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O R D E R

Sri. P. Satheesh Chandran Nair (President):

                 The complainants filed this petition u/s.12 of the C.P. Act for getting reliefs against the opposite parties.

                 2. The case of the complainant is as follows:  The 1^st complainant is the mother and 2^nd complainant is the sister of one Subhash. S.  The said Subhash.S was murdered on 4^th May 2010 and the Kodumon police has registered a case against the culpridge as Crime No.204/2010.  This complainants are the only legal heirs of the deceased Subhash.S as per Hindu Law of Succession.  According to the complainants, the said Subhash was a holder of Life Insurance Policy with the 2^nd opposite party bearing No.394303900 for an amount of Rs.1,30,000/-.  The policy was commenced in June 2009 and the premium was regularly remitted by the policy holder up to his death.  The deceased paid 3 half yearly premiums and Rs.4,220/- was the single premium amount.  The maturity date of the policy is on 25.06.2015.  The complainants contended that as per the terms and conditions of the policy, the opposite parties are liable to pay the assured amount plus an equal to that amount plus bonus to the complainants.  The opposite party paid only Rs.1,35,460/- being the sum assured plus bonus.  Apart from the above contention, the complainant filed a statement showing the amount and interest due to the complainants from the opposite parties. 

Balance amount due to complainants                 Rs. 1,30,000/-

Interest for the same @ 9% per annum from       Rs.    52,650/-

04.05.2010 to 04.11.2014.                                                       

                                 Total                                  Rs. 1,82,650/-

         3. The complainant again stated that the opposite parties are not complying the terms and conditions of the policy and thereby committed deficiency in their service towards the complainants.  The claim application was duly came before the opposite party immediately after the death of the deceased.  Hence the opposite parties are liable to pay the principal amount as well as interest for the same as per the statement above cited.  The cause of action for the complaint has arisen on 04.05.2010, i.e. the date of death of insured Subhash. S.  The complainant prayed that this Forum may pass an award against the opposite party for a sum of Rs.1,82,650/- as stated in the above statement and allow to realise the same from the opposite parties.

        4. The opposite parties in this case appeared before this Forum on the basis of the notice issued from this Forum and filed joint version for 1^st and 2^nd opposite party.  The version filed by the opposite parties are briefly stated below:  The complaint is not maintainable either in law or on fact.  The opposite parties admitted that the deceased was a policy holder of opposite parties.  The claim of double accident benefit is denied by the opposite parties.  According to the opposite parties, on receipt of intimation of the insurance claim the assured amount Rs.1,30,000/- together with a bonus for Rs.5,460/- was paid to the nominees, i.e. complainants.  The double accident benefit which is applicable only in cases of death involving accident but not falling within the exceptions contained in the policy conditions.  The death covers under exception contained in condition 10(b)(iv) of general condition of life insurance policy.  The 10(b) Death of the Life Assured, it is also quoted in their version 10(b) “To pay an additional sum equal to the sum assured under the policy, if the life assured shall sustain any bodily injury resulting solely and directly from the accidents, caused by outward, violent and visible means and such injury shall within 180 days of it’s occurrence, solely, directly and independently of all other causes result in the death of the life assured”.  The strong contentions of the opposite parties are that they are not liable to pay the additional sum referred in (a) or (b) above if the disability of the death of the life assured shall caused by intentional self injury, attempted suicide, insanity or immorality or whilst the life assured is under the influence of intoxicating liquor, drug or narcotic.  The opposite parties again contended that the death of the assured happened as a result of breach of law on the part of the life assured.  In order to establish the above contention the opposite parties referred the criminal case records of the assured, and contended that it is evident to see that the accident occurred when the life assured was engaged in criminal acts and breach of law and hence false within the above said exceptions in the policy and the LIC is not in a position to settle double accident benefit.  It is the duty of the claimant to satisfy the LIC that there was an accident and death not falling within the exceptions in the general conditions.  The LIC has directed the complainant to produce the result of chemical analysis report of viscera of the assured but the same has not been produced and hence LIC was not in a position to proceed within the claim.  The allegation to the effect that the LIC is unnecessarily retaining the complainants is false.  The LIC has disbursed the claim to the complainants within 3 days from the receipt of the application for claim.  This can be seen that the LIC was too prompt in handling the matter.  Hence on the part of the opposite parties no deficiency in service can be found.  According to the opposite parties in spite of the letter dated 29.07.2011 calling for chemical analysis report, this complaint is filed before this Forum only on 31.10.2014 which is beyond the limitation period of 2 years.  The opposite parties prayed before this Forum to dismiss the complaint with cost to the opposite parties.

                 5. In the light of the complaint and the version we would like to raise the following issues: 

1. Whether the complaint is maintainable before this Forum?
2. If it is maintainable what relief can be granted to the complainant?

        6. Point No.1 & 2:- For the sake of convenience the above points are considering together.  On the side of the complainant, she filed a chief affidavit in lieu of chief examination along with Exts.A1 to A7 documents. In cross-examination, the counsel appearing for the opposite parties produced the policy certificate and the said document is marked as Ext.B1through the comlpainant.  Ext.A1 document is the photocopy of the FIR in Crime No.204/10 of Kodumon Police Station, the Ext.A2 is the post-mortem certificate in the above said crime and Ext.A3 is the inquest report of the same crime, Ext.A4 is the copy of the charge sheet in the said crime, the Ext.A5 is the letter sent to the Branch Manager, LIC, Adoor Branch by the complainant, Ext.A6 is the office copy of the advocate notice dated 25.08.2014 along with postal receipt and acknowledgment card and Ext. A7 is the reply notice sent to advocate from LIC Branch office, Adoor.  Ext.B1 is the policy certificate of the life assured late Subhash. S dated 24.06.2009.  The counsel appearing for the opposite parties cross-examined PW1 on the same day.  When considering the available evidence before this Forum we can see that there is no dispute regarding the policy certificate of the life assured as per Ext.B1.  There is no dispute regarding the cause of death of the assured also.  The main contention raised by the opposite party in this case is that the petition is bar by limitation.  The subsequent contention of the opposite party is that the death happened when the life assured committed a breach of law.  Hence the legal heirs are not eligible for double claim. Their main contention is that the life assured was an anti social person who was always making troubles to the public and the cause of the death was due to his own act and it happened when he was engaged in acts of breach of law and hence this incident false within the exceptions which is described in general conditions clause 10(b)(i), (iv).  Another contention raised by the opposite party in this case is that the chemical analysis report of viscera of the life assured has not been produced in time hence LIC was not in a position to proceed with the claim. 

         7. When considering the 1^st contention, whether this case is barred by limitation it can be seen from Ext.B1 that the maturity period of the life assured is expired only on 25.06.2025.  The complainant preferred this petition before Forum before the maturity period i.e. 25.06.2025.  It is seen from the pleadings and evidence before the Forum that on 4^th May 2010 the life assured was murdered and a crime registered by the Kodumon Police as Crime No.204/10.  Considering all these facts we come to a conclusion that the bar of limitation plea of the opposite party has not been sustained and the Point No.1 found in favour of the complainant.  The next question to be considered is whether the legal heirs of the life assured Subhash. S have a right to get double benefit from this B1 policy.  It is clear from Ext.B1 page No.3  Clause 10(b) Accident benefit it is stated as,  “To pay an additional sum equal to sum assured under this policy.  If the life assured shall sustain any bodily injury resulting solely and directly from the accidents, caused by outward, violent and visible means and such injury shall within 180 days of its occurrence, solely, directly and independently of all other causes result in the death of the Life Assured.  The Corporation shall not be liable to pay the additional sum referred in (a) or (b) above if the disability or the death of the Life Assured shall,

         (i) be caused by intentional self injury, attempted suicide, insanity or immorality or whilst the life assured is under the influence of intoxicating liquor, drug or narcotic: or

        (ii) take place as a result of accidents while the life assured is engaged in aviation or aeronautics in any capacity other than that of a fare paying, part paying or non paying passenger in any aircraft which is authorized by the relevant regulations to carry such passengers and flying between established aerodromes, the life assured having at that time no duties on board the aircraft or requiring descent there from: or

       (iii) be caused by injuries resulting from riots, civil commotion, rebellion, war (whether war be declared or not) invasion, hunting, mountaineering, steeple chasing or racing of any kind; or

         (iv) result from the life assured committing any breach of law”.

         8. On the basis of the condition clause stated as per Ext.B1 above it is clear that the legal heirs of the life assured is eligible to get an additional sum equal to the sum assured under this policy if the life assured died due to an accident.  We do admit that in this Ext.B1, exception clauses are also discussed.  When we peruse the Ext.A1 to A4, the document connected to murder of the life assured we find that this case does not comes under any of the exceptions stated in Ext.B1.  The opposite parties strongly argued that the incident took place while the life assured engaged in breach of law and he is the aggressor, and the same is evident by Ext.A4 charge sheet.  When we peruse the Ext.A1 to A4, it is clear that the accused persons assaulted the life assured with a “Virakukambu” and the said weapon was broken and subsequently the accused stabbed the life assured with a knife and killed him.    When we peruse the charge sheet (Ext.A4) we can be seen that the life assured was an aggressor and overtact of the accused can be inferred.  When considering this petition it is none of our business to look into the whole character of the life assured.  It is the duty of the life insurance corporation to study or examine the character of the life assured before issuing a policy.  It is pertinent to see that the life insurance corporation is liable to pay an equal amount to the life assured if an accident death is occurred.  We do admit that if the death comes under the exception clause the life assured claim would have not been sustain.  Here the complainant is succeeded to prove her case with cogent and conclusive evidence that an accident death is occurred and the said death is not comes under any of the exceptions stated in Ext.B1 i.e. “conditions and privileges within referred to”.  It is evident to see that the opposite party was so prompt to pay the assured amount of Rs.1,30,000/- plus bonus to the legal heirs within 3 days of their application.  When we peruse Ext.A6 and A7 it can be seen that the absence of the chemical analysis report is the only obstacle for considering the Ext.A3 notice.  When the opposite party issuing the Ext.A6 notice to the counsel of the complainant it is interesting to see that the opposite party did not raise any kind of legal objection against the claimant for the non payment of the double amount.  So we found that the contention raised by the opposite party for the non-payment of the double amount at this stage has not been sustained and there is no bonafide for this contention.  In support of the complainant’s case the counsel for the complainant produced a decision reported as 2014 ACJ 1237 of the Hon’ble High Court of Allahabad.  The dictum of the decision is, “Life Insurance-Double accident benefit—Repudiation of claim—Assured took policies on his life with double accident benefit—Assured was kidnapped due to business rivalry and murdered—Claim of mother as nominee was accepted for basic sum assured but claim for double accident benefit was repudiated by LIC on the ground that death was due to murder after kidnapping which was not an accident—Writ petition contending that kidnapping and murder cannot be held to be foreseen or probable causes of death and it was an accidental happening—Even ‘willful murder’ of the assured is accidental as far as insured is concerned and such murder is to be described as ‘by chance’ or ‘fortuitous’—Policy excludes death due to limited causes mentioned in exclusion clause and it does not exclude death due to murder for any reason—Whether LIC was justified in repudiating claim for double accident benefit—Held: no; LIC directed to disburse the amount accrued towards double accident benefit claim including bonus with interest at 8 per cent per annum from the date it has fallen due”.  The above citation is also in favour of the complainant for a positive decision in this case.  This decision is very clear and correlated to this case.  As per the above stated decision, the legal representatives of the deceased life assured is eligible for double claim benefit as well as for the bonus.  Considering the above finding it is clear that the opposite parties are committed clear deficiency in service.    

         9. As a result, we pass the following:

1. The opposite party is directed to pay an amount of Rs.1,30,000/- (Rupees One Lakh Thirty Thousand only) to the complainant with interest of 10% from the date of application of the claim amount i.e. 04.05.2010 onwards.
2. The opposite party is directed to pay a bonus of Rs.5,460/- (Rupees Five Thousand four hundred and sixty only) to the complainants with interest of 10% from the date of order onwards.
3. The opposite party is directed to pay Rs.3,000/- (Rupees Three Thousand only) with cost of the proceedings to the complainant with 10% interest from the date of order.
4. Considering the nature of the case, no order for compensation.

           Declared in the Open Forum on this the 21^st day of April, 2015.

                                                                    (Sd/-)

                                                   P. Satheesh Chandran Nair,

                                                                (President)

Smt. K.P. Padmasree (Member - I)      :  (Sd/-)

Smt. Sheela Jacob (Member – II)        :   (Sd/-)

Appendix:

Witness examined on the side of the complainant:  Nil

Exhibits marked on the side of the complainant:

A1 :  Photocopy of the FIR in Crime No.204/10 of Kodumon

         Police Station.

A2 :  Post-mortem certificate.

A3 :  Inquest report

A4 :  Charge sheet.

A5 :  Letter sent by the complainant to the Branch Manager, LIC,  

        Adoor Branch.

A6 :  Office copy of the advocate notice dated 25.08.2014 along with  

        postal receipt and postal acknowledgment card.

A7 :  Reply notice sent to advocate from LIC Branch office, Adoor. 

Witness examined on the side of the opposite parties:  Nil

Exhibits marked on the side of the opposite parties:

B1 :  Policy certificate of the life assured late Subhash. S

        dated 24.06.2009.

                                                                             (By Order)

                                                                                       (Sd/-)

                                                                    Senior Superintendent.

Copy to:- (1) Vimala, Rtd. Govt. Servant, Uthivilavadakkethil House,

            Aickadu Muri, Kodumon.P.O., Adoor Taluk,

            Pathanamthitta Dist.

              (2)  Suchithra Babu, Chaithram House, Vallikode Village,              

           Pathanamthitta.

              (3) Divisional Manager, LIC of India, Divisional Office,   

                   “Jeevan Prakash”, P.B.No.1001, Pattom, 

                    Thiruvananthapuram – 695 004.

              (4)  The Branch Manager, LIC of India, Adoor Branch 

    Office, Adoor, Pathanamthitta Dist.,

            Pin – 691 523.

       (5) The Stock File.