IN THE HIGH COURT OF ALLAHABAD
KSHITIJ SHAILENDRA, J.
L.I.C. Of India And Another – Appellant
Versus
The Permanent Lok Adalat And Another – Respondents
Writ C No.20577 of 2016
Decided on : 06-04-2023
Writ petition, are , brother of respondent No. 2, aged 47 years, was insured with the L.I.C. under Policy No. dated - Proposal of said insured was accepted by the L.I.C. and Policy No. dated was issued to him towards insurance of his life - Unfortunately, died - On receipt of information about the death, along with the claim papers, the L.I.C. made enquiries in matter, whereupon, it stood revealed that prior to submitting proposal for Policy No. dated assured was suffering from Enteric Fever and Urinary Tract Infection and was being treated for same in Hospital and Surgical Care Centre - Accordingly, the L.I.C., by its letter dated, repudiated the claim of the respondent No.2.
Finding of Court : It has elaborately been discussed that medical opinion furnished by Doctor of Corporation as contained in the certificate filed as annexure No. CA-1 to counter affidavit, when compared to the subsequent report of Investigating Official of Corporation, clearly established that cause of death, which occurred, had absolutely no co-relation with fever suffered by assured one year ago, and non-disclosure of such a Fever/Enteric Fever/Urinary Tract Infection cannot be treated as suppression of a material fact while deciding claim made by respondent No. 2. - While Court fully satisfied that grounds raised by petitioner Life Insurance Corporation of India challenging impugned award of Permanent Lok Adalat do not have any substance, claim made by respondent No.2 has rightly been allowed by Permanent Lok Adalat under the order impugned.
Result : Writ petition fails and is accordingly dismissed
JUDGMENT :
1. The instant writ petition has been filed by the Life Insurance of India (herein-after referred to as “L.I.C.”), challenging the impugned judgement and award dated 15.02.2016, whereby the Permanent Lok Adalat (herein-after referred to as “P.L.A.”) has allowed the claim made by respondent No. 2 directing the L.I.C. to pay to the claimant-respondent a sum of Rs. 14,00,000/-(rupees fourteen lacs only) along with interest @ 9% per anum as covered by the Insurance Policy held by the insured, who was real brother of the claimant-respondent.
2. In short compass, the facts of the case, as pleaded in the writ petition, are that Thakur Prasad Singh, the brother of respondent No. 2, aged 47 years, was insured with the L.I.C. under Policy No. 297170129 dated 28-11-2011. Proposal of the said insured was accepted by the L.I.C. and Policy No. 297170129 dated 28-11-2011 was issued to him towards insurance of his life. Unfortunately, Thakur Prasad Singh died on 10-09-2012.
3. On receipt of information about the death of Thakur Prasad Singh, along with the claim papers, the L.I.C. made enquiries in the matter, whereupon, it stood revealed that prior to submitting the proposal for Policy No. 297170129 dated 28-11-2011, the assured was suffering from Enteric Fever and Urinary Tract Infection and was being treated for the same in Chitransh Hospital and Surgical Care Centre, Shivpur, Varanasi. Accordingly, the L.I.C., by its letter dated 28-11-2013, repudiated the claim of the respondent No.2.
4. After the claim was repudiated, respondent No.2 filed a Case No. 406 of 2014, (Kali Prasad Singh versus Life Insurance Corporation of India and others) before the Permanent Lok Adalat at Azamgarh for recovery of a sum of Rs.14,00,000/-(rupeees fourteen lac only) towards death claim of Late Thakur Prasad Singh.
5. Having coming to know about the filing of complaint, the L.I.C. filed its reply in the matter denying the averments made by respondent No.2 in his application and stating therein that the Corporation had repudiated the claim of respondent No.2. on account of the wrong declaration made in the proposal form. It was further stated that the contract of insurance being one of utmost good faith (uberima-fide), repudiation was rightly done by the L.I.C. for breach of utmost good faith and payment of premium by the brother of respondent No.2 and revival of policies by the L.I.C. has no relevance qua the repudiation of policy. It was further stated that Section 45 of the Insurance Act authorizes the L.I.C. to repudiate the claim on the ground of fraud, misrepresentation or concealment of fact. Since the contract of insurance is a contract of utmost good faith, everything starts from submission of proposal form issued by the Insurance Company. The proposal form issued by the L.I.C. contains a declaration that the statements made in the form are true and correct to the best of the knowledge of the insured. Accordingly, the proposer/insured should not hide any fact in the proposal form. If the insured gives wrong information in the proposal form, the contract of insurance is vitiated. Further, on account of misstatement made by the deceased life-assured in reply to the questions in the proposal form with regard to his previous ailment, the life-assured had suppressed the facts, which were material for him to disclose. Accordingly, the contract of insurance became void and nothing was payable to the respondent No.2. It was further stated that the L.I.C. was not willing to settle the matter with the claimant.
6. After the parties led evidences in support of their respective claim and defence, the P.L.A., Azamgarh, by impugned judgment and award dated 15.02.2016, has allowed the claim and directed the L.I.C. to pay to the claimant-respondent a sum of Rs. 14,00,000/-(rupees fourteen lac only) along with 9% interest per anum as covered by Insurance Policy.
7. A counter affidavit has been filed by the claimant-respondent No. 2 stating that his brother was ins
Bar Council of India vs Union of India
Bahrein Petroleum Co. Ltd. v. P.J. Pappu AIR 1966 SC 634.
Harshad Chiman Lal Modi vs D.L.F. Universal Ltd. and another reported in AIR 2005 SC 4446
Hira Lal Patni v. Kali Nath AIR 1962 SC 199
Kiran Singh and others vs. Chaman Paswan and others
Krishna Bahadur vs M/s Purna Threatre and others
Martin and Harris Limited vs Sixth Additional District Judge and others
M/s Power Control Appliance and others vs Sumeet Machines Pvt. Ltd. reported in 1994 (2) SCC 448
Om Prakash Agarwal (since deceased) through L.R. and others vs Vishan Dayal Rajpoot and another
Kiran Singh v. Chaman Paswan AIR 1954 SC 340
R.S.D.V. Finance Co. Pvt. Ltd. Vs Shree Vallabh Glass Works Ltd
Surendra Mahanti vs Ghasiram Mahanti and others
Subhash Mahadevasa Habib vs Nemasa Ambasa Dharmadas (Dead) by LRs. and others
In insurance contracts, the insured must disclose all material facts; failure to do so can lead to repudiation of claims under Section 45 of the Insurance Act, 1938.
The court established that conciliation proceedings under the Legal Services Authorities Act are mandatory, and failure to adhere to this process invalidates any resultant award.
The insured's obligation to disclose health status is limited to knowledge of such conditions, and unsubstantiated claims of suppression cannot invalidate a life insurance policy.
Insurers must comply with statutory obligations of disclosure; failure to do so prevents repudiation of claims based on misrepresentations in policy applications.
Point of Law : Plea of limitation taken up in the present case on the strength of clause 20 of the agreement read with Article 44 of the Schedule appended to the Limitation Act, would not defeat the ....
Insurers cannot repudiate a policy for suppression of facts unless they prove a causal link to the cause of death; mere suppression is insufficient.
Login now and unlock free premium legal research
Login to SupremeToday AI and access free legal analysis, AI highlights, and smart tools.
Login
now!
India’s Legal research and Law Firm App, Download now!
Copyright © 2023 Vikas Info Solution Pvt Ltd. All Rights Reserved.