Bombay High Court
H.H.KANTHARIA
Asha Goel - Appellant
Versus
Life Insurance Corporation of India - Respondent
Decided On : 09/02/1985
WRIT - MANDAMUS - LIFE INSURANCE POLICY - LIABILITY OF L.I.C. - STATUTORY OR CONTRACTUAL - DISPUTED QUESTIONS OF FACTS - WRIT JURISDICTION - SCOPE - FAIRNESS AND REASONABLENESS - L.I.C. OBLIGATIONS TO POLICY-HOLDERS.
Fact of the Case:
The Petitioner, Smt. Asha Goel, is the widow of deceased Naval Kishore Goel who was an employee of the Digvijaya Woollen Mills Ltd., Jamnagar, as a Labour Officer. He submitted a proposal for a life insurance policy at Meerut in Uttar Pradesh on May 29, 1979 which was accepted and he was granted such a policy bearing No. 48264637 for a sum of Rs. 1,00,000 (One lakh). According to the petitioner her husband maintained sound health and was hale and hearty throughout his life. However, he had retrosternal chest pain sometime in Dec. 1979 when he consulted Dr. P. S. Kulkarni, Professor of Medicine, M. P. Shah Medical College, Jamnagar. He was advised rest and was relieved of his ailment within few hours. Thereafter he attended office till Dec. 1, 1980. However, on Dec. 2, 1980 he had again slight pain in the chest. He was attended to by the same Dr. P. S. Kulkarni and was admitted in Irwin Group of Hospitals at Jamnagar on Dec. 3, 1980. But he passed away at the age of 46 leaving behind a young widow and a daughter and a son aged about 18 and 16 respectively on Dec. 12, 1980. The cause of death was certified as Acute Myocardial Infarction and Cardiac arrest. The Petitioner being the nominee of the deceased informed .the Divisional Manager, Meerut City (U. P.) of the Respondent 1, viz., Life Insurance Corporation of India (hereinafter referred to as "L.I.C." for short) about the death of her husband.
Finding of the Court:
1. The liability of L.I.C. under a policy of life insurance is a statutory liability and hence a writ can lie under Art. 226 of the Constitution. 2. Even if the liability of L.I.C. under a policy of life insurance is not a statutory liability and is a contractual liability even then, in my judgment, a writ under Art. 226 of the Constitution can lie against L.I.C. for enforcement of such a liability. 3. There are no disputed questions of facts involved in this case on account of which, as submitted by Mr. Paranjape, writ jurisdiction of the High Court under Art.226 does not lie. 4. The action of LIC in repudiating the claim of the petitioner was irrational, capricious and arbitrary which violates the provisions of Art. 14 of the Constitution.
Issues: 1. Whether the liability of L.I.C. under a life insurance policy is a statutory liability or a contractual liability. 2. Whether a writ of mandamus under Art.226 of the Constitution can be issued in this case. 3. Whether there are disputed questions of facts involved in this case. 4. Whether the action of LIC in repudiating the claim of the petitioner was fair and reasonable.
Ratio Decidendi: 1. The liability of L.I.C. under a policy of life insurance is a statutory liability. This is because S. 45 of the Insurance Act, 1938, which applies to L.I.C. as it applies to any other insurer, provides that no policy of life insurance shall be called in question by an insurer on the ground that a 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 tending to the issue of the policy, was inaccurate or false, unless the insurer shows that such statement was on a material matter or suppressed facts which it was material to disclose and that it was fraudulently made by the policy-holder and that the policy-holder knew at the time of making it that the statement was false or that it suppressed facts which it was material to disclose. 2. A writ of mandamus under Art.226 of the Constitution can be issued in this case because the liability of L.I.C. under a policy of life insurance is a statutory liability. 3. There are no disputed questions of facts involved in this case. This is because the documents produced by the parties are not inconsistent with each other. 4. The action of LIC in repudiating the claim of the petitioner was not fair and reasonable. This is because LIC did not give the petitioner a proper opportunity to present her case and because LIC's decision was based on oral enquiries rather than on documentary evidence.
Final Decision: The Life Insurance Corporation of India and the Respondent 3 are hereby directed to pay to the petitioner an amount of Rs. 1,00,000 (one lakh) arising out of the Life Insurance Policy of her husband deceased Naval Kishore Goel, bearing No. 48264637, together with all the benefits accruing therefrom with interest at the rate of 15% from the date of the death of the petitioner's husband within a month. The LIC is also directed to pay cost of Rs. 2,000/-to the petitioner.
2. The Petitioner, Smt. Asha Goel, is the widow of deceased Naval Kishore Goel who was an employee of the Digvijaya Woollen Mills Ltd., Jamnagar, as a Labour Officer. He submitted a proposal for a life insurance policy at Meerut in Uttar Pradesh on May 29, 1979 which was accepted and he was granted such a policy bearing No. 48264637 for a sum of Rs. 1,00,000 (One lakh). According to the petitioner her husband maintained sound health and was hale and hearty throughout his life. However, he had retrosternal chest pain sometime in Dec. 1979 when he consulted Dr. P. S. Kulkarni, Professor of Medicine, M. P. Shah Medical College, Jamnagar. He was advised rest and was relieved of his ailment within few hours. Thereafter he attended office till Dec. 1, 1980. However, on Dec. 2, 1980 he had again slight pain in the chest. He was attended to by the same Dr. P. S. Kulkarni and was admitted in Irwin Group of Hospitals at Jamnagar on Dec. 3, 1980. But he passed away at the age of 46 leaving behind a young widow and a daughter and a son aged about 18 and 16 respectively on Dec. 12, 1980. The cause of death was certified as Acute Myocardial Infarction and Cardiac arrest. The Petitioner being the nominee of the deceased informed .the Divisional Manager, Meerut City (U. P.) of the Respondent 1, viz., Life Insurance Corporation of India (hereinafter referred to as "L.I.C." for short) about the death of her husband.
She was instructed to fill up certain claim forms and was asked to return the same along with the original insurance policy and the death certificate, etc., to the said office. The petitioner accordingly submitted all the necessary documents along with a covering letter (Exh. 'C') and requested the Divisional Manager of the L.I.C. at Meerut City to consider her claim and make the payment at the earliest. The concerned Divisional Manager (Respondents) by his letter dt. June 8, 1981 repudiated the liability under the policy and refused to make any payment on the grounds that the deceased had withheld correct information regarding his health at the time of effecting the assurance with L.I.C. He further informed the petitioner that in the proposal for assurance dt. May 29, 1979, the deceased had answered the following questions as under :-
Questions
Answers
(1) What has been your usual state of health?
Good
(2) Have you consulted a Medical Practitioner within the last five years for any ailments requiring treatment for more than a week?
No.
(3) Have you remained absent from place of your work on ground of health during the last five years?
No
He also informed the Petitioner that the above answers were false and the L.I.C, was in possession of indisputable proof to show that before the proposal for the policy her husband had suffered from various ailments for which he had consulted a medical man and had taken treatment and was on medical leave for 34 days for various periods from 20-8-76 to 6-6-79 which facts he had not disclosed in his proposal for insurance policy and instead he had given false answers. Thereafter the Petitioner herself and through her brother one Mr.K.K. Garg appealed to the various authorities of L.I.C. but with no fruitful result. Even an Advocate's notice was served on the authorities of L.I.C. to review the matter sympathetically but to no avail. The petitioner, therefore, filed the present Writ Petition under Art. 226 of the Constitution for a Writ of Mandamus directing the Respondents 3 and L.I.C. to pay the Petitioner the claim under the insurance policy of her deceased husband together with all other accruing benefits with interest. The petition has been vehementl
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