Section 45 of the Insurance act, the appellant pleaded that they were entitled to repudiate the policy. ( 4 ) THE trial Court framed the following issues : (I) Whether the plaintiff is entitled to the suit amount? (ii) To what relief?additional issue : whether there was no concluded and binding contract of Insurance between the husband of the plaintiff and the defendant? ( 5 ) ON behalf of the respondent-plaintiff. P. Ws. 1 and 2 were examined and Exs. A. 1 to A. 3 were marked. On behalf of the appellant-defendant. D. Ws. 1 to 5 were examined and Exs. B. 1 to B. 14 were marked. ( 6 ) ON appreciation of oral and documentary evidence, the trial Court decreed the suit. Hence, the appeal.
P. Ws. 1 and 2 were examined and Exs. A. 1 to A. 3 were marked. On behalf of the appellant-defendant. D. Ws. 1 to 5 were examined and Exs. B. 1 to B. 14 were marked. ( 6 ) ON appreciation of oral and documentary evidence, the trial Court decreed the suit. Hence, the appeal. ( 7 ) SRI M. S. K. Sastry learned senior counsel appearing for the appellant submits that the policy proposal submitted by the deceased husband of the respondent can be said to have been accepted only on 23-6-1982, when Ex. B7-Insurance Policy was. issued. According to him, the acceptance of the first premium through Ex. B. 5 does not constitute the acceptance. In that view of the matter, there is no concluded contract and as such, the appellant is not under the obligation to pay the amount. The alternative submission of the learned senior counsel is that even if for any reason the policy is said to have been accepted, the appellant has the right to repudiate the same in exercise of its right under Section 45 of the Insurance Act, since the deceased-insured was suffering from Diabetes and he suppressed the said fact, while submitting the proposal. ( 8 ) SRI Y. Srinivasa Murthy, learned counsel appearing for Sri T. Veera Bhadraiah. learned counsel for the respondent-plaintiff submits that the oral and documentary evidence that has been placed before the court has clinchingly established that the policy, in question, has been accepted on 15-3-1982 and it is not open to the appellant to contend otherwise. As far as the plea of suppression is concerned, learned counsel submits that the appellant did not place anything on record to suggest, much less prove, that late Panduranga Rao was suffering from Diabetes and at any rate, he suppressed that fact, while submitting the proposal. ( 9 ) IN view of the rival contentions of the parties, the following questions arise for consideration in this appeal. (1) Whether there was valid acceptance of the policy in question? (2) Whether the appellant was entitled to repudiate the contract on the alleged ground of misrepresentation? ( 10 ) PEW dates are necessary to be noted. The policy proposal-Ex. B3 was submitted by the husband of the respondent through an agent of the appellant on 15-3-1982. Under Ex.
(1) Whether there was valid acceptance of the policy in question? (2) Whether the appellant was entitled to repudiate the contract on the alleged ground of misrepresentation? ( 10 ) PEW dates are necessary to be noted. The policy proposal-Ex. B3 was submitted by the husband of the respondent through an agent of the appellant on 15-3-1982. Under Ex. B. 5, the same was processed through what is known as proposal review slip and the Administrative Officer of the appellant at Nuzivid subscribed his signature in token of acceptance on the same day. At subsequent point of time, the insured was examined by the panel doctor of the appellant on 28-3-1982. The Insured died on 2- 4-1982. The policy document-Ex. B. 7, which is signed on 23-6-1982 was forwarded to the address of the deceased, but was returned on account of the death of the insured. Thereafter, the factum of death of the insured was informed and the appellant got the matter enquired through D. W. I on 25-7-1982, he obtained letters of certain persons on the same day and ultimately they addressed a letter dated 10-11-1983 Ex. B. 11 repudiating the contract on the ground that the insured suppressed the material facts, while submitting the proposal. The respondent got issued notice dated 11-4-1984 Ex. A. 2 calling upon the appellant to pay the amount. The same was replied by the appellant through Ex. A. 3 dated 12-4-1984. ( 11 ) HAVING regard to the various developments that have taken place on different dates, referred to above, it has to be seen as to whether the proposal of the deceased for insurance has been accepted before his death i. e. 2-4-1982. According to the learned counsel for the appellant, there was valid acceptance of the policy only on 23-6-1982 when Ex. B. 7 was prepared and communicated; and the various steps that have taken place are only preparatory in nature. In support of his contention, he relied upon the judgment of the Supreme Court in LIC of india v. R. Vasireddy, AIR 1984 SC 1014 . The contention of the learned counsel for the respondent, on the other hand, is that ex. B. 5, which is signed by the Administrative Officer constitutes valid acceptance and the same was before the death of the insured.
The contention of the learned counsel for the respondent, on the other hand, is that ex. B. 5, which is signed by the Administrative Officer constitutes valid acceptance and the same was before the death of the insured. ( 12 ) IT needs to be observed here that when the respondent informed the factum of death of the Insured, the appellant has undertaken an enquiry into the matter through D. W. 1. The emphasis in enquiry is as to whether there was any misrepresentation or suppression by the Insured. In the written statement, the result of the enquiry undertaken by D. W. 1 has been elaborately stated. There was absolutely no controversy as to the factum of acceptance of policy at that stage. In fact, the enquiry undertaken by the appellant and subsequent communication of the repudiation of their contract presupposes the existence of policy. If there was no valid policy followed by acceptance, there is no necessity for them to repudiate the same. A reading of the notice/reply that emanated from the appellant viz. , Exs. A. 3 and B. 11 vouch for this fact. ( 13 ) SO far as the plea of absence of acceptance of the policy is concerned, in the written statement, it was stated as under :"4. It is submitted that this defendant was informed of the death of the life assured on 2-4-82 by the nominee under the suit policy by her letter dated 29-6-82. Even before the proposal was scrutinized arid accepted by this defendant Corporation back dating the commencement of risk from 1 -1 -1982. the life assured had died. In fact the policy was prepared and sent to the insured on 23-6-82. ""9. By the date of acceptance of the proposal, the offerer (proposer) was not alive". ( 14 ) FROM a reading of paragraph No. 4 of the written statement, it is evident that the date 23-6-1982 signifies only the preparation of policy as distinct from acceptance. In the written statement, it is not clearly stated as to what exactly is the date of acceptance of policy, according to the appellant. In the oral evidence, D. W. 1, who deposed extensively, stated in his cross-examination as under :". . . . . . INSURANCE of premium receipt is indicative of the acceptance of the proposal. Premium received will be credited to the premium account of the Corporation. Ex.
In the oral evidence, D. W. 1, who deposed extensively, stated in his cross-examination as under :". . . . . . INSURANCE of premium receipt is indicative of the acceptance of the proposal. Premium received will be credited to the premium account of the Corporation. Ex. A. 1 is the first premium receipt. Ex. A. 1 is also acceptance letter. The date of commencement of risk is 1-1-1982 as per Ex. A. I. "ex. A. 1 is dated 31-3-1982. He further stated as under :"the risk will be covered with effect from the date of acceptance of 1st premium. . . . . . . . . . . I was not present when Ex. B. 5 was prepared. As per Ex. B. 5 proposal was completed. " ( 15 ) THE next witness, who was examined by the appellant to speak about the acceptance of the policy was D. W. 5, who was an Assistant Administrative Officer, who worked with them at the relevant point of time. In his chief-examination itself, he stated that he was authorised to accept the policies on behalf of the Corporation up to rs. 40,000. 00 sum assured. He has stated categorically, in his evidence, that Ex. B. 5 constitutes acceptance and it is dated 15-3-1982. He has further clarified the matter by stating that the proposals received before 31st March in the month of March will be accounted for under March policies in the name of the policyhorler, even if accepted after 3. 1st March. The fact that the premium was received on 15-3-1982 was established beyond any pale of doubt, these facts taken together, leave, no doubt that the policy Was accepted by the appellant on 15-3-1982, the date on which, Ex. B. 5 was issued or at any rate, on the date of Ex. A. 1, which is dated 31-3-1982. ( 16 ) PLACING reliance upon the judgment of the Supreme Court in LIC of India v. R. Vasireddy (supra), learned senior counsel for the appellant submits that there was no valid acceptance of the policy in the eye of law. In paragraph No. 14 of the said judgment, their lordships observed as under at page 1018 of AIR:"14.
( 16 ) PLACING reliance upon the judgment of the Supreme Court in LIC of India v. R. Vasireddy (supra), learned senior counsel for the appellant submits that there was no valid acceptance of the policy in the eye of law. In paragraph No. 14 of the said judgment, their lordships observed as under at page 1018 of AIR:"14. Though in certain human relationships silence to a proposal might convey acceptance but in the case of insurance proposal, silence does not denote consent and no binding contract arises until the person to whom an offer is made says or does something to signify his acceptance. Mere delay in giving an answer cannot be construed as an acceptance, as, prima facie, acceptance must be communicated to the offerer. The general rule is that the contract of insurance will be. concluded only when the party to whom an offer has been made accepts it unconditionally and communicates his acceptance to the person making the offer. Whether the final acceptance is that,of the assured or insurers, however, depends simply on the way in which negotiations for an insurance have progressed," ( 17 ) IN that case, the Supreme Court has also taken note of the fact that various authorities were prescribed for acceptance of the policies, covering different amounts and the policy in question in that case, was to be accepted by the Divisional Manager and there was nothing on record to show that it was accepted by the said authority. In the present case, it has come in the evidence of d. W. 5 that too in the chief-examination that he was authorised to accept the policies up to Rs. 40,000. 00 sum assured a,nd that he accepted the policy in question on 15-3-1982. It is also relevant to refer to the judgment of a Division Bench of Kerala High court in LIC of India v. L. Kamalamma, AIR 1986 Kerala 215, which dealt with the questions of acceptance of the proposals, wherein it was held that acceptance of the first premium by a person, who is authorised, would constitute acceptance. ( 18 ) THERE is another facet of this proposition.
( 18 ) THERE is another facet of this proposition. A reading of paragraph No. 14 of the judgment extracted above, indicates that the fact whether a policy was accepted or not would dependent upon number of circumstances, such as, as to whether the final acceptance is that of the assured or insurers and the same would dependent on the way in which negotiations for an insurance have progressed. In this case, the proposal emanated from the insured. The decision to accept is at the end of the appellant. That brought about a concluded contract before the insured died. Therefore, the first premium issued in this appeal stands answered in favour of the respondent. ( 19 ) THE next issue is as to whether there was any misrepresentation on the part of the insured, while submitting the proposals. Under Section 45 of the Insurance Act, the insurer is entitled to repudiate the contract, if it is established that the insured has suppressed the relevant facts or misrepresented, while submitting the proposals for insurance. The whole correspondence and a major portion of the written statement is devoted to this aspect by the appellant. It is their case that the enquiry conducted by d. W. 1 on 25-7-1982 reveals that the insured was suffering from Diabetes and that he took treatment with D. W. 4 about one and half years prior to the submission of the proposal. The only source of information in this aspect was from D. W. 4. It is not in dispute that after submission of the proposal, the insured was examined by the panel doctor of the appellant by name Mr. R. Satyanarayana Rao. Ex. B. 4 is the report of the panel doctor. There are specific columns and entries in respect of each and every disease, for which, the panel doctor was to undertake his own investigation and submit his report. The concerned column regarding the Diabetes reads as under :"10. Operation and other details : (a} and (b) xxx xxx (c), Is there personal history of (see instruction No, iii) (i) and (ii) xxx xxx , (iii ). Diabetes, cancer or tumour of any type; kidney disease? ( 20 ) THE finding of the panel doctor against this column was "no". ( 21 ) IT should not be forgotten that Diabetes is not a disease which occurs occasionally.
Diabetes, cancer or tumour of any type; kidney disease? ( 20 ) THE finding of the panel doctor against this column was "no". ( 21 ) IT should not be forgotten that Diabetes is not a disease which occurs occasionally. Of the many diseases, Diabetes is the one which persists once it occurs. If the panel doctor, on examination found that there was no trace of Diabetes, it is not stated that on what basis D. W. 1 came to the conclusion that the insured was suffering from the same disease. For the reasons best known to them, the appellant did not choose to examine the panel doctor, who could have been in a position to explain on what basis he arrived at that conclusion and whether there was any misrepresentation to him by the insured. The only witness spoke about the disease is D. W. 4. On the request of D. W. 1, he issued Ex. B. 10 letter dated 25-7-1982. which is to the following effect: to Dt. 25-7-82. Senior Divisional Manager, l. I. C. of India, machilipatnam. Sir, your employee has called on me today at my Nursing Home in connection with enquiry into the bearer bonds of the death claim of late Sri Venkadaru Panduranga Rao s/o Anjaiah of Ramanakkapeta. I informed him as follows. The said V. Panduranga Rao, has been my patient about one and half year and I treated him for Diabetes for a period of 10 days as inpatient. Later on he used to come to me as out-patient. After 6 months I referred him to Dr. A. V. S. Chalapathi Rao of vijayawada. Afterwards I do not know about him. Yours faithfully, sd/- t. Tataiah Babu, babu Nursing Home, Nuzvid, krishna District. D. W. 4 was examined to speak about Ex. B. 10. In his chief-examination, he stated as under :". . . . . . ABOUT 10 years back, I treated a person by name Vankadaru Panduranga Rao of Ramanakkapet village. I cannot say for what ailment I treated unless I see the record. "in cross-examination, he stated as under :"i cannot say from which date to which date I treated the said Panduranga Rao, We maintain record of inpatients. It is true I is sue certificates on the strength of the record maintained . I issued Ex.
I cannot say for what ailment I treated unless I see the record. "in cross-examination, he stated as under :"i cannot say from which date to which date I treated the said Panduranga Rao, We maintain record of inpatients. It is true I is sue certificates on the strength of the record maintained . I issued Ex. B. 10 without perusing any previous record i. e. , why I mentioned about the years. . . . . . . . . I have Ex. B. 10 Information relying on my memory as the officer who visited me In that connection was In a hurry while I was preoccupied with patients. He refreshed memory by furnishing the name and other particulars of the patient in question. I am one of the panel doctors for the L. I. C. It is true for diagnosis of Diabetes, we conduct certain tests. It is true to say that I obliged the L. I. C. Officer to give ex. B. 10. . . . . . . . . . . The relevant record is not now available with me. " ( 22 ) TO say the least, the conduct of D. W. 4 was unprofessional, both as regards disclosure of the nature of the disease to a third person and also giving false certificates Without verification of the records, that too, to oblige the officer of L. I. C. , because he was the panel doctor. Not only the evidence of d. W. 4 deserves to be eschewed, but the conduct of D. Ws. 1 and 4 in resorting to such practices deserves to be deprecated seriously. With their unholy behaviour they have reduced the whole concept of life insurance to the level worse than that of a money lending ( 23 ) LEARNED counsel for the respondent relied upon several decisions touching upon the circumstances under which Section 45 of the Insurance Act can be invoked, and on the issue of existence of any misrepresentation etc. Having regard to my finding, which is in concurrence with that of the trial Court, i do not feel it necessary to refer to them. In these circumstances, the judgment and decree of the trial Court do not suffer from any legal infirmity. Accordingly, the same is affirmed. Cross-objections : ( 24 ) THE respondent-plaintiff filed cross- objections on the question of interest.
In these circumstances, the judgment and decree of the trial Court do not suffer from any legal infirmity. Accordingly, the same is affirmed. Cross-objections : ( 24 ) THE respondent-plaintiff filed cross- objections on the question of interest. The trial Court granted interest only at the rate of 6% per annum on the claim amount. Viewed from any angle. Interest at the rate of 6% per annum is too low. The respondent and her family virtually became destitute on account of the death of the sole earn ing member, and were deprived of their rightful claim on account of the unlawful denial by the appellant. Having regard to the factors of Inflation etc. , ends of Justice will be met, If Interest at the rate of 12% per annum is ordered. The cross-objections are, therefore, allowed. ( 25 ) IN the result, the appeal is dismissed and the cross-objections are allowed. The suit amount shall carry on the Interest at the rate of 12% per annum from the date of suit till payment. There shall be no order as to costs. Order accordingly.