DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, BARNALA, CAMP COURT AT AMRITSAR, PUNJAB.

 

Complaint Case No : RBT/CC/2018/258

Date of Institution : 6.04.2018/29.11.2021

Date of Decision : 04.07.2022

Jasbir Singh son of Sh. Chanan Singh resident of VPO Bhitewad, Via Rajasansi, Tehsil Ajnala, District Amritsar.    …Complainant

Versus

Life Insurance Corporation of India, Unit-I, Near Suraj Chanda Cinema, City Centre, Amritsar through its Manager/Branch Manager/Divisional Manager/Person over all incharge.

…Opposite Parties

Complaint U/S 11 and 12 of The Consumer Protection Act

Present: Sh. Munish Kohli Adv counsel for complainant.

Sh. Vikram Puri Adv counsel for the opposite party.

Quorum.-

1. Sh. Ashish Kumar Grover : President

2. Sh. Navdeep Kumar Garg  : Member

(ORDER BY ASHISH KUMAR GROVER PRESIDENT):

    The present complaint has been received by transfer from District Consumer Commission, Amritsar in compliance of the order dated 26.11.2021 of the Hon'ble State Consumer Disputes Redressal Commission, Punjab, Chandigarh. The complainant filed the present complaint under Section 11 and 12 of the Consumer Protection Act against Life Insurance Corporation of India, Amritsar. (in short the opposite party). 

2. The facts leading to the present complaint as stated by the complainant are that Manpinder Singh son of Jasbir Singh since deceased son of the complainant was insured with the opposite party and complainant is the nominee of the insured. The son of the complainant had obtained two life insurance policy No. 471397449 for sum assured of Rs. 75,000/- dated 24.3.2005 and policy No. 471396232 for sum assured of Rs. 50,000/- dated 25.2.2005 alongwith Rider Double Accident Benefit and he had been regularly paying installments of the amount of premium of said policy. On 26.8.2013 Narinder Singh and his nephew Manpinder Singh son of Jasbir Singh reached at area built in memory of Martyr Sarabjit Singh for milking cow. Some persons with their weapons came there and raised lalkaras that Narinder Singh and Manpinder Singh be shot dead and they be taught a lesson for stopping their businss of Malathi (Licorice) and they be not allowed to go safely. Upon this Harwinder Singh fired two shots from his rifle which hit Manpinder Singh on his right shoulder and the chest of Manpinder Singh and he died at the spot. In this way, son of the complainant died due to multiple, serious and grievous injuries caused to him by the said persons. The son of the complainant was not having any criminal background and never involved in any criminal activities in any manner. Thereafter, information with respect to the death of Manpinder Singh was given to the opposite party and the death claim of son of the complainant was filed by the complainant. All the original papers and original policy bond were handed over to the opposite party but opposite party has only given claim of sum assured of Rs. 75,000/- alongwith bonus and other benefits amounting to Rs. 98,429/- with respect to policy NO. 471397449 and further given claim of sum assured of Rs. 50,000/- alongwith bonus and other benefits amounting to Rs. 66,173/- with respect to policy NO. 471396232 by considering the death of Manpinder Singh as natural death whereas the fact remains that he was entitled for Rider Double Accident Benefit sum assured of Rs. 1,64,602/- but the opposite party failed to pay the said benefit to the complainant and lastly vide letter dated 12.2.2018 repudiated the genuine claim of the complainant, which amounts to deficiency in service and unfair trade practice on their part. Hence, the present complaint is filed seeking the following reliefs.-

1) The opposite parties may be directed to pay a sum of Rs. 1,64,602/- being benefit of Rider Double Accident Benefit Sum assured  alongwith interest at the rate of 12% per annum. 

2) To pay Rs. 25,000/- on account of compensation for mental agony and harassment. 

3) To pay litigation expenses.

4) Any other relief to which the complainant is found entitled. 

3. Upon notice of this complaint, the opposite party filed written statement taking preliminary objections that the present complaint is not maintainable. The complainant has not come to this Commission with clean hands and suppressed the material facts. The complainant has no cause of action to file the present complaint. 

4. On merits, it is admitted that deceased life assured Manpinder Singh was insured with the opposite party under Policy No. 471397449 and 471396232 and Jasbir Singh father of the DLA was the registered nominee under both the policies. It is also admitted that the DLA used to make payments of half yearly premiums up to February 2010 within six months but the policy was revived on 31.10.2011 for the premium due 8.2010 to 8.2011. It is also admitted that DLA died due to multiple injuries caused to him and which fact came to knowledge of the opposite party vide postmortem report dated 28.3.2013 at Civil Hospital, Amritsar. In the present case the murder was not a murder by accident but a murder simplicitor and as per the rules and regulations of the opposite party double accident benefit is not all payable in the present case. The death claim under both the policies were settled and payments were released in favour of the complainant. It was also held during the trail before the learned Sessions Court Amritsar that murder in the present case is a murder simplicitor and not a murder by accident as per judgment and decree dated 20.7.2017 passed by Learned Court of Additional Sessions Judge, Amritsar in which accused were convicted, The complainant never approached the opposite party after the rejection of the claim vide letter dated 12.2.2018. There is no deficiency in service and unfair trade practice on the part of the opposite party. Lastly, the opposite party prayed for the dismissal of the present complaint with costs. 

5. In support of his complaint, the complainant tendered into evidence his affidavit Ex.CW-1/A, copy of challan form Ex.C-1, copy of status report of policy No. 471397449 Ex.C-2, copy of status report of policy No. 471396232 Ex.C-3, copy of account statement Ex.C-4, and closed the evidence. 

6. To rebut the case of the complainant, the opposite party   tendered in evidence affidavit of Rajinder Kumar then Manager Legal LIC Ex.OP-1, copies of both the policy scheduel Ex.OP-2 and Ex.OP-3, copy of judgment dated 20.7.2017 by Learned Court of Sh. Sarabjit Singh Dhaliwal policy Ex.OP-4, copy of repudiation letter dated 12.2.2018 Ex.OP-5, copy of circular letter dated 25.2.1972 Ex.OP-6 and and closed the evidence. 

7. We have heard the learned counsel for the parties and gone through the record on the file. 

 

8. The opposite party admitted in the written version that the DLA was insured with the opposite party under two policies Ex.OP-2 and Ex.OP-3 for sum insured of Rs. 50,000/- and Rs. 75,000/- respectively and complainant is the nominee in both the policies. It is also admitted that DLA has paid the premiums regularly. Even, it is also admitted that the DLA died in a murder due to multiple injuries caused to him. It is admitted fact between the parties that the death claim of the DLA has already been given to the complainant alongwith bonus and other benefits. The only dispute in the present case is that the murder is an accidental death or not. 

9. Learned counsel for the complainant argued that the murder in the present case is an accidental death so the complainant is entitled to the Rider Double Accident benefit. On the other hand, the learned counsel for the opposite party argued that in the present case the murder was not a murder by accident but a murder simplicitor and as per rules of the opposite party double accident benefit is not payable. 

10. We have heard the learned counsel for the parties and are of the view that the murder is an unlooked for or mishap or untoward event which was not expected or designed. Even, the willful murder of the assured is accidental as far as is insured is concerned, as such murder is to be described as by chance or fortuitious. The learned counsel for the complainant argued that the murder of the insured is like an accident for insured as he did not know that what will happen with him. 

11. Learned counsel for the complainant relied upon citation of Hon'ble National Commission, New Delhi titled Pawan Kumari Verus Life Insurance Corporation of India and anr. Reported in 2016 (3) CPR-98 in which the Hon'ble Commission held that Life Insurance. Death of insured by murder. Denial of accidental benefit by insurer. From the standpoint of the deceased, it was an unexpected event. Murder in this case comes under the definition of accident. LIC is liable to pay claim for accident benefit as well under the three policies taken by the husband of the appellant. 

12. Learned counsel for the complainant also relied upon citation of Hon'ble Allahabad High Court titled Smt. Pushpa Agrawal Versus Insurance Ombudsman UP and others reported in 2012 AIR CC-2185 in which the Hon'ble Court held that Insurance Claim. Repudiation. Murder of insured. Insurer accepted the petitioner's claim for basic sum assured but rejected the claim for double accident benefit on the ground that death of insured due to murder after kidnapping is not by accident. Even the willful murder of the assured is accidental as far as insured is concerned and such murder is to be described as by chance or fortuitous. 

13. Both the above citations are fully applicable in the present case as in the present case also the DLA had died due to murder which unexpected for him and opposite party also paid the basic sum insured to the complainant. So by not paying the double accident benefit to the complainant is a clear cut deficiency in service and unfair trade practice on the part of the opposite party. 

14. In view of the above discussion, present complaint is partly allowed and opposite party is directed to pay Rs. 1,25,000/- to the complainant i.e. Rs. 50,000/- and Rs. 75,000/- under both the policies alongwith interest at the rate of 6% per annum from the date of filing of present complaint till actual realization. The opposite party is also directed to pay Rs. 5,500/- to the complainant as compensation for mental tension and harassment and Rs. 3,300/- as costs and litigation expenses.  Compliance of this order be made within the period of 45 days from the date of the receipt of the copy of this order. Copy of the order will be supplied to the parties by the District Consumer Disputes Redressal Commission, Amritsar as per rules. File be sent back to the District Consumer Disputes Redressal Commission, Amritsar. 

ANNOUNCED IN THE OPEN COMMISSION:

        4th Day of July 2022

 

            (Ashish Kumar Grover)

            President

              

(Navdeep Kumar Garg)

Member