KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAUD, THIRUVANANTHAPURAM
APPEAL NO. 263/03 JUDGMENT DATED.12.02.08
PRESENT: SRI.M.V.VISWANATHAN : JUDICIAL MEMBER SRI.S.CHANDRA MOHAN NAIR : MEMBER The Divisional Manager, M/s.New India Assurance Co. Ltd., Divisional Office, P.B.No.213, 2nd Floor, KSFE Building, : APPELLANT Chinnakkada, Kollam 691 001.
(By Adv.M.Nizamudeen)
Vs 1. Mary Leela W/o. Walter Louis, Kovilvilakathu Veedu, Cheriblossom Cottage, Ambalathumukku, Pettah, Thiruvananthapuram.
(By Adv.S.Seena)
2. The Managing Director, : RESPONDENTS Malayala Manorama Company, Aristo Junction, Thampanoor, Thiruvananthapuram.
JUDGMENT SRIM.V.VISWANATHAN: JUDICIAL MEMBER The above appeal is preferred from the order dated 27th February 2003 passed by the CDRF, Thiruvananthapuram in OP.403/01 which was filed by the 1st respondent herein as complainant against the second respondent and the appellant as opposite parties 1 & 2 respectively. The complaint in the said OP.403/01 was filed claiming the insurance amount under the policy of Accident insurance policy issued by the 2nd opposite party/appellant. The above said claim was repudiated by the appellant/2nd opposite party/insurance company on the ground that the insured committed suicide and thereby the claim is unsustainable under the policy issued by the appellant/insurance company in favour of the insured Walter Louis. The lower forum accepted the case of the complainant and thereby the appellant/second opposite party is directed to pay the insured amount of Rs.1 lakh to the complainant being the nominee and widow of the deceased insured. The lower forum has also awarded compensation of Rs.15,000/- with costs of Rs.1000/- with further direction to pay future interest at the rate of 14.5% on the insurance amount. Aggrieved by the said order the present appeal is filed by the second opposite party/insurance company. 2. We heard the counsel for the appellant/second opposite party and the 1st respondent/complainant. There was no representation on behalf of the second respondent/1st opposite party. The learned counsel for the appellant/second opposite party submitted his arguments based on the grounds urged in the memorandum of the present appeal. He much relied on Ext.D1 investigation report dated.8.2.01 and canvassed for the position that the appellant/insurance company is not liable to pay the insurance claim because of the fact that the insured Walter Louis committed suicide. The appellant/insurance company has also questioned the correctness of the order passed by the lower forum awarding compensation of Rs.15,000/-. It is vehemently argued by the learned counsel for the appellant that there was no claim for compensation, but the forum below awarded a sum of Rs.15,000/- as compensation. The appellant requested to set aside the impugned order passed by the lower forum. On the other hand, the learned counsel for the 1st respondent/complainant supported the findings and conclusions of the lower forum and requested for dismissal of the present appeal. 3. The points that arise for consideration are:- 1. Whether the appellant/second opposite party/insurance company can be justified in repudiating the insurance claim put forward by the 1st respondent/complainant being the nominee and widow of the insured Walter Louis? 2. Whether the lower forum can be justified in awarding compensation of Rs.15,000/- and also ordering future interest at the rate of 14.5%? 3. Is there any illegally sustainable ground to interfere with the impugned order passed by the lower forum in OP.403/01? 4. Points 1 to 3:- For the sake of the convenience we will refer the parties to this appeal according to their status before the lower forum in OP.403/01. 5. There is no dispute that the 2nd opposite party/insurance company namely M/s.New India Assurnce Company Ltd., issued the group accidental insurance policy in favour of the subscribers of Malayala Manorama daily and thereby the complainant’s husband Walter Louis being the subscriber of the Malayala Manorama daily was insured under the above said group accidental insurance policy. It is also admitted that as per the said insurance policy the insured had the insurance coverage for an amount of Rs.1 Lakh. The complainant is the widow and the nominee of the insured Walter Louis. There can be no dispute about the fact that the insured Walter Louis died in a train accident which occurred on 5.4.2000 near All Saints College Railway Track. Exhibits P7 FIR; P8 death report; P9 Post Mortem certificate; P10 final report in crime No.49/2000 and P11 Death Certificate dated 25.4.2000 would make it clear that the insured Walter Louis died in the train accident which occurred on 5.4.2000. Thus, the complainant being the nominee and the widow of the insured is entitled to get the insurance amount under the accidental insurance policy issued by the second opposite party/insurance company. 6. The second opposite party/insurance company repudiated the insurance claim put forward by the complainant on the ground that the insured committed suicide. The definite case of the second opposite party/insurance company is that the claim is barred by exclusion clause incorporated in the policy of insurance. There can be no doubt that the fact that suicidal death is excluded in the policy of insurance issued in favour of the insured Walter Louis. Then the question to be considered is as to whether the insured committed suicide as contended by the second opposite party/insurance company. The only piece of evidence available on record to substantiate the aforesaid contention taken by the insurance company is Ext.D1 investigation report dated.8.2.01 submitted by one V.Chellayan Chettiyar. It is to be noted that the above said V.Chellayan Chettiyar who submitted D1 report before the second opposite party/insurance company has not been examined before the forum below. There is nothing on record to show that the investigation was conducted by the aforesaid private investigator with notice to the complainant or the other close relatives of the deceased Walter Louis. Even D1 investigation report could not give a clear indication regarding the alleged suicide. D1 report would make it clear that the private investigator Sri.V.Chjellayan Chettiyar is not expert in conducting an independent and impartial investigation. The investigator is also not sure about the identity of the train which ran over the insured Walter Louis. He has no idea about the age of the deceased who died in the train accident on 5.4.2000. There is also no case for the investigator that the insured Walter Louis committed suicide by deliberately jumping over a running train. On the other hand, D1 report only give the indication that the insured Walter Louis died in a train accident on 5.4.2000. D1 report cannot be relied on for the purpose of coming to a definite conclusion that the insured committed suicide. The forum below has rightly rejected the D1 investigation report. The second opposite party/insurance company has not adduced any acceptable evidence to substantiate the contention regarding suicidal death of the deceased. So, the second opposite party/insurance company cannot be justified in repudiating the insurance claim put forward by the complainant. 7. There is no dispute about the death of the insured. The insurance company is legally bound to pay the insurance amount of Rs.1 lakh. The forum below is fully justified in directing the second opposite party/insurance company to pay the insurance amount of Rs.1 Lakh to the complainant being the nominee and widow of the insured Walter Louis. 8. The lower forum has awarded future interest at the rate of 14.5% on the insurance amount of Rs.1 lakh. The complainant has not adduced any evidence to substantiate the her claim regarding interest at the rate of 18% per annum. The lower forum has awarded interest at the rate of 14.5%. We are of view that the interest awarded by the forum below at the rate of 14.5% is on the higher rate. By considering the prevailing rate of interest at the relevant time, 9% can be treated as reasonable. So, the rate of interest ordered by the forum below at 14.5% is modified and reduced to 9% per annum. The insurance amount of Rs.1 lakh will carry interest at the rate of 9% per annum from the date of the order passed by the CDRF. Thiruvananthapuram ie; dated.27.2.2003. 9. The forum below has also awarded a sum of Rs.15, 000/- as compensation. It is to be noted that there is no specific request for compensation. It is also to be noted that the forum below has ordered future interest on the insurance amount. So, the compensation over and above future interest can be treated as unreasonable or unjustifiable. It is to be noted that the second opposite party Divisional Manager of the insurance company was reluctant for honouring the insurance claim because of the existence of D1 investigation report submitted by the private investigator who was appointed by the insurance company. So, the second opposite party Divisional Manager of the insurance company can be justified to some extent in not honouring the insurance claim. We can not find fault with the Divisional Manager of the insurance company in his reluctance to disburse the insurance amount on getting the insurance claim made by the complainant. Thus, in all respects the order passed by the forum below directing payment of compensation of Rs.15,000/- is unsustainable. This commission has no hesitation to set aside the aforesaid order passed by the forum below regarding payment of compensation. 10. The forum below can be justified in awarding a sum of Rs.1,000/- towards cost of the proceedings. The complainant is entitled to get the said amount by way of cost. So, the same is upheld. These points are answered accordingly. In the result the appeal is allowed in part. The impugned order dated.27.2.03 passed by the CDRF, Thiruvananthapuram is modified. Thereby the order passed by the forum below directing payment of Rs.15,000/- as compensation is set aside and that the future interest ordered by the forum below at the rate of 14.5% per annum is reduced to 9% per annum from the date of the order passed by the forum below(27.2.03). The impugned order passed by the CDRF, Thiruvananthapuram regarding payment of Rs.1 lakh to the complainant as the insurance amount with costs of Rs.1000/- is upheld. As far as the present appeal is concerned the parties are directed to suffer their respective costs. SRI.M.V.VISWANATHAN : JUDICIAL MEMBER
SRI.S.CHANDRA MOHAN NAIR : MEMBER
R.AV | 
