NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
Ashok Bhan, President and B.K. Taimni, Member
DAYA RANI AND ORS. - Appellants
Versus
LIFE INSURANCE CORPORATION OF INDIA - Respondent
Revision Petition No. 482 of 2005 from Order dated 17.1.2004 in Appeal No. 882/SC of 1998 of Uttar Pradesh State Consumer Disputes Redressal Commission
Decided on : 15-09-2009
Mr. G.C. Tyagi, Mr. Kailash Pandey and Mr. Mukesh Tyagi, Advocates, for the Appellant; Mr. Kamal Mehta, Advocate, for the Respondent
Headnote:
Insurance - Material Information - Insurance Act, 1938, Section 45 - Summary of Section 45 - [45. Policy not be called in question on ground of mis-statement after two years No policy of life insurance effected before the commencement of this Act shall after the expiry of two years from the date of commencement of this Act and no policy of life insurance effected after the coming into force of this Act shall after the expiry of two years the date on which it was effected, 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 leading 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.......]. Note: Material shall mean and include all important, essential and relevant information in the context of under-writing the risk to be covered by the Corporation.
Fact of the Case:
Petitioners filed a complaint alleging deficiency in service by the respondent Insurance Company after the insured's murder. The claim was repudiated on the ground of suppression of material facts. The State Commission allowed the appeal and dismissed the complaint. The petitioners filed a revision petition.
Finding of the Court:
The Court analyzed the meaning of 'material' in the context of the deceased's obligation to declare information about pending criminal cases. It found that the insurer limited the information sought in the proposal form, and the deceased cannot be held responsible for suppressing information not sought by the insurer. The Court also held that the deceased's murder fell within the ambit of an accident as per previous Commission rulings.
Issues: Interpretation of 'material' information in the context of insurance contracts, obligation of the insured to disclose information, and applicability of Section 45 of the Insurance Act, 1938.
Ratio Decidendi: The Court determined that the deceased cannot be held liable for suppressing information not sought by the insurer, and the murder fell within the ambit of an accident as per previous Commission rulings.
Final Decision: The State Commission's order was set aside, and the majority order of the District Forum was restored. The revision petition was allowed in favor of the petitioners.
ORDER
B.K. Taimni, Member - Petitioners were the complainants before the District Forum, where they had filed a complaint alleging deficiency in service on the part of the respondent Insurance Company
2. Undisputed facts of the case are that one Shri Gulbir Singh had obtained 3 life insurance policies for Rupees one lakh each, commencing from 28.2.1990. The premium was paid in time. The insured was murdered on 5.10.1990, upon which when the petitioners, who were the nominees in the policies preferred the claim before the Life Insurance Corporation of India, it was repudiated on the ground of suppression of material facts. It is in this situation, a complaint was filed before the District Forum, who by a majority judgment allowed the complaint. Aggrieved by this order, the respondent Insurance Company filed an appeal before the State Commission, who after hearing the parties allowed the appeal and dismissed the complaint. Aggrieved by this order, this revision petition has been filed before us.
3. We heard the learned Counsel for the parties at some length. It was the case of the learned Counsel for the petitioner that information sought for in the proposal form was given in respect of each column and there is no material fact which has been suppressed in view of which the repudiation has to be held to be not in order. The basic facts are not disputed by the learned Counsel for the respondent Insurance Company, except to state that material information about the criminal cases pending against the insured was withheld, which is a material information in terms of summary of Section 45 of the Insurance Act, 1938, which stipulates as under:
"45. Policy not be called in question on ground of mis-statement after two years No policy of life insurance effected before the commencement of this Act shall after the expiry of two years from the date of commencement of this Act and no policy of life insurance effected after the coming into force of this Act shall after the expiry of two years the date on which it was effected, 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 leading 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.......].
Note: Material shall mean and include all important, essential and relevant information in the context of under-writing the risk to be covered by the Corporation. "
4. After hearing the learned Counsel for both the parties, what is to be decided by us is the meaning of word material appearing in the policy issued to the deceased/insured as well as in the note appearing under the head summary of Section 45, reproduced earlier.
5. Learned Counsel for the petitioner / complainant wishes to rely upon the following Judgments of the Hon'ble Supreme Court:
1. United India Insurance Co. Ltd. v. Harchand Rai Chandan Lal, (2004) 8 SCC 644 and SCYD 2004.
2. United India Insurance Co. Ltd. v. M.K.J. Corporation, (1996) 6 SCC 428.
3. General Assurance Society v. Chandmull Jain, AIR 1966 SC 1644.
6. As against this the learned Counsel for the respondent is relying upon Format of Agent confidential report, the provision of Marine Insurance Act, 1963, Halsbury's Law of England, IVth Edition and Judgments in the case of All India General Insurance Co Ltd. and Ors. v. S.P. Maheswari, AIR 1960 Mad. 484, Banque Financiere de la Cite SA v. Westgate Insurance Co. Ltd., (1989) 2 All.ER 952) and extracts of commentary by Avtar Singh, Edition 2004.
7. We have very carefully gone through these judgments and find that one common strains which runs through these all the judgments cited by the learned Counsel for the complainant is, "In interpreting documents relating to a contract of insurance, the duty of the Court is to interpret the words in which the contract is