Tripura

West Tripura

CC/14/13

Smt. Niyati Sharma. - Complainant(s)

Versus

Life Insurance Corporation of India and others. - Opp.Party(s)

Mr.B.Debnath,Mr.P.Rathor,Mr.T.Debbarma,Miss.T.R.Shil.

17 Jan 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSSAL FORUM
WEST TRIPURA : AGARTALA

    CASE NO:  CC- 13   of   2014

Smt. Niyati Sharma,
W/O- Sri Khagendra Sharma,
West Jolaibari, Baikhora,
South Tripura.                ........Complainant.

     ______VERSUS_____

1. Life Insurance Corporation of India,
    Silchar Divisional Office,
    Jeevan Prakash Silchar- 15,
    (Represented by the Divisional Manager,)

2. Life Insurance Corporation of India,
    Agartala Branch No.2, 
    Krishnanagar,
    Agartala, Tripura West.
   (Represented by the Branch Manager).     .....Opposite parties.
    

                    __________PRESENT__________

 SRI S. C. SAHA
PRESIDENT,
  DISTRICT CONSUMER  DISPUTES REDRESSAL FORUM,
      WEST TRIPURA, AGARTALA. 

SMT. B. BHATTACHARYA,
MEMBER,
  DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.

SHRI B. BHATTACHARYA,
MEMBER,
  DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.

C O U N S E L

 

For the Complainant       : Sri Pradip Rathor,
                                      Sri Tapan Debbarma
                                      Sri Bupendra Debnath and
                                      Miss Titu Rani Shil,
                                      Advocates. 
                           
For the Opposite Party    : Sri Nepal Majumdar,
                                       Advocate.

        JUDGMENT  DELIVERED  ON : - 30.01.15.

 

J U D G M E N T

 
        This is a complaint u/s 12 of the Consumer Protection Act, 1986 (herein after referred to as 'the Act') filed by the complainant, Smt. Niyati Sharma, w/o Sri Khagendra Sharma of West Jolaibari, South Tripura against the O.Ps, namely LIC of India, Divisional Office, Silchar  and LIC of India, Agartala Branch No.2, Krishnanagar, Agartala over a consumer dispute alleging negligence and deficiency in rendering service on the part of the O.Ps.   

2.         The fact of the case as gathered from the record is that the complainant's son late Rajesh Sharma during his lifetime had taken a 20 year-Money Back Policy with profits plus Accidental Benefit on his own life for a sum assured Rs.4,75,000/- in pursuance of the proposal No-12324 dated 12.11.10 with half yearly premium of Rs.15,390/-. Having accepted the proposal, Money Back Policy issued by the LIC is No- 492740239. The life assured died in Tripura Sundari District Hospital on 09.02.11 as a result of assault given by the furious crowd within 2 years of the commencement of the policy. The complainant, who is the nominee u/s 39 of the Insurance Act, lodged claim under the said policy with LIC. By a letter dated 31.01.13 the LIC repudiated the liability under the policy on account of the deceased having fraudulently suppressed material fact in the proposal form and also for committing breach of law by killing a couple.

3.         The O.Ps contested the case by filing joint written objection. They opposed the claim mainly on the ground that as the insurance contract based on the principle of utmost good faith, there is responsibility cast on the insured to give full and correct information contained in the proposal from. Section 45 of the Insurance Act, 1938 says 'any policy can be called into question in case of any inaccurate information or any fraudulent suppression of material fact by the life assured. The life assured while effecting  the insurance policy violated the basic principle of utmost good faith. The life assured had brutally killed a couple infront of their children by entering into the Govt. quarter and thereby committed breach of law. The life assured was assaulted by furious mob at the place of occurrence and he was brought to hospital with grievous injuries on his person where he died on the same day. Accordingly, the death claim under Money Back Policy No-492740239 on the life of the deceased, Rajesh Sharma, was repudiated by the corporation on 31.01.13. It is denied that there was any negligence and deficiency in service on their part.
         
4.         In support of the case, the complainant has examined herself as P.W. 1 and has proved and exhibited the following documents:
     Exhibit 1: Proposal Form dated 15.11.10
     Exhibit 2: Policy of Insurance,
     Exhibit 3: Claim statement form,
     Exhibit 4: Medical attendance certificate,
     Exhibit 5: Certificate of hospital treatment,
     Exhibit 6: Copy of F.I.R.,
     Exhibit 7: Post Mortem Report of the life assured,
     Exhibit 8: Letter dated 11.09.13 of the Divisional Manager, LIC,
     Exhibit 9: Letter dated 31.01.13 of the Divisional Manager, LIC repudiating the claim and 
     Exhibit 10: Letter dated 15.05.13 of the Zonal Manager, LIC.
             
5.         On the other hand, one Sri Nabarun Ghosh, Branch Manager of LIC Branch No-2, Agartala has examined himself as O.P.W. 1 as a witness of the O.P. side and has proved and exhibited the following documents:
         Exhibit A Series: Photocopies of the paper book in connection with CRLA(J) 32/2012 and Trial Court record of Baikhora P.S. Case Nos.13/2011 and 25/11,
     Exhibit B: The decision of the Divisional Manager regarding repudiation of the claim.
         FINDINGS:
6.         The points that would arise for consideration in this proceeding are; 
         (i) Whether the life assured withheld material facts in the proposal form dated 12.11.10;
         (ii) Whether the O.P rightly repudiated the claim of the complainant and
         (iii) Whether the O.Ps are guilty of negligence and deficiency in rendering service. 
7.         We have already heard the arguments advanced by the learned counsel appearing for the parties. Also perused the pleadings, documents on record, evidence adduced by the parties and the memorandum of written argument filed on behalf of the complainant meticulously.

8.         On perusal of the written objection filed by the O.Ps, the evidence adduced on behalf of the O.Ps and the documents on record, it is very much apparent that the O.Ps repudiated the claim preferred by the complainant mainly on two counts. Firstly, the life  assured fraudulently suppressed the material fact in the proposal form dated 28.10.10 at the time of taking the policy and thus violated the provisions of section 45 of the Insurance Act, 1938. Secondly, the life assured had brutally killed a couple infront of the very eyes of their children entering into their Govt. quarter. On hearing the hue and cry, the neighbouring people rushed to the place of occurrence and assaulted the life assured resulting in grievous injuries on his person. Soon after the incident, he was brought to Udaipur hospital in a serious condition where he succumbed to his injuries. According to the O.Ps, the death  of the life assured was a result of his inhuman and immoral act of killing of two persons which amounted to breach of law of the land, for which and the O.Ps are not liable for any payment under the policy in question.
9.         As regards suppression of material fact in the proposal form is concerned, it appears that the life assured was killed by the furious crowd following his involvement in the murder of a couple within 3 months of taking the policy. It is an absurd proposition that the life assured knew that he would murder the couple and as  retaliation he would be killed by the furious mob within 3 months of taking the policy in question. Having gone through the judgment passed by the Learned Addl. Sessions Judge, Belonia in case no- ST-27(ST/B)/2012, we find that in paragraph- 13 of the judgment it is held that ''the prosecution has failed to prove that there was any conspiracy or prior meeting of mind between Raju Sharma and Dipak Sarkar regarding the murder of two victims''. From the above observation it is clear that the murder of the two victims were not committed by the life assured in a pre-meditated and calculated manner. Probably, the murder was the result of sudden hit and spur of the moment. In this background, we are not in agreement with the plea taken by the O.Ps that the life assured has fraudulently suppressed  any material fact in the proposal form at the time of taking the policy as averred.

10.         Now, we may turn to the next point regarding commission of breach of law by the life assured as raised by the O.Ps.
         Admittedly, the policy was a Money Back Policy with profits plus Accidental Benefit. As per terms of policy, if the death of the life assured takes place before date of maturity, the nominee would get the sum assured with vested bonus.
         The only question which requires consideration in this case is whether the death suffered by the life assured can be held to accidental death. The relevant terms of the said Money Back policy is as under;
     ''Death of Life Assured: To pay an additional sum equal to the Sum Assured 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 this policy together with any such additional sums payable under other Policies on the life of the Life Assured shall not exceed Rs.25,000. 
     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 result from the Life Assured committing any breach of law.'' As per Exclusion Clause IV, the Corporation shall not be liable to pay the additional sum referred in (a) or (b), if the disability of the death of the life assured was resulted from the life assured committed breach of law.

11.         On perusal of the FIR, that was registered as Baikhora P.S. Case No-25/2011, charge sheet filed by the investigating agency, depositions of the witnesses, particularly the evidence of P.W. 15 and P.W. 16, who happened to be the eye witnesses to the occurrence, recorded by the learned Additional Sessions Judge, Belonia in case no- ST-27(ST/B) of 2012 and the judgment passed thereof, we have no hesitation to hold that the life assured was involved in committing the murder of a couple, namely Subodh Debbarma and his wife Bibha Das Debbarma and for that reason the co-accused one Dipak Sharkar was sentenced to suffer RI for life with fine.

12.         There can not be any doubt about that the life assured by taking active part in the killing of two victims committed breach of law within  the meaning of Exclusion Clause IV of the terms of the Money Back Policy of insurance and hence the corporation is not liable to pay the additional sum under Accident Benefit. A bare reading of clause 10.2 of the terms of Money Back Policy, we find that this provisions deals with granting of Accident Benefit when the life assured suffered disability or at any time when the policy is in force for the full sum assured before the expiry of the period for which premium is paid  provided it does not fall within the Exclusion Clauses. We have already pointed out that the case of the life assured is covered by the Exclusion Clause IV because the death of two victims resulted from breach of law committed by the life assured. In our view, the said Exclusion Clause of the policy does not debar the complainant from getting the sum assured with bonus.

13.        In view of the Exclusion clause IV, the corporation has the right not to pay additional sum equal to the death benefit under the Money Back Policy, but they can not deprive the complainant from the sum assured with vested bonus  under the policy as it does not come under the purview of clause 10.2 (b) of the terms of Money Back Policy. It is well settled that even in case where there is criminal background of the life assured, it would not be legally permissible to restrict the nominee from getting the sum assured minus Accident Benefit under the policy. It is needless to say that for not paying the assured sum under the policy the complainant suffered mental agony and harassment which amounts to deficiency in rendering service on the part of the O.Ps.

14.         In the result, therefore, the complaint U/S 12 of the Act filed by the complainant is allowed. The O.Ps are directed to pay to the complainant the sum assured with bonus under the Money Back Policy with interest @9% P.A. with effect from the date of preferring the claim till the payment is made. The O.Ps shall also pay Rs.5000/-(Rupees Five Thousand) to the complainant as compensation for causing mental agony and harassment together with Rs.2,000/-(Rupees Two Thousand) as costs of litigation. The O.Ps shall pay the said amount to the complainant within 6 (six) weeks from the date of judgment.          
    
 A N N O U N C E D

 

SRI S. C. SAHA
PRESIDENT,
DISTRICT CONSUMER  DISPUTES 
REDRESSAL FORUM,
WEST TRIPURA,  AGARTALA.

 

SRI B. BHATTACHARYA,
MEMBER,
  DISTRICT CONSUMER DISPUTES 
REDRESSAL FORUM, 
  AGARTALA, WEST TRIPURA.