This is a complaint petition under section 12 of the Consumer Protection Act, 1986 with the prayer for an order directing the O.Ps. to pay the accidental benefit amount of Rs.2,00,000/- with interest, Rs.80,000/- as compensation and Rs.20,000/- as litigation cost to the complainants.

The complainants’ case in short is that the complainant No.1 herself and on behalf of her minor son as complainant No.2 has filed this case. Her deceased husband Pradip Roy during his lifetime purchased a LICI Policy being No. 456226718, sum assured of Rs.2,00,000/- on 22.04.2009 and during the policy coverage period said insured, Pradip Roy was murdered by some antisocial by gun shot on 26.05.2014 and after his death as a nominee the complainant No.1 submitted death claim before the O.Ps.; but the O.Ps. paid only death benefit without any accidental benefit. So, on 15.09.2015 the complainant again submitted an application to get accidental benefit in respect of the said policy from the O.Ps. But the O.Ps. refused to pay the accidental benefit. So, finding no other alternative the complainant filed this complaint petition before this Forum to get proper relief.

On the other hand, the O.Ps. by filing written version have contested this case. Their specific case is that the O.Ps. already paid Basic claim with vested Bonus to the complainant on 26.12.2014 as per terms and conditions of the policy without any accidental benefit because the death of the insured was not an accident but it was a planned murder as per Final Report made by the police authority. So, there is no any negligence on the part of the O.Ps. Therefore,  the O.Ps. pray for dismissal the petition of complainant without cost.

To establish the case, the complainant filed only one document, Xerox copy of the duplicate policy of the insured and she also examined, cross examined as P.W.-1 by both sides’ Ld. Lawyers.

DECISIONS WITH REASONS

Giving due consideration to the contents of the petition of complaint, W.V., documentary evidence of record and hearing argument advanced by the Ld. Lawyers of both sides, the Ld. Forum has come to the findings as follows: -

It is admitted fact that the husband of the complainant No.1 was a policy holder of the O.ps. vide policy No.456226718, sum assured of Rs.2,00,000/- commenced on 22.04.2009 and he was murdered by gun shot on 26.05.2014 during the policy coverage period. After that, submitting the death claim application by the complainant No.1before the O.Ps. But the O.Ps .paid only policy death benefits amount to the complainant No.1 as a nominee without accidental benefit. Thereafter complainant No.1 again submitted an application to the O.Ps. for getting the accidental benefit of the said deceased insured on 15.09.2016. But the O.Ps. by sending a letter on 23.10.2015 repudiated the accidental benefit on the ground that the death of the insured was not an accidental but it was a planned murder as per Final Report made by the Police Authority.

It reveals from the case record the O.P./ insurance company has not provided any oral or documentary evidence in this case regarding the repudiation of accidental death benefit that the death of the insured was not an accident but it was a planned murder as per FRT. Therefore, the O.P./insurance company fail to prove that it is not an accidental death of the insured; as reported in 2005 (2) CPR 478 (NC), Hon’ble National Commission held that willful murder may be accidental as per as victim is concerned. Therefore the complainants will get the accidental benefit.

Moreover, it reveals from the cross examination of the complainant No.1 where she deposed that her husband, policy holder was murder and she only got death benefit from the O.Ps. except accidental benefit and she also stated that after the death of her husband one police case was started.

From the above discussion it is clear that the complainants should get the benefit of the policy following the death of her husband. To our considered view that she is entitled to additional sum equal to sum as per terms and conditions of the insured policy. The sum assurance was of Rs.2,00,000/- in this policy. So, she is entitled to get additional sum as accidental benefit in this case which the O.Ps. did not paid to the complainant No.1.

Fees paid is correct.

Hence it is,

ORDERED

That the consumer complaint being No.CC-82/2015 is allowed on contest against the O.P. Nos. 1&2 without cost.

That the O.P. Nos. 1&2 are directed to pay additional sum as accidental benefit of the policy of the deceased insured of Rs.2,00,000/-, as compensation of Rs.3,000/- and Rs.2,000/- as litigation cost;  altogether of Rs.2,05,000/- to the complainant No.1 within one month from the passing of this Final order, failing which the complainants will be at liberty to realize their claim in accordance with law.

Let photocopies of this order be supplied to the parties free of cost.