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1958 Supreme(Pat) 166

PATNA HIGH COURT
B.N.Rai and K.Ahmad JJ.
Ratan Lal
Versus
Metropolitan Insurance Co.Ltd.
Appeal from Original Decree No. 23 of 1950 ;
Decided On : OCTOBER 07, 1958

An insured person is not required to disclose ordinary disorders that do not pose a significant risk to their life.

Headnote:

LIFE INSURANCE - CONTRACT - UBERRIMA FIDES - DUTY OF DISCLOSURE - MATERIAL FACT - ILLNESS - DISORDER - WARRANTY - BREACH - AVOIDANCE OF POLICY - INSURANCE ACT, 1938, S. 45.

Fact of the Case:

The insured, Pyare Lal, applied for a life insurance policy on January 23, 1946, and paid the first annual premium. The insurance company conducted a medical examination and found him to be a first-class life. On March 27, 1946, the company sent an acceptance letter to Pyare Lal, subject to certain conditions, including a requirement to disclose any illness or change in health. On March 28, 1946, the company issued a premium collection receipt, indicating that the policy was accepted and the risk commenced. Pyare Lal died on April 19, 1946, from an illness that began on March 28, 1946. The insurance company denied liability, claiming that Pyare Lal breached the warranty by not disclosing the illness.

Finding of the Court:

The court found that Pyare Lal did not fall ill until the evening of March 28, 1946, after the policy was accepted by the insurance company. The court held that the complaint Pyare Lal had on March 27, 1946, was an ordinary disorder and not an illness. Therefore, there was no breach of warranty by Pyare Lal, and the insurance company was liable to pay the claim.

Issues: 1. Whether Pyare Lal breached the warranty by not disclosing the illness that began on March 28, 1946? 2. Whether the insurance company was justified in withholding payment of the claim?

Ratio Decidendi: 1. The duty of disclosure in insurance contracts requires the insured to disclose all material facts that may affect the risk. A material fact is one that would influence the insurer's decision to accept the risk or the terms of the policy. 2. An illness is a condition that affects the health of a person and may shorten their life. A disorder is a temporary disturbance of a person's physical or mental health that is not serious and does not pose a significant risk to their life. 3. In this case, the court found that the complaint Pyare Lal had on March 27, 1946, was an ordinary disorder and not an illness. Therefore, Pyare Lal did not breach the warranty by not disclosing it to the insurance company.

Final Decision: The court allowed the appeal, set aside the judgment and decree of the trial court, and decreed the suit in favor of the plaintiffs, with interest at 6% per annum from the date of the institution of the suit until the date of realization.

Judgment

K.Ahmad, J.

1. This appeal arises out of a suit for the realisation of a claim under an insurance policy on the death of the life insured, namely, that of one Pyare Lal of Siwan. It is not denied that Pyare Lal died on 19-4-1946, and the plaintiffs, who are his sons and appellants in this Court, are his successors and heirs. Obviously, therefore, here there is no scope for any controversy as to the title of the plaintiffs nor in fact there is any.

Further it is not denied that on 23-1-1946, Pyare Lal filled up an application form supplied by the agent of the respondent company to insure his life for a sum of Rs. 10,000.00 on twenty years endowment and having signed it handed over the same to that agent along with a cheque for a sum of Rs. 549/1/-, that being the first annual premium payable for the year 1946 and that thereafter on medical examination by the doctor of the company his life was found to be a first class life.

Exhibit 2 (a), which is dated 31-1-1946, is the kutcha receipt of the aforesaid amount granted by the respondent Metropolitan Insurance Company Ltd., under the signature of one H.N. Chakravarty, Collector. It reads: "Received with thanks from Mr. Pyare Lal the sum of Rupees Five hundred forty-nine and one anna on account of advance against a new proposal. Rs. 549/1/- by cheque.

Sd. H. N. Chakravarty, Collector".

Thereafter on 27-3-1946, the respondent company sent a letter which is headed as Acceptance letter of proposal granted by the Metropolitan Insurance Co. Ltd. to Pyare Lall" and the contents of it read as follows:

We beg to inform you that your proposal for an Assurance dated 23-1-1946 has been accepted for a sum assured of Rs. 10,000/- on the following terms and under conditions noted overleaf and that a policy for the said sum assured will be issued on receipt of the sum noted hereunder as net due provided all formalities required by the Company for acceptance thereof to take up risk on your life have been duly complied with.

Terms of Acceptance--

On 20 years endowment with enhanced profits.

Premium payable yearly at Rs. 549/1/-

First instalment payable Rs. 549/1/-

Less amount in deposit Rs. 549/1/-

Net due Rs.

Kindly oblige us by remitting the aForesaid amount within fifteen days from

this date, if it has not already been paid.

Yours faithfully,

Sd. Illegible

For Secretary.

And finally this was followed by a regular receipt which is dated 28-3-1946. It is headed as "Premium collection receipt granted by the Metropolitan Insurance Company Ltd. to Pyare Lall" and the body runs in the following terms:

Premium Collection Receipt No. XVI. 1550.

Received with thank on 28-3-1946 the sum of Rs. 549 as. 1 (Rupees five hundred and forty nine and anna one only) being the yearly premium due on nil against policy No 98700/28329/46 on life of Mr. Pyare Lall.

Sd. Illegible,

Collector,

Sd. Illegible.

Accounts Officer.

(On two annas stamp)

Bengal.

Seal of Metropolitan Insurance".

It, however, so happened that before this acceptance could be supplemented by a regular policy, the assured, as already stated, died on 19-4-1946. The finding of the trial court as to the amount, which was paid along with the proposal, is that originally the defendant company kept it in suspense account and thereafter it was on 28-3-1946, that they finally adjusted the same towards the first annual premium.

Accordingly at the trial it has been held that it was on 28-3-1946 that the policy was finally accepted and then became a binding contract between the parties. It is, however, not denied that even then had the matter rested there all alone, there was no difficulty in the claim being decreed as prayed for in the plaint. But the matter seems to have been complicated by the plea set up by the defendant company that though the insured died on 19-4-1946, that is to say, long after the acceptance of the policy but the illness which was responsible for bringing about this death had already set in and was there since 23-3-1946, that mea































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