BEFORE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,
FATEHABAD.
Complaint Case No.: 234 of 2016.
Date of Institution: 06.09.2016
Date of order: 10.03.2017.
1.Smt.Jeeto Bai wife of Gurnam Singh 2. Gurnam Singh son of Pathana Singh residents of Basti Bhiwan, Fatehabad Tehsil & District Fatehabad.
….. Complainants.
Versus
- Life Insurance Corporation of India, Branch Office, Fatehabad District Fatehabad through its Branch Manager.
- Life Insurance Corporation of India, Divisional Office SCO no.3, 4 & 5 Sector-1 HUDA Rohtak District Rohtak through its Divisional Manager.
….Opposite parties.
Complaint U/s 12 of the Consumer Protection Act
BEFORE: Sh. Raghbir Singh, President.
Smt. Ansuya Bishnoi, Member.
Present: Shri Dinesh Gera, Advocate for the complainants.
Shri S.K.Dharnia, Advocate for the opposite parties.
ORDER:
The complainants have filed the present complaint under Section 12 of the Consumer Protection Act, 1986 against the opposite parties (hereinafter to be referred as OPs).
2. Briefly stated the facts of the present complaint are that son of the complainants namely Gurmeet Singh had got himself insured with the OP No.1 vide insurance policy No.179156581 for a sum assured of Rs.50,000/-. The date of commencement of the policy was 28.11.2012 and its maturity date was 11/2032. The complainant No.2 has been appointed as nominee in respect of the said insurance policy. It has been further averred that son of the complainants was murdered and in this regard FIR No.404 dated 14.08.2013 was registered in police station Sadar, Fatehabad on the statement of complainant No.2. Post mortem on the dead body of Gurmeet Singh was also conducted in General Hospital, Fatehabad on 14.08.2013. After his death, the complainant submitted the claim form for getting the benefits of insurance with the Ops. However despite completing all the formalities the OPs did not release the benefit arising out of accident due to murder of life assured and had repudiated the claim vide letter dated 09.06.2016 with the remarks that the death of the life assured was not due to accidental murder. The complainants have requested the OPs to release the payment of the accidental benefits to them but to no avail. The act and conduct of the Ops clearly amounts to deficiency in service. Hence, this complaint. In evidence, the complainant No.1 has tendered her affidavit as Annexure CW1 and documents as Annexure P1 to Annexure P8.
3. Upon notice, OPs appeared and contested the complaint by filing reply asserting therein that the complaint is not maintainable in law or on the facts and the same is liable to be dismissed. It has been further submitted that Gurmeet Singh was insured vide policy No.178515772 with the OPs and he was murdered, therefore, the complainants are not entitled to get any accidental death claim as per terms and conditions of policy. It has also been further submitted that payment to the tune of Rs.50,000/- has been made to the complainants on 22.10.2013 being liability of basic sum assured. Since the matter in question is related to murder case of the DLA which was done intentionally, therefore, accidental death claim is not payable and the same has rightly been repudiated vide letter dated 09.06.2016. Other allegations made in the complaint have been controverted and prayer for the dismissal of the complaint has been made. In evidence, the OPs have tendered affidavit of Smt.Gurveen Kaur, as Annexure R1 and documents Annexure R2 to Annexure R7.
4. We have heard learned counsel for the parties and have perused the case file carefully.
5. Learned counsel for the complainant has contended that complainant No.2 being nominee of his son in the life insurance policy besides the benefits of insurance is also entitled to the benefit of accidental death of his son. He further contended that the son of the complainants was not involved in any criminal case and there was no provocation from the side of their son at the time of incident. He further argued that complainants or their son were not having any prior intimation or apprehension that Gurmeet Singh DLA would be murdered, therefore, the death of DLA by murder amounts to accidental death and prayed for acceptance of the complaint. In support of his contentions, he placed reliance of judgments of Hon’ble National Consumer Disputes Redressal Commission, New Delhi in cases titled as Maya Devi Versus Life Insurance Corporation of India, III (2008) CPJ 120 (NC) and Daya Rani & Ors. Versus Life Insurance Corporation of India IV (2009) CPJ 174 (NC).
6. On the other hand, learned counsel for OPs contended that after intimation about the death of life assured, the matter was investigated and it was found that the murder of the life assured was committed by the culprits who were having motive against the complainants and their son and have been held guilty and convicted for commission of offence punishable under Section 302/201 read with Section 34 IPC. He further contended that the complainants are not entitled to get accidental death claim as per terms and conditions of the policy and prayed for dismissal of the complaint. In support of his contention the counsel for OPs has relied on the observations of Hon’ble Supreme Court in case titled as Rita Devi & Ors. Vs. New India Assurance Co.Limited & Anr. II (2000) ACC (SC). The counsel has also placed reliance on the observations of Hon’ble National Consumer Disputes Redressal Commission, New Delhi in cases titled as Prithvi Raj Bhandari Versus Life Insurance Corporation of India Limited and others 2006 (3) CPJ 213, N.Kabilan Versus New India Assurance Co.Limited & others 2015 (2) CLT 525, LIC of India & Anr. Vs. Chinthareddy Vijayamma decided on 25.01.2016 in Revision Petition No.2460 of 2013 Part No.XXXV Volume III.
7. We have considered the rival contentions of the parties and have gone through the case file and the authorities relied upon by learned counsel for the parties. There is no dispute that the son of the complainants namely Gurmeet Singh, insured with the OPs, was murdered on 14.08.2013. The question to be decided by this Forum is as to whether death of the son of the complainants can be held to be an “Accidental Death” and the complainants are entitled to receive the accidental death claim. In the present case, complainant No.2 got recorded his statement with the police and on the basis thereof FIR No.404 dated 14.08.2013 under Sections 302,201/34 IPC in police station, Sadar, Fatehabad was registered. It is also not disputed that post mortem on the dead body of DLA was conducted on14.08.2013. The police had investigated the matter and challan was submitted in the Court. After conducting the trial against the accused arrested in the above said FIR Hon’ble Additional Sessions Judge-I, Fatehabad convicted and sentenced the accused vide judgment dated 20.05.2016/23.05.2016 (Annexure R7). Perusal of the judgment (Annexure R7) clearly depicts that the DLA did not start the quarrel and there was no any provocation from his side. The Hon’ble National Commission, New Delhi in case titled as Maya Devi Vs. Life Insurance Corporation of India (supra) has held as under:-
“Consumer Protection Act, 1986- Section 21 (b)- Life Insurance- Accidental death- Insured murdered- Benefits under policy denied to heirs of insured- Complaint allowed by Forum- Appeal against order allowed- Complaint dismissed by State Commission-Hence revision-Murder not excluded in policy- Insured not party to murder- Not gave rise to provocation-Immediate cause of action (bullet injury) not result of deliberate willful act of insured- Event is unlooked for mishap which was not expected- Even willful murder of insured is accidental and not be described as ‘by chance’ or ‘fortuitous’- Death of insured accidental proved- Insurer liable under policy- Order of Forum restored”.
Similarly, the Hon’ble National Commission in the case of Daya Rani & Ors. Vs. Life Insurance Corporation of India (supra) has held as under:-
“As far as the question of the ‘murder’falling in the category of accident is concerned, this question has already been settled by three Member Bench of this Commission in the case of Maya Devi Vs. Life Insurance Corporation of India RP No.2824 of 2007 decided on 21.05.2008 in which it is held that even though the ‘murder’ being a accident or otherwise, would be seen in the facts and circumstances of each case and went on to hold, “Further, even in case where there is a criminal background of the assured, it would be difficult to hold that his murder was not accidental unless he has taken up the quarrel and that the immediate cause of injury was deliberate and willful act of the insured himself.
In the present case, no such allegation has been made that if was the insured who took up the quarrel and thus, got murdered, in view of which, respectfully following the law laid down by this Commission, in the given facts and circumstances, this case would come within the ambit of accident as occurring in the policy.”
8. The above said authorities are squarely applicable to the facts and circumstances of the present case. As mentioned above, there is no such allegation that it was the insured who took up the quarrel and that there was any provocation from his side. The son of the complainants, since deceased or the complainants were not having such apprehension that any of them will be murdered by the accused party; therefore even the 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’. In view of the legal and factual position as discussed above, we are of the considered opinion that the OPs without any valid and tenable reason has not released the claim amount alongwith its benefits to the complainants forcing them to approach this Forum. It is obligatory on the part of the insurance company that whenever any claim is made, then the same has to be decided as early as possible and the basic purpose of the insurance policy is to indemnify the claimant for which the premium has been paid. However, in the present case it appears that the OPs are trying to avoid the claim of the complainant on one pretext or the other. The verdict made in the case laws relied upon by learned counsel for the OPs is not disputed but the same are not helpful to its case, therefore, same are being distinguished.
9. Thus, as a sequel to our above discussion, we accept the present complaint and direct the OPs to pay the amount of Rs. 50,000/- as accidental benefit to the complainants alongwith interest @ 6 % per annum from the date of filing of present complaint till actual realization. We also direct the OPs to further pay a sum of Rs.5,000/- for harassment including litigation expenses to the complainant. This order should be complied within a period of 30 days from the date of this order, failing which the complainant will be entitled to initiate legal proceedings under Section 25/27 of the Act against the opposite party. A copy of this order be supplied to the parties free of costs. File be consigned to the record room after due compliance.
Announced in open Forum.
Dated: 10.03.2017
(Raghbir Singh)
President
(Ansuya Bishnoi) Distt.Consumer Disputes
Member Redressal Forum, Fatehabad.
