Haryana

Karnal

CC/6/2015

Smt Hukmi Devi Wd/o Ishwar Singh - Complainant(s)

Versus

Life Insurance Company Of India - Opp.Party(s)

Ravinder Kumar

06 Apr 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.     

                                                               Complaint No.6 of 2015

                                                               Date of instt.: 14.01.2015

                                                                Date of decision:06.04.2016

 

Smt. Hukmi Devi widow of Ishwar Singh son of Datta Ram resident of village Santri tehsil Indri district Karnal.

.                                                                   ……..Complainant.

                                      Vs.

LIC Insurance Corporation of  India 489, Model Town, Karnal through its Manager.

                                                                   ………… Opposite Party.

                     Complaint u/s 12  of the Consumer

                     Protection Act.

 

Before          Sh.K.C.Sharma……….President.

                   Sh.Anil Sharma…….Member.

 

Present:-        Sh.Ravinder Kumar Advocate for the complainant.

                     Smt.Shakuntla Dagar  Advocate for the Opposite Party.

 

 ORDER:

 

                        This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986, on the averments that her husband Ishwar Singh (the deceased life assured) obtained insurance policy No.177327399   from the Opposite Party. He was murdered, which falls in the category of accident, therefore, the Opposite Party was liable to make payment of the double of the sum assured as per terms and conditions of the policy. The matter was reported to the Opposite Party and all the formalities were completed, but the Opposite Party repudiated the claim, vide letter dated 21.5.2013 on the ground that life assured was intentionally murdered, therefore, the accidental benefits could not  be given.  The order of repudiation of the claim by the Opposite Party was illegal and the same amounted to deficiency in services. Such illegal act of the Opposite Party caused mental pain, agony and harassment to her apart from financial loss.

 

2.                Notice of the complaint was given to the Opposite Party, who appeared and filed written statement disputing the claim of the complainant. Objections have been raised that the complainant has no locus standi and cause of action to file the present complaint and that the present complaint is not maintainable in the present form and the same is an abuse of the process of law.

 

                   On merits, it has been submitted  that the policy No.177327399 was obtained by the deceased life assured under T-T-149-53-16 which was to commence on 17.6.2010 and the sum assured was Rs. Five lacs .The cause of death of the deceased life assured was murder. Even as per the judgment of the Sessions court dated 10.1.2014 in case titled State Versus Karam Chand and another  bearing FIR No.184 dated 6.6.2012  relating to Police Station, Indri, it was held that it was a case of intentional murder and the accused were sentenced to life imprisonment.  Therefore, as per the policy condition, it was not a case of accident and  as such accidental benefit was not payable under the policy. The basic claim under the policy was already  paid to the complainant through NEFT on 14.11.2012 and accidental claim under the policy was rightly repudiated by the competent authority and duly conveyed to the complainant,  vide letter dated 21.5.2013. Thereafter, the complainant sent representation to ZOCDRC, Delhi for reconsideration of the decision of the Opposite Party, but the Zonal Officer after examining the facts of the case upheld the decision  vide letter dated 30.8.2014. It has further been pleaded that the complainant  had  herself admitted that her husband was murdered and he had not met with an accident. Intentional  murder cannot be termed as accident.

 

3.                In evidence of the complainant, her affidavit Ex.C1 and documents Ex.C2 to Ex.C4 have been tendered.

 

4.                 On the other hand, in evidence of the Opposite Party, affidavit of Balihar Singh Manager Legal, Ex.O1 and documents Ex.O2 to Ex.O9 have been tendered.

 

5.                We have appraised the evidence on record,  the material circumstances of the case and the arguments advanced by the learned Counsel for the parties.

 

6.                  The husband of the complainant had obtained insurance policy from the Opposite Party and in the said policy, the death due to accident was also covered and in that case double the sum of the assured was to be paid. As per the case of the complainant her husband was murdered. However, her claim was repudiated by the Opposite Party on the ground that the life assured was intentionally murdered, therefore, accidental benefits cannot be given.

 

7.                   The learned counsel for the Opposite Party has put a great thrust upon the contention that cause of death of the life assured was intentional murder. This fact  stands established even from the copy of the judgment dated 10.1.2014 Ex.O8, passed by the Learned Sessions Judge, Karnal in case  FIR No.184 dated 6.6.2012 pertaining to Police Station Indri. The accused Karam Chand and Rattan alias Attra were held guilty for the commission of the offences punishable u/s 302 read with Section 34 of the Indian Penal Code for committing murder of the life assured  and they were sentenced, vide order dated 13.1.2014, the copy of which is Ex.O9. Only accidental death was covered under the policy and not intentional murder. As the life assured was intentionally murdered by the aforesaid Karam Chand and Rattan alias Attra, therefore, it could not be said that it was accidental death of the life assured and   as such claim of the complainant was rightly repudiated by the Opposite Party.  In support of her contention, she has placed reliance upon Rita Devi  and Ors Versus  New India Assurance Co.Ltd.and Anr. 2000(II)ACC 291 (SC) and United India Insurance Co.Ltd.and another Versus G.Rajyalakshmi and another 2011(II) CPJ 280.

 

8.                To wriggle out of the aforesaid contention, the learned counsel for the complainant vehemently argued that as per term of the said policy, even intentional murder by the third party does not fall within the exclusion clause. If, the life assured sustained any bodily injury results solely and directly from the accident caused by outward violent and visible means which results in death of the life assured, heirs would be  entitled to get accidental benefits.  In the case of murder also bodily injuries are  caused by outward violent and visible, which results into death. Therefore,  Insurance Company was liable to pay accidental benefits to the complainant regarding the death of  her husband due to his murder, but the claim was repudiated wrongly and  illegally by the Opposite Party.  In this context he relied upon  Maya Devi Versus  Life Insurance Corporation 2008(3) CLT 291 and Daya Rani and others Versus  Life Insurance Corporation of India 2009(V) CPJ 174(NC).

 

                  

9.                          In Rita Devi and others’s case(Supra)  one  Dasarath Singh  was  employed to drive auto rickshaw for  ferrying passengers on hire. On the fateful day, his auto rickshaw was engaged by some unknown persons for their journey and during that journey, it was alleged that passengers caused murder of Dasarath Singh.  Under those circumstances, the Hon’ble Supreme Court held that death in such case was due to accident. It was further observed that difference between murder which is not an accident and murder which  is an accident depends on the proximity of the cause of such murder. If, the cause of murder or act of murder was   originally not intended and the same was caused in furtherance of any other felonious act, then such murder is an accidental murder arising out of use of motor vehicle and the Insurance Company was liable to reimburse the claimants. In  G.Rajyalakshmi and another’s case (Supra)   proposition of law laid down in Reta Devi and other,s caser(Supra) was considered,  but under the facts and circumstances, it was held by the Hon’ble Andhra Pradesh State Consumer Disputes Redressal Commission, Hyderabad,  that deceased neither had long criminal record nor did the Opposite Party filed any material to evidence that there were any criminal cases filed against the deceased/insured to prove that it was a murder by design and intent rather than a case of accidental murder. Therefore, the death was held to be accidental murder.

 

10.                                  In Maya Devi’s case (Supra)  life assured went to the shop of one shopkeeper  for purchasing biri. Upon being refused, some altercation between the insured and shopkeeper took place. On the next day, brother of the shopkeeper shot the injured at his forehead with his country made revolver, which resulted in the death of the insured. The Insurance Company contended that death of the insured was due to murder, hence, Insurance Company was not bound to pay the sum assured. The Hon’ble National Commission considered the term of the policy and observed in para nos. 4,5,6,7  13  and 14 as under:

 

                                                                                                         

 4.                         “10(b) Death of the life assured-To pay an additional sum equal to the Death Benefit under this policy, if the life assured shall sustain any bodily injury resulting solely and directly from the accident 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. However, such additional sum payable in respect of all the policies taken under this plan and under Bima Kiran Plan(Table no.III) on the same life to which this benefit will apply shall not exceed Rs.5,00,000/-

                   The Corporation shall not be liable to pay the additional sum referred in (a) or (b) above, if the disability of the death of the life assured shall-

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

                   (iv) result from the life assured committing breach of law or…”

                  

5.                “The main part of the policy specifically provides that if the life assured sustains any bodily injury resulting  solely and directly from the accident caused by outward violent and visible means, which results in the death of the life assured, heirs would be entitled to get accidental benefit. It is apparent that in case of murder bodily injury is caused by outward violent and visible means which results in the death.

 

6.                “Further exclusion clauses would not be applicable in such cases.”

7.                “In case of murder of assured, Clause (i) which provides that if the death is caused by intentional self injury, attempted suicide or insanity etc. would not be applicable. Secondly, Exclusion Clause (iv) would also not be applicable because if doesnot resulted from any breach of law committed by the life assured. The policy  does not exclude death due to murder for any reason. In that set of circumstances, exclusion clause which deprives the complainant from accidental benefit would not be applicable in the present case.”   

13.              “In the present case-

                   i) As per the post mortem report, the  insured was shot dead by the assailant who appeared from  no where.

                   ii)the insured is not party to the murder i.e. he did not give rise to the provocation. After appearing before a Panchayat, he was going some where when this attack was made at him. Hence, he is not a party or privy to the event of murder.

                   iii)the immediate cause of injury(bullet injury) is not the result of the deliberate or willful act of the insured;

                   iv) this event is an unlooked for mishap or an outward event which was not expected or designed by the insured nor the insured had expected the occurrence.”

14.              “Hence,it is to be held that death of the insured was accidental.”                                                                                                                   

 

11.                        The Hon’ble National Commission discussed  the judgment of Hon’ble Supreme Court in  Rita Devi and others’s case(Supra)   and held that life   Insurance Corporation policy excluded death due to  limited cause mentioned in the exclusion clause under para 10(B) and therefore, it is  irrelevant to find out the back ground of the  deceased. Further in case where there is criminal background of the assured, it would be difficult to   hold that murder was not accidental unless he has taken up quarrel and that the immediate cause of injury was deliberate and willful act of the insured himself. In Daya Rani’s case (Supra)           the same principle of law was followed by the Hon’ble National Commission.

 

12.                   The facts of the present case are to be  considered in the light of the aforediscussed authorities. Admittedly, the insurance policy obtained by the life assured covered the benefits of the accidental death also. Para No.10(b) of the policy is regarding death of the life assured.  For appreciation of the matter, the same is reproduced as under:

 

                   10(b) Death of the life assured: To pay an additional sum equal ;to the Death benefit under this policy, if the Life Assured shall sustain any bodily injury resulting solely and directly from the accident 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. However, such additional sum payable in respect of all the policies  taken under this plan and under Bima Kiran Plan(Table No.111)on the same life to which this benefit will apply shall not exceed Rs.6,00,000/-.

                   The Corporation  shall not be liable to pay the additional sum referred in (a) or (b) above, if disability of the death of the life assured shall

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

                   ii) take place as a result of accident while the life assured is engaged in aviation or aeronautics in any capacity other then that of a fare-paying part paying or non paying passenger in any air craft which is authorized by the relevant regulation to can /such passenger 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 was (whether war be declared or not), invasion hunting, mountaineering staple chasing or racing of any kind or.

                   iv) result from the life assured committing any branch of law or.

                   V)  Arise from employment of the life assured in the armed  forces or  military service any court/ at war (whether war be declared or not)

 

13.               A bare reading of the said condition of the policy, makes it  quite clear that if the life assured sustains  any bodily injury  resulting solely and directly from the accident 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 death of the  life assured  , the Corporation shall pay the additional sum equal to the sum assured to the heirs of the life assured.  However, Corporation shall not be liable to pay additional sum, if the death of the life assured is caused by intentional  self injury, attempted suicide, insanity or immorality or while the  life assured was under the  influence  of intoxicating, liquor , drug or narcotic or  takes place as a result from life assured committing any breach of law. The other exclusion clauses are not relevant for the purpose of present case, therefore, there is no need to discuss the same.  The policy does not exclude death due to murder for any reason.

 

14.               Admittedly, the life assured was murdered by Karam Chand and Rattan alias Attra and they have been held guilty and convicted and sentenced for committing his murder. The life assured was not a party to the murder as he did not give rise to the provocation. Injuries were caused by Karam Chand and Rattan alias Attra as he had given land to some other on theka and had thus insulted them. Immediately, before the occurrence, the life assured had not given any provocation to the aforesaid persons. The cause of death was injuries caused to him in the said occurrence and not result  as deliberate or willful act of the injured. As per version put forth in the First Information Report,  by the  wife of life assured, Karam Chand and Rattan alias Attra came to the house of the life assured , took him with them to talk with each other on tubewell. When life assured did not return to home, his wife again went to  the said tubewell in order to bring him to take meal and on seeing her Karam Chand and Attra got enraged and told that they will not leave life assured to take meal, because he had given his land to some other on  Theka and had insulted them. Thereafter, Karam Chand took the life assured  in his grip and Attra picked up a brick from the spot and attacked on the head of life assured in order to murder him.  Such event  was not expected  or designed by the life assured  nor he had expected such occurrence. Under such circumstances, death of the life assured was not covered under the exclusion clause of the policy, therefore, the Corporation could not repudiate the claim of the complainant on the ground that life assured was intentionally murdered. The proposition of law laid down by the Hon’ble National Commission in Maya Devi’s case(Supra)  is fully applicable to the facts  of the present case, therefore, the order of repudiation of the claim of the complainant  by the Opposite Party was not in accordance with the terms and conditions of the insurance policy. Under such facts and circumstances, the proposition of law laid down in Rita Devi’s case(Supra) does not render any help to the Opposite Party, therefore,  the argument advanced by the learned counsel for the Opposite Party cannot be accepted. The repudiation of the claim of the complainant by the Opposite Party amounted to deficiency in services.

 

15.               As a sequel to the foregoing discussion, we accept the present complaint and direct the Opposite Party to make the payment of the accidental benefits i.e. equal to the sum insured under the policy to the complainant together all other admissible benefits  and interest @ 9% per annum from the date of filing of the present complaint i.e.14.01.2015 till its actual realization. The complainant shall also be entitled for a sum of Rs.15000/- for the mental harassment and agony caused to him and for the litigation expenses. The Opposite Party shall make the compliance of this order within a period of thirty days from the date of receipt of the copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

 

Announced
dated:6.04.2016.

                                                               (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

            (Anil Sharma ) 

               Member.

 

 

 

 

 

Present:-        Sh.Ravinder Kumar Advocate for the complainant.

                     Smt.Shakuntla Dagar  Advocate for the Opposite Party.

 

                   Remaining arguments heard. Vide our separate order of the even date, the present complaint has been accepted. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

 

 

Announced
dated:06.04.2016.

                                                               (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

            (Anil Sharma ) 

               Member.