PUNJAB AND HARYANA HIGH COURT AT CHANDIGARH
Deepak Gupta, J.
Usha Chopra And Others – Appellant
Versus
LIC And Others – Respondent
RSA-2359-1996
Decided on : 03-11-2025
JUDGMENT :
Deepak Gupta, J.
This Regular Second Appeal is directed against the judgment and decree dated 16.12.1995 passed by the first Appellate Court of learned Additional District Judge, Ludhiana, whereby the insurer's appeal was allowed and the suit for recovery of the assured sum under a life insurance policy filed by plaintiffs (appellants herein) was dismissed, reversing the trial Court's decree dated 03.05.1993 in favour of the plaintiff-nominee.
2. Factual Matrix: The undisputed facts, which emerge on perusal of the file are that Sh. Rajinder Kumar Chopra, husband of plaintiff Smt. Usha Chopra got his life insured with defendant respondent - life insurance Corporation of India for a sum of Rs. 25,000/- on 19.09.1985 by submitting proposal form Ex.DW6/1. He expired on 26.04.1987 i.e. about one year and seven months after the policy date. The nominee Smt. Usha Chopra i.e. wife of deceased along with her children filed a claim for the sum assured by the insurer. However, the said claim was repudiated by insurance company on the ground that the deceased had made mis-representation in the proposal for the life insurance. Said defence of the respondent- Life Insurance Corporation of India, was though not accepted by the learned trial Court, which decreed the suit on 03.05.1993 but the first Appellate Court reversed the finding and accepted the appeal of the Life insurance company, thus dismissing the suit on 16.12.1995.
3.1 Contentions: Assailing the aforesaid reversal, it is contended by learned counsel for the appellants-plaintiffs that well-reasoned judgment decreeing the suit by the trial Court has been wrongly reversed by the fist Appellate Court by mis-appreciating the evidence on record.
3.2 Despite service of notice of this appeal upon the respondents, no-body has turned up on their behalf to contest the appeal.
4. After considering the trial Court record as available on the DMS of this Court, this Court finds no substance in the submissions made by learned counsel.
5. Analysis by this Court: Undisputedly, it was a non-medical policy, which was issued in the name of Shri rajinder Kumar Chopra, i.e. insured, which means that insured was not required to undergo physical tests like blood, ECG or urine examination etc. and in such cases, the insurer relies upon the applicant's self-declaration of health in the proposal form. Under the Insurance Regulatory and Development Authority of India (IRDAI) guidelines, insurers are free to offer non-medical policies provided - the proposer signs a good-faith declaration about health; and the company discloses that false statements can void the policy.
6. In such like cases, the applicant-insured is required to make truthful declarations in the proposal form. It is based upon the principle of contract of insurance namely, uberrima fides' which is a Latin phrase and means "utmost good faith", i.e., the highest degree of honesty. The applicant is required to make full disclosure of all the material facts that could affect the risk being insured. Insurance contracts are not like ordinary, commercial contracts and they rely heavily on the information given by the proposer. The insurer cannot verify every fact independently before issuing the policy and therefore, the law demands complete transparency and good faith.
7. In the present case, in the proposal form Ex.DW6/1 dated 19.09.1985, which was submitted by the insured Sh. Rajinder Kumar Chopra, he made following declaration on some of the material questions :
Sr. N: | Question | Declaration by insured |
18 | Have you ever suffered from or are you suffering from - (b) High or low blood pressure, rheumatic liver, pain in chest, breathlessness, palpitation, infarction or any disease of heart of arteries? | No |
19 | Have you been suspected to diabetes or are you suffering from diabetes or have ever passed sugar, albumin, pus or blood in urine. | No. |
21 | Have you remained absent from the place of your work on the ground of health during the last five years. | No. |
8. However,
Insurers have the right to repudiate life insurance policies for suppression of material facts, emphasizing the duty of utmost good faith in insurance contracts.
(1) The “Three-Year Rule” (Section 45) – Under the amended Section 45, a policy cannot be questioned after three years from issuance or risk commencement on any ground.(2) Agent’s Responsibility – Th....
Insurers cannot reject claims on trivial grounds or without substantial evidence of pre-existing conditions, as it violates the insured's fundamental rights and undermines the principles of good fait....
A policy cannot be repudiated for non-disclosure of lapsed or terminated policies, especially when ambiguity exists in proposal forms; the insured must only disclose material facts that directly affe....
Revival of Policy - It is settled proposition of law that when the policy has been revived, it revives from the date when it was originally issued.
Insurers must comply with statutory obligations of disclosure; failure to do so prevents repudiation of claims based on misrepresentations in policy applications.
(1) Full Knowledge – DLA had the full knowledge of pre-existing ailments at the time of filling the proposal form and there was a nexus with preexisting disease and the cause(s) of death.(2) Proposal....
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