Research › Search › Judgment

Madhya Pradesh High Court · body

2006 DIGILAW 1325 (MP)

Shayam Sunder Tripathi v. Life Insurance Corporation of India

2006-11-23

DIPAK MISRA

body2006
ORDER :- The petitioner was an agent of the Life Insurance Corporation of India (hereinafter referred to as the "LIC") since 1987. During his functioning as an agent, he had received many a reward for his excellent performance. In March, 1998, he got insured one Harish Chandra Gupta who unfortunately died in June, 1999. Because, of this situation, he was, as set forth, served with a show-cause notice by the authority of the Corporation why he had not informed the Corporation that the assured was suffering from diabetes for the last 15 years and stones in the kidney. The petitioner offered his explanation but the same was not accepted and his agency was terminated by order dated 3-2-2001. Against the aforesaid order of termination of agency, the petitioner preferred an appeal before the appellate authority who rejected the same as per order dated 8-11-2002 which has led him to prefer this writ petition under Articles 226 and 227 of the Constitution of India for issuance of a writ of certiorari for quashment of the aforesaid orders as contained in Annexures-P-4 and P-6 respectively and to command the respondents to make payment of his commission to which he is entitled under law. 2. It is urged in the petition that before termination of agency, he was not afforded an opportunity to defend his case effectively and, therefore, there has been complete violation of the principles of natural justice which makes the order of termination of agency totally indefensible. It is further put forth that the termination is solely on the basis that he had not given information about the ill health of the policy holder though the agent merely fills the form and makes entries on the basis of information received from the proposed policy holder. It is the stand in the writ petition that the Corporation had accepted the medical report of the policy holder which is the same quo non before insuring any person and therefore, the authority could not have put the entire blame on the agent. It is contended that before terminating agency, the authorities of the Corporation had not kept in view the past performance of the petitioner and passed a harsh order on the basis of presumption which is unsustainable. In essence, the stand is that there has been violation of principles of natural justice and doctrine of proportionality has not been kept in view. In essence, the stand is that there has been violation of principles of natural justice and doctrine of proportionality has not been kept in view. 2. A counter-affidavit has been filed by the respondents contending inter alia, that the proposal was submitted by the petitioner and it was accepted by the Corporation and on the basis of such proposal the policy was issued. As the assured died within a short span time, an inquiry was held and on inquiry, it was found that the policy holder was suffering from diabetes and several other complications. It is the stand in the return that the petitioner had acted in utter disregard to the rules and settled norms. In fact he himself had submitted a confidential report as regards his acquaintance with the assured for the last five years but did not disclose about the health condition of the assured. It is put forth that the petitioner was asked to show cause to which he offered the explanation and the same being not found satisfactory, an order contained in Annexure-P-4 terminating his agency was passed. It is the stand of the Corporation that due to the deliberate suppression of facts by the petitioner, the Corporation has suffered heavy loss. The Corporation had conducted inquiry and found out that the assured had got treatment at Sanghi Medical Centre, New Delhi, All India Institute of Medical Sciences New Delhi. Triveni Hospital Jabalpur and Verdhman Medical Centre, Jhansi, Reference has been made to the Regulation 8(2)(b) of the Life Insurance Corporation of India (Agents) Regulations, 1972 (hereinafter referred to as 'the Regulations') to show that it was incumbent on the part of the agent to make all reasonable inquiries regarding the proposal and to bring to the notice of the Corporation any circumstances which may adversely affect the risk undertaken. The petitioner, despite stating that he knew the assured Shri Gupta for the last five years, did not disclose the same and hence, the Corporation had to proceed against him and terminate the agency. 3. I have heard Mr. Atul Nema, learned counsel for the petitioner and Mr. D. K. Dixit for the respondents. 4. It is submitted by Mr. Nema is that there should have been an inquiry and that having not been done, the termination is vulnerable in law. 3. I have heard Mr. Atul Nema, learned counsel for the petitioner and Mr. D. K. Dixit for the respondents. 4. It is submitted by Mr. Nema is that there should have been an inquiry and that having not been done, the termination is vulnerable in law. The learned counsel has contended that due diligence was shown by the petitioner but the Corporation has drawn adverse inference without any foundation and, therefore, the order is unsustainable. Learned counsel has drawn attention of this Court to Section 45 of the Insurance Act, 1938 and placed reliance on the decisions reported in the cases of P. Sarojam v. LIC of India, AIR 1986 Kerala 201; S. Prasanna v. The Senior Divisional Life Insurance Corporation of India, AIR 1993 Madras 150 and Life Insurance Corporation of India v. Gulabchandra Agrawal, 2004 MPLJ 91 . 5. Mr. D. K. Dixit, learned counsel for the respondents has submitted that the natural justice has been duly complied with by affording the petitioner to show cause and, therefore, the contention that there has been violation of principles of natural justice has no substance. The learned counsel has laid emphasis on the regulations which govern the field. It is his further submission that the doctrine of proportionality is not attracted to a case of this nature when the Corporation has sustained huge loss. He has relied upon the decision reported in the case of Saroj Agrawal v. Life Insurance Corporation of India, AIR 2003 Jharkhand 134. 6. First I shall deal with the stand relating to non-compliance of principles of natural justice. There is no dispute that the petitioner was asked to show cause. He had offered the explanation. The same was not accepted. Submission of Mr. Nema is that the burden is on the assured to disclose the facts and when he had not disclosed, the petitioner cannot be punished for the same. In the case of P. Sarojam ( AIR 1986 Ker 201 ) (supra) a Division Bench of the High Court of Kerala has expressed the view as under:- "A contract of insurance is uberrima fides and the person seeking insurance is bound to disclose all material facts relating to the risk involved in the policy of insurance. In the case of P. Sarojam ( AIR 1986 Ker 201 ) (supra) a Division Bench of the High Court of Kerala has expressed the view as under:- "A contract of insurance is uberrima fides and the person seeking insurance is bound to disclose all material facts relating to the risk involved in the policy of insurance. Where the assured was suffering from a serious heart ailment not only when the proposal was made for insurance on his life but also for several years prior to that, he was bound to disclosed all material facts relating to his state of health. The assured gave false answers to the questions in the proposal form relating to his state of health inducing the insurer the Life Insurance Corporation to accept the proposal. The assured died of the heart ailment shortly after the date of the policy even before the premium for the second quarter had fallen due. In such case, the mere fact that the Medical Officer of the Corporation had certified the life assured as good would not be of much consequence. The false answers to the questions in the proposal form given by the assured relating to the state of his health vitiate the contract of insurance and the Corporation is entitled to repudiate the policy and decline payment thereunder." 7. In the case of S. Prasanna ( AIR 1993 Mad 150 ) (supra) it has been held as under:- "Before terminating the agency of an agent of the Life Insurance Corporation he should be given a reasonable opportunity to show cause against the termination of his Agency. If a reasonable opportunity is not afforded it would be in gross violation of the principles of natural justice. If a reasonable opportunity is not afforded it would be in gross violation of the principles of natural justice. Where the Life Insurance Corporation had come to the final conclusion that an agent was guilty of the offences for which the charge had been issued, he was asked to show cause as to why his agency should not be terminated and in doing so, the LIC relied upon the statements of persons which were admitted taken behind the back of the agent and he was not put on notice of the contents of those statements and was never given a chance to cross-examine the authors of those statements, there was absolute non-compliance with the principles of natural justice and terminating his agency was illegal and the same was liable to be set aside. The order has been passed in violation of rule 16 itself which provides that the agent should be given a reasonable opportunity. The order is also liable to be set aside on ground of non-application of mind." 8. In the case of Saroj Agrawal (AIR 2004 Jharkhand 134) (supra) after referring to the decision rendered in the case of Life Insurance Corporation of India v. Smt. Asha Goel, AIR 2001 SC 549 , the learned Judge has expressed the view as under :- "The duty to disclose material facts continues right up to the conclusion of the contract. If there are any mis-statements or suppression of material facts, the insurer certainly has the right to repudiate the claim made under a Policy which was obtained on the basis of suppression of truth." 9. The Agents Regulations, 1972 deals with terms and conditions of appointment of agents. Regulation 8 deals with functions of agents. Regulation 8 (2)(a) and (b) read as under :- "8(2)(a) Take into consideration the needs of the proposers for life insurance and their capacity to pay premium; (b) make all reasonable inquiries in regard to the lives to be read before recommending proposals for acceptance, and bring the notice of the Corporation any circumstances which may adversely affect the risk to be underwritten;" The submission of the learned counsel for the petitioner is that it is the assured who had given the false answers and, therefore, the agent cannot be punished. What is perceivable is that the agent is required to make all reasonable inquiries in regard to the lives to be assured before recommending the proposals for acceptance and bring to the notice of the Corporation any circumstances which may adversely affect the risk to be undertaken. 10. Regulation 16 deals with termination of agency for certain lapses. Regulation 16(1)(b) reads as under :- "16(1)(b) If he acts in a manner prejudicial to the interests of the Corporation or to the interests of its policyholders;" Proviso to the said Regulation 16 stipulates that the agents shall be given a reasonable opportunity to show cause against such termination. An agent in the Life Insurance Corporation of India has a different role. He procures policies for the Corporation. As is noticeable, the Corporation issued show-cause notice and has recorded non-satisfaction with regard to the explanation offered. The acid test is that his conduct should not be prejudicial to the interest of the Corporation. In the instant case, as is evident, the petitioner had not taken due care and made reasonable inquiries. He has tried to put the blame on the issued. But the Regulation required an agent to make all reasonable inquiries. He has failed to do the same. By such negligent act, the Corporation has suffered loss. The decisions cited at the Bar pertain to the liability of the Corporation vis-a-via the legal representatives of the assured. This has nothing to do with the conduct or performance of the agent. If Regulation 8(1)(b) and Regulation 16(1)(b) are read in a conjoint manner, there can be no iota of doubt that the action taken by the Corporation cannot be found fault with. 11. In the result, the writ petition, being devoid of merit, stands dismissed without any order as to costs. Petition dismissed.