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Madhya Pradesh High Court · body

2007 DIGILAW 786 (MP)

Munni Devi Silawat v. Life Insurance Corporation of India

2007-07-24

S.K.SETH

body2007
ORDER 1. This is plaintiff's revision in view of section 102 of the CPC. She has lost the first appeal in the appellate Court and the suit filed by her for recovery of Rs. 25,000/- against respondents was dismissed. 2. Plaintiff case in nutsheel was that her son Rishikesh, took a Life Insurance Policy for a sum of Rs. 25,000/- (Rupees twenty five thousand). Plaintiff was nominated to receive the sum assured and payable in terms of the Insurance Policy. Said Policy was in force from 28.9.1991. Rishikesh unfortunately died within two years on 8.6.1993 because of 'Nephritic syndrome'. Plaintiff staked her claim to the sum assured. Respondents after verification and investigation turned down the claim on the ground that said Policy was obtained on false statements and deliberate fraudulent suppression of material particulars relating to health of the insured. This led to filing of the civil suit. Learned trial Court decreed the suit, but in appeal, said judgment was reversed. Hence this revision by the plaintiff. 3. Now the question for consideration is whether the policy was vitiated by fraudulent suppression of material facts by Rishikesh? 4. So far as the question is concerned, Trial Judge found in affirmative and held that the respondent company could not repudiate the claim of the nominee and accordingly decreed the suit. In appeal, appellate Court upon appreciation of evidence found that deceased obtained the policy fraudulently suppressed material fact, as a result, the policy was void and the respondents were justified in repudiating the claim of the plaintiff under the void policy. Thus, it reversed judgment of the trial Court. 5. Before us, learned counsel for the applicant urged that the finding recorded by the learned trial Judge was the correct finding and the appellate Court committed material irregularity or at any rate illegality in coming to the contrary finding in view of the evidence given in the case. We have therefore, allowed learned counsel to take as through the evidence in the case. On a consideration of that evidence we have come to the conclusion that the finding of the appellate Court is the correct finding. 6. We shall presently consider the evidence, but it may be advantageous to keep in mind provisions of section 45 of the Insurance Act, 1938 which deal with the repudiation of a claim of the insured or nominee by the Insurance Company. 6. We shall presently consider the evidence, but it may be advantageous to keep in mind provisions of section 45 of the Insurance Act, 1938 which deal with the repudiation of a claim of the insured or nominee by the Insurance Company. The section provides, inter alia, that no policy of life insurance effected after the coming into force of this Act shall, after the expiry of two years from the date on which it was effected, be called in question by an insurer on the ground that a statement made in the proposal for insurance or in any report of a Medical Officer, or referee, or friend of the insured, or in any other document leading to the issue of the policy, was inaccurate or false, unless the insurer shows that such statement was on a material matter or suppressed facts which it was material to disclose and that it was fraudulently made by the policy holder and that the policy holder knew at the time of making it that the statement was false or that it suppressed facts which it was material to disclose. 7. On a fair reading of the section it is clear that it is restrictive in nature. It lays down three conditions for applicability of the second part of the section namely: (a) the statement must be on a material matter or must suppress facts which it was material to disclose; (b) the suppression must be fraudulently made by the policy-holder; and (c) the policy-holder must have known at the time of making the statement that it was false or that it suppressed facts which it was material to disclose. Mere inaccuracy or falsity in respect of some recitals or items in the proposal is not sufficient. The burden of proof is on the insurer to establish these circumstances and unless the insurer is able to do so there is no question of the policy being avoided on ground of misstatement of facts. The contracts of insurance including the contract of life assurance are contracts uberrima fides and every material fact must be disclosed, otherwise, there is good ground for rescission of the contract. If there are any misstatements or suppression of material facts, the policy can be called into question. The contracts of insurance including the contract of life assurance are contracts uberrima fides and every material fact must be disclosed, otherwise, there is good ground for rescission of the contract. If there are any misstatements or suppression of material facts, the policy can be called into question. For determination of the question whether there has been suppression of any material facts it may be necessary to also examine whether the suppression relates to a fact which is in the exclusive knowledge of the person intending to take the policy. 8. The crucial question before us is whether these three conditions were fulfilled in the present case. We think that they were. We are unable to agree with the learned Trial Judge that ailment which the deceased was suffering was trivial or casual ailment. Nor do we think that deceased was likely to forget about it when he submitted the insurance proposal for getting his life covered under a policy. Interestingly, no evidence was led by the plaintiff to show that deceased developed the 'Nephritic syndrome' after he took out the policy. On the other hand from the evidence of Dr. Ashok Bajpai (DW 3) and Sharad Kulkarni (DW 1), it is quite clear that deceased was suffering from 'Nephritic syndrome' for a long time in the past. Nephritic syndrome is not a disorder which does show symptom suddenly. Nephritic syndrome is a disorder where the kidneys have been damaged, causing them to leak protein from the blood into the urine. It is characterised by puffiness around the eyes, characteristically in the morning, edema, and undue weight gain. The most common sign is excess fluid in the body. It is too far-fetched to accept that either deceased was unaware of the illness or seriousness thereof when he took the policy. In his answers to the questions relating to health in the proposal form, he not only failed to disclose what it was material for him to disclose, but he made a false statement to the effect that he was not suffering from any serious ailment or disorder. In other words, deceased knowingly and fraudulently made a deliberate suppression of material fact. We are in full agreement with the appellate Court that applicant is not entitled to any sum under the vitiated policy. In other words, deceased knowingly and fraudulently made a deliberate suppression of material fact. We are in full agreement with the appellate Court that applicant is not entitled to any sum under the vitiated policy. Respondents have successfully shown that the deceased knowingly and fraudulently made deliberate suppression of material facts and as such the policy was hit by second part of section 45 of the Insurance Act, 1938. This Court is of the view that the impugned judgment and decree does not suffer from any infirmity or illegality calling for interference in the revision. 9. In this view of the matter, this revision fails, and accordingly it is hereby dismissed. However, there shall be no orders as to costs. Order accordingly.