Punjab

Rupnagar

CC/14/131

Mohinder Kaur - Complainant(s)

Versus

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

Sh. Ram Avtar, Adv

11 Feb 2015

ORDER

BEFORE THE DISTT. CONSUMER DISPUTES REDRESSAL FORUM, ROPAR

 

Consumer Complaint No.: 131 of 17.10.2014

                                      Decided on                          : 11.02.2015

         

1. Mohinder Kaur, aged about 52 years, wife of Kuldeep Singh son of

    Inder Singh, (Complaint filed on behalf of complainant No.1 was

    dismissed as withdrawn on 6.2.2015)

 

 2. Kuldeep Singh, aged about 55 years, son of Inder Singh,

   

    Both residents of Village Saupur, PS Nurpur Bedi, Tehsil Anandpur

   Sahib, Distt. Rupnagar.

                                                                                      ....Complainants

 

 

                                                  Versus

 

Life Insurance Corporation of India through its Branch Manager, Jeevan Jyoti Building, Nangal Township-140124, Distt. Rupnagar.    

                                                                                                                                                                                             ....Opposite Party

 

                            

 

QUORUM

                             MRS. NEENA SANDHU, PRESIDENT

                             SMT. SHAVINDER KAUR, MEMBER

 

ARGUED BY

                             Sh. Ram Aavtar Advocate, counsel for

                             the complainant

Sh. H.C. Verma Advocate, counsel for the Opposite Party

 

 

ORDER

          MRS. NEENA SANDHU, PRESIDENT

                   Although this complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’ only) was filed by Smt. Mohinder Kaur & Sh. Kuldeep Singh, against the Opposite Party (hereinafter referred to as the O.P.), yet complaint filed on behalf of Smt. Mohinder Kaur was dismissed as withdrawn, in view of the statement suffered by her counsel on 06.02.2015.  It has been prayed in the complaint that the O.P. be directed to admit the claim of the complainant, in the interest of justice.

 

2.                In brief, the case of the complainant is that his son Satnam Singh was working as a truck driver on the truck bearing No.HP-12-A-9247 owned by one Sh. Ravinder Singh. Said Satnam Singh had loaded a consignment, from factory of Hindustan Lever, Baddi (HP) and unloaded the same at Sonepat (Haryana) at about 9.00 P.M. in the evening of 30.10.2012. After unloading the said consignment, when he was coming back on the said truck from Sonepat to Baddi (HP), he was stopped on the way by some dacoits and was murdered. His dead body was recovered by the police from the nearby Barota canal. FIR No. 387 dated 3.11.2012 was lodged at PS Sadar, Sonepat (Haryana) and dead body of Satnam Singh was cremated by the police as unidentified body. After seeing the news published in the newspaper by the police on 8.11.2012, the owner of the said truck came to know that Satnam Singh had been murdered. Thereafter, parents of Satnam Singh alongwith their relatives reached at PS Sadar, Sonepat and identified the clothes and photographs of their son and on investigation, it was found that their son had been murdered by the dacoits. During his life time, said Satnam Singh had taken an insurance policy bearing No. 165162799 (wrongly written as 85162799) for a sum of Rs.2,10,000/- by paying an amount of Rs.6957/- as premium, the maturity date of which was 28.1.2032. After the above said incident, intimation about the same was given to the O.P. and the certain documents and forms, duly filled in as directed by the O.P. were submitted. Inspite of that the claim has not been settled and the O.P. is putting off the matter on one pretext or the other. A legal notice dated 30.8.2014 was also served upon the O.P. After receipt of the said notice, the O.P. started demanding chemical analysis report and certain other reports. The said documents are in the custody of the police. Whatever documents were available with the complainant, the same have already been submitted to the O.P. It is stated that a claim petition bearing No. 6/13 on 4.1.2013, filed before the Learned Court of Employees Compensation Commissioner-cum-Workmen’s Compensation Commissioner, Mohali Camp at Rupnagar, under the Employees Compensation Act, 1923, was decided on 4.7.2013 and the claim of the complainants has been accepted by the said learned court and the insurance company has been directed to pay the amount of compensation. Copy of the said judgment was also provided to the O.P. The investigating agency of ICICI Lombard Insurance Company had investigated the matter at length and came to the conclusion that Satnam Singh was murdered during the course of his employment. Therefore, the O.P. is illegally demanding unnecessary documents simply with the motive to delay the matter, as all the requisite documents have already been supplied to it to settle the claim in January, 2013 itself. As per terms & conditions of the policy in question, the O.P. is liable to pay double of the insured amount i.e. Rs.4,20,000/-. Non-payment of the claim amount by the O.P. amounts to deficiency in service on its part. Hence, this complaint.

 

3.                On being put to notice, the O.P. filed written statement in the shape of affidavit of Smt. Hem Lata, Manager (Legal) resisting the complaint taking preliminary objections; that the complainant has no locus standi to file the complaint against the O.P., which is not maintainable and is liable to be dismissed; that this Forum has no jurisdiction to entertain and try the complaint and the same is liable to be dismissed; that there is no deficiency in service on the part of the O.P. and that the complainant has no cause of action against the answering O.P. On merits, it is admitted that a policy bearing No.165162799 was issued to Satnam Singh for a sum of Rs.2,10,000/- and the half yearly premium amount to be paid under the same was Rs.6957/- and the maturity date of the said policy was 28.1.2032. It is also admitted that Sh. Kuldeep Singh, father of the deceased Satnam Singh, had intimated the O.P. about the death of said Satnam Singh on 6.5.2013. It is stated that the claim was very early claim, as it had happened in about 9 months after obtaining the policy in question, therefore, certain documents were called from the claimants to establish the bonafides of the claim. The documents, such as, chemical analysis report, Diatom Test report and police final report were called for through registered letters dated 12.8.2013, 1.8.2014 and 4.9.2014 from the claimants, who instead of submitting the same, have filed the instant complaint. It is stated that on the strength of the judgment given by the Hon’ble Commissioner, whereby compensation petition filed under the Employees Compensation Act, 1923 was admitted, a copy of which was supplied by the claimants alongwith the instant complaint, the death claim liability has been admitted on 3.12.2014 and payment of sum of Rs.2,18,190/- (BSA =2,10,000/- + Bonus =Rs.8190/-) vide cheque No.726347 dated 15.12.2014 has been made to Sh. Kuldeep Singh (nominee), father of Satnam Singh(DLA). It is admitted that the policy was with accident benefit. The claim benefit due to the accident is an additional benefit under the policy and is only payable when the death of the life assured is due to sustaining any bodily injuries resulting solely and directly by the accident caused by outward violent and visible means. The murder is not an accident. The Corporation is not liable to pay the additional amount as accident benefit, if the death is caused by an intentional self injury, attempted suicide, insanity or immorality or whilst the life assured is under the influence of intoxicating liquor, drugs or narcotics. The terms & conditions to that effect are mentioned at 10.2 under the title Accident Benefits, in the policy. For considering the accident benefit under the policy, the cause of death should conclusively proved as solely due to accident and the onus to prove the same lies on the claimants. In the present case, FIR was registered under Section 302 of IPC and in such a case, the accident benefit is not payable. All other allegations made in the complaint have been denied and a prayer has been made for dismissal of the same with costs.

 

4.                On being called upon to do so, Sh. Kuldeep Singh, complainant, tendered his affidavit Ex.C1, photocopies of various documents Ex. C2 to C11 and closed the evidence. On the other hand, the learned counsel for O.P. tendered affidavit of Smt. Hem Lata, Manager (Legal), Ex. OP-1, photocopies of documents Ex. OP-2 & OP-3 and closed the evidence.

5.                 We have heard the learned counsel for the parties and gone through the record on the file, including written arguments filed on behalf of the O.P., carefully.

 

6.                At the outset of the arguments, the learned counsel for the O.P. submitted that claim amount of Rs.2,18,190/- has already been paid through cheque vide letter dated 15.12.2014 to Sh. Kuldeep Singh, who was appointed as nominee in the policy document(Ex. OP-2) itself. The death of the life assured had occurred due to murder by the dacoits, which cannot be said to be an accident, therefore, accidental benefits cannot be granted under the policy. In support of his contention, the learned counsel has drawn our attention to the order passed by the Hon’ble National Commission in the case of ‘Prithvi Raj Bhandari’ Vs. Life Insurance Corporation of India Ltd. and others, 2006 (3)  CLT, Page 253, wherein it was held that killing by shooting in the ear as also in the ribs, leaves no doubt that this was a murder by design and intent rather than a case of accident murder and it shall not fall within the term ‘accident. The learned counsel has also drawn our attention to the judgment passed by the Hon’ble Punjab & Haryana High Court in the case ‘ PRTC Vs. Jogindero & others’ Vol. CLXIX-(2013-1) PLR, 205, wherein it was held that there was an occurrence of hijacking by the militants and the deceased became victim on account of the shooting spree undertaken by the militants, such an incident may be classified as an occurrence, but definitely it cannot be classified as an ‘accident’ in the context of Section 163A of the Motors Vehicles Act,1988.

7.                In rebuttal, the learned counsel for the complainant submitted that the plea taken by the O.P. that murder is not an accident is baseless and the O.P. has wrongly declined to pay the accidental benefits, because   there is no such term/condition, in the policy document, on the basis of which, it can be inferred that death by murder cannot be considered as an accident. Since the death of the life assured was an accidental death, therefore, the O.P. is liable to pay the accidental benefits as per Term No. 10.2 of the terms & conditions of the policy. In support of his submission that murder is an accidental death, he has placed reliance on the judgment passed by the Hon’ble High Court of Judicature at Allahabad in the case ‘ Pushpa Agrawal Vs. Insurance Ombudsman, U.P.  and Uttaranchal and another’ 2014 ACJ 1237 and submitted that in para No.31 of the said judgment, it has been clearly held that even 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’. Further in para No. 34 of the said judgment, it has been clearly held that LIC policy excludes death due to limited causes mentioned in the exclusion clause and it does not exclude death due to murder for any reason. He further submitted that the O.P. has paid a sum of Rs.2,18,190/- only to the nominee under the policy, vide letter dated 15.12.2014, i.e. during the pendency of the instant complaint and is still liable to pay the remaining amount, due under accidental benefits, alongwith compensation for harassment and litigation expenses.

 

8.                Vide order dated 06.02.2015, the complaint filed on behalf of Smt. Mohinder Kaurm, complainant No. 1, has already been dismissed as withdrawn. From the letter dated 15.12.2014(Ex. C11), it is evident that the O.P. has already paid a sum of Rs.2,18,190/- towards payment of the claim amount under the policy in question to Sh.Kuldeep Singh, nominee/father of the deceased life assured i.e. complainant No.2. Now the question for consideration before us is, whether Sh. Kuldeep Singh, complainant No.2, is entitled for payment of the accidental benefits as per terms & conditions of the policy? It has been borne out on record that Satnam Singh, the life assured, was murdered by the dacoits, while he was driving the truck in question. Perusal of the policy document (Ex.OP-2) reveals that it was a Money Back Policy with Profits + ACC. (Accident) Benefits. Its Term No.10.2 (b) reads as under:-

“ Death of the 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 policies on the life of the life assured shall not exceed Rs.25,00,000/-.

The Corporation shall not be liable to pay the additional sum referred in (a) or (b) above, it the disability or the death of Life Assured shall:

(i)      be caused by intentional self-injury attempted suicide, insanity or immorality 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 engaged in aviation or aeronautics in any capacity other than of a fare-paying, part paying or non-paying passenger in any air-craft which is authorized by the relevant regulation to carry such passengers and flying between established aerodromes, the Life Assured having at that time no duties on board the aircraft or requiring descent therefrom, or,

(iii)    be caused by injuries resulting from riots, civil commotion, rebellion, war (whether war be declared or not), invasion, hunting, mountaineering, steeple-chasing or racing of any kind, or

(iv)    result from the Life Assured committing any breach of law, or

(v)     arise from the employment of the Life Assured in the armed forces or military service of any country at war (whether war be declared or not) or from being engaged in policy duty in any military, naval or police organization.”

 

          From the above reproduced Term/Condition of the policy, it is apparent that the policy excludes death due to other limited causes and it does not exclude death due to murder for any reason. Thus, the plea of the O.P. that as the life assured was murdered, therefore, his death cannot be said to be an accidental death, is baseless. It may be stated that the parties are bound by the terms and conditions of the policy. Therefore, as per Term/Condition No.10.2 (b), referred above, the O.P. is liable to pay an additional sum equal to the sum assured. The nominee, under the policy, was entitled to get the sum assured + vested bonus + Accident Benefit, but the O.P. has paid him only Rs.2,18,190/- that too on 15.12.2014, after filing of the instant complaint, therefore, we do not hesitate to conclude that the O.P. is deficient in providing services, and is also liable to pay the remaining amount due towards accidental benefits alongwith compensation and litigation costs to the complainant No.2, Sh.Kuldeep Singh.

 

9.                In view of the aforesaid discussion, we allow the complaint and direct the O.P. in the following manner:-

i)       To pay to the complainant No.2, Sh. Kuldeep Singh, the sum assured i.e. Rs.2,10,000/- alongwith profits + an additional sum equal to the sum assured i.e. Rs.2,10,000/- towards Accident Benefits under the policy, after deducting the amount of Rs.2,18,190/-, already paid to him,

ii)      To pay a sum of Rs.10,000/- as compensation,

iii)     To pay Rs.3000/- as litigation expenses.

 

                   The O.P. is further directed to comply with the order within 30 days from the date of receipt of certified copy of this order, failing which the amounts mentioned at Sr. No. i) & ii) will carry interest at the rate of  9% P.A. from the date of filing of complaint i.e. 17.10.2014 till realization.

10.              The certified copies of this order be supplied to the parties forthwith, free of costs, as permissible under the rules and the file be indexed and consigned to the Record Room.

 

ANNOUNCED                                           (NEENA SANDHU)

Dated: 11.02.2015                                                PRESIDENT

 

 

                                                (SHAVINDER KAUR)                                                     MEMBER.