Dismissed

L.I.C. of India and Anr. v. Ram Pyari

Rajasthan HC20 Aug 2019CFA/17/1991

Case brief

AI extract

What is this about?

In this life insurance appeal, the High Court rejected the insurer's repudiation of a claim based on alleged concealment of high blood pressure and age misstatement. The court held that medical records submitted by the insurer were inadmissible photocopies, while the insurer failed to prove fraud or concealment.

What did the court decide?

Appeal dismissed; suit decreed; insurer directed to release claim amount with interest.

L.I.C. of India and Anr. Vs Ram Pyari — Contract and Commercial Disputes | Rajasthan HC (2019)

¶1

HIGH COURT OF JUDICATURE FOR RAJASTHAN AT JODHPUR

¶2

S.B. Civil First Appeal No. 17/1991

¶3

Bhartiya Jeevan Bima Nigam through

¶4

(1) Senior Divisional Manager, Bhartiya Jeevan Bima Nigam, Mandal Karyalaya, Jeevan Prakash, Bhawani Singh Road, Jaipur.

¶5

(2) Shakha Prabandhak, Bhartiya Jeevan Bima Nigam, K.I.M Road, Bikaner.

¶6

----Appellant

¶7

Versus

¶8

Rampyari w/o Late Shri Badri Prasad, b/c Sunar, Saakin, Rampuriyon ki Haveli Ke Piche, Bikaner.

¶9

----Respondent

¶10

For Appellant(s) : Mr. Suresh Kumbhat For Respondent(s) :

¶11

HON'BLE MR. JUSTICE SANJEEV PRAKASH SHARMA Judgment

¶12

Reserved on 13/08/2019 Pronounced on 20/08/2019

¶13

This appeal is directed against the judgment and order dated 07.11.1990 passed by the learned Additional District Judge, Bikaner in Civil Original Suit No.47/1986 preferred by one Rampyari w/o Late Badri Prasad claiming recovery of Rs.50,000/as against the appellant-Life Insurance Corporation ( for short, ‘LIC’ ) for life insurance of her late husband.

¶14

Brief facts, stated in the plaint, are that on 31.08.1982, the insured late Badri Prasad proposed a policy for a sum of Rs.50,000/- on life, which was issued by the LIC in his favour.

¶15

(2 of 9)

¶16

[CFA-17/1991]

¶17

The plaintiff was the nominee, but on 31.12.1982, the insured died. Upon his death, his wife/plaintiff claimed the amount, but the appellant-LIC repudiated the claim vide its letter dated 31.03.1984/27.07.1984 stating that the deceased insured had concealed from the LIC of already suffering from High Blood Pressure in his disclosure form. The plaintiff stated that the deceased had no knowledge of his suffering of Blood Pressure and there was no concealment. He died of cancer of liver and pancreas, and LIC was liable to pay the insurance amount.

¶18

In written statement, the appellant/defendant admitted of the claimant/plaintiff being wife of deceased Badri Prasad and of being his nominee in the insurance policy. However, it was reiterated that the insured had concealed from the LIC about late Badri Prasad of suffering from the High Blood Pressure.

¶19

It was further stated that late Badri Prasad was more than 48 years of age at the time of getting himself insured, and he wrongfully mentioned his age as 40 years.

¶20

It was further stated that because Badri Prasad died within six months of getting himself insured, she was not entitled to the amount insured.

¶21

The trial court framed nine issues as under:

¶22

“1- vk;k okfnuh Lo- cnzhizlkn lqukj dh iRuh gS \

¶23

2- vk;k Lo- cnzhizlkn us fnukad 31-8-82 dks 50000/- :i;s dh chek izfroknh ds djok;h Fkh \

¶24

3- vk;k okfnuh Lo- cnzhizlkn dh ikWfylh la[;k 50873734 ds tfj;s 50000/- :i;s dh jkf”k e; C;kt ikus dh vf/kdkjh.kh gS \

¶25

4- vk;k Lo- cnzhizlkn dh e`R;q ihfy;k jksx dh otg ls gqbZ gS \

¶26

5- vk;k cnzhizlkn chek djkrs le; jDr pki ls ihfM-r Fkk vkSj mlus vius LoLFk “kjhj gksus dh ?kks’k.kk xyr nh gS\

¶27

(3 of 9)

¶28

[CFA-17/1991]

¶29

6- vk;k cnzhizlkn us chek ds jkst viuh mez 48 o’kZ gksrs gq, Hkh 40 o’kZ fy[kkdj izfroknh ls chek djk;k gS rks nkos ij D;k vlj gS\

¶30

7- vk;k izfroknh ds fpfdRlk vf/kdkjh }kjk fn;s x;s lR;kiu ls izfroknh ikcan ugha gS\

¶31

8- vk;k nkok vanj fe;kn gS\

¶32

9- nknjlh-”

¶33

The plaintiff got herself examined as PW-1, Manakchand as PW-2 and Dr. Hanuman Singh as PW-3 in her support; while appellant/defendant got Laxman Singh and Tara Chand Middha examined as DW-1 and DW-2 respectively.

¶34

The plaintiff got exhibited the letter dated 31.03.1984/27.07.1984 as Exhibit-1, letter dated 01.10.1985 as Exhibit-2, discharge card as Exhibit-3, and the appellant-LIC got exhibited the Bed ticket dated 12.12.1982 as Exhibit A-1 and Bed ticket dated 10.11.1982 as Exhibit A-3, and LIC proposal form as Exhibit A-2.

¶35

Learned counsel appearing for the appellant/defendant submitted that from perusal of Exhibit A-3, it is seen that at the note of past illness, it is mentioned that the patient aged 40 years had past history of Hypertension for two years, which was not disclosed in the Insurance form Exhibit A-2, wherein there is a specific condition, which mentions of correctly informing all details including previous illness like that of High Blood Pressure under Column 17(kha).

¶36

Learned counsel further submitted that in Exhibit A-1, which is a subsequent bed ticket, it is mentioned that patient was of 52 years of age and admitted in the medical ward about a month back with essential Hypertension and increased Hepatitis & Gastritis.

¶37

(4 of 9)

¶38

[CFA-17/1991]

¶39

Learned counsel thus submitted that there is apparently a concealment of information relating to previous illness of Blood Pressure and therefore the claim was rightly repudiated.

¶40

Learned counsel relied on Life Insurance Corpn. of India Vs. Smt. Kailashi Devi, reported in 2014 WLC (Raj.) UC 125 to submit regarding suppression of material fact.

¶41

He also relied on Life Insurance Corporation of India Vs. Manish Gupta, reported in AIR 2019 SC 2606 , wherein the Supreme Court had disallowed the claim on the ground of concealment in the declaration form furnished by the proposer. 6. I have considered the submissions and examined the record of the trial court. 7. In the present appeal, the issue which requires to be determined is whether there has been concealment on part of the deceased insured at the time of furnishing of the form. 8. In the proposal form issued by the LIC Exhibit A-2, the insured has signed on the last page from A to B. In column 17 of the said cover note, it is mentioned that ‘ whether you have ever been suffering from the following diseases’ , and in column 17(kha), it is mentioned of High or Low Blood Pressure, Chest Pain, Suffocation, Heartbeat Pulse or any other Heart or relating to Heart Disease, wherein the insured has mentioned “ No ”.

¶42

Alongwith the proposal form, there is a Medical Examiner’s Confidential Report, which is part of the form and insured late Badri Prasad was examined by the doctor designated by the LIC, who mentions his age as 40 years and his Ist reading Blood Pressure Systolic is mentioned as 120 mm. Hg and 5^th phase Systolic is mentioned as 80 mm. Hg., which is normal.

¶43

(5 of 9)

¶44

[CFA-17/1991]

¶45

After the entire process, the LIC Policy has been issued in his favour, which is on record in the file of the trial court.

¶46

In the Bed Ticket dated 10.11.1982 Exhibit A-3, it is noticed that the same is not in original, but a photocopy of the attested photocopy.

¶47

In the past illness, there is a clear word “No H/O Hypertension for two years”, “No H/o Jaundice”, “No H/o diabetes” and “No H/o Tuberculosis”.

¶48

However, the word “No” has been crossed, and below “two years”, two lines have been mentioned. However, as the document is photocopy of attested copy, it is not known whether it is in same ink.

¶49

Learned counsel for the appellant/defendant was asked whether the original of the Exhibit A-3 was ever produced, which he has replied in negative.

¶50

In the first page of Exhibit A-3, in an apparent different handwriting, words have been mentioned as “Benign Essential Hypertension”, although there is no measurement of Hypertension on the entire bed ticket. Thus, the document Exhibit A-3 cannot be believed, as it is neither original nor attested true copy of original and there is a cutting on the words “No” before H/O hypertension. It is also noticed that there is no mention of any previous medicine which the patient might have been taking prior to the date of admission for hypertension which could show whether he was an old patient of hypertension.

¶51

From the next bed ticket dated 12.12.1982, it is noticed that the concerned person has been shown of different age and was suffering from Calead Pancreas Hepatic Carcinoma on account of which he ultimately expired. In this ticket at one place it is

¶52

(6 of 9) [CFA-17/1991]

¶53

mentioned that patient was having hypertension for last one year but does not show any medication.

¶54

Both the documents Exhibit A-3 and Exhibit A-1 are photocopies of the attested copies of the original and the doctor, who is alleged to have written the said bed ticket has not been brought in evidence to prove the bed ticket. The exhibiting of documents was objected by the counsel for the plaintiff, but the trial court has allowed the documents to be marked as exhibits which, in the opinion of this Court, was contrary to law as Photostat copies of Attested copies cannot be admissible even as secondary evidence.

¶55

Even the attestation of a photocopy of the original has to be in original and must be proved. However, both the documents Exhibit A-1 and Exhibit A-3 are mere photocopies of the attested document.

¶56

Reliance upon such documents would be too dangerous, especially when it is noticed that there are several cuttings and markings. It is also noticed that in both the documents, there is variation in mentioning of the past history and age, and writings are also different at different places. Thus any verdict relying on such document could not have been given by any court.

¶57

Thus, this Court is satisfied that the appellants have not been able to prove that the plaintiff’s husband was suffering from any previous history of High Blood Pressure and that there was concealment on his part, and repudiation of claim on the said basis was wrongful and illegal.

¶58

The aspect if examined that the approved doctor of LIC has checked the patient and found his Blood Pressure normal on the date when the LIC policy was issued, being 120 mm. Hg - 80

¶59

(7 of 9)

¶60

[CFA-17/1991]

¶61

mm. Hg. Exhibit A-2 is document of LIC and no pleading has come for not relying on it.

¶62

Keeping in view the same, the issue is decided in favour of the plaintiff.

¶63

So far as the age part is concerned, it is noticed that the doctor, who examined the insured, while issuing the insurance policy, has mentioned his age as 40 years.

¶64

As this Court has reached to the conclusion that Exhibit A-1 and Exhibit A-3 could not be relied upon as admissible piece of evidence, age mentioned therein cannot be a ground to repudiate the claim. As the insurance policy issued to the deceased mentions age of deceased insured as 40 years, the same shall be treated as correct.

¶65

In P.C. Chacko & Anr. Vs. Chairman, Life

¶66

Insurance Corporation of India & Ors., III (2008) CPJ 78 (SC) , the Apex Court held that there are three conditions, which apply to the repudiation of a policy of insurance, as under:

¶67

“(a) the statement must be on a material matter or must suppress facts which it was material to disclose; (b) the suppression must be fraudulently made by the policy- holder; and

¶68

(c) the policy-holder must have known at the time of making the statement that it was false or that it suppressed facts which it was material to disclose.”

¶69

In the present case, if we examine, the insurer has not been able to prove that the deceased policy-holder had given any false statement at the time of getting himself insured. Neither they have been able to show that on the day when the insurance policy

¶70

(8 of 9)

¶71

[CFA-17/1991]

¶72

was issued, plaintiff’s husband was suffering from High Blood Pressure or he was taking any medicines or undergoing any treatment.

¶73

The medical tickets, which were otherwise not admissible in evidence, being photocopies of the attested photocopies, issued in the November, 1982 and December, 1982 i.e. much after the date on which insurance policy was issued, the action of repudiation of policy is found to be unjustified.

¶74

It is well settled that a contract of insurance is of utmost good faith. Utmost good faith has to be read to mean good faith on both the parties.

¶75

Since this Court has reached to the finding that there was no wrongful disclosure in the proposal form, and whereas there was a medical check up on the day when the deceased was insured and it did not disclose any medical ailment, it was necessary for the LIC to have released the claim.

¶76

The judgment relied by appellant in the case of Life Insurance Corporation of India Vs. Manish Gupta (supra) is on completely different facts; there a person was a known case of rheumatic heart disease since childhood, and he was ultimately treated also for heart problem, whereas in the present case, evidence has been produced by plaintiff of the treating doctor PW3 Dr. Hanuman Singh, who has stated that the patient went into C oma, on account of Hepatitis and on account of suffering from cancer of pancreas and liver. He also specifically stated that deceased Badri Prasad was not suffering from Blood Pressure, which cannot be doubted.

¶77

Keeping in view the evidence, which has come on record, the appeal is found to be without any merits.

¶78

(9 of 9)

¶79

[CFA-17/1991]

¶80

This Court vide the interim order dated 14.02.1991, had directed the appellant to deposit the amount alongwith interest with the trial court, with further direction to the trial court to release the amount in favour of the plaintiff subject to submission of solvent security to the satisfaction of the trial court.

¶81

The judgment passed by the court below thus does not call for any interference. The appeal is dismissed. The suit is decreed in terms of the judgment passed by the court below.

¶82

If the amount has not been released, the same shall be now released alongwith interest uptill date, otherwise the solvent security shall be returned.

¶83

The record of trial court is directed to be sent back forthwith. All pending applications stand disposed of.

¶84

(SANJEEV PRAKASH SHARMA),J

¶85

SKant/-

L.I.C. of India and Anr. v. Ram Pyari

Case brief

What is this about?

What did the court decide?

L.I.C. of India and Anr. v. Ram Pyari

Case brief

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