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Madhya Pradesh High Court · body

2012 DIGILAW 664 (MP)

Rajendra Prasad Pathak v. Union of India

2012-07-03

A.K.SHRIVASTAVA

body2012
ORDER : By this petition under Articles 226 and 227 of the Constitution of India the petitioner has challenged the action of the respondents 2 and 3 by which the claim of the petitioner to benefit him from the death insurance policy of his mother has been denied. 2. In brief, the case of the petitioner is that his mother, namely, Pavitra Devi Pathak (hereinafter referred to as the assured took the death claim policy No. 370725612 (for short the policy and signed the proposal and personal statement for insurance on 27-2-1995. However, unfortunately she died within two months on 21-4-1995 in the M.P. Electricity Board Hospital, Jabalpur. Thereafter, on being approached by the petitioner to respondent No. 2, Senior Divisional Manager to provide benefit of the policy, the said respondent vide letter dated 31-3-1999 (Annexure P-1) declined to provide such benefit on the ground that there was material concealment of fact at the time when the proposal to obtain policy was submitted by the assured and on the basis of wrong and false information in regard to her health the policy was obtained. The petitioner against the order of the respondent No. 2, Senior Divisional Manager, filed a departmental appeal before the Regional Manager, LIC, Bhopal (respondent No. 3) vide appeal memo dated 10-5-1999 (Annexure P-3). The appellate authority (respondent No. 3) on 10-5-1999 intimated the petitioner that his appeal shall be decided immediately but till the date of filing of the petition (i.e. 17-8-1999) the appeal was not decided and hence, the present petition has been filed and it has been prayed by the petitioner that because the assured was holding a valid policy and on account of her death, the petitioner is entitled for the claim under the policy. 3. All the respondents have filed a joint return and raised the plea of dismissal of the petition because alternative remedy to file the civil suit is available. On merits it has been contended that deliberately incorrect information in regard to health was supplied by the assured stating that she did not remain ill for last five years with a disease which was persisting for more than a week; she was never admitted in any hospital for surgery; she is not suffering from any ailment of liver; abdomen, heart, lungs, kidney and brain etc. and she is also not suffering from diabetes, tuberculosis, high or low blood pressure etc. According to the stand taken in the return, the assured/deceased was a chronic patient of renal disease. It is further stated in the return that the appeal filed by the petitioner had already been dismissed on 4-9-1999 and it has also been intimated vide order contained in Annexure R-/2(4) to the return. Hence, it has been prayed in the return that the petition be dismissed. 4. The contention of Shri Pandit, learned counsel for the petitioner is that the policy was obtained on 27-2-1995, however, after two months all of a sudden the assured sustained heart attack on 18-4-1995, as a result of which she was admitted in M.P. Electricity Board Hospital, Jabalpur where she breathed her last after three days on 21-4-1995 on account of cardio respiratory arrest. According to learned counsel, the assured was not aware that she was suffering from any chronic renal disease and therefore, in the proposal form she answered the question in negative and therefore, since the assured was fully covered under the policy the petitioner is entitled for the claim under the policy. 5. On the other hand, Shri Dixit, learned counsel for the respondents submitted that deliberately the assured concealed that she is a chronic patient of renal disease and by submitting false information the insurance policy was obtained and therefore, the claim of petitioner under the policy cannot be accepted. It has also been put forth by him that since there is factual dispute, the petitioner should have filed the civil suit. In this regard he has placed reliance on the decision of Supreme Court, Life Insurance Corporation of India and others v. Smt. Kiran Sinha, AIR 1985 SC 1265 . By placing reliance on Single Bench decision of this Court Shyam Sunder Tripathi v. Life Insurance Corporation of India and another, W.P. No. 7269/2002 decided on 23-11-2006 reported in AIR 2007 MP 57 by Hon’ble Mr. Justice Dipak Misra (as His Lordship then was) it has been submitted that if the assured at the time of obtaining the policy has concealed the ailment etc., then after the death of the assured) heirs are not entitled for the claim under the policy. On these premised submissions it has been prayed that this petition be dismissed. 6. Justice Dipak Misra (as His Lordship then was) it has been submitted that if the assured at the time of obtaining the policy has concealed the ailment etc., then after the death of the assured) heirs are not entitled for the claim under the policy. On these premised submissions it has been prayed that this petition be dismissed. 6. Having heard learned counsel for the parties I am of the view that this petition deserves to be dismissed. 7. Although normally the claimant should have filed a civil suit because there is factual dispute but in the present case the stand of the respondents appears to be correct that at the time of obtaining the policy the assured concealed the reality that she was suffering from renal disease. On bare perusal of the bed-ticket (Annexure R-2/(3)) of the M.P. Electricity Board Hospital, Jabalpur where the assured was admitted on 18-4-1995 it is gathered that she was a patient of CRF (Chronic Renal Failure) for last four years. Learned counsel for the petitioner submits that assured was not aware that she is suffering from such ailment. To me, if she was a chronic patient of renal failure for last four years certainly she must not be healthy and must be having some complaint in that regard and therefore, according to me, since she deliberately did not disclose in the proposal form that she is suffering from renal disease, I am of the view that her heirs are not entitled for the claim under the policy after her death. 8. Admittedly, the death policy was obtained on 27-2-1995 and after within two months therefrom the assured had died in the hospital on 21-4-1995. In the decision of Shyam Sunder Tripathi, ( AIR 2007 MP 57 ) (supra) reliance was also placed on the Division Bench of Kerala High Court, P. Sarojam v. L.I.C. of India, AIR 1986 Kerala 201 in which it was held that even before obtaining death policy Medical Officer of the Corporation had certified the life assured as good would not be of any consequence. The false answers to the question in the proposal form given by the assured relating to the state of her health vitiate the contract of insurance and according to me the insurer is entitled to repudiate the policy and to decline the payment. The false answers to the question in the proposal form given by the assured relating to the state of her health vitiate the contract of insurance and according to me the insurer is entitled to repudiate the policy and to decline the payment. To me, it was the duty of the assured to disclose material facts because it continues right upto the conclusion of the contract. 9. If there is any misrepresentation or suppression of material fact the insurer certainly has a right to repudiate the claim made under the policy which was obtained under the suppression of true facts. In this regard, I may profitably place reliance on the decision of Supreme Court, Life Insurance Corporation of India v. Smt. Asha Goel, AIR 2001 SC 549 . Since the assured was suffering from renal disease for last four years before she was admitted in the hospital, according to me, material facts have been suppressed and therefore, the petitioner is not entitled for any relief. 10. For the reasons stated hereinabove, this petition fails and is hereby dismissed with no order as to costs. Petition dismissed.