Aggrieved by the order dated 17.2.2011 passed by Haryana State Consumer Disputes Redressal Commission, Panchkula (in short, ‘the State Commission) in appeal No. 3253 of 2007, the original complainant has filed this revision petition in order to invoke the supervisory jurisdiction of this Commission under Section 21(b) of the Consumer Protection Act, 1986. The facts of the case are that Mr. Anup Sahani, who had taken an insurance policy with Accident Security Plan in the sum of Rs. 10 lakh from the opposite party, died in Johannesburg, South Africa when the car in which he was riding met with an accident. The blood sample of the deceased showed concentration of alcohol in the -3- blood to the extent of 0.12 grams/100 ml of blood. Post Mortem examination conducted on the body of deceased confirms the cause of death as multiple injuries on account of accident. The complainant as wife and nominee of the life assured filed a claim, which was repudiated by the insurance company primarily on the strength of an exception clause appearing in the terms and conditions of the policy, which debarred the claim in cases where the life assured met with an accident while he was under the influence of drugs or intoxicating liquor. The complainant filed the complaint, which was resisted by the insurance company on the same ground. The District Consumer Forum on a consideration of the relevant factors and the evidence and material brought before it, allowed the complaint and directed the opposite party-insurance company to pay insurance claim to the complainant together with interest @9% per annum from the date of lodging the claim by the complainant till payment besides awarding a sum of Rs.5,000/- on account of cost of litigation and the compensation for the harassment caused to the complainant with the stipulation that the order shall be complied with within one month. Aggrieved by the said order, the insurance company filed appeal -4- before the State Commission and the State Commission going by its own interpretation to the relevant exclusionary clause appearing in the terms and conditions of the policy, reversed the finding of the District Consumer Forum and consequently dismissed the complaint. We have heard Mr. S. C. Singhal, learned counsel for the petitioner and Ms. Suman Bagga, learned counsel for the respondents and have considered their respective submissions. In this case, the only question which needs to be considered is as to whether the present case falls under clause No. 4 of the exception clauses of the insurance policy. The said clause reads as under:- “4) Payment of compensation in respect of death, injury or disablement of the Insured Person. a) from intentional self-injury, suicide or attempted suicide. b) Whilst under the influence of intoxicating liquor or drugs.” This clause has to be interpreted in a manner so as to give its full and proper meaning and effect and should not be interpreted in a manner so as to negate a legitimate insurance claim. The State Commission has referred to decisions of some foreign courts in -5- support of its view that the present case is covered under the said exclusion clause. In our view, the ratio of foreign decisions cannot be applied in context of Indian Law. In any case, the circumstance of the life assured being under the influence of intoxicating liquor or drugs has to be considered in the context of the facts and circumstances of particular case. Certainly, if the life assured meets with an accident while driving a motor vehicle or by committing any overt, rash or negligent act whilst under the influence of intoxicating liquor or drugs leading to his death, his case would clearly fall under the above referred exception clause. However, such influence of intoxication if could not have even a remote effect on the cause of the accident it will not fall under the said clause. In the case in hand, the life assured though was found to have consumed a little quantity of alcohol still the fact is that he was not driving the vehicle in question and was simply riding the same on its rear seat. He could not have contributed to negligence or rashness in driving the vehicle.Going by the very object of insurance and giving harmonious construction to the various clauses or the terms and conditions of the policy, it would be -6- incongruous to deny an insurance claim on the strength of said exception clause even when the death of the life assured had taken place in a pure and simple motor accident for which he cannot be held responsible in any way, on the ground that he was under some slight influence of intoxicating liquor or drug which did not influence the incidence of accidents in any manner. There-being no denial of the factual position in regard to the death of the life assured, Mr. Anup Sahani on account of a motor accident on the alleged date, time and place in Johannesburg, South Africa, we are of the considered opinion that the repudiation of the claim by the insurance company on the strength of the said above referred exception clause, was unjustified and amounts to deficiency in service. We must, therefore, set aside the order passed by the State Commission and restore the order passed by the District Consumer Forum. Learned counsel for the respondent-insurance company made a plea that in the given facts and circumstances of the case, the rate of interest and the period for which the District Consumer Forum has directed it to be paid should be suitably modified. In our view, even -7- this modification is not called for because the District Consumer Forum has awarded interest @9% per annum which by no standard can be said to be harsh or excessive. However, in the peculiar circumstances, we direct that such an interest shall be payable on the insurance amount of a sum of Rs. 10 lakh w.e.f. the date of the filing of the complaint rather than from the date of the lodging of the claim as directed by the District Forum. The amount shall be paid within a period of four weeks from today, failing which, the rate of interest shall stand enhanced to 12% per annum w.e.f. the date of default. In the given facts and circumstances of the case, the parties to bear their own cost throughout. The revision petition is allowed in the above terms. |