Punjab

Faridkot

CC/18/200

Shyam Sunder - Complainant(s)

Versus

LIC - Opp.Party(s)

Babu Lal

16 Oct 2019

ORDER

 DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FARIDKOT

 

C.C. No. :                      200 of 2018

Date of Institution:  06.12.2018

Date of Decision :  16.10.2019

 

Shyam Sunder aged about 60 years, son of Kalyan Singh r/o House No. B-8/315 Sahibzada Fateh Singh Nagar, Main Street, Kotkapura, Tehsil Kotkapura, District Faridkot.

                                                                                      ...Complainant

Versus

1. The Director/ Incharge of Divisional Office of Life Insurance Corporation of India, Jeevan Parkash, Model Town Road, Jallandhar City-144001, District Jallandhar.
2. The Branch Manager Office of Life Insurance Corporation of India, Near Sadiq Chowk Ferozepur Road, Faridkot District Faridkot (Regarding Policy No.133437384 issued in the name of deceased Mangal Kumar son of Sham Sunder).
3. The Branch Manager Office of Life Insurance Corporation of India, Moga District Moga (Regarding Policy No.132251575 issued in the name of deceased Mangal Kumar son of Sham Sunder).

                                                                         .............OPs

Complaint under Section 12 of the

Consumer Protection Act, 1986.

 

Quorum: Sh. Ajit Aggarwal, President,

               Smt Param Pal Kaur, Member.

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Present: Sh Ashu Mittal, Ld Counsel for Complainant,

              Sh Ashok Monga, Ld Counsel for OPs.

 

ORDER

(Ajit Aggarwal, President)

                                                Complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 against  OPs seeking directions to OPs to pay Double Accident Benefits in respect of Insurance Policies purchased by deceased Mangal Singh and for further directing OPs to pay compensation for deficiency in service and harassment alongwith litigation expenses.

2                                              Briefly stated, the case of the complainant is that Mangal Singh deceased son of complainant purchased two insurance policies from OPs on 26.02.2011 and 28.10.2006 with date of maturity on 26.02.2031 and 28.04.2027 respectively and his son kept depositing premiums with OPs till his death. It is submitted that his son was employed in the shop of one Sanjiv Kumar, Raj Kumar and he used to work at shop by 9.00 am and returned at about 5.00 p.m. On 27.08.2016 at about 3.30-4.00 p.m. son of complainant was murdered at the shop of said Sanjiv Kumar and when complainant came to know about this, he immediately approached the said shop and found his son dead over there and dead body of one lady wife of Piara Singh was also lying over there. FIR No. 132 dated 27.08.2016 to this effect was got recorded

 

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in Police Station, City Kotkapura under section 302 of Indian Penal Code against Piara Singh who was later on acquitted from the charges of murder by the Ld Court of Sh Rajesh Kumar, Additional District and Sessions Judge, Faridkot on 5.01.2018 by giving him benefit of doubt. Complainant gave intimation regarding death of his son to OPs and completed requisite formalities and then after obtaining original policies from complainant, OPs credited Rs. 144,163/-on 23.09.2016 and Rs.1,18,116/-on  26.09.2016 in his account. On 15.03.2017, complainant gave application to Ops wherein requested them to pass Death Claim for Double Accident Benefits of Rs. One lac each against policies in question, but OPs repudiated the same vide letter dated 21.04.2017 stating that Murder is not Accident. Complainant made several requests to OPs to pass his genuine claim on account of death of his son, but they paid no heed to his requests. Even legal notice issued by complainant to OPs through his counsel also served no purpose. All this act and conduct of OPs amounts to deficiency in service and has caused harassment and mental tension to complainant. Complainant has prayed for directing the OPs to pay double accident benefit in respect of policies purchased by his deceased son and for compensation and litigation expenses. Hence, the complaint.

3             The counsel for complainant was heard with regard to admission of the complaint and vide order dated 11.12.2018, was admitted and notice was ordered to be issued to the opposite party.

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4                                 On receipt of the notice, the OPs filed written statement wherein they have denied all the allegations levelled by complainant being wrong and incorrect and averred that there is no deficiency in service on their part. It is averred that complaint involves no cause of action and is not maintainable in the present form. It is averred that death claim for the basic sum assured under policies in question has already been paid to complainant. Amount of Rs.1,18,116/-under policy no.133437384/- has been deposited in the account of complainant on 23.09.2016 and Rs.1,44,163/-have been paid against policy no.132251575 on 22.09.2016 on account of death claim of insured after thorough enquiry and with due application of mind on merits as per terms and conditions of the policies, which was duly received by complainant without any protest and now, he is stopped by his own act and conduct to file the present complaint. It is further averred that present complaint involves complicated questions of law and facts requiring lengthy evidence, which is not possible in summary proceedings of this Forum and moreover, complainant has concealed the material facts from this Forum. Basic Sum Assured under policies in question has already been paid to him and Double Accident Benefit sought by complainant is not payable to him. It is reiterated that there is no deficiency in service on the part of OPs and all the other allegations and allegation with regard to relief sought too are refuted being wrong and incorrect and prayer for dismissal of complaint with costs is made.

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5                                      Parties were given proper opportunities to prove their respective case. Complainant tendered in evidence her affidavit Ex.C-1 and documents Ex C-2 to C-17 and then, closed the evidence.

6                                     In order to rebut the evidence of the complainant, ld Counsel for OPs tendered in evidence affidavit of R K Verma as Ex OP-1 and document Ex OP-2 to Ex OP-9 and then, closed the same on behalf of OPs.

7                                              We have heard the ld counsel for complainant as well as OPs and have carefully gone through evidence and documents placed on record by respective parties.

8                                              From the careful perusal of record and evidence placed on record and from the pleadings and arguments put forward by complainant and OPs, it is observed that case of the complainant is that son of complainant was insured with OPs and during subsistence of policies purchased by him, he was murdered by someone at his workplace and FIR to this effect was got recorded by Police and complainant also gave due intimation regarding death of his son to OPs for processing the claim. OPs paid basic sum assured to complainant for the two policies purchased by his deceased son, but grievance of the complainant is that despite repeated requests and issuance of letters and legal notice to OPs, they have not paid him Double Accident Benefit worth Rs. One lac each for said policies on the ground that murder is not

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an accident and no Double Accident Benefit is permissible to  him. On the other hand in reply, OPs have stressed mainly on the point that they have already made payment of sum assured to complainant and now nothing is due towards them on account of insurance claim of deceased son of complainant. There is no denial by OPs that Mangal Singh son of complainant was murdered by someone, but they have refused to make payment of Double Accident Benefit to him on the ground that son of complainant did not die accidental death, rather he was murdered by someone and for act of murder, Doubt Accident Benefit cannot be granted to complainant. Ld Counsel for complainant has relied upon order passed by Hon’ble National Consumer Disputes Redressal Commission, New Delhi in R.P.No.722 of 2010 titled as Ganga Ram Rai Vs LIC of India and another wherein it is held that Consumer Protection Act, 1986 Sections 15, 17, 19 and 21 Insurance – Kidnapping and murder – Complainant obtained insurance policy with double accident benefit – Insured was kidnapped and later on murdered – Charge sheet under Section 364, Indian Penal Code was filed as dead body was not recovered – Even wilful murder of assured is accidental as far as insured is concerned and such murder is to be described as by chance or fortuitous – When insured was kidnapped and later on murdered it is to be held that death of insured was accidental – he was entitled to additional sum equal to sum assured as per terms and conditions of policy – Denial of double accident benefit not proper.

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9                                    It is observed that it is reasonable to conclude that a person takes personal accident shield insurance policy to insure himself against accidental injury resulting in death caused by an unexpected and unintentional incident. In present case, there was no deliberate wilful act on the part of insured/deceased son of complainant that led to his murder. Putting himself to risk of injury by immediate wilful deliberate act or carelessness or instigation or aggression etc is not evidence. Death of son of complainant is unexpected and unintentional incident i.e an accident. ‘Murder per se was not specifically excepted in the policy. Hence, death of son of complainant was clearly accidental and was squarely covered under the policy.  Moreover, death of his son occurred during the subsistence of said policies and he was periodically paying premiums for said policies. Murder was not specifically excepted. No immediate wilful deliberate act of insured deceased son of complainant led to his murder, was visible as he was murdered at his work place during working hours. Death was unexpected and unintentional. Suicide or self injury etc are ruled out. Repudiating the claim of complainant on account of murder of his son without due application of mind to the facts on a mechanical application that ‘murder is not an accident’, caused harassment and difficulty to complainant and his family members.

10                                      From the above discussion and case law produced by complainant counsel, it is made out that there is deficiency in service on the part of OPs in repudiating the claim of complainant for

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double accident benefit on account of death of son, which caused harassment and mental agony to him. Therefore, complaint in hand is hereby allowed. OPs are directed to make payment of Double Accident Benefit for both the insurance policies i.e Rs.1,00,000/- (One lac) each purchased by deceased son of complainant with interest at the rate of 9% per anum from the date of filing the present complaint till final realization. They are further directed to pay Rs.5,000/-to complainant as consolidated compensation for harassment and mental agony suffered by them and for litigation expenses. Compliance of this order be made within one month of the receipt of the copy of the order, failing which complainant shall be entitled to proceed under Section 25 and 27 of Consumer Protection Act. Copy of the order be supplied to parties free of cost. File be consigned to record room.

Announced in Open Forum

Dated : 16.10.2019

                                      (Param Pal Kaur)              (Ajit Aggarwal)

                                        Member                          President