Tamil Nadu

StateCommission

A/266/2019

Dr.Sudhahari, W/o Dr.Aravinth, Ganesh Nursing Home, No.21, Arcot Road, Ranga Puram, Vellore District. - Complainant(s)

Versus

1.M/s.Royal Sundaram Alliance, Insurance Co. Ltd, by its Manager, Chennai 600 014.And Another - Opp.Party(s)

M/s.Nageshwaran & Narichania

29 May 2023

ORDER

IN THE TAMILNADU STATE CONSUMER DISPUTES REDRESSAL COMMISSION, CHENNAI.

 

Present: Hon’ble THIRU  JUSTICE R. SUBBIAH  :     PRESIDENT

                 THIRU R   VENKATESAPERUMAL         :      MEMBER

 

F.A. No. 266 of 2019

[Against the order passed in C.C. No.114 of 2018 dated 18.06.2019 on the file of the D.C.D.R.F., Chennai (North)].

 

 Monday, 29^th day of May 2023

Dr. Sudhahari

W/o. Dr.Aravinth

Ganesh Nursing Home

No.21, Arcot Road

Rangapuram

Vellore District.                                          .. Appellant/Complainant

 

- Vs –

 

1.  M/s. Royal Sundaram Alliance

       Insurance Co. Ltd.,

     Rep. by its Manager

     Chennai – 600 014.    

 

2.  The Branch Manager

     M/s. Royal Sundaram Alliance

        Insurance Co. Ltd.,

     Vellore – 6.                                           ..  Respondents/

                                                                             Opposite Parties

 

Counsel for the Appellant/Complainant: M/s. Nageswaran & Narichania

 

Counsel for the Respondents/OP          :  M/s. M.B.Gopalan Associates

                                               

        This appeal came before us for final hearing on 27.01.2023, and on hearing the arguments of the counsel for the Appellant and the respondents and on perusing the material records, this Commission made the following :-

O R D E R

R.SUBBIAH J., PRESIDENT

                This appeal has been filed by the complainant under Section 15 of the Consumer Protection Act, 1986 as against the dismissal of the complaint in C.C. No.114 of 2018, dated 18.06.2019, by the District Consumer Disputes Redressal Forum, Chennai (North). 

 

 

                2.  The factual background culminating in this appeal is as follows:   The case of the complainant before the District Forum is that her husband Dr.V.Aravinth, had taken an insurance policy No.PASBIG 0010/ Certificate No. PS 00052659000106 covering the period from 02.08.2012 to 01.08.2013 from the opposite party for a sum of Rs.20 lakhs, for any unnatural and unforeseen death that might occur to him.  The complainant is the nominee under the Insurance Policy.  Whileso, on 23.10.2012 at about 7.15 pm, the complainant’s husband Dr.Aravinth was killed by some unknown persons at LPM Street, Kosapet, Vellore.  A case was registered in Cr.No.653 of 2012 in South Police Station, Vellore.  Since the complainant had taken a policy from the opposite parties, the complainant submitted a claim form along with certified copy of the policy, copy of the FIR, Death Certificate and also other relevant details to the 1^st opposite party.  The 1^st opposite party sent a reply stating that the policy covers only accidental death and not death caused due to murder.  Hence the complainant sent a notice dated 22.02.2013 through her Advocate apprising the 1^st opposite party that the policy covers not only the unnatural death due to accident but also an unnatural death due to unforeseen causes like murder.  Though the said notice was received by the 1^st opposite party on 26.02.2013, they have not chosen to send any reply.  Therefore, alleging deficiency of service, a complaint has been filed before the District Forum by the complainant, seeking to direct the opposite parties, to pay the complainant a sum of Rs.20,00,000/- under the insurance policy.

 

 

        3.  Resisting the case of the complainant, the opposite parties have filed a written version stating that the husband of the complainant Mr.Aravinth Reddy had taken a personal accident policy No.PS00052659000106 valid from 02.08.2012 to 01.08.2013.  The said personal accident policy was issued to Mr.Aravinth Reddy, subject to terms and conditions and covers only accidental death caused due to external, violent and visible means but not otherwise.  In such a situation, the complainant made a claim on 07.12.2012 stating that her husband Mr.Aravinth Reddy was intentionally murdered on 23.10.2012 by a 3 member gang who came in a motorcycle and stabbed him with a knife at the back of his neck and the complainant’s husband succumbed to death, on the spot.  He was intentionally murdered as per the plan that was hatched by the gang.  The complainant’s husband was murdered due to some previous enmity as the dominant intention of the act of felony was to kill Mr.Aravinth Reddy, which only shows that this is a clear cut case of murder simpliciter and the same is not covered under the personal accident policy issued by the opposite parties to the deceased Aravinth Reddy. The motorcycle borne culprits targeted Mr.Aravinth Reddy, while he was coming out of his clinic and hacked him to death on the spot and fled, which clearly shows that the intention of the gang was to kill Mr.Aravinth due to previous enmity.  The claim for intentional murder of Mr.Aravinth is not maintainable under the terms of policy, since the complainant’s husband was murdered due to some previous enmity.  Therefore, the claim is liable to be dismissed and thus sought for dismissal of the complaint.

 

 

        4.  In order to prove the case, on the side of the complainant, along with proof affidavit, 9 documents were filed and the same were marked as Ex.A1 to A9.  The opposite parties have filed their proof affidavit and 5 documents and the same were marked as Ex.B1 to B5. 

 

 

        5.  The District Forum, on analyzing the entire evidence on record, had observed that in the present case the complainant being a Doctor by profession, herself had admitted and filled up the claim form indicating that the death is a planned murder.  In the FIR it is narrated as for some reasons he was killed and thereby prima facie it is proved that the dominant intention of the act of felony was to kill the insured, which only shows that it is a clear case of Murder Simpliciter.  Therefore, the opposite parties are right in rejecting the claim filed by the complainant and thus dismissed the complaint.  Aggrieved over the same, the present appeal has been filed by the complainant.

 

        6.  When the matter was taken up, learned counsel for the appellant/complainant made a detailed submission by adverting to the averments made in the complaint.  It is the specific submission of the counsel for the appellant/complainant that nowhere in the policy it has been specifically stated that death due to murder is an excluded peril under the policy.  The term accident is very clear and as per Black’s Law Dictionary, an accident is defined as “An unintended and unforeseen injuries occurrence: something that does not occur in the usual course of events or that could not be reasonable anticipated”.  Further, counsel for the appellant/ complainant submitted that the District Forum had failed to note that the death of the complainant’s husband, who was a Doctor by profession, had no enmity with anybody nor he had criminal/civil cases filed by him or against him.  The death was not due to an act of murder for gain.  Neither the deceased Doctor nor their family members anticipated such a murder, as such the death was accidental and due to external and violent means.  The cause of death of her husband was due to an act committed by few persons which is a case of mistaken identity.  But, the District Forum had failed to consider these aspects.  The legal definition of the word “accident” contains 2 important expressions, namely, ‘unforeseen’ and ‘unintended’.  The act of murder was no doubt, ‘unforeseen’ as the victim had no enmity with anybody.  The word ‘unintended’ has to be seen from the view of the victim and not from the view of the offender.  Therefore, dismissal of the complaint by the District Forum holding that the death of the deceased was due to Murder Simpliciter is patently illegal and thus he prays to set aside the order of the District Forum and consequentially direct the Insurance company to pay the insurance amount.

 

        7.  Countering the same, counsel for the Respondents/ Opposite parties submitted that as per Ex.B1 the Insurance Policy, it covers “… the Insured person shall sustain any bodily injury resulting solely and directly from accident caused by external, violent and visible means, anywhere in the world, then the company shall pay to the insured person or nominee(s)/ legal heir(s) of the insured person…”.  Therefore, it is clear that the coverage is only for injury resulting solely and directly from accident.  In the present case, the claim was made for death of the Insured Dr.Aravinth on 23.10.2012 when he was attacked and murdered by a 3 member motor cycle gang who stabbed him with a knife in the back of the neck and killed him on the spot and thereafter the offenders fled away.  In the Claim form Ex.B2, the complainant herself had stated that the deceased was murdered as per plan and it was a ‘planned murder’.  Therefore, the same cannot be treated as an accidental murder.  Hence, the District Forum had rightly rejected the complaint.  In support of the same, the counsel for the complainant had also relied on the judgment of the Supreme Court in the case of Rita Devi v. New India Assurance Co.Ltd. (2000 SCC Online 826).

 

        8.  Keeping in mind the submission made by the Counsel for the Appellant/ complainant and the respondents/opposite parties, we have carefully gone through the entire material available on record. 

 

        9.  On examining the order passed by the District Forum, we find that, to record a finding that murder could not be construed as an accident for the purposes of insurance claim, the District Forum had relied upon the findings of the National Consumer Disputes Redressal Commission, New Delhi in the case of LIC of India & anr. Vs.Chinthareddy Vijayamma (2016 SCC Online NCDRC 734) ; Dheerajkumar & anr. Vs.Bajaj Allianz General Insurance Co. Ltd. (2018 SCC Online NCDRC 605); and Smt.Mamta Thakur Vs. United India Insurance Co. Ltd. & anr., (2016 SCC Online NCDRC 1607), wherein the Apex Court has distinguished the difference between the murder which is not an accident and the murder which is an accident, as it depends on the proximity of the cause of such murder.  If the dominant intention of the felony is to kill any particular person then such murder is not an accidental murder but is a murder simpliciter, while if the cause of the murder or act of the murder was originally not intended and the same was caused in furtherance of any other felonies act then such murder is an accidental murder.  Thus, in the present case the District Forum has come to the conclusion that the complainant herself had stated in the claim form that it is a planned murder and hence repudiation of the claim by the opposite parties is perfectly correct.   Further, we find that in the judgment of the Apex Court rendered in Rita Devi vs. New India Assurance Co. Ltd. (2000-5-SCC-113), it is held that the murder in the set of facts involved in that case amounts to an accident. In fact, in the case of Rita Devi, while dealing with an issue as to whether a 'murder' can be treated as an 'accident', by framing a specific question 'can a murder be an accident in any given case?', the Apex Court has determined that the murder which is not an accident and the murder which is an accident, by holding that it depends on the proximate cause of the murder and that, if the dominant intention of the act of felony is to kill any particular person, then such killing is not an accidental murder but a murder simpliciter.  It would be of much relevance here to quote below the relevant portion from the said case law:-

                        " The question, therefore, is can a murder be an accident in any given case ? There is no doubt that murder, as it is understood, in the common parlance is a felonious act where death is caused with intent and the perpetrators of that act normally have a motive against the victim for such killing. But there are also instances where murder can be by accident on a given set of facts. The difference between a murder which is not an accident and a murder which is an accident, depends on the proximity of the cause of such murder. In our opinion, if the dominant intention of the Act of felony is to kill any particular person then such killing is not an accidental murder but is a murder simplicitor, while if the cause of murder or act of murder was originally not intended and the same was caused in furtherance of any other felonious act then such murder is an accidental murder.

 

From the above ruling of the Apex Court, it is quite categoric that an intentional murder does not amount to accident.  In the instant case, even in the claim form submitted by the complainant it has been clearly stated that it is a planned murder.  Therefore, at any stretch of imagination, the murder of the husband of the complainant cannot be treated as an accidental murder.  In these circumstances, we do not find any infirmity in the order passed by the District Forum in rejecting the claim made by the complainant and hence the appeal is liable to be dismissed.

 

             10.  In the result, the appeal is dismissed and the order passed by the District Consumer Disputes Redressal Forum, Chennai (North) in C.C. No.114 of 2018, dated 18.06.2019, is confirmed.  No costs.   

 

 

R   VENKATESAPERUMAL                                                                                                 R.SUBBIAH

         MEMBER                                                                                                                     PRESIDENT

 

Index :  Yes/ No

 

AVR/SCDRC/Chennai/Orders/May/2023