Date of Order : 25.02.2017
- In the instant case the Complainant has sought for following reliefs against the Opposite party:-
- To direct the opposite parties to pay entire benefits of the policy nos. 513015761 and 513015764 along with 18% interest from the date of information i.e. 29.09.2006 to the date of final payment.
- To direct the opposite parties to pay Rs. 75,000/- ( Rs. Seventy Five Thousand only ) as compensation.
- To direct the opposite parties to pay Rs. 20,000/- ( Rs. Twenty Thousand only ) as litigation costs.
- The facts of this case lies in a narrow compass which is as follows:-
The complainant has asserted that the deceased Vijendra Kumar had taken several policies out of which policy no. 514448611 sum assured of Rs. 2,00,000/- had been paid through cheque vide annexure – 2. So far other policy being no. 513015761 and 513015764 in which sum of Rs. 1,00,000/- each were assured with profit has not been paid to the nominee i.e. the complainant.
It has been further asserted during the continuance of life of the aforesaid policies, the complainant’s husband Vijendra Kumar (Life Assured) was murdered and in this connection F.I.R. was lodged with Naubatpur Police Station giving rise to Naubatpur P.S. Case no. 87/06 dated 18.07.2006 U/s 324, 307, 34 and 27 Arms Act and later on section 302 IPC was added with the permission of the court. The police submitted Charge sheet. Photocopies of F.I.R. Charge Sheet, postmortem report as well as death certificate of the deceased husband of the complainant has been annexed as annexure – 4 series.
It has been further asserted by the complainant that she has lodged insurance claim through opposite party no. 3 who is an authorized agent of opposite parties. Opposite party no. 3 had received all information and documents on behalf of opposite party no. 1 and 2 and the same has been furnished to opposite party no. 1 and 2 for processing the claim of the complainant (vide annexure – 5). Thereafter annexure – 6 was issued by opposite party no. 2 and opposite party no. 3 furnished the required documents and as such claim of insurance policy no. 514448611 has been paid.
The grievance of the complainant is that despite receiving all the documents the opposite parties are not taking interest regarding rest two policies i.e. 513015761 and 513015764.
On behalf of opposite party (insurance) a written statement has been filed denying the allegation of the complainant and asserting that the sum assured under policy no. 514448611 was paid on 31.03.2008 sum assured of Rs. 2,00,000/-. So far policy no. 513015761 is concerned all the benefits are payable at the time of maturity i.e. on 28.07.2021.
It has been further asserted by opposite parties that there was no intimation about policy no. 513015764 hence it was not considered at that time. In Para – 8 of aforesaid written statement opposite party no. 1 and 2 have asserted following facts, “that with regard to relief portion of the complaint petition it is submitted that the claim for policy no. 513015761 is to be made on the date of maturity i.e. on 28.07.2021. Regarding policy no. 513015764 the claim has not reported to the insurance office hence the question of payment of interest does not arise. The question of compensation also does not arise as the claim reported to the insurance office has already been settled.”
We have narrated the brief facts asserted by both the parties in forgoing paragraphs.
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It appears from the assertion of the complainant as well as opposite parties that deceased had taken three policies being policy no. 514448611, 513015761 and 513015764 out of which the opposite parties have paid Rs. 2,00,000/- on 31.03.2008 of policy no. 514448611.
So far policy no. 513015761 is concerned the opposite parties have stated that the assured amount of this policy is payable at the time of maturity i.e. on 28.07.2021. Hence we are not passing any order with regard to aforesaid insurance policy i.e. 514448611 and 513015761. Thus only one policy now remains i.e. 513015764 with regard to this policy the opposite parties have asserted that they have no intimation. It seems to be very surprising that the opposite parties have paid Rs. 2,00,000/- after finding the relevant papers submitted by the complainant genuine. Thus the relevant documents i.e. insurance policy being no. 513015764 as well as F.I.R., Postmortem report, Charge Sheet and death certificate are with the opposite parties which can be used in deciding the claim of widow complainant. If needed the opposite party no. 1 and 2 may take claim form from the complainant.
The other grievance of the opposite parties are that as the complainant’s husband was murdered due to enimity hence the complainant is not entitled to received accidental benefits because such type of murder are not accident.
It goes without saying that Hon’ble Apex Court and several other Hon’ble Courts have held that if any murder takes place due to provocation or initiation of any assault etc. by the deceased then the accidental insurance claim is not payable but the murders with simple animosity are not always murder rather it can be treated as pure accident.
From bare perusal of relevant documents annexed as annexure – 4 series i.e. F.I.R., Charge Sheet etc. It is crystal clear that there was neither any provocation or initiation of any assault etc. on the part of deceased and hence we are of the considered opinion that the complainant has right to receive the sum assured under accidental benefit of accrued to her vide policy no. 513015764.
We have already stated in above Paras that if necessity arises the opposite parties may obtain claim form from widow complainant and they must make use of all other documents furnished on her behalf on which insurance policy no. 514448611 has been paid.
We therefore direct the opposite parties to pay the sum assured of Rs. 1,00,000/- ( Rs. One Lack only ) vide policy no. 513015764 within a period of two months from the date of receipt of this order or certified copy of this order failing which opposite parties will have to pay 10% interest on the sum assured amount of Rs. 1,00,000/- ( Rs. One Lack only ) till its final payment.
Opposite parties are further directed to pay Rs. 25,000/- ( Rs. Twenty Five Thousand only ) to the complainant by way of compensation and litigation costs within the period of two months.
Accordingly this complaint stands allowed to the extent referred above.
Member President
