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45 (1) No policy of life insurance shall be called in question on any ground whatsoever after the expiry of three years from the date of the policy, How three years calculated a)from the date of issuance of the policy b) the date of commencement of risk or c)the date of revival of the policy or d) the date of the rider to the policy, whichever is later (2) Ground for re-calling policy Fraud & Misrepresentation What is fraud the expression 'fraud' means any of the following acts committed by the insured or by his agent, with intent to deceive the insurer or to induce the insurer to issue a life insurance policy: 1. the suggestion, as a fact of that which is not true 2. the active concealment of a fact by the insured having knowledge or belief of the fact; 3. any other act fitted to deceive; and 4. any such act or omission as the law specially declares to be fraudulent. Is silence considered misrepresentation or concealment of fact ? 1. Mere silence as to facts likely to affect the assessment of the risk by the insurer is not fraud, unless the circumstances of the case are such that regard being had to them, it is the duty of the insured or his agent keeping silence, to speak, or unless his silence is, in itself, equivalent to speak. Who is to prove no fraud ? Its the insured to prove What is non-disclosure of material fact? SC In the matter of Asha rani v/s LIC of india 2009 1. Insured concealed the material fact 2. Fact so concealed was of such importance that insurance may not have issued policy 3. The facts so alleged having concealed was known the the insured Who is to prove misrepresentation –Insurance company
1. Surveyor report is a very important document In the matters concerning insurance whether it is a matter related to vehicle insurance, an accidental case or general insurance of house, factory or even insurance of goods on the way through carrier. Surveyor report is a very important document and ordinarily it cannot be challenged. Surveyor is an authorised agent of insurance companies who conducts survey of the spot, investigate the incident, evaluates loss and communicate to insurance company about the loss payable to the insured as per rules with its report 2. Immediate information necessary for prompt survey To appreciate evidence, avoid loss and misreporting in theft cases, police action and survey is the immediate requirement, hence information of the incident to insurance as well as police also important. Evidence gets diluted in case of delayed information and investigation gets hampered 3. Claimant cannot have a good case to challenge the report of the surveyor If the decision of the insurance company is based on the survey conducted by them, claimant cannot have a good case to challenge the report of the surveyor unless integrity of the surveyor is questioned and malaise on their part is proved on the basis of sound eveidence.Surveyor is a professional entity equipped with proper licence and his performance is considered to be as per the established system and style. If surveyor makes an assessment of loss on the basis of rules under the policy, it cannot be challenged if the terms agreed between the parties. 4. Claim is to be approved within the four corners of law as per contract As per the Sikka Papers Limited V National Insurance Company Ltd.111(2009)CPJ 90 SC and number of other judgement such as General Assurance Society Ltd. Vs. Chandumull Jain and another, AIR 1966 SC 1644, Oriental Insurance Co. Ltd. Vs. Sony Cheriyan (1999) 6 SCC 451 and United India Insurance Co. Ltd. Vs. Harchand Rai Chandan Lal (2004) 8 SCC 644,’terms of the contract are the most important factor while deciding the claim “the endeavour of the court must always be to interpret the words in which the contract is expressed by the parties. The court while construing the terms of policy is not expected to venture into extra liberalism that may result in re- writing the contract or substituting the terms which were not intended by the parties. The insured cannot claim anything more than what is covered by the insurance policy. 5. Insurance company cannot appoint number of surveyors one after another to get report in their favour IRDA (Protection of Policy Holders’ Interest Regulations 2002) The Insurance company , on receipt of the legally appointed surveyor’s report, if found the report incomplete, was required to intimate the same to the legally appointed surveyor within 15 days with request to furnish additional report on the basic issues If he fails to do so, then there can be question of second surveyor Case Law The insurance company can appoint another surveyor only after recording the reasons for doing the same. In number of cases along with one in the matter of Sikka Papers Limited V National Insurance Company Ltd.111(2009)CPJ 90 SC had condemned the practice of some insurance companies in appointing one surveyor after another without recording reasons for the same and at the back of insured without his knowledge. 6. Whether a company can claim compensation for mental harassment The complainant is a company and, therefore, claim for mental harassment is not legally permissible. It is only the natural person who can claim damages for mental harassment and not the corporate entity (Sikka Papers Limited V National Insurance Company Ltd.111(2009)CPJ 90 SC)
How to establish your case when important document not available-Find solution from Dr Prem Lata
How to establish your case when important document not available-Find solution from Dr Prem Lata
How to establish your case when important document not available-Find solution from Dr Prem Lata
How to establish your case when important document not available-Find solution from Dr Prem Lata

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