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2022 MarsdenLR 2520
HIGH COURT MALAYA JOHOR BAHRU
KALIAMMA SINNASAMY – Appellant
Versus
AIA BERHAD – Respondent
[Civil Appeal No: JA-12BNCVC-07-08/2020]
The court reaffirmed the insured's duty to disclose pre-existing medical conditions, permitting the insurer to reject claims based on non-disclosure.
Headnote:(A) Insurance Act – Sections pertaining to disclosure – The court emphasizes the duty of disclosure by the insured regarding pre-existing medical conditions and its implications for insurance claims – The deceased failed to disclose significant health issues which led to the rejection of the claims. (Paras 20-22)
Facts of the case: The deceased purchased two insurance policies, passing away shortly after, with claims made by the plaintiff (the widow) being dismissed due to non-disclosure of health issues. (Paras 2-5)
Findings of Court: The Sessions Court found that the deceased had knowledge of his condition and failed to disclose critical information, validating the defendant's rejection of the claims. (Paras 20, 28)
Issues: The main issues included whether the deceased had a pre-existing condition, whether he was aware of it, and whether he misrepresented material information on the insurance application forms. (Paras 8)
Ratio Decidendi: The court upheld the principle that non-disclosure or misrepresentation of material facts by the insured allows the insurer to repudiate the policy. (Paras 21-22)
Result: The plaintiff’s appeal was dismissed with costs. (Para 28)
JUDGMENT
Introduction
[1] This is an appeal by the plaintiff against the decision of the Johor Bahru Sessions Court after trial delivered on 29 July 2020 dismissing her claim against the defendant. The parties will be referred to as they were in the Sessions Court.
Background Facts
[2] The plaintiff is the widow of the late M Jaganathan a/l Muthusamy ("the deceased").
[3] On 30 August 2015, the deceased purchased a Mortgage Decreasing Term Assurance (Policy No.-80812705) ("the MRTA policy") from the defendant to insure a housing loan obtained from Public Bank Berhad. The plaintiff was named as the nominee in the MRTA policy.
[4] Subsequently, on 15 September 2015, the deceased purchased a life insurance policy, called an Empower Plan Assurance (Policy No: 04508015A00) ("the Empower Plan"), from the defendant.
[5] The deceased passed away on 13 January 2016.
[6] Upon the demise of the deceased, the plaintiff claimed for the sums insured by the defendant under the two policies but the claims were rejected by the defendant on the grounds of failure by the deceased to disclose in the application forms that he had a pre-existing medical condition and was hospitalised for a medical condition, namely, for a blood disorder.
[7] The plaintiff filed her claim in the Sessions Court against the defendant for the following insured sums:
i. For the MRTA policy - RM315,000.00
ii. For the Empower Plan - RM100,000.00
After a full trial, the Sessions Court Judge dismissed the plaintiff's claim on 29 July 2020. The plaintiff, being dissatisfied with the decision of the Sessions Court, then filed an appeal against the decision.
Issues Before The Sessions Judge
[8] The three issues which had to be decided by the Sessions Judge and which were pivotal to the plaintiff's claim against the defendant were:
i. Whether the deceased was hospitalised and was diagnosed with a pre-existing medical condition classified as a blood disorder.
ii. Whether the deceased had prior knowledge that he suffered from a blood disorder before signing the application forms for the two (2) policies; and
iii. Whether the deceased had failed to disclose the above when he signed the application forms and thus, misrepresented material information, which entitled the defendant to reject the plaintiff's claim under the two policies.
The Law
[9] This appeal is from the decision of the Sessions Court after a full trial. The principles guiding the Appellate Court with respect to such an appeal is well settled. In the case of Wee Lian Construction Sdn Bhd v. Ingersoll-Jati Malaysia Sdn Bhd , [2010] 3 MLJ 425, the Court of Appeal stated as follows:
"An appellate Court will not, generally speaking, intervene and interfere unless the trial Court is shown to be plainly wrong in arriving at its conclusion... The instant appeal revolved around the finding of primary facts which are unassailable and so should neither be overruled nor supplemented by an appellate Court."
[10] In the case of Tan Sri Khoo Teck Puat & Anor v. Plenitude Holdings Sdn Bhd, , the Supreme Court again enunciated the principles governing appeals from the lower courts after a full trial. Gunn Chit Tuan, CJ (Malaya) held:
"As regards the principles on which an appellate Court may interfere with a lower Court's findings of fact, we would refer to the following passage in the judgment of Lord Guest in Tay Kheng Hong v. Heap Moh Steamship Co Ltd, [1964] 1 MLJ 87, in which his Lordship stated as follows:
Where a question of fact has been tried by a judge without a jury, and there is no question of misdirection of himself by the judge, an appellate Court which is disposed to come to a different conclusion on the printed evidence, should not do so unless it is satisfied that any advantage enjoyed by the trial judge by reason of having seen and heard the witnesses, could not be sufficient to explain or justify the trial judge's conclusion."
Later, His Lordship quoted, with approval, a passage from the speech of Lord Shaw in
