1973 Supreme(AP) 92
Andhra Pradesh High Court
Judges : O.CHINNAPPA REDDY
Life Insurance Corporation of India - Appellant
Versus
Shakuntala Bai - Respondent
Decided On : 07-17-73
The insurer cannot repudiate a life insurance policy based on an inaccurate statement in the personal statement unless the statement was material and fraudulently made by the policy-holder, and the insurer has properly explained the implications of the basis clause and the questions in the personal statement to the insured.
Headnote:
INSURANCE - LIFE INSURANCE - REPUDIATION OF POLICY - INACCURATE OR FALSE STATEMENT IN PROPOSAL OR PERSONAL STATEMENT - MATERIALITY OF STATEMENT - DUTY OF INSURER TO EXPLAIN IMPLICATIONS OF BASIS CLAUSE AND QUESTIONS IN PERSONAL STATEMENT - FAIR CONSTRUCTION OF ANSWERS - UNTRUE STATEMENT - REPUDIATION OF POLICY NOT JUSTIFIED.
Fact of the Case:
The Life Insurance Corporation of India sought to repudiate a life insurance policy on the ground that the insured had made an inaccurate statement in his personal statement by stating that he had not suffered from any illness or consulted a medical practitioner within the last five years when in fact he had suffered from indigestion for a few days and had taken a cihoornam from an Ayurvedic practitioner. The jaundice of which the insured died had no connection with the indigestion.
Finding of the Court:
The court held that the insurer was not justified in repudiating the policy as the insured's statement was not untrue in a fair sense. The court found that the insurer had not established that it had properly explained the implications of the basis clause and the questions in the personal statement to the insured. The court also found that the undisclosed indigestion was not a material fact that needed to be disclosed.
Issues: 1. Whether the insurer was justified in repudiating the policy based on an inaccurate statement in the personal statement. 2. Whether the insured's statement was untrue in a fair sense. 3. Whether the insurer had properly explained the implications of the basis clause and the questions in the personal statement to the insured. 4. Whether the undisclosed indigestion was a material fact that needed to be disclosed.
Ratio Decidendi: 1. The insurer has the right to repudiate a policy on the ground of inaccuracy or falsehood of a statement in the proposal or personal statement only if the statement was material and fraudulently made by the policy-holder. 2. A statement is not untrue in a fair sense if it is accurate in the context of the question asked and the explanations provided by the insurer. 3. The insurer has a duty to explain the implications of the basis clause and the questions in the personal statement to the insured in a clear and comprehensive manner. 4. An undisclosed fact is material if it is likely to influence the insurer's decision to issue the policy or the premium charged.
Final Decision: The appeal was dismissed with costs.
( 1 ) KESHAVADAS Jamanadas died of jaundice on 4-11-1966. The Life Insurance Corporation of India seeks to repudiate a policy of insurance which Keshavdas Jamanadas had taken out about one and a half years earlier on the ground that in his personal statement he had stated that he had not suffered from any illness and had not consulted any medical practitioner within the last five years when in fact he had once suffered from indigestion for a few days and had taken a cihoornam from an Ayurvedic practitioner, The jaundice of which Keshavdas Jamanadas died had not the remotest connection with the indigestion from which he suffered for a few days several months earlier. But the Life Insurance Corporation wants to profit by the inaccuracy and seeks to deprive the assured s dependents of the amount of insurance. I consider the attitude of the Life Insurance Corporation highly improper and grotesquely unfair. But the learned counsel for the Life Insurance Corporation urges that such is the rigour of the law and that the Corporation is within its rights in repudiating the policy. Let me examine whether the law is indeed so harsh and the dependents of Keshavadas Jamanadas so helpless.
( 2 ) KESHAVADAS Jamanadas submitted a proposal for insurance of his life on 13-1-1965 for a sum of Rs. 5,000. 00. He signed a declaration in a printed form to the effect that the statements of answers given in the proposal were true in every particular and that those statements and the declaration together with the further statements to be made before the Medical Examiner and the declaration relative thereto shall be the basis of the contract of assurance and that if there was any untrue averment, the contract shall be absolutely null and void. On 18-2-1966 he made a personal statement before the Medical Examiner appointed by the Life Insurance Corporation of India and was then examined by the Medical Examiner. The personal statement was in the form of printed questions and written answers. The answers were not written by the assured but were written by one Sawarikar, the Development Officer of the Life Insurance Corporation of India employed in its Secunderabad Branch. Keshavadas Jamanadas, however, signed a printed declaration at the foot of the personal statement that the answers were given by him after fully understanding the questions, that they were true in every particular, that he had not withheld any information and that he agreed that the declaration together with the proposal for assurance shall be the basis of the contract of assurance. The Medical Examiner has also signed the personal statement certifying that the proposer had signed in his presence after admitting that all the answers had been correctly recorded. The certificate is in a printed form. Sri Sawarikar has also signed a declaration in a printed form at the foot of the personal statement that he bad explained the questions to the proposer who had signed after satisfying himself that the answers had been correctly recorded. The alleged false particulars in the personal statement are these. To question 4 (d)"have you consulted a medical practitioner within the last five years?"the answer was "no". To question 6 (d)"have you ever suffered from any of the following ailments, Sprue, Jaundice, anaemia, piles, dysentery, cholera abdominal pain, appendicitis, or any other disease of the stomach, liver, spleen, or intestines?"the answer was No. To question 6 (k) "any other illness within the last five years requiring treatment for more than a week?" the answer was No. According to the evidence it transpires that Keshavdas Jamnadas suffered from indigestion between 14-10-1965 t and 28-10-1965 and had taken a choomam from Dr. A. Ananthaswamy, an Ayurvedic practitioner. The Medical Examiner who examined Keshavdas Jamnadas after the personal statement was recorded submitted a confidential report to the Life Insurance Corporation of India, again in a printed form, wherein t