( Passed on dated 28^th  January, 2016 )

Per Shri Atul D. Alsi – Hon’ble President.

              The complainant No. 1 is the legally wedded wife and the complainant No. 2 to 4 are issues of said deceased Mangalsing s/o. Hanumansing  Parihar.

2.            Late Mangalsing had purchased following L.I.C. policies from the O. P.

     Name of Policy      Policy No.             Date            Sum Assured  

a)  Endowment           971684248         20/10/1986         Rs. 30,000/-

b)  Jivan Sathi             971934953         28/03/1992        Rs.25,000/-

c)  Marriage Endo.      s/972080352      28/10/1992        Rs.20,000/-

d)  Jivan Mitra             972118943        28/03/1993        Rs.20,000/-

e)  Money Back          972366711        28/03/1996        Rs.25,000/-

f)  Marri. Endo.           972521553        28/01/1998        Rs.75,000/-

g)  Jivan Chhaya         972567738         28/11/1999        Rs.50,000/-

h)  Endo. Assure.       972753066         11/03/2000        Rs.75,000/-

i)   Jivan Anand           973237165        28/10/2003        Rs.1,00,000/-

j)   Endo. Assure.       972993572        10/12/2003         Rs.50,000/-

                                                                 Total             Rs. 4,70,000/-

3.            In the year 2004 in an unfortunate incident said Mangalsing was murdered by some culprits and first information report in this regard was lodged by his wife the complainant no. 1.  The dead body was thrown away in “Bagh” River at Amgaon by the culprits.

4.            The charge sheet of the offence u/s 302,343,201,364 R/w 34 of the Indian Penal Code came to filed by the police before the Hon’ble Session Court, Gondia vide session trial no. 8/2005 (State v/s Banthu + other two).

5.            The death of said Mangalsing, the complainant No. 1 has been granted the family pension.  The complainant lastly served legal notice to the respondent No. 1 on dated 22/01/2014 asking him for granting the sum assured of the said policies.  The complainant No. 1 on dated 25/06/2014 served the legal notice to the respondent No. 2.  Hence the complainants have been constrained to file instant complaint.    

6.            The complainant prayed to direct the O. P. to settle the insurance death claim of the complainants and to pay twice the amount of sum assured of each policy total amount of Rs.9,40,000/- along with appropriate bonus as per rule and regulations with interest @12% p.a. from the date of death of the deceased  till its realization and also prayed for Rs.30,000/- towards mental agony, physical harassment and economic loss along with cost of litigation.    

7.            After receiving the notice issued by this Forum, the O. P. No.1 & 2 approaches before this Forum through their counsel and filed their reply. 

8.            In their reply the O. P. No. 1 & 2 submitted that, the O. P. launching different types of policies is not in dispute.  It is also not disputed that Shri. Mangalsing Parihar had taken different policies on his life.  It is not in dispute that Shri Mangalsingh Hanumansingh Parihar was employee of Forest Department and complainant No.1 is his wife.  There is no conclusive proof of death of Mangalsingh Parihar on record to enable this O.P. to proceed with consideration of death claim in respect of policies on his life.  The documents submitted by complainant do not conclusively prove the death of her husband.  For want of sufficient and conclusive proof of death of policy holder, no cause of action would accrue to the complainant.  It is not denied that complainant is nominee in most of the policies.

9.            In his specific reply he stated that, as per post mortem report dated 27/06/2014, the Age, Sex and Cause of death of the UNKNOWN PERSON, in respect of whom only on some parts of the dead body, post mortem was conducted, could not be ascertained.  Therefore, it can not be said conclusively that the parts of death body under post mortem were that of the husband of complainant.   The Medical Officer who conducted post mortem only on some parts of dead body recovered by police which were handed over CLOTH, BONES-WRAPPED, SEALED to the police constable for being sent for expert opinion to FORANSIC AND ANATOMY DEPARTMENT of Government Medical Collage, Nagpur for determining the age, sex and cause of death in respect of the person on whose some parts of body post mortem was conducted.  But report or the expert opinion to this effect was never submitted by complainant to the opposite party.

10.                   The BRAIN matter (dead body was not found intact but only some parts like skull and pieces of some bones) was preserved during post mortem and sent for CHEMICAL ANALYSIS for further investigations and expert opinion.  However, report to this effect was also not submitted by complainant to the opposite party.  It is therefore clear that death of policy holder, husband of complainant, could not be established conclusively.   It is also on record that the samples of TEETH, BONE (FEMUR) and , BLOOD of Smt. Shobha (wife), Hemendrasingh and Yogendrasingh both sons  of Mangalsingh Parihar, and Ku. Priyanka, daughter of Mangalsingh were sent to FORENSIC SCIENCE LABORATORY Maharashtra State, Vidya Nagar, Mumbai for DNA Test, and , result of analysis and opinion submitted by them is as under-

               “THE UNKNOWN DECEASED PERSON IS EXCLUDED TO BE BIOLOGICAL FATHER OF SUSPECTED SON HEMENDRASINGH AND SUSPECTED DAUGHTER PRIYANKA”.

              From the above report and analysis it can be easily concluded that the deceased person was not the policy holder, Shri. Mangalsingh S/o.Hanumansingh Parihar.  Copy of DNA report is filed with reply as DOCUMENT No.2.

11.                   In the circumstances narrated above, although the Gram Panchayat, Amgaon issued death certificate and as also that the employer of Mangalsingh Parihar reportedly sanctioning pension to complainant, is of no avail for the purpose of considering death claim payments under policies of Mangalsingh Parihar for the simple reason that there is no sufficient, conclusive and cogent evidence to establish his death.  It appears that Gram Panchayat issued death certificate only on the information of death given by someone and such certificate can not be treated as conclusive proof of death of Mangalsingh Parihar due to reasons narrated above.

12.                   It is absolutely premature to conclude before final verdict of the court that the murdered person was in fact one Shri. Mangalsingh S/o. Hanumansingh Parihar.   It is further submitted that premiums under all policies are not received upto alleged death of policy holder and there are several gaps of premiums intermittently due to which death claims for full sum assured under all policies are not admissible. Hence, present complaint is liable to be dismissed and be accordingly dismissed.

13.                   The complainant has filed copies of policies at page no. 14 to 23, Copy of application dated 02/08/2004 at page no. 24, Copy of F.I.R. at page no. 25, Copy of Spot Panchnama at page no. 28, Copy of Inquest Panchnama dated 27/06/2004 at page no. 30, Copy of Post-Mortem Report at page no. 32, Copy of Final Report at page no. 36, Copy of death certificate at page no. 37, Copy of claim form at page no. 38, Copy of particulars of family pension of complainant at page no. 39, Copies of letters of Accountant General, Nagpur at page no. 44 to 48,  Copy of postal receipt & acknowledgement at page no. 49,  Copy of legal notice at page no. 50 on record.  Subsequently the complainant filed documents at page no. 67 to 78 and page no. 103 to 115 on record. 

14.          The opposite parties have also filed copies of documents at page no. 86 to 98 on record.

15.                   The advocate of complainants Mr. M.B.Yadav in his written notes of argument submitted that, in the year 2004, in an unfortunate event the husband of the complainant died due to murder committed by some culprits.  That, the First Information Report in this regard came to be lodged by the complainant in the police station Amgaon, Tah-Amgaon, Dist.-Gondia (M.S.) and thereafter police visited spot of the incident, they have conducted investigation, carried out spot Panchanama, Inquest Panchanama was also prepared by the Hon’ble Sub-Divisional Officer, Deori.  Since the making of said application i.e. since 02/08/2004 it is pending and respondent deliberately and intentionally avoided to take any favourable step in favour of complainant nor intimated in this regard in spite of several requests by the complainant.    It is also further submitted that, after the death of said Mangalsingh the complainant has been granted the family pension after compliance and making all legal formalities.   The complainant lastly served legal notice to the respondent No.1 on 22/01/2014.

              It is submitted that, on perusal of the spot panchanama, inquest panchanama, statement of complainant, identification of dead body of late Mangalsingh Parihar and incident of his death has been categorically established.   It is further submitted that the D.N.A. report submitted by the O.P. is vague, false, incorrect and incomplete as it silence as to analysis report of Yogendrasingh i.e. son of Mangalsingh.  It is well settled law that the result of D.N.A. test is ultimately an opinion and it does not have the value of conclusive proof as to contents thereof. (vide ruling-Manik Jibhkate v/s State of Maharashtra 2012 (2) A.I.R. Bom. 600 – Nagpur Bench).   Looking to the above mentioned facts and circumstances of the case the instant complaint filed by the complainant, kindly be allowed.

16.                   The counsel for O. P. Adv. Mr. Anant Dixit argued that there is no conclusive proof of death; hence the claim is not tenable for want of cause of action.  As per Post Mortem Report the death mentioned of “unknown person”.  The D.N.A. report not supported the death of Mangalsing.  The death certificate and pension sanctioned to complainant as family pension for the death of husband of complainant can’t be proof of death.  Hence case may be dismissed with cost. 

17.                   As per petition and arguments and documents filed on record following points came for consideration:-

REASONING & FINDINGS

18.                    The policies of complainant in paragraph 4 are admitted by opposite parties.  Hence the deceased had insured with opposite parties for the policies as per Para. No. 2 for the total sum assured Rs.4,70,000/- along with double benefit and double accident benefit.  The O. P. has not allowed the claim for non availability of proof of death of deceased Mangalsing Parihar.  The insurance policies are matured.  The insurance policies filed on record are seen to be double accident benefit policies as per document no. 14 to 23.

19.                   The deceased was missing since 30/04/2004.  As per report in Amgaon Police Station the human parts were found at bank of river “Bagh” between the borders of Maharashtra & Madhya Pradesh. The body parts of skull, teeth, pant, shirts were received which were kept in “Bag” in intact position.  As per spot panchnama & as per inquest panchnama the skull was fracture and bears hole.  Similarly the different parts of body were found in that bag.  So somebody was murdered the deceased as per inquest panchnama.  The teeths, hair, cloths and rings were identified by the complainant; hence it is proved that the dead body was of complainant’s husband.  The complainant has filed report in police station that her husband had illicit relation with a woman & she has suspicious that the accused might have murdered the husband of complainant for the reason of knowledge of illicit relations to whom they are related.

20.                     The family pension was sanctioned in favour of complainant and death certificate issued by Gram Panchayat, Amgaon, Distt. Gondia at page 37.   Inquest panchnama & Spot panchnama and identification of body by complainant as per circumstantial evidence is the conclusive proof of death of husband of complainant.  The D. N. A. report is not only conclusive proof of evidence.  The D. N. A. test is helpful in investigation so it can’t be a conclusive piece of evidence.  Therefore non sanction of insurance claim to complainant by O. P. amounts to deficiency of service.  Therefore the claim of complainant is partly allowed. Hence direction is given to O. P. to disburse the insurance claim along with profit and benefit of double accident claim along with interest and compensation to the complainant except the policies bearing No. 972366711 and 973237165 which were in lapsed condition.  When the policies are of lapse condition in that case the complainant are not entitled to receive insurance claim as per Insurance Act and it amounts to breach of term and condition of policy.  Hence following order is passed

-: ORDER :-

1.            The complaint is partly allowed.

2.            The O. P. are directed to pay the amount of insurance claim under the policies bearing nos. 971684248, 971934953, 972080352, 972118943, 972521553, 972567738, 972753066, 972993572 along with profit and double accident benefit along with interest @ 9% p.a. from admission of case i.e. 17/11/2014 till its realization.

3.            The O. P. are directed to pay Rs.15,000/- towards compensation for mental torture & agony for non settlement of insurance claim of complainant along with Rs.10,000/- towards cost of litigation to the complainant.

4.            The insurance claim in respect of policies bearing no. 972366711 and 973237165 are rejected because these are under lapse conditions.  

5.            The O. P. are directed to comply the above order within 30 days from the date of receipt of this order.

6.            The O. P. are directed to comply the above order jointly or separately.