Haryana

Kaithal

252/19

Neena Choudhary - Complainant(s)

Versus

Life insurance corporation of India - Opp.Party(s)

Sh.Vinay Verma

05 Aug 2022

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KAITHAL.

                                                     Complaint Case No.252/2019.

                                                     Date of institution: 21.08.2019.

                                                     Date of decision:05.08.2022.

1. Neena Choudhary Wd/o Sh. Sanjeev Kumar @ Sanjeev Choudhary S/o Sh. Naresh Kumar.
2. Anshika Choudhary D/o late Sh. Sanjeev Kumar @ Sanjeev Choudhary.
3. Anshul Choudhary (minor) S/o Sh. Sanjeev Kumar @ Sanjeev Choudhary through his mother as natural guardian and next friend namely Smt. Neena Choudhary, all residents of House No.404/8, Choudhary Mohalla, near Annapurna Temple, Kaithal, Tehsil and Distt. Kaithal.

 

                                                                        …Complainants.

                        Versus

Life Insurance Corporation of India, Kaithal through its Branch Manager.

….Respondent.

        Complaint under Section 12 of the Consumer Protection Act

CORAM:     DR. NEELIMA SHANGLA, PRESIDENT.

                SMT. SUMAN RANA, MEMBER.

                SH. RAJBIR SINGH, MEMBER.

       

Present:     Sh. Vinay Verma, Advocate, for the complainants.   

                Sh. Sudeep Malik, Advocate for the respondent.

               

ORDER

DR. NEELIMA SHANGLA, PRESIDENT

        Neena Choudhary and others-Complainants have filed this complaint under Section 12 of Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’) against the respondent.

                In nutshell, the facts of present case are that the husband of complainant No.1 and father of complainants No.2 & 3 namely Sh. Sanjeev Kumar has taken three insurance policies bearing No.177591004 namely New Bima Gold for the sum of Rs.2,00,000/-, 178485327 namely new Endowment for the sum of Rs.4,00,000/- and 479015090 namely New Bima Bachat for the sum of Rs.4,00,000/- from the respondent.  It is alleged that as per the above-said policies, the policy-holder was also entitled for accidental benefits.  It is further alleged that on 28.04.2017 at about 10.00 p.m. the policy-holder was attacked by some unknown persons and was mercilessly beaten and the policy-holder died while he was being taken to Shah Hospital, Kaithal from the spot of occurrence.  An FIR bearing No.166 of 2017 was also lodged in Police Station, Kaithal under Sections 148/149/302/323 IPC against some unknown persons.  The complainant No.1 after the death of her husband lodged the claim for taking the benefits under the insurance policies and completed all the formalities but the respondent kept on postponing the matter regarding payment of accidental benefit claim amount to the complainant on one or the other pretext, however, the respondent vide their letter dt. 28.01.2019 repudiated the claim of complainant vide regarding the accidental benefit claim under the policies No.M177591004 & M178485327.  It is further alleged that the complainant No.1 thereafter applied to the respondent for taking the status report of all the policies of her husband/policy-holder and came to know that the respondent has also repudiated the claim of complainants regarding policy bearing No.M479015090 on 23.01.2019.  The said repudiation of claim is stated to be wrong and illegal.  So, it is a clear cut case of deficiency in service on the part of respondent and prayed for acceptance of complaint.     

2.            Upon notice, the respondent appeared before this Commission and contested the complaint by filing their written version raising preliminary objections with regard to locus-standi; maintainability; cause of action; The real facts are that the deceased life assured Sh. Sanjeev Kumar had purchased three policies in question from the respondent.  After the death of life assured, the basic sum assured under all the three policies was released in favour of nominee (complainant No.1) for Rs.2,00,000/-, Rs.4,62,800/- & Rs.2,38,500/- on 09.10.2017, 09.10.2017 & 31.10.2017 respectively through NEFT in the account of complainant.  The accidental benefits under policy No.177591004 and 178485327 was not payable since the deceased life assured had not died due to accidental injuries rather as per version stated in the FIR, there was dispute due to water between the life assured and accused persons and life assured was killed by them due to old enmity.  Since it was a simplicitor planned and intentional murder, so accident benefit is not payable.  The manner in which life assured died invokes the exclusion clause for accidental benefit, hence, accidental benefits have rightly been regretted under the policy numbers 177591004 and 178485327, however in policy No.479015090 double accidental benefits was not opted by the life assured at the time of taking of policy and it was not granted.  This plan is without cover of accident benefit/disability benefit and no premium was charged for accident benefit & disability benefit; Hence, accidental benefit under the said policy was not considered.  There is no deficiency in service on the part of respondent.  On merits, the objections raised in the preliminary objections are reiterated and so, prayed for dismissal of complaint.

3.             To prove his case, the complainant tendered into evidence affidavit Ex.CW1/A alongwith documents Anneuxre-C1 to Annexure-C12 and thereafter, closed the evidence.

4.             On the other hand, the respondent tendered into evidence affidavit Ex.RW1/A alongwith documents Annexure-R1 to Annexure-R14 and thereafter, closed the evidence.

5.             We have heard the learned Counsel for both the parties and perused the record carefully.

6.             Sh. Sudeep Malik, Adv. for the Life Insurance Corporation-respondent has argued that the basic sum of the policies in question have already been given to the complainant No.1 being nominee and no accidental benefit is payable to the complainant as the life assured namely Sanjeev Kumar due to murder.  Ld. counsel for the Life Insurance Company-respondent has placed reliance upon the case law laid down by Hon’ble National Commission in case titled as United India Insurance Co. Ltd. Vs. Smt. B.Purnamma bearing revision petition No.924 of 2008 in Appeal No.1430 of 2006 decided on 25.01.2016.    

7.             On the other hand, Sh. Vinay Verma, Adv. for the complainants has argued that the husband of complainant No.1 and father of complainants No.2 & 3 namely Sh. Sanjeev Kumar had taken three insurance policies bearing No.177591004 namely New Bima Gold for the sum of Rs.2,00,000/-, 178485327 namely new Endowment for the sum of Rs.4,00,000/- and 479015090 namely New Bima Bachat for the sum of Rs.4,00,000/- from the respondent.  It has been further argued that as per the above-said policies, the policy-holder was also entitled for accidental benefits.  It has been further argued that on 28.04.2017 at about 10.00 p.m. the policy-holder was attacked by some unknown persons and was mercilessly beaten and the policy-holder died while he was being taken to Shah Hospital, Kaithal from the spot of occurrence.  It has been further argued that an FIR bearing No.166 of 2017 was also lodged in Police Station, Kaithal under Sections 148/149/302/323 IPC against some unknown persons.  It has been further argued that the complainant No.1 after the death of her husband lodged the claim for taking the benefits under the insurance policies and completed all the formalities but the respondent kept on postponing the matter regarding payment of accidental benefit claim amount to the complainant on one or the other pretext and ultimately, the respondent vide their letter dt. 28.01.2019 repudiated the claim of complainant vide regarding the accidental benefit claim under the policies No.M177591004 & M178485327 and also repudiated the claim of complainants regarding policy bearing No.M479015090 on 23.01.2019.  Ld. counsel for the complainants has placed reliance upon the case law laid down by Hon’ble National Commission in case titled as National Insurance Co. Ltd. Vs. Theegala Laxmi and another, 2012(3) CLT 303 in which Hon’ble National Commission has held that in a case where insured was murdered as a result of encounter and death by murder was held to be accidental in which insurance was allowed to be given.  In the present case also, Sh. Sanjeev Kumar was assaulted by some Bihari persons on the road and he died due to injuries.  Hence, it is held to be accidental death.

8.             Similarly, in the case decided by Hon’ble National Commission titled as Maya Devi Vs. Life Insurance Corporation of India, 2008(55) RCR (Civil) 176 wherein it was held that death due to murder is held to be accidental and is held to be covered under Life Insurance Policy.

9.             The present case falls under the precincts of the aforesaid law laid down by Hon’ble National Commission, New Delhi.  Similar support is taken from the authority laid down by Hon’ble National Commission in case titled as Ganga Ram Rai Vs. LIC of India, 2015(66) RCR (Civil) 196. The authority submitted by ld. counsel for the respondent has been perused and considered by us but the same is not applicable to the facts of instant case.

10.            In view of the aforesaid law laid down by Hon’ble National Commission (supra), the family of insured has given the insured amount for accidental death.  Thus, as a sequel of aforesaid discussion, there is merit in the present complaint and same is hereby accepted with cost.  The respondent is hereby directed to pay the accidental benefit claim amount of Rs.2,00,000/- to the complainants under the policy bearing No.177591004 and accidental benefit claim amount of Rs.4 lacs under the policy bearing No.178485327 and total accidental benefit claim amounting to Rs.6,00,000/- (Rs.2,00,000/-+Rs.4,00,000/-) alongwih interest @ 6% p.a. from the date of death of Sanjeev Kumar i.e. 28.04.2017 till its actual realization.  The cost is assessed as Rs.11,000/- which shall be paid by the respondent to the complainant.            

 11.           In default of compliance of this order, proceedings shall be initiated under Section 72 of Consumer Protection Act, 2019 as non-compliance of court order shall be punishable with imprisonment for a term which shall not be less than one month, but which may extend to three years, or with fine, which shall not be less than twenty five thousand rupees, but which may extend to one lakh rupees, or with both.  A copy of this order be sent to both the parties free of cost.  File be consigned to the record room after due compliance.     

Announced in open court:

Dt.:05.08.2022.

  

                                                                (Dr. Neelima Shangla)

                                                                President.

 

       

(Rajbir Singh),            (Suman Rana),          

Member.                            Member.

 

Typed by: Sanjay Kumar, S.G.