DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,

BATHINDA (PUNJAB)

CC No. 369 of 16-08-2010

Decided on : 03-01-2011

Bhupinder Singh Dhillon aged about 54 years S/o Tara Singh Dhillon R/o Gardan Colony, Shri Mukatsar Sahib.

.... Complainant

Versus

1. ICICI Prudential Life Insurance Company Ltd., 2047/2-1, Crown Plaza, 1^st Floor, The Mall, Bathinda 151 001 through its Manager/Competent Authority.

2. ICICI Prulife Towers, 1089 Appasahas Marathe Marg, Prabhadevi, Mumbai 400025 (India) through its Manager/Competent authority

3. ICICI Prodential Life Insurance Company Ltd., Central Claims Department inod Silk Mills Compound, Chakravarti Ashok Road, Ashok Nagar, Kandivali (East) Mumbai 400101 through its Manager/Competent authority

   .... Opposite parties

Complaint under Section 12 of the Consumer Protection

Act, 1986.

 

QUORUM

Ms. Vikramjit Kaur Soni, President

Dr. Phulinder Preet, Member

Sh. Amarjeet Paul, Member

For the Complainant : Sh. Iqbal Singh Brar, counsel for the complainant.

For the Opposite parties : Ms. Navneet Kumari, counsel for the opposite parties.

O R D E R

VIKRAMJIT KAUR SONI, PRESIDENT

1. This complaint has been filed by the complainant under Section 12 of the Consumer Protection Act, 1986 as amended upto date (Here-in-after referred to as 'Act'). The complainant's son Abhyjeet Singh, deceased purchased policy from of the opposite parties vide policy No. 07240298. He deposited Rs. 70,000/- as premium on 3-1-2008 and total sum assured was Rs. 3,50,000/- and the type of policy was Life Time Gold. Abeyjeet Singh died on 27-10-2008. He was suffering from mental tension and was taking medicines daily. On 27-10-2008, he took sulphos instead of his medicine and as a result, he died. In this way, he has mistakenly consumed Sulphos and has not committed suicide. The complainant received a letter dated 18-02-2010 vide which the opposite parties had informed him that only Rs. 33,943.70 being the value of the unit under the policy would be paid to him and he is not entitled for the total sum assured as mentioned in the policy. In the said letter, the opposite parties had mentioned that the poison reached in considerable quantities and such quantity cannot be ingested accidentally, so it is case of suicide. The complainant alleged that he is entitled to get total sum assured of Rs. 3,50,000/- on the death of Abheyjeet Singh, but the opposite parties without any cause and reason refused to pay the sum assured and had sent only Rs. 33,943.70 and this amount was credited in the account of the complainant. As per letter dated 18-02-2010 issued by the opposite parties, it is mentioned vide laboratory report vide dated 28-04-2009 Aluminum Phosphide was detected in the visra of Abheyjeet Singh. It has been wrongly held that deceased Abheyjeet Singh has committed suicide and has taken large quantity of poison. This large quantity of poison can only be ingested intentionally and not accidentally. By holding the death of Abheyjeet Singh as suicide, his claim was wrongly decided. The complainant had also sent a legal notice dated 30-03-2010, but no reply has been filed to this legal notice.

2. The opposite parties on the other hand, in their written statement, have taken preliminary objections that this Forum has no territorial jurisdiction as the office of the opposite parties is situated at Muktsar; the complainant is also resident of Mukatsar and complaint is not supported by any proof provided by the Doctor or any other authority to the effect that life assured died mistakenly after taking sulphos as alleged in this complaint. During investigations which were carried out, it was discovered that the complainant died of poisoning. Since life assured died of poisoning and there does not exist any police records or medical records of cause of death in favour of the complainant. Moreover, as the life assured had died within 10 months from the date of issuance of the policy, which clearly shows that life assured administered poison by himself and it is case of suicide. The company has already refunded the value of units under the policy. In the present case, the death has occurred within the first policy year, and the amount of Rs. 33,943.70 being the value of units under the policy was payable. This amount was duly transferred in the complainant's account No. 14181000020563 of HDFC Bank and intimation to this effect was sent to the complainant vide letter dated 18-02-2010. A DDR was also registered to this effect and proceedings under Section 174 CRPC were initiated by the police. The DDR clearly states that the life assured was suffering from mental tension and was undergoing medical treatment at Adesh Hospital, Mukatsar. It is also mentioned in this report that sometimes life assured use to lose his consciousness and sensation and in this respect family members were very vigilant towards him. It also states that life assured was having headache i.e. not feeling well and leading towards unconsciousness. The Forensic Science Laboratory report dated 28-04-2009, mentions that Aluminum Phosphide insecticide was detected in stomach and parts of small and large Intestines. Phosphine, a constituent of Aluminum Phosphide , detected in parts of Lungs, Heart, Spleen, liver and kidneys and Blood. As per the medical opinion any ingested poison to have reached all these organs must have been consumed in considerable quantities. Detection of poison in the stomach, in the blood as well as in the solid organs like liver, spleen, lungs, heart and kidney denote that life assured consumed large quantity of poison and large quantity of poison can only be ingested intentionally and not accidentally. The opposite parties have pleaded that this was a case of suicide and the complainant has concocted the false story to take the benefit. They have further pleaded that as per the proposal form submitted to the opposite parties by life assured, he was an employee of ICICI Bank earning Rs. 1,00,000/- per annum and did not appear to be suffering from any medical problem nor was the same disclosed to the company at the time of taking the policy. The submission made by the complainant appears to be false and frivolous on the face of it since no kind of mental tension can cause a person to accidentally take poison in large quantity as was consumed by the life assured and in-fact mental tension can lead a person to commit suicide.

3. Parties have led evidence in support of their pleadings.

4. Arguments heard and written submissions submitted by the parties perused.

5. Admittedly life assured died on 27-10-2008. He was holding a Life Insurance policy of total sum assured of Rs. 3,50,000/- and paid a premium of Rs. 70,000/-. On 3-1-08 Bhupinder Singh, father of deceased Abheyjeet Singh, has deposed in his affidavit Ex. C-1 that Abheyjeet Singh was suffering from mental tension and was taking medicine daily and on 27-10-2009, he mistakenly took Sulphos instead of his medicine and as a result he died He has not committed suicide. The opposite parties had informed the complainant vide letter dated 18-02-2010 that only Rs. 33,943.70 being the value of unit under the policy would be paid to him and he is not entitled for the total sum as this is a case of suicide. Rs. 33,943.70 was duly credited in the account of the complainant by the opposite parties. The opposite parties have quoted the reason for the non-payment of the sum assured that poison taken by life assured had reached in considerable quantities and such quantity cannot be ingested accidentally, so it is a case of suicide. It is mentioned in the laboratory report dated 28-04-2009 that Aluminum phosphide was detected in the visra of Abheyjeet Singh, but it had been wrongly held that deceased Abheyjeet Singh has committed suicide as he has taken large quantity of poison. This large quantity of poison can only be ingested intentionally and not accidentally.

6. The opposite parties have denied the payment of sum assured vide letter 12-08-2009 Ex. C-3, wherein they have mentioned that :-

   “........As per the First Police investigation dated October 28, 2008, it is noted that Life Assured was suffering from mental tension from last 2 years and was taking medicine daily and on October 27,2008, he mistakenly took Sulphos instead of his medicines. The Post mortem report dated October 28, 2008 mentions that “Cause of death would be declared after receipt of chemical examiner's report.

   The Final Police investigation report dated June 05, 2009 confirms the above stated fact as mentioned in the First Police Investigation. The report also mentions that the cause of death is due to Aluminum Phosphide Insecticide Poisoning on the basis of report of Chemical examiner, Patiala vide his report No. 992 dated April 28, 2009 and the death has occurred due to taking Aluminum Phosphide.

   It is also confirmed in the report that there is no role of any person in causing the death of Abhayjeet Singh rather his death has been caused due to taking poisonous matter/medicine.

   The Forensic Science Laboratory;s report dated April 28,2009 mentions that Aluminum Phosphide insecticide was detected in stomach and its contents, in parts of small and large intestines, Phosphine, a constituent of Aluminum Phosphide, detected in the contents of parts of Lungs, Heart, Spleen, liver and kidneys and Blood.

   We have obtained medical opinion to the effect that any ingested poison to have reached all these organs considerable quantities must have been ingested. Detection of poison in the stomach, in the blood as well as also in the solid organs like liver, spleen, lungs, heart and kidney denotes that Life Assured consumed large quantity of poison and large quantity of poison can only be ingested intentionally and not accidentally.

   In view of the above, we are therefore satisfied that the death of Mr. Abhayjeet Singh is a result of suicide.

   In the event of death as a result of suicide during the first policy year, the above mentioned policy, vide general condition No. 4 provide for return of the value of units. As in the instant case the death has occurred within the first policy year, an amount of Rs. 33,943.70 (Value of Units under the policy) becomes payable to you.”

7. The opposite parties have produced on record post mortem report Ex. R-7 which reads as under :-

   “...... Cause of death will be declared after receipt of report from Chemical examiner, Punjab.”

   The chemical examiner report Ex. R-6 does not reveal that how much quantity of Sulphos is life threatening. It is only mentioned in this report that Aluminum Phosphide insecticide detected in the stomach and parts of small and large Intestines. Phosphine a constituent of Aluminum Phosphide detected in parts of lungs, heart, spleen, liver, kidneys and blood. A perusal of record placed on file reveals that opposite parties have failed to prove their version by producing opinion of any expert or doctor that Abheyjeet Singh has consumed sulphos intentionally and not accidentally. They have not even got the matter investigated at their own level and did not appoint any Investigator etc., before deciding the claim of the complainant.

8. The opposite parties have taken preliminary objection that this Forum has got no territorial jurisdiction to try and decide the complaint as the office of the opposite parties is situated at Mukatsar and complainant also resides at Mukatsar. This objection is not tenable as Insurance Policy Ex. R-1 shows that the policy in question has been issued from Bathinda. Hence, the complainant has rightly chosen this Forum for the redressal of his grievances and this Forum has got the territorial jurisdiction to try and adjudicate this complaint. Another preliminary objection of the opposite parties is that complaint is not supported by any documentary proof stating the exact cause of death of the life assured. The complaint is not supported by any proof provided by the doctor(s) or any other authority to the effect that the life assured died of mistakenly taking sulphos as alleged in this complaint. As discussed above, the opposite parties have themselves have also not placed on file any such document to prove that life assured has committed suicide. Presence of poison in the body of the life assured cannot be considered that he has intentionally consumed poison. Hence, this objection is also without any base.

9. In view of what has been discussed above, this Forum is of the view that the opposite parties have miserably failed to prove that son of the complainant has taken sulphos intentionally and his case was a suicide case. The opposite parties have taken a plea that life assured has taken large quantity of sulphos whereas a perusal of documents placed on file by the opposite parties does not reveal that life assured has taken large quantity of sulphos. The opposite parties have not placed any terms and conditions of the policy in question according to which sum assured cannot be paid if death occurs within one year of the issuance of policy.

   Hence, this Forum concludes that the life assured was suffering from headache and he has consumed sulphos accidentally. The opposite parties have not paid the sum assured to the complainant without any reason which amounts to deficiency in service on their part.

10. In the result, this complaint is accepted with Rs. 10,000/- as compensation and cost. The opposite parties are directed to pay Rs. 3,50,000/- to the complainant. The compliance of this order be made within 45 days from the date of receipt of copy of this order. In case of non-compliance, the interest @9% will yield on the amount of Rs. 3,50,000/- till realisation.

A copy of this order be sent to the parties concerned free of cost and the file be consigned.

Pronounced

03-01-2011 (Vikramjit Kaur Soni)

President

(Dr. Phulinder Preet)

Member

(Amarjeet Paul) Member