P.Deepika vs The Executive Director (Mktg)
2021 Latest Caselaw 22007 Mad

                                                                               W.P.No.31824 of 2013

                                  IN THE HIGH COURT OF JUDICATURE AT MADRAS

                                                DATED : 08.11.2021

                                                          CORAM

                              THE HONOURABLE MR.JUSTICE S.M.SUBRAMANIAM
                                               W.P. No. 31824 of 2013
                                                         and
                                          M.P. Nos. 1 of 2013 and 1 of 2015

                     P.Deepika                                                   ...Petitioner

                                                           Vs

                     1.The Executive Director (Mktg)
                       L.I.C. Of India – Central Office
                       Mktg./CRM/CRC Dept.
                       Yogakshama
                       Mumbai – 400 021.

                     2.The Senior Divisional Manager
                       LIC of India
                       Trichy Road
                       Coimbatore – 641 018.                                    ... Respondents

                     PRAYER : Writ Petition filed Under Article 226 of the Constitution of
                     India, to issue a Writ of Certiorari, to call for the records of the second
                     respondent dated 20.06.2013 in Claim No. 1727 and 1728 of 760,
                     confirming the orders of the second respondent dated 04.09.2012 in Claim
                     No. 1727 and 1728 / 760 and by the issue of a Writ of Certiorarified
                     Mandamus or any other appropriate Writ, order or direction; quash that
                     order and direct the second respondent to pay the petitioner the sum of

                     1/7
https://www.mhc.tn.gov.in/judis
                                                                                           W.P.No.31824 of 2013

                     Rs.35 plus 35 lakhs of the total Rs.70 at 18% as per annum from 04.09.2012
                     being the date of the order of the second respondent.


                                        For Petitioner             : Mr.M.Kalyanasundaram
                                                                     Senior Counsel
                                                                     For Mr. V.Srinivasan

                                        For Respondents            : Mr.M.B.Raghavan
                                                                     [For R1 and R2]


                                                             ORDER

The order dated 20.06.2013 repudiating the claim of the writ

petitioner and subsequent order of rejection passed by the Insurance

Ombudsman are under challenge in the present writ petition.

2.It is not in dispute that the petitioner's father took Bheema Budget 2

money back policies at Rs.35,00,000/- each on his 61st year appointing the

petitioner as nominee under those policies. The police holder,

viz., Mr. S.Palanisamy died within a few months on 17.03.2012. Further, it

is not disputed between the parties that the respondent /Life Insurance

Corporation of India settled an ex-gratia of Rs.22,90,869/- on each of the

policies totaling to Rs.45,81,738/- instead of full payment of Rs.35,00,000/-

in each of the policies. Regarding the differential amount, the petitioner

https://www.mhc.tn.gov.in/judis W.P.No.31824 of 2013

filed an appeal before the authorities, who in turn rejected the same by

invoking the repudiation clause in the insurance policy. Thereafter, the

petitioner approached the Insurance Ombudsman, who in turn returned the

petition on the ground that the Ombudsman has no jurisdiction to entertain

the claim over and above a sum of Rs.20,00,000/-. Thus, the petitioner is

constrained to move the present writ petition.

3.Learned Senior Counsel appearing on behalf of the Petitioner made

a submission that the policy and the payment of premium are not disputed.

The death of the policy holder is also not disputed. While so, there is no

reason whatsoever to deny the sum assured to the writ petitioner as per the

terms and conditions of the policies.

4.In view of the fact that the Respondent /Life Insurance Corporation

failed to honour the sum assured, the petitioner approached the authorities,

who in turn invoked the repudiation clause on certain flimsy grounds. Thus,

the petitioner further approached the Insurance Ombudsman and the petition

was returned on the ground that the Insurance Ombudsman has no

jurisdiction to entertain the claim over and above a sum of Rs.20,00,000/-.

https://www.mhc.tn.gov.in/judis W.P.No.31824 of 2013

Thus, the relief sought for is to be granted.

5.The Learned Counsel appearing on behalf of the Respondent /Life

Insurance Corporation objected the said contentions by stating that basic

facts are not in dispute between the parties. However, the policies were

taken by the father of the Petitioner at the age of 61 years and the fact

regarding the medical treatments were suppressed by the policy holder at the

time of proposal. Thus, the authorities are empowered to invoke the

repudiation clause on the ground of suppression of medical records and

there is no infirmity as such.

6.Considering the mitigating factors, the LIC has considered the case

of the petitioner and paid ex-gratia payment of Rs.45,81,738/- in respect of

two policies. The payment of ex-gratia itself is a concession already

extended to the writ petitioner and therefore, the full payment cannot be

granted.

7.Learned Counsel appearing for the Respondent relied upon the

https://www.mhc.tn.gov.in/judis W.P.No.31824 of 2013

judgment of the Hon'ble Supreme Court of India in the case of Reliance

Life Insurance Co. Ltd. Vs. Rekhaben reported in [2019 (6) SCC 175].

8.This Court is of the considered opinion that the contractual

obligations between the parties cannot be adjudicated with reference to its

terms and conditions in a writ proceedings under Article 226 of the

Constitution of India. Such adjudication requires examination and

scrutinization of original records, evidences including oral evidences. In the

present case, the Respondents invoked the repudiation clause on the ground

that the policy holder suppressed medical records at the time of proposal.

Such disputes require an adjudication /trial, which cannot be undertaken by

the High Court in a writ proceedings. As far as the policies are concerned,

the respondents have already paid ex-gratia payment of Rs.22,90,869/-

(being 90% of the premium of Rs.25,45,410/-) under each policy without

any admission of liability.

9.This being the factum, this Court is of the considered opinion that

the petitioner if at all aggrieved in respect of the invocation of the

repudiation clause by the Respondent Life Insurance Corporation has to

https://www.mhc.tn.gov.in/judis W.P.No.31824 of 2013

approach the competent court of law for the purpose of redressal of her

grievances.

10.With these observations, this writ petition is disposed off. No

costs. Consequently, connected Miscellaneous Petitions are closed.

08.11.2021 Internet:Yes Index : Yes Speaking order:Yes

Maya

To

1.The Executive Director (Mktg) L.I.C. Of India – Central Office Mktg./CRM/CRC Dept. Yogakshama Mumbai – 400 021.

2.The Senior Divisional Manager LIC of India Trichy Road Coimbatore – 641 018.

S.M.SUBRAMANIAM, J.

https://www.mhc.tn.gov.in/judis W.P.No.31824 of 2013

Maya

W.P. No. 31824 of 2013

Dated : 08.11.2021

https://www.mhc.tn.gov.in/judis