CLJ Bulletin, Issue 2013, Vol 30 25 July 2013 Print this page |
INSURANCE: Duty of disclosure - Material non-disclosure - Discrepancy in estimated income of insured - Whether insured bound by warranty in proposal forms - Whether amounted to material non-disclosure or incorrect disclosure - Insurance Act 1996, ss. 149(4) & 150
INSURANCE: Accident insurance - Cause of death - Medical evidence - Whether death due to illness - Whether there was direct evidence of a fall - Whether beneficiary proved death caused by accident
AMERICAN INTERNATIONAL ASSURANCE COMPANY LTD v. NADARAJAN SUBRAMANIAM
COURT OF APPEAL, PUTRAJAYA
AZIAH ALI JCA; LIM YEE LAN JCA; MAH WENG KWAI JCA
[CIVIL APPEAL NO: W-02-2987-2010]
6 MAY 2013
The insured purchased three personal accident insurance policies and in all three proposal forms, the insured stated that his estimated annual income to be RM150,000 and described himself as 'a self-employed managing proprietor of a business selling and buying oil palm bunches'. Subsequent to the insured's death, the respondent's claim under the policies, as the beneficiary, was declined by the appellant on the ground that the cause of death of the insured was due to an illness whilst the purported personal accident policies only covered accidental death sustained as a result of "bodily injury effected directly and independently of all other causes by accident". The respondent therefore commenced an action in the High Court which decided in favour of the respondent and hence this appeal by the appellant. The issues for determination in this appeal were: (i) whether there was material non-disclosure by the insured; and (ii) whether the insured's demise was an accidental death or due to illness.
Held (allowing appeal with costs)
Per Mah Weng Kwai JCA delivering the judgment of the court:
(1) While there was no incorrect disclosure or misrepresentation of an actual fact when the insured described himself as being 'self employed (Managing Proprietor) in the selling and buying of oil palm bunches', there was a material non-disclosure or incorrect disclosure when the insured stated in the proposal forms that his estimated annual income was RM150,000 when in fact, he was only earning an annual income of about RM50,000. (paras 20 & 22)
(2) Part IV of the insurance policies clearly stated that the proposal forms shall be the basis of the insurance policies. The insured was therefore bound by the warranty in each of the three proposal forms that the answers given were true and that the answers would form the basis of the contract between the insured and the appellant. In the case of Pacific & Orient Insurance Co Sdn Bhd v. VR Kathirvelu, the court was not concerned with the 'basis clause' when concluding that the non-disclosure was not material, whereas in the instant case, the 'basis clause' was applicable to the contract of insurance entered into between the insured and the appellant (China Insurance Co Ltd v. Ngau Ah Kau; foll). (paras 23 & 28)
(3) The issue of whether there was a non-disclosure or incorrect disclosure or misrepresentation in an answer in the proposal form is a question of fact to be determined by the court. In light of the decision in China Insurance Co Ltd v. Ngau Ah Kau, it was not the court's function to inquire into the materiality of the answer. The answer to the question in the proposal form will be deemed material as the truth of the answer had been made a condition of the policy. In the circumstances, the appellant had discharged its burden of proving the allegation of non-disclosure or incorrect disclosure of a material fact in the proposal form. (pars 28 & 30)
(4) The proximate cause of the insured's death was consistent with a stroke which was an illness and not due to a fall. The findings by the learned trial judge that the insured died as a result of a fall was against the weight of the evidence as there was no direct evidence of a fall, only circumstantial, and the learned trial judge had made an inference therefrom. (para 31)
(5) The court was very mindful that it should be slow to interfere with and reverse any finding of fact made by a trial court. However, in the instant case, the finding of the learned trial judge had to be set aside in view of the strong medical evidence and the falsification of the answer to the cause of death question set out in the physician's statement. (para 31)
(6) The respondent, as the beneficiary, must show that the death of the insured was due to a risk insured by the policy, ie, that the insured died as a result of an accident (a fall) and not as a result of any other cause. However, the respondent had failed to show that the insured had died as a result of an accident. (paras 31 & 32)
Bahasa Malaysia Translation Of Headnotes
Pengambil insurans membeli tiga polisi insurans kemalangan diri dan dalam ketiga-tiga borang cadangan, pengambil insurans menyatakan bahawa jumlah anggaran pendapatan tahunannya adalah RM150,000 dan menyatakan dirinya sebagai 'a self-employed managing proprietor of a business selling and buying oil palm bunches'. Selepas kematian pengambil insurans, tuntutan responden di bawah polisi-polisi tersebut, sebagai benefisiari, ditolak oleh perayu atas alasan bahawa sebab kematian pengambil insurans adalah penyakit manakala polisi-polisi kemalangan diri yang ditujukan hanya melindungi kematian disebabkan oleh kemalangan yang diakibatkan oleh "bodily injury effected directly and independently of all other causes by accident". Responden dengan itu memulakan tindakan di Mahkamah Tinggi di mana keputusannya memihak kepada responden dan oleh itu, rayuan ini oleh perayu. Isu-isu untuk dipertimbangkan dalam rayuan ini adalah: (i) sama ada terdapat ketidakpendedahan material oleh pengambil insurans; dan (ii) sama ada kematian pengambil insurans adalah akibat kemalangan atau penyakit.
Diputuskan (membenarkan rayuan dengan kos)
Oleh Mah Weng Kwai HMR menyampaikan penghakiman mahkamah:
(1) Walaupun tiada pendedahan salah atau salah nyata fakta sebenar apabila pengambil insurans menyatakan dirinya sebagai 'self employed (Managing Proprietor) in the selling and buying of oil palm bunches', terdapat ketidakpendedahan material atau pendedahan salah apabila pengambil insurans menyatakan dalam borang cadangan bahawa pendapatan anggaran tahunannya adalah RM150,000 apabila sebenarnya, dia hanya memperolehi pendapatan tahunan sebanyak RM50,000.
(2) Bahagian IV polisi insurans jelas menyatakan bahawa borang-borang cadangan adalah menjadi asas polisi-polisi insurans tersebut. Pengambil insurans oleh itu terikat dengan waranti dalam setiap daripada ketiga-tiga borang cadangan bahawa jawapan-jawapan yang diberikan adalah benar dan bahawa jawapan-jawapan tersebut akan membentuk asas kontrak di antara pengambil insurans dan perayu. Dalam kes Pacific & Orient Insurance Co Sdn Bhd v. VR Kathirvelu, mahkamah tidak mempertimbangkan 'klausa asas' apabila memutuskan bahawa ketidakpendedahan tidak material, sementara dalam kes ini, 'klausa asas' adalah terpakai kepada kontrak insurans yang dimasuki di antara pengambil insurans dan perayu (China Insurance Co Ltd v. Ngau Ah Kau; diikuti).
(3) Isu sama ada terdapat ketidakpendedahan atau pendedahan salah atau salah nyata kepada soalan dalam borang cadangan adalah persoalan fakta yang perlu diputuskan oleh mahkamah. Berikutan keputusan dalam China Insurance Co Ltd v. Ngau Ah Kau, ia bukan fungsi mahkamah untuk menyelidik kepentingan jawapan. Jawapan kepada soalan dalam borang cadangan akan dianggap penting setakat kebenaran jawapan tersebut dijadikan syarat kepada polisi. Dalam keadaan tersebut, perayu telah melepaskan beban pembuktian dakwaan ketidakpendedahan atau pendedahan salah fakta material dalam borang cadangan tersebut.
(4) Alasan paling hampir bagi kematian pengambil insurans adalah konsisten dengan strok iaitu satu penyakit dan bukannya kerana terjatuh. Dapatan yang arif hakim bicara bahawa pengambil insurans mati kerana terjatuh adalah bertentangan dengan beban keterangan kerana tidak terdapat keterangan langsung bahawa dia terjatuh, hanya keterangan ikut keadaan, dan yang arif hakim bicara telah membuat inferens daripadanya.
(5) Mahkamah faham bahawa ia sepatutnya tidak campur tangan atau mengakas apa-apa dapatan fakta yang dibuat oleh mahkamah perbicaraan. Walau bagaimanapun, dalam kes ini, dapatan oleh yang arif hakim bicara perlu diketepikan memandangkan keterangan perubatan yang kuat dan penipuan kepada jawapan dalam soalan-soalan kepada sebab kematian yang dikemukakan dalam pernyataan doktor.
(6) Responden sebagai benefisiari, mesti menunjukkan bahawa kematian pengambil insurans adalah disebabkan oleh risiko yang diinsuranskan oleh polisi tersebut, iaitu bahawa pengambil insurans mati akibat kemalangan (terjatuh) dan bukannya disebabkan oleh apa-apa sebab lain. Walau bagaimanapun, responden telah gagal menunjukkan bahawa pengambil insurans mati akibat kemalangan.
Case(s) referred to:
Amanah Raya Bhd v. Jerneh Insurance Bhd [2005] 2 CLJ 393 CA (refd)
Azizah Abdullah v. Arab-Malaysian Eagles Sdn Bhd [1996] 3 CLJ 426 HC (refd)
China Insurance Co Ltd v. Ngau Ah Kau [1971] 1 LNS 171 HC (foll)
Leong Luen Kiew & Anor v. The New Zealand Insurance Co Ltd [1939] 1 LNS 50 HC (refd)
Pacific & Orient Insurance Co Sdn Bhd v. VR Kathirvelu [1992] 1 CLJ 348; [1992] 1 CLJ (Rep) 251 SC (dist)
Regina Fur Company, Ltd v. Bossom [1958] Lloyd's Law Reports 425 (refd)
Vasudevan Vazhappulli Raman v. T Damodaran PV & Anor [1981] CLJ 84; [1981] CLJ (Rep) 101 FC (refd)
Watts v. Simmons [1924] Lloyd's Law Reports 177 (refd)
Legislation referred to:
Insurance Act 1996, ss. 149(4), 150
Counsel:
For the appellant - Andrew Khoo; M/s Khoo & Sidhu
For the respondent - Ram Karpal Singh; M/s Karpal Singh & Company
[Appeal from High Court, Kuala Lumpur; No: S9-22-04-2001]
Reported by S Barathi
ADMINISTRATIVE LAW: Rules of natural justice - Breach of -Dismissal - Disciplinary proceedings - Appellant dismissed from police force - Appellant asked to leave room when his witness was giving evidence before Investigation Committee - Whether appellant had knowledge as to what questions were put to his witness - Whether appellant had no opportunity to re-examine his witness - Whether a breach of natural justice - Public Officers (Conduct and Discipline) Regulations 1993, regs. 37(5) & 378B(3)
POLICE: Disciplinary proceedings - Dismissal - Setting up of Investigation Committee to obtain further clarification - Proceedings of - Appellant asked to leave room when his witness was giving evidence - Whether appellant had knowledge as to what questions were put to his witness - Whether appellant had no opportunity to re-examine his witness - Whether a breach of natural justice - Public Officers (Conduct and Discipline) Regulations 1993, regs. 37(5) & 37B(3)
NG CHUAN HOCK v. TAN SRI MUSA DATO HJ HASSAN & ORS
COURT OF APPEAL, PUTRAJAYA
HISHAMUDIN MOHD YUNUS JCA; SYED AHMAD HELMY JCA; MOHD ZAWAWI SALLEH JCA
[CIVIL APPEAL NO: W-01-119-11-2011]
14 MARCH 2013
The appellant was a chief inspector in the Royal Malaysian Police. A disciplinary proceeding was taken against the appellant under the Public Officers (Conduct and Discipline) Regulations 1993 ('the 1993 Regulations'). The second respondent, the Disciplinary Authority of the Royal Malaysian Police ('Disciplinary Authority') met on 20 June 2007 and decided that an Investigation Committee ('the Committee') had to be set up under r. 37(5) of the 1993 Regulations for the purpose of obtaining further clarification. During the proceeding before the Committee, the appellant was asked to leave the room when it was the appellant's time to call his witness to give evidence. Thus, the appellant's witness gave evidence in his absence and no explanation was given by the Committee as to why the appellant was asked to leave the room. After considering the Committee's report and the appellant's representation, the Disciplinary Authority found the appellant guilty and dismissed him from the police force. Aggrieved by the decision, the appellant filed a judicial review application for an order of certiorari to quash the decision of the Disciplinary Authority. The High Court, however, dismissed the appellant's application and hence, this appeal. The issue that arose for consideration was whether there was a breach of natural justice during the Committee's proceeding when the appellant was asked to leave the room where the inquiry by the Committee was held.
Held (allowing appeal; setting aside decision of the High Court)
Per Hishamudin Mohd Yunus JCA delivering the judgment of the court:
(1) Regulation 37(5) of the 1993 Regulation provides that if the Disciplinary Authority considers that a case against an officer requires further clarification, it may establish an Investigation Committee for the purpose of obtaining such further clarification. Further, reg. 37B(3) of the 1993 Regulations provides that if witnesses were called and examined by the Investigation Committee, the officer should be allowed to be present and to cross-examine the witnesses. (paras 10 & 11)
(2) It is elementary justice that the appellant must be present during the inquiry when his own witness was giving evidence. On the facts, there was a serious breach of the rules of natural justice when the appellant, for no apparent reason, was asked to leave the room when his own witness was giving evidence. Therefore, the appellant had no knowledge as to what evidence was given by his own witness. He also had no knowledge as to what were the questions that were put to his witness by the officer conducting the inquiry before the Committee during cross-examination. In addition to that, the appellant had no opportunity to re-examine his own witness which led to further injustice. (paras 24 & 25)
Bahasa Malaysia Translation Of Headnotes
Perayu merupakan ketua inspektor yang telah bertugas dengan Polis DiRaja Malaysia. Satu prosiding tatatertib telah diambil terhadap perayu di bawah Peraturan-Peraturan Pegawai Awam (Kelakuan dan Tatatertib) 1993 ('Peraturan 1993'). Responden kedua, Pihak Berkuasa Disiplin Polis DiRaja Malaysia ('Pihak Berkuasa Tatatertib') telah berjumpa pada 20 Jun 2007 dan memutuskan bahawa satu Jawatankuasa Penyiasatan ('Jawatankuasa') perlu ditubuhkan di bawah per. 37(5) Peraturan 1993 bagi mendapatkan penjelasan lanjut. Semasa prosiding di hadapan Jawatankuasa, perayu telah diminta untuk meninggalkan bilik apabila sampai masanya untuk perayu memanggil saksinya memberi keterangan. Oleh itu, saksi perayu telah memberi keterangan dalam ketidakhadiran perayu dan tiada penjelasan telah diberi oleh Jawatankuasa berkenaan kenapa perayu telah diminta untuk meninggalkan bilik itu. Selepas mempertimbangkan laporan Jawatankuasa dan representasi perayu, Pihak Berkuasa Tatatertib telah mendapati perayu bersalah dan memecatnya daripada pasukan polis. Terkilan dengan keputusan tersebut, perayu telah memfailkan permohonan untuk semakan kehakiman bagi satu perintah certiorari untuk membatalkan keputusan Pihak Berkuasa Tatatertib. Mahkamah Tinggi walau bagaimanapun, telah menolak permohonan perayu dan oleh itu, rayuan ini. Isu yang dibangkitkan untuk pertimbangan adalah sama ada terdapatnya kemungkiran keadilan asasi semasa prosiding Jawatankuasa apabila perayu diminta untuk meninggalkan bilik di mana siasatan Jawatankuasa diadakan.
Diputuskan (membenarkan rayuan; mengenepikan perintah Mahkamah Tinggi)
Oleh Hishamudin Mohd Yunus HMR menyampaikan penghakiman mahkamah:
(1) Peraturan 37(5) Peraturan 1993 memperuntukkan bahawa jika Pihak Berkuasa Tatatertib mempertimbangkan bahawa sesuatu kes terhadap seseorang pegawai memerlukan penjelasan lanjut, ia boleh menubuhkan sebuah Jawatankuasa Penyiasatan untuk memperolehi penjelasan lanjut sebegitu. Peraturan 37B(3) Peraturan 1993 pula memperuntukkan bahawa jika saksi-saksi dipanggil dan disoal oleh Jawatankuasa Siasatan, maka kehadiran pegawai itu mestilah dibenarkan supaya saksi-saksi boleh disoal balas.
(2) Ia adalah keadilan asasi perayu untuk hadir semasa penyiasatan apabila saksinya memberi keterangan. Berdasarkan fakta, terdapat pelanggaran serius keadilan asasi di mana perayu, tanpa sebarang sebab, telah diminta untuk meninggalkan bilik apabila saksinya memberi keterangan. Oleh itu, perayu tidak mempunyai pengetahuan berkenaan keterangan yang telah diberi oleh saksinya tersebut. Beliau juga tidak mempunyai pengetahuan berkenaan soalan-soalan yang dituju kepada saksinya oleh pegawai yang mengendalikan siasatan di hadapan Jawatankuasa semasa soal silang. Tambahan, perayu tidak mempunyai peluang untuk menyoal semula saksinya yang telah menyebabkan ketidakadilan selanjutnya.
Case(s) referred to:
B Surinder Singh Kanda v. The Government of the Federation of Malaya [1962] 1 LNS 14 PC (refd)
Fauzilah Salleh v. Universiti Malaysia Terengganu [2012] 4 CLJ 601 HC (refd)
Ganasan Marimuthu v. Public Services Commission & Anor [1998] 4 CLJ 331 CA (refd)
Ghazi Mohd Sawi v. Mohd Haniff Omar, Ketua Polis Negara, Malaysia & Anor [1994] 2 CLJ 333 SC (refd)
Lembaga Tatatertib Perkhidmatan Awam Hospital Besar Pulau Pinang & Anor v. Utra Badi K Perumal [2001] 2 CLJ 525 FC (refd)
Legislation referred to:
Public Officers (Conduct and Discipline) Regulations 1993, regs. 37(5), 37B(3)
Counsel:
For the appellant - Karpal Singh (Sangeet Kaur Deo with him); M/s Karpal Singh & Co
For the respondents - Suzana Atan; SFC
[Appeal from High Court, Kuala Lumpur; Civil Suit No: R2-405-2010]
Reported by Kumitha Abd Majid
PROSEDUR JENAYAH: Pembelaan - Alibi - Penafian bahawa tertuduh berada di tempat kejadian - Sama ada prosedur memasukkan notis alibi di bawah s. 402A Kanun Tatacara Jenayah dipatuhi - Sama ada kegagalan mematuhi peruntukan s. 402A menjejaskan kes tertuduh
PROSEDUR JENAYAH: Hukuman - Faktor-faktor yang dipertimbangkan - Faktor-faktor memberatkan dan meringankan hukuman - Sama ada hukuman menurut undang-undang
UNDANG-UNDANG JENAYAH: Kanun Keseksaan - Seksyen 395 - Rompakan - Sama ada unsur-unsur kesalahan dibuktikan - Sama ada kes prima facie dibuktikan - Sama ada pembelaan adalah fikiran kemudian - Sama ada pembelaan berjaya membangkitkan keraguan munasabah - Sama ada keterangan saksi-saksi konsisten - Sama ada pendakwaan berjaya membuktikan kes melampaui keraguan munasabah
PP lwn. MOHD SOUFI OMAR [2013] 1 SMC 254
MAHKAMAH SESYEN, TELUK INTAN
ADLI ABD GHALIB HS
[KES TANGKAP NO: 62-10-2-2012]
17 DISEMBER 2012
Tertuduh telah dituduh dengan satu kesalahan melakukan rompakan yang boleh dihukum di bawah s. 395 Kanun Keseksaan ('Kanun'). Fakta kes adalah bahawa tertuduh dan Man, abang tertuduh, telah melakukan suatu rompakan di rumah pengadu yang tinggal berdekatan dengan rumah tertuduh. Pengadu, yang mencuba untuk melawan semasa rompakan tersebut telah dipukul dengan besi yang dibawa oleh Man. Pengadu telah membuat pengecaman ke atas tertuduh dalam kawad cam yang diadakan. Di akhir kes pendakwaan, mahkamah mendapati bahawa pihak pendakwaan telah membuktikan satu kes prima facie terhadap tertuduh dan tertuduh dipanggil untuk membela diri.
Diputuskan (mensabitkan tertuduh dan menjatuhkan hukuman enam tahun penjara dari tarikh tangkap dan tiga kali sebatan):
(1) Tertuduh menafikan bahawa beliau berada di tempat kejadian. Oleh demikian, tertuduh tidak terkecuali daripada prosedur memasukkan notis alibi di bawah s. 402A Kanun Tatacara Jenayah. Berdasarkan fakta, tertuduh jelas tidak mematuhi peruntukan seksyen tersebut. (perenggan 20)
(2) Tiada sebarang cabaran dikemukakan bahawa tertuduh tidak berada di rumah pengadu atau menyamun pengadu. Tiada percakapan tertuduh kepada polis yang dikemukakan bagi menunjukkan bahawa perkara ini telah ditimbulkan di peringkat penyiasatan polis. Oleh itu, perkara ini merupakan suatu "afterthought" kerana ia hanya dibangkitkan apabila tertuduh dipanggil untuk membela diri. (perenggan 20)
(3) Keterangan saksi pembelaan sendiri adalah konsisten dengan keterangan pengadu khususnya berkaitan dengan identiti tertuduh dan Man. Sebaliknya, keterangan saksi-saksi pembelaan bercanggah antara satu sama lain. Dengan itu, tidak ada sebarang keraguan yang berjaya ditimbulkan oleh pembelaan dan pihak pendakwaan telah berjaya membuktikan kesnya di bawah s. 395 Kanun seperti pertuduhan dengan melebihi keraguan munasabah. (perenggan 20)
(4) Mahkamah telah mengambilkira faktor-faktor yang memberatkan hukuman dan yang meringankan hukuman dalam menjatuhkan hukuman terhadap tertuduh. Antara perkara-perkara yang diambilkira oleh mahkamah dalam menjatuhkan hukuman terhadap tertuduh adalah: (i) kesalahan yang dilakukan adalah serius dan melibatkan kekerasan; (ii) kepentingan awam; (iii) trauma yang dialami oleh mangsa akibat disamun; dan (iv) masa dan kos yang ditanggung oleh pihak-pihak dalam mengadakan perbicaraan penuh. (perenggan 25 & 26)
Kes-kes yang dirujuk:
PP v. Loo Chang Hock [1988] 1 CLJ 76; [1988] 2 CLJ (Rep) 263 HC (dirujuk)
PP v. Wong Chak Heng [1985] 1 CLJ 375; [1985] CLJ (Rep) 717 HC (dirujuk)
Perundangan yang dirujuk:
Criminal Procedure Code, s. 402A
Penal Code, s. 395
Kaunsel:
Bagi pihak pendakwaan - Mohd Suffian; TPR
Bagi pihak tertuduh - Francis Sinnapan; T/n Francis & Co
Dilaporkan oleh S Barathi