ORIGINAL JURISDICTION - Orissa High Court

ANUPAMA BEHERA -V- D.M., LIC OF INDIA , CTC. [S.C.PARIJA,J.]
saving scheme, which have been repudiated on account of the insured
withholding material information regarding his health, while submitting the
proposal form at the time of effecting the assurance with the LIC. In this
regard, it is submitted that the insured had given false statements to the
questionnaire contained in the proposal form, which was with regard to the
personal medical history of the proposed insured. To the questions in sl.
no.11(a) to 11(h) of the proposal form, the insured had answered in the
negative as ‘No’ and in sl. no.11(i), the insured had answered as ‘Good’. It is
submitted that after the death of the insured on 18.6.2004, as the claim was
an early death claim, an enquiry was conducted by the LIC for settlement of
the claims made by the petitioners. On enquiry, it came to the knowledge of
the LIC that the insured had suffered illness on various occasions, as per the
medical book maintained by the employer and as such the insured was not
in a good health condition, at the time of effecting the insurance policies.
5. Accordingly, learned counsel for the LIC submitted that as the medical
book maintained by the employer revealed that the insured had suffered
from ailments on various occasions and had availed sick leave, as per the
certificate given by the employer (Annexure-A series), the same amounted to
deliberate mis-statement and withholding of material information from the
LIC regarding his health, at the time of effecting the insurance policies.
Therefore, in terms of the policy contract and the declarations contained in
the proposal for assurance, the LIC repudiated the claims of the petitioners,
as provided under Section 45 of the Insurance Act.
6. On a perusal of the impugned letter of repudiation dated 30.3.2005
(Annexure-7), it is seen that the LIC has repudiated the claims of the
petitioners in respect of the Policy Nos.58385230, 583851466 and
583707315 on the ground that the insured had withheld material information
regarding his health at the time of effecting the assurance with the LIC. The
relevant portion of the said letter of repudiation is extracted below :
“We may, however, state that all these answers were false as we
hold indisputable proof to show that before he proposed for the
above policy he suffered from diseases as per the medical book on
several dates before his death. Such suffering was suppressed at
the time of completing the proposal.
It is therefore evident that she had made deliberate misstatement
and with-held material information from us regarding her
health at the time of effecting the assurance and hence in terms of
the Policy Contract and the Declarations contained in the forms of
Proposal for Assurance, we hereby repudiate the claim and
accordingly we are not liable for any payment under the above policy
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