C. Navaratanmal Jain v. Chairman, Life Insurance Corporation of India
2015-10-06
A.S.BOPANNA
body2015
DigiLaw.ai
ORDER : A.S. Bopanna, J. 1. The petitioner is assailing the orders dated 31.12.2010, 17.02.2012 and 30.01.2013 passed by the Disciplinary Authority, Appellate Authority and the Chairman, respectively. 2. The petitioner was appointed as an agent of the respondent-Corporation. During the tenure of his agency, the petitioner had recommended one Sri Bastimal Harlalji Dalal for issue of policy by the respondents. Accordingly, the policy bearing No. 612232894 was issued on 09.11.1998 based on the recommendation made by the petitioner. The said policy resulted in early claim due to the death of the policy holder on 07.04.2001. The policy was repudiated by the respondents alleging suppression of material facts. It is in that view, a show cause notice dated 09.01.2006 was issued to the petitioner seeking to initiate action for the same. Pursuant to the same, on having considered the reply submitted by the petitioner, an order dated 24.01.2006 was passed by the Disciplinary Authority imposing the penalty and terminating the agency of the petitioner with forfeiture of renewal Commission. The petitioner preferred an appeal to the Appellate Authority which was dismissed and the further representation made to the Chairman was also dismissed. The said orders are assailed in this petition. 3. The respondents have filed their objection statement. It is contended that this Court while disposing of W.P. No. 26395/2004 on 06.10.2005 on an issue relating to the transfer of agency sought by the petitioner had reserved the liberty to the respondents to initiate action and thereafter, the subsequent action has been initiated. It is their contention that the said policy holder who had been introduced by the petitioner was a chronic liver disease patient and this fact had been concealed both by the policy holder as well as the petitioner. In that view, it is contended that the petitioner had not fulfilled his responsibilities while recommending the case of the policy holder and as such, the action was necessitated. Reference is made to Clause 8(2)(b) of the Life Insurance Corporation of India (Agents) Regulations, 1972, to indicate the functions of an agent and it is pointed out that the petitioner has not fulfilled the said requirements and as such, the action has been initiated.
Reference is made to Clause 8(2)(b) of the Life Insurance Corporation of India (Agents) Regulations, 1972, to indicate the functions of an agent and it is pointed out that the petitioner has not fulfilled the said requirements and as such, the action has been initiated. Though the learned counsel for the respondents has also made certain references with regard to the agency of the wife of the petitioner being terminated, the same is not required to be noticed for consideration of the case on hand. 4. In the light of the above, what requires consideration in the instant petition firstly is as to whether the allegations as made by the respondents against the petitioner would be justified and even in a circumstance where the policy issued in favour of Bastimal Harlalji Dalal has resulted in early claim due to his death on 07.04.2001, whether the petitioner should be held responsible for having introduced a person who was suffering from liver disease and whether such introduction was made knowingly. Above all, what is to be taken into consideration is that even if there was certain irregularity, whether the case of the petitioner warrants termination of agency in the facts as arising in the instant case. 5. At this stage, it is also to be noticed that when the petition was heard on the last hearing date, keeping in view the fact that the Appellate Authority had referred to the medical report for having been performed medical examination on the policy holder, the need was to find out as to whether the medical examination was made at the instance of the respondents and as to whether the doctor, who conducted examination was an empanelled doctor. Learned counsel for the petitioner has filed copy of the Medical Examiner's Confidential Report. The Medical Examiner of the respondents has taken note of different aspects that have been provided for in the form. One of the columns as rightly pointed out is with regard the evidence to be noticed by the doctor regarding enlargement of liver or spleen. The doctor has recorded as "No" against that column. Therefore, at the outset, what is to be noticed is that even if the policy holder had suffered from any liver disease, it was not of a nature which was evident even in the medical examination itself. 6.
The doctor has recorded as "No" against that column. Therefore, at the outset, what is to be noticed is that even if the policy holder had suffered from any liver disease, it was not of a nature which was evident even in the medical examination itself. 6. If that be the position, the question is as to whether merely because the petitioner in his reply to the show cause notice has admitted that he knew the policy holder whom he has introduced for the last ten years, he could be held responsible for not disclosing the alleged liver disease of the policy holder. As noticed, the medical examination itself did not detect such liver disease having been suffered by the policy holder. Therefore, unless there is material to indicate that the petitioner was aware and deliberately suppressed the information from the respondents, a charge of serious nature cannot be made against an agent. An agent during the course of his business would have to introduce several persons who are interested in securing policy. Normally a person known to the agent would secure policy through the agent and that in itself cannot be a basis to hold that the petitioner or such agent is to be held responsible in all circumstance when an early claim is made in respect of the policy. There could be several circumstances which may lead to an early claim. 7. In the instant case, though the policy holder died on 07.04.2001 resulting in early claim, when the respondents seek to rely on the Regulations to contend that the agent is required to make reasonable queries and when in addition to the same, a medical examination has also been performed on the policy holder, the petitioner thereafter cannot be held responsible. In fact, the decision of the High Court of Delhi in the case of P.K. Singh v. Life Insurance Corporation of India relied on by the learned counsel for the petitioner would fortify the opinion expressed herein since the learned Judge while considering a similar contention with regard to reasonable enquiry to be made by the agent has after taking note of Clause 8(2)(b) has held that the phrase "all reasonable inquiries" contemplates knowledge on the part of the agent not to the extent of a medical practitioner. 8.
8. If that be the position, notwithstanding the medical report, if there was material with the respondents to indicate that the petitioner had knowledge and has suppressed the same, it is only then an allegation against the petitioner could have been made. That part, what is also to be kept in view is the mitigating circumstance to be taken into consideration before a harsh measure is adopted. The petitioner was functioning as an agent of the respondents in Nanjangud and there are no earlier complaints of the similar nature against the petitioner. The policy had resulted in early claim on 07.04.2001 and immediately thereafter no action had been initiated against the petitioner. In fact, the petitioner was before this Court in W.P. No. 26395/2004 seeking certain relief against the respondents with regard to transfer of his agency to Bengaluru. It is only at that stage, when the petition had been taken up for consideration on 06.10.2005, the respondents had come up with a plea that certain actions are pending against the petitioner to defend the denial of transfer. This Court while considering the allegation as has been made therein, had only made a passing observation that if there is any action to be initiated against the petitioner by the respondents, it would be open to them to do so in accordance with the Rules. It is only thereafter show cause notice dated 09.01.2006 had been issued in respect of an early claim which was within the knowledge of the respondents as far back as on 07.04.2001. Further what is also to be noticed is that though there was an early claim on 07.04.2001, the claim itself had been repudiated for suppression of material facts as against the policy holder as has been stated in the show cause notice. Learned counsel for the petitioner would however submit that the repudiation was not in relation to the illness of the policy holder, but because a cheque which was issued towards the premium, had been dishonoured. 9. Be that as it may, for whatever reason the amount had not been paid, the fact remains that no loss has been suffered by the respondent-Corporation on account of the petitioner.
9. Be that as it may, for whatever reason the amount had not been paid, the fact remains that no loss has been suffered by the respondent-Corporation on account of the petitioner. If that be the position, when the petitioner has introduced several policy holders to the respondent-Corporation and in one of the cases if unfortunately the policy holder has died and an early claim is lodged and incidentally if the respondents have concluded that he was suffering from some illness, that in itself cannot be a reason to take a harsh view in the matter by terminating the agency and forfeiting the commission amount. 10. In that light, a perusal of the order passed by the Disciplinary Authority, Appellate Authority and the Chairman would indicate that they have not kept in view these aspects of the matter, but have only been guided by the Regulations by which the responsibilities of the 'agent' is indicated and in that background, the same is taken into consideration in a circumstance where there was early claim and such claim was by a policy holder who had suffered from liver aliment. Such conclusion as reached by the Disciplinary Authority, Appellate Authority and the Chairman would not be justified in the present facts and circumstances of the case. 11. Accordingly, the orders dated 31.12.2010, 17.02.2012 and 30.01.2013 passed by the Disciplinary Authority, Appellate Authority and the Chairman stand quashed. Consequent thereto, the petitioner be reinstated as a Club Member Agency of the respondent-Corporation and all consequential actions be taken in that regard to restore the position. In terms of the above, the petition stands disposed of.