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1970 Supreme(AP) 53

Andhra Pradesh High Court
Judges : P.RAMACHANDRA RAJU, S.OBUL REDDY
Life Insurance Corporation of India South Zone, Madras - Appellant
Versus
Bhogadi Chandravathamma - Respondent
Decided On : 03-04-70

The insurer bears the burden of proving that the policyholder fraudulently suppressed a material fact, knowingly making a false statement or suppressing material facts, to avoid a policy under Section 45 of the Insurance Act, 1938.

Headnote:

LIFE INSURANCE - AVOIDANCE OF POLICY - NON-DISCLOSURE OF MATERIAL FACT - BURDEN OF PROOF - SECTION 45 OF THE INSURANCE ACT, 1938.

Fact of the Case:

The appellant, Life Insurance Corporation of India, challenged the decree of the Subordinate Judge, Machilipatnam, which granted the respondent, the widow of the insured, a sum of Rs. 53,100.00 under five life insurance policies. The appellant claimed that the insured had fraudulently suppressed the material fact of his diabetes, rendering the contracts null and void.

Finding of the Court:

The court held that the appellant failed to discharge the burden of proof under Section 45 of the Insurance Act, 1938, as it did not examine the medical officers or agents involved in the proposal process. The court found that the insured's signature on the declarations, in a language he did not understand, was insufficient to prove fraudulent concealment or suppression of material facts.

Issues: 1. Whether the insured fraudulently suppressed the material fact of his diabetes, thereby avoiding the insurance policies. 2. Whether the appellant discharged the burden of proof under Section 45 of the Insurance Act, 1938.

Ratio Decidendi: 1. The court interpreted Section 45 of the Insurance Act, 1938, and held that the insurer must satisfy three conditions to avoid a policy on the grounds of misstatement or untrue answers: a) The statement must be inaccurate or false and suppress material facts. b) The suppression must be fraudulently made by the policyholder. c) The policyholder must have known at the time of making the statement that it was false or that it suppressed material facts. 2. The court found that the appellant failed to establish that the insured had fraudulently suppressed the fact of his diabetes. The medical examiners' confidential reports showed no evidence of sugar in the insured's urine. The court also noted that the insured was not conversant with English, the language of the proposal forms, and that the appellant did not examine the agents or medical officers who recorded the answers in the proposal forms.

Final Decision: The court dismissed the appeal, upholding the trial court's judgment and decree. The cross-objections filed by the respondent, seeking costs, were also dismissed.

OBUL REDDI, J.

( 1 ) THE defendant the Life Insurance Corporation of India, represented by its Divisional Manager Machilipatnam, is the appellant. The Subordinate Judge Machilipatnam, decreed the suit brought by the widow of the insured against the defendant for recovery of a sum of Rs. 53,100. 00 being the total amount due under five life insurance policies.

( 2 ) B. Venkateswarlu, the husband of the plaintiff insured his life under Policy Nos 12807645, 12876162, 12881223, 12882042 and 12999925085 for Rs. 10,000. 00 Rs. 5,000. 00 on 1-1-56, 11-111-58, 17-7-1959 and 12-10-59 respectively at Machilipatnam and nominated his wife, the plaintiff as the person entitled to the amounts due under the policies in the event of her surviving him. Venkastewarlu died on 23-4-1961 at his village Viswanathapalli, the cause, according to the plaintiff, being "loose motions and vomiting". The plaintiff, thereafter, intimating the death of her husband, asked for claim forms and, on receipt of those forms, she duly filled them up and dispatched them on 25-7-1961 along with the five policies by registered post to the Divisional Manager of the Corporation at Machilipatnam for payment of the amounts under theologies at nearly date. The defendant, on receipt of the claim forms and the polices informed the plaintiff by a registered notice dated 16-3-62 that it was gathered in the course of routine esquires made by an Official of the Corporation that her husband. Bh. Venkateswarlu, suffered from diskettes prior to the proposals made by him for insurance and that he had also under -gone treatment for the said ailment and that he wilfully with he the material facts relating to his disease and that the non-disclosure of full facts amounted to breach of warranty which he had given regarding his health and as such, the contracts have become null and void disentitling the plaintiff to any claim under the five policies. The plaintiff then sent a reply stating that her husband never suffered from diabetes or at any rate to his knowledge prior to the proposals made by him. that he had never undergone any treatment for the said ailment and that the doctors of the defendant-corporation examined him thoroughly and sent their reports which were accepted by the defendant before the policies were issued. According to her, the defendant-corporation played into the hands of the enemies for the false information given about her husbands health. As her claims were not acceded to the plaintiff gave a notice and laid action.

( 3 ) THE suit was resisted by the defendant-Corporation among other grounds, that the deceased wilfully gave false answers in the personal statements submitted by him in respect of the five policies on the basis of which the Corporation issued the policies covering risks on the life of the assured. To the knowledge of Venkateswarlu, all the answers given to the questions were false and were made with fraudulent intention of obtaining the policies withholding the truth regarding his state of health. It is alleged that he was suffering from diabetes at least fourteen years prior to his placing the proposals for insurance and that he was taking treatment from 1951 on wards from various doctors for the said disease. He had also purchased insulin from Machilipatna, drug Stores and taken injections daily from one Subbarao, an Ayurvedic Doctor at Viswanathpalli. The questionnaire and the declarations contained in the proposal forms were explained to him in Telugu and it is only after he understood the amen that he gave answers and signed underneath the declarations. In the circumstances having regard to the terms and conditions of the policies, the Corporation is entitled to repudiate its liability under the policies.

( 4 ) ON the two main issues that arose for decision, the Subordinate Judge held that he cannot give a positive finding that Venkateswarlu was suffering from diabetes by the time he took the insurance policies and that he suppressed the fact t



































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