BEFORE THE A.P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION
AT HYDERABAD.
C.C. 41/2008
Between:
Smt. K. Rajeswari
Mother of K. Devender (deceased)
H.No. 18-4-66/B, Orus
Keeramabad, Warangal. *** Complainant
And
1. The Senior Divisional Manager
Divisional Office,
L.I.C. of India, Warangal
2. The Zonal Manager
L.I.C. of India, Zonal Office
Zeevan Bhagya, Secretariat Road
Saifabad, Hyderabad-63. *** Opposite Parties
Counsel for the Complainants: M/s. K.N.V. Radha Krishna.
Counsel for the O.Ps: Dr. . G. Shyamala
CORAM:
HON’BLE SRI JUSTICE D. APPA RAO, PRESIDENT
&
SMT. M. SHREESHA, MEMBER
WEDNESDAY, THIS THE FOURTH DAY OF AUGUST TWO THOUSAND TEN
Oral Order: (Per Hon’ble Justice D. Appa Rao, President)
***
1) This is a complaint filed to recover Rs. 25 lakhs towards the amount due under insurance policies together with compensation and costs.
2) The case of the complainant in brief is that his son late K. Devendar had taken three insurance policies viz., : i) Bima Kiran Policy (without profits) bearing No. 686522196 commencing from 28.11.2001 to 28.11.2031 for sum assured of Rs. 1 lakh (Ex B9); ii) New Bima Kiran Policy (Premium back term assurance with loyalty additions) bearing No. 686533087 commencing from 23.7.2002 to 23.07.2032 for sum assured of Rs. 9 lakhs
(Ex. B7) and iii) Anomol Jeevan (without profits) bearing No. 686534340 commencing from 24.9.2002 to 24.09.2022 for sum assured of Rs. 5 lakhs (Ex. B8). While so on 26.5.2004 he was murdered. The matter was taken up for investigation by the police and pending with them. When she submitted claims, the insurance company had repudiated the claim alleging that the deceased was of criminal intent got his brother murdered for financial gains from policy of his brother, to clear his own debts, and that the persons who advanced finance to the deceased life assured got him murdered. He had no regular income, and the insurance was taken for higher sums to have unlawful gain. Assailing the repudiation she claimed Rs. 25 lakhs with interest together with compensation of Rs. 1 lakhs towards mental agony and Rs. 10,000/- towards personal expenses and Rs. 10,000/- towards costs.
3) The opposite party insurance company resisted the case. It admitted issuance of policies however, defended they were issued in good faith. The deceased was running three small business establishments’ viz., Pan Shop, bakery and hotel. He could not have paid the premium from the income from these small sources. Admittedly he was murdered on 26.5.2004. When enquiry was made it found that LIC of India was served with an injunction order dt. 16.7.2004 in IA 682/2004 in O.S. No. 280/2004 on the file of I Addl. Senior Civil Judge, Warangal in the suit filed by one N. Ranjith Babu subjecting the claim amount on the above three policies to an ad-interim injunction. They learnt that his brother and others who advanced finance got him murdered to clear their debts from the claim amount payable by the opposite party. However the death claim under one of the policies for Rs. 1 lakh was admitted on ex-gratia basis, and they sought instructions in view of the orders of injunction in the money suit filed by one N. Ranjith Babu for principal amount of Rs. 2,30,000/-+ interest thereon. The other policies were repudiated. Therefore they prayed for dismissal of the complaint with costs.
4) The complainant in proof of her case filed her affidavit evidence and got Exs. A1 to A12 marked while the opposite parties filed the affidavit evidence of Sri S. N. Natarajan, Secretary (L&HPF) and got Exs. B1 to B10 marked.
5) The points that arise for consideration are:
i) Whether the complainant is entitled to amounts covered under the policies?
ii) To what relief?
6) It is an undisputed fact that the deceased late K. Devender son of the complainant had taken three policies viz., Bima Kiran Policy (without profits) bearing No. 686522196 commencing from 28.11.2001 to 28.11.2031 for sum assured of Rs. 1 lakh (Ex B9); New Bima Kiran Policy (Premium back term assurance with loyalty additions) bearing No. 686533087 commencing from 23.7.2002 to 23.07.2032 for sum assured of Rs. 9 lakhs (Ex. B7) and Anomol Jeevan (without profits) bearing No. 686534340 commencing from 24.9.2002 to 24.09.2022 for sum assured of Rs. 5 lakhs (Ex. B8). In all the policies the complainant was shown as nominee. The complainant submitted claim forms vide Exs. B1 to B3 mentioning that her son died on 26.5.2004 due to murder.
7) Sister of the deceased Smt. Kodem Sarala gave a report to the police vide Ex. A7 when her brother was murdered, on which the police registered a case in Crime No. 180/2004 u/s 148, 307 r/w 149 vide Ex. A8 arraying nine accused and others. An inquest was conducted on the body of the deceased vide Ex. A11 followed by post-mortem examination vide Ex. A12 wherein the medical officer found as many as 12 stab injuries, many lacerated wounds on various parts of the body and finally opined that he died of head injury. The police after investigation laid charge sheet Ex. A10 against 11 accused. A perusal of charge sheet discloses that the deceased and A3 are friends and they were doing finance business. The deceased had taken loan of Rs. 2 lakhs from A10 when disputes arose A3 acted as mediator. The deceased had sustained loss in the finance business. In November, 2003 the elder brother of the deceased Kuchana Prasad died in a train accident. Due to family and financial problems the deceased could not return the amount to A10. A1 to A10 gathered at the house of Koppula Suresh (A2) on 25.5.2004 and killed him. Therefore they sought for punishment of A1 to A10 for the offence u/s 120-B, 148, 302 r/w 149 IPC.
8) When the complainant/nominee claimed the amounts they were repudiated on the ground that (1) the deceased life assured was of criminal intent and got his brother murdered for financial gains from policy of his brother, to clear his own debts fearing their fate at the hands of deceased life assured, the persons who advanced finance to deceased life assured got him murdered. (2) The assured had no regular income and the decision to go in for insurance cover of higher sum assured with low premium and was a premeditated effort to make money in a shortcut manner. (3) He had made incorrect statements and with-held correct information regarding his income at the time of effecting the assurance.
9) Coming to the first objection a perusal of FIR as well as charge sheet do not in any way show that he got his brother murdered for financial gain to clear his own debts. On the other hand charge sheet discloses that in November, 2003 the elder brother of the deceased Kuchana Prasad died in a train accident. Therefore the very repudiation on the ground that the deceased with criminal intent got his brother murdered for financial gain is unjust and motivated. They intend to connect by describing facts not borne out by any record. It is not known how the insurance company could gather such information. As it is contrary to FIR, we are of the opinion that the repudiation on that ground is band under law.
10) Yet another contention is that the assured had no regular income and therefore in order to make money he had taken all these policies. No doubt the assured was in financial problems. He was a business man. He was running a pan shop, bakery and hotel, obviously in order to earn money. It might be that he had sustained loss but it cannot be said that he was not having any money towards payment of premium. At any rate the policies would mature in 2031 2032 and 2022. It was a long term investment, he made. He would get the amounts covered under the policies only in the years 2022 – 2032. When he had taken long term policies and no scope for getting money within a reasonable time the assumption of the insurance company that he had taken the policies to make money in a shortcut manner has no meaning. He could not have benefited in case of death. They intend to link one fact or the other without any basis.
11) The final contention was that he with-held the correct information regarding his income at the time of taking of the policies. The insurance company did not file the proposal forms submitted by him before taking of the policies in order to find out whether he mentioned incorrect information. The suggestion is not innocent. It intended to defeat the claim on one ground or the other.
12) The insurance company did not allege that the death of assured was not covered by the terms and conditions of the policy. A perusal of terms and conditions of the policy do not in any way indicate that such eventuality is not covered by the policy. The repudiation was wholly unjust. This is a classic case to show how the insurance companies adept in raising false pleas to deny just claims to the poor and needy. The insurance company intends to process one of the claims evidently as the sum assured was only Rs. 1 lakh covered under Ex. B9. Necessarily the complainant is entitled to the amounts covered under the policies with all the attendant benefits.
13) In the result the complaint is allowed in part directing the opposite party insurance company to pay the amounts covered under all the three policies with all attendant benefits with interest @ 6% p.a., from the date of repudiation viz., 30. 3. 2005 till the date of realization together with costs of Rs. 10,000/-. Time for compliance four weeks.
1) _______________________________
PRESIDENT
2) ________________________________
MEMBER
APPENDIX OF EVIDENCE
WITNESSES EXAMINED FOR
COMPLAINANTS: OPPOSITE PARTIES
None None.
Documents marked for complainant:
Ex A-1 Repudiation letter of OP in respect of Policy No.
686534340 in the name of Sri K. Devender.
Ex A-2 Repudiation letter of OP in respect of Policy No.
686533087 in the name of Sri K. Devender.
Ex A-3 Repudiation letter of OP in respect of Policy No.
686522196 in the name of Sri K. Devender.
Ex A-4 copy of Policy Bond for Policy No. 686534340
Ex A-5 copy of Policy Bond for Policy No. 686533087
Ex A-6 copy of Policy Bond for Policy No. 686522196
Ex A-7 Complaint dt :26.5.2004 lodged with Police, Warangal
in regard to offence of Murder against his brother namely K. Devender (decreased Insured)
Ex A-8 FIR dt :26.5.2004 prepared by the Police, Warangal.
Ex A-9 Memo of evidence in Crime No. 180 /2004
U/S 120-B, 148,302 r/w 149 of Cr.P.C
Ex A-10 Charge Sheet dt : 26.5.2004 framed by the Police, Warangal.
Ex A-11 Panchnama dt : 26.5.2004.
Ex A-12 Post Mortem Examination dt : 26.5.2004. issued by the
Dept. of Forensic Medicine Institute of Kakatiya Medical College, Warangal.
DOCUMENTS MARKED FOR OPPOSITE PARTIES:
Ex B-1 Original Claim form –A under Policy No. 686533087
Ex B-2 Original Claim form –A under Policy No. 686534340
Ex B-3 Original Claim form –A under Policy No. 686522196
Ex B-4 Original Claim form –C dt:6.9.2004
Ex B-5 Original Claim form-C dt 31-8-2004
Ex B-6 Original Claim form-C dt:31-8-2004
Ex B-7 Policy Bond bearing No. 686533087
Ex B-8 Policy Bond bearing No.68653440
Ex B-9 Policy Bond bearing No.686522196
Ex B-10 Confidential Report.
1) _______________________________
PRESIDENT
2) ________________________________
MEMBER
Dt. 04. 08. 2010.
*pnr
“UP LOAD – O.K.”
