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2006 Supreme(MP) 1262

High Court Of Madhya Pradesh
DIPAK MISRA, J.
SHAYAM SUNDER TRIPATHI - Appellant
Versus
LIFE INSURANCE corporation OF INDIA - Respondents
W. P. 7269 Of 2002
Decided On : 11/23/2006

Advocates Appeared:
Atul Nema, D.K.DIXIT

The duty of the agent to disclose material facts and make reasonable inquiries is essential for the validity of insurance contracts.

Headnote:

Natural Justice - Life Insurance Corporation of India - Regulation 8(2)(b), Regulation 16(1)(b) - The court discussed the principles of natural justice, the duty of the agent to make reasonable inquiries, and the termination of agency for prejudicial acts under Regulation 16. The court referred to Section 45 of the Insurance Act, 1938 and various case laws to support its decision.

Fact of the Case:

The petitioner, an agent of the Life Insurance Corporation of India, had his agency terminated due to failure to disclose the health condition of an insured person. He filed a writ petition alleging violation of natural justice and doctrine of proportionality.

Finding of the Court:

The court found that the petitioner was given an opportunity to show cause, and his conduct was prejudicial to the interests of the Corporation, leading to the dismissal of the writ petition.

Issues: Violation of natural justice, duty of the agent to make reasonable inquiries, and termination of agency for prejudicial acts.

Ratio Decidendi: The duty to disclose material facts continues until the conclusion of the contract, and the agent is required to make all reasonable inquiries regarding the lives to be assured. The termination of agency for prejudicial acts is permissible under Regulation 16(1)(b).

Final Decision: The writ petition was dismissed for being devoid of merit.

( 1 ) THE petitioner was an agent of the Life Insurance Corporation of India (hereinafter referred to as the "lic") since 1987. During his functioning as an agent, he had received many a reward for his excellent performance in March, 1998, he got insured one Harish Chandra Gupta who unfortunately died in June, 1999. Because, of this situation, he was, as set forth, served with a show-cause notice by the authority of the Corporation why he had not informed the Corporation that the assured was suffering from diabetes for the last 15 years and stones in the kidney. The petitioner offered his explanation but the same was not accepted and his agency was terminated by order dated 3-2-2001. Against the aforesaid order of termination of agency, the petitioner preferred an appeal before the appellate authority who rejected the same as per order dated 8-11 2002 which has led him to prefer this writ petition under Articles 226 and 227 of the Constitution of India for issuance. of a writ of certiorari for quashment of the aforesaid orders as contained in Annexures-P-4 and P-6 respectively and to command the respondents to make payment of his commission to which he is entitled under law.

( 2 ) IT is urged in the petition that before termination of agency, he was not afforded an opportunity to defend his case effectively and, therefore, there has been complete violation of the principles of natural justice which makes the order of termination of agency totally indefensible. It is further put forth that the termination is solely on the basis that he had not given information about the ill health of the policy holder though the agent merely fills the form and makes entries on the basis of information received from the proposed policy holder. It is the stand in the writ petition that the Corporation had accepted the medical report of the policy holder which is the same quo non before insuring any person and therefore, the authority could not have put the entire blame on the agent. It is contended that before terminating agency, the authorities of the Corporation had not kept in view the past performance of the petitioner and passed a harsh order on the basis of presumption which is unsustainable. In essence, the stand is that there has been violation of principles of natural justice and doctrine of proportionality has not been kept in view.

2. A counter-affidavit has been filed by the respondents contending inter alia, that the proposal was submitted by the petitioner and it was accepted by the Corporation and on the basis of such proposal the policy was issued. As the assured died within a short span time, an inquiry was held and on inquiry, it was found that the policy holder was suffering from diabetes and several other complications. It is the stand in the return that the petitioner had acted in utter disregard to the rules and settled norms. In fact he himself had submitted a confidential report as regards his acquaintance with the assured for the last five years but did not disclose about the health condition of the assured. It is put forth that the petitioner was asked to show cause to which he offered the explanation and the same being not found satisfactory, an order contained in Annexure-P-4 terminating his agency was passed. It is the stand of the Corporation that due to the deliberate suppression of facts by the petitioner, the Corporation has suffered heavy loss. The Corporation had conducted inquiry and found out that the assured had got treatment at Sanghi Medical centre, New Delhi, All India Institute of medical Sciences New Delhi. Triveni Hospital jabalpur and Verdhman Medical Centre, Jhansi, reference has been made to the regulation 8 (2) (b) of the Life Insurance Corporation of india (Agents) Regulations, 1972 (hereinafter referred to as the Regulations')to show that it was incumbent on the part of the agent to make all reasonable inquiries regarding the proposal and to bring to the notice of the Corporation any circumstance



















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