SupremeToday Landscape Ad
Back
Next
Judicial Analysis Court Copy Headnote Facts Arguments Court observation
Listen Audio Icon Pause Audio Icon
judgment-img

1988 Supreme(Kar) 382

Karnataka High Court
Life Insurance Corporation of India - Appellant
Versus
B.Kusuma, T.Rai - Respondent
Decided On : 08-23-88
R.F.A. : 136 of 1977

Advocates:
B.V.ACHARYA RAO, C.SRINIVASA IYENGAR

Headnote:

The insurer can repudiate the policy after a period of two years only if he shows that the 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, referred to in the first part of the section, was on a material matter, or facts have been suppressed which it was material for the policy-holder to disclose. It is further to be proved that the statement was fraudulently made by the policy-holder with the knowledge of the falsity of statement or that the suppression was of the material facts which had not been disclosed. In other words, proof of deliberate fraud and not merely of constructive fraud or of mis-statements has to be shown.

Fact of the Case:

The assured had omitted to refer to the fact of his having undergone treatment for diarrhoea and anaemia by a Doctor. The supreme Court in the said case has laid down the necessary ingredients to be established by an insurer in order to avoid a liability under a policy of insurance, in accordance with the terms of Section 45.

Finding of the Court:

The three conditions for the application of the second part of Section 45 are- (a) the statement must be on a material matter of 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.

Issues: 1. Whether the defendant has succeeded in establishing the contention that the statement made by the assured in the personal statement (Ex. D-59) was on material matters or suppressed facts which it was material to disclose; that the suppression was fraudulently made by the assured and that the assured knew at the time of making the statement that it was false or that he suppressed facts which it was material to disclose? 2. Whether the defendant was entitled to repudiate the claim under the policy? 3. Whether the Judgment and Decree under appeal are correct, legal and proper?

Ratio Decidendi: The insurer can repudiate the policy after a period of two years only if he shows that the 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, referred to in the first part of the section, was on a material matter, or facts have been suppressed which it was material for the policy-holder to disclose. It is further to be proved that the statement was fraudulently made by the policy-holder with the knowledge of the falsity of statement or that the suppression was of the material facts which had not been disclosed. In other words, proof of deliberate fraud and not merely of constructive fraud or of mis-statements has to be shown.

Final Decision: Appeal allowed.

NAVADGI, J.

( 1 ) THIS is defendant's appeal against the judgement and Decree dated 31-8-1977 made by the I Additional Civil Judge, mangalore. The Life Insurance Corporation of India - the Appellant, and smt. B. Kusuma t. Rai the respondent herein were the defendant and the plaintiff respectively in the trial Court. The appellant and the respondent in this appeal, for the sake of convenience, would be referred to in the course of this Judgement as the defendant and the plaintiff respectively.

( 2 ) THE plaintiff filed a suit in O. S. No. 6 of 1975, seeking a decree directing the defendant to pay a sum of Rs. 30,000/- as due under the policy bearing No. S. 39675124, a sum of Rs. 5,385/- towards interest on Rs. 30,000/- from 6-1-1972 to 3-1-1975 at the rate of 6 per cent per annum, and a sum of rs. 15/- towards the cost of registered notice.

( 3 ) THE facts on which the plaintiff founded her reliefs are these : b. S. Thimmappa Rai (Hereinafter referred to as the assured), the husband of the plaintiff, had insured his life for a sum of rs. 30,000/- under policy No. S. 39675124. The assured had nominated the plaintiff as a nominee. The assured died on 6-1-1972 at Father muller's Hospital at Kankanady, Mangalore. The assured, prior to his death, had assigned his policy in favour of the Vijaya Bank limited as security for the amounts borrowed by him. The Vijaya Bank, after the death of the assured, on the strength of the assignment, furnished proof of death and lodged claim with original policy on 8-4-1972 the defendant repudiated the claim on 30-7-1973 on the ground that the policy holder had made deliberate mis-statements and had withheld material information regarding his health at the time of effecting the assurance. The plaintiff paid the amounts due to the vijaya Bank and got the policy re-assigned in her favour. Hence, she was entitled to claim the amounts due under the policy. She made a request to the defendant on 8-10-1973 to pay the amounts due to her under the policy. The defendant neither paid the amounts nor replied. On 10-6-1974, the plaintiff sent a registered notice through her lawyer to the defendant demanding the amounts due under the policy. The defendant sent a reply dated 11-7-1974 repudiating the claim once again on the same grounds on which it had repudiated the claim on 30-7-1973 when the same had been lodged by the vijaya Bank. The plaintiff alleged that the contentions raised by the defendant for repudiating the claim were neither true nor valid in law. She denied the material allegations made by the defendant in the reply dated 11-7-1974. She averred that the terms, if any, in the policy of contract entitling the defendant to repudiate the claim were unenforceable, invalid and opposed to law and public policy. She stated that the assured, at the time of proposal of the policy, has been examined by a Doctor approved by the defendant and that the defendant after getting a certificate from the Medical Officer and after being satisfied about the state of health of the assured, issued the policy, adding that the repudiation of the claim was unjust and opposed to law.

( 4 ) THE defendant filed written statement, taking very many defences. Among other things, it contended that the proposal and the personal statement made by the assured for taking the Insurance Policy constitute basis for the contract of insurance; that they are the material parts of the contract; that the assured had made false and incorrect statements in the personal statement submitted by him knowing fully well that the statement he was making was false and incorrect; that the assured was under an obligation to disclose all material facts regarding his health so that it could determine whether or not to accept the risk; that the assured had suppressed material facts while making the personal statement; that he had suggested false facts; and that the answers given by the assured to Items Nos. 4,6,8,9 and 10 of the personal statement dated 28-9-












































































































Click Here to Read the rest of this document

1
2
3
4
5
6
7
8
9
10
11
SupremeToday Portrait Ad
supreme today icon
logo-black

An indispensable Tool for Legal Professionals, Endorsed by Various High Court and Judicial Officers

Please visit our Training & Support
Center or Contact Us for assistance

qr

Scan Me!

India’s Legal research and Law Firm App, Download now!

For Daily Legal Updates, Join us on :

whatsapp-icon Back to top