By Jayasree Kallat, Member:

            The petition is filed by Mrs. Snehalatha Baburaj, W/o. Baburaj, along with their three children who are all minors and Mrs. Thankam, Mother of Baburaj.  All these five persons are the legal heirs of Late Baburaj.  Mr. Baburaj during his lifetime had taken life insurance policies in his name.  Policy No. 793915336 dated 18-9-04 for a sum assured Rs.5,00,000/-, Policy No. 793914783 dated 28-3-04 for a sum assured Rs.1,00,000/-, Policy No. 793914790 dated 28-3-04 for a sum assured Rs.1,00,000/- and Policy No.793914782 dated 28-3-04 for a sum assured Rs.1,00,000/-.  He had been paying premium in time.  On 27-9-04 Mr. Baburaj met with an accident and succumbed to his injuries.  After the death of Baburaj his wife approached the opposite party and filed a claim representing other complainants, too.  As per the condition of the policy issued by the first opposite party in case of accidental death Double Accident Benefit would be awarded to the legal heirs of the deceased policyholder.  The complainants herein are entitled to Double Accident Benefit claim under the policy issued to Late Baburaj.  Even though the complainants were entitled for Double Accident Benefit the opposite party repudiated the claim stating false allegations.  The first opposite party repudiated the claim and sent a letter dated 29-8-06 in which no reason has been stated for rejecting the Double Accident Benefit claim.  Late Baburaj has been paying the premium in time.  He was eligible for Double Accident Benefit.  The opposite party repudiated the claim.  This action of opposite party shows negligence and deficiency in service on the part of opposite parties.  Opposite parties had been doing unfair trade practice.

            Opposite parties filed a version denying all the averments in the complaint except those that are specifically admitted.  The opposite party admits the fact that Late Baburaj held 4 policies on his life covering the risk of natural death for the sum assured and accidental death for the sum equal to basic sum assured.  Opposite party had settled the claim for the basic sum assured under the 4 policies for Rs.7,78,671/-.  The amount was paid to the claimant.  The claim for Double Accident Benefit was considered and repudiated on the basis of the chemical analysis report that the deceased was under the influence of intoxicating liquor when he met with an accident and succumbed to it.  The repudiation do not involve deficiency of service.   The claim for Double Accident Benefit is not due and payable as per Clause-10 (i) of the terms and conditions in the policy.  Opposite party have obtained the report of the chemical analysis, which states that Ethyl Alcohol contents in blood = 57.50mg/100ml sample, Ethyl Alcohol in Urine = 115mg/100ml sample which implies that the deceased was under the influence Alcohol while riding the scooter at the time of the accident.  On this reason opposite party had to repudiate the claim for the accident benefit in terms of the conditions-10 (2) (b) of the policies.  The complainants are not eligible for the Double Accident Benefit.  There was no negligence or deficiency of service on the part of opposite party.  Opposite party has not done any unfair trade practice.  Opposite party prays to dismiss the complaint with cost to the opposite party.

            The point for consideration is whether the complainant is entitled for the relief sought in the petition?

            PW1 was examined and Ext.A1 to A7 were marked on complainant’s side.  RW1 was examined and Ext.B1 to B7 were marked on opposite party’s side.

            The case of the complainants is that Baburaj, husband of the first complainant, had taken 4  Life Insurance Policies of the opposite party.  Late Baburaj was remitting the premium without any default.  According to the condition of the policy the legal heirs of the deceased policyholder can claim Double Accident Benefit in case of accidental death.  The specific case of the complainants is that opposite party had rejected Double Accident Benefit claim for which the complainants are entitled.  Opposite party did not mention any specific reason for the repudiation.  The accident occurred while the insured was riding a motorcycle.  Maheendra Jeep KL-11/L 5185 was overtaking another vehicle in a very high speed.  The driver of the said vehicle was driving the vehicle in a rash and negligent manner and hit on the motorcycle of the insured and he died on the spot.  The police registered a crime as 2482/04 U/S 279 and 304 (a) IPC against the driver of the offending vehicle.  The report of the police shows that the accident occurred due to rashness and negligence on the side of the jeep driver.  The F.I.R., Ext.B1 filed by opposite party clearly shows that the driver of offending vehicle KL-11/L-5185  No. Maheendra jeep was driving in high speed, carelessly and in such a way to cause even death to people.  The jeep had collided with the two wheeler KL-11-54811 which was driven by late Baburaj, the complainant’s husband.  Ext.B1 also states that Baburaj was seriously injured in this accident.  Baburaj died on the way to Medical College about 12.45P.M.  Naushad Ali the driver of the offending jeep was found to be guilty.  Ext.B1 F.I.R. is produced by the opposite party.  Opposite party’s own documents gives the above mentioned details regarding the death of Mr. Baburaj, the husband of the complainant No.1.   Late Baburaj  had taken four life insurance policy of the opposite party and he has paid the premium in time.  His legal heirs were eligible for the Double Accident Benefit as per policy condition.  Opposite party had repudiated the claim on the basis of Ext.B2 and B3 Chemical Analysis reports.  Ext.B2 and Ext.B3 show that it was detected that there was contents of Ethyl Alcohol in the blood and urine of the deceased Baburaj.  Opposite party had repudiated the claim on the basis of Clause-10 (2) (b) (i)  which reads as “ The Corporation shall not be liable to pay the additional sum referred in (a) or (b) above if the disability or the death of the life assured shall (i) be caused by inten tional self injury, attempted Suicide, insanity or immorality or whilst the life assured is under the influence of intoxicating, liquor, drug or narcotic.”  Opposite party has taken the contention that the complainant was under the influence of Alcohol, which is shown in Ext.B2 and Ext. B3.  Hence the opposite party had repudiated the claim of Double Accident Benefit.  Now the specific point to be noted is whether the accident had occurred due to any of the action of the sum assured as per Clause-10(2) (i).  The counsel for the complainant had vehemently argued that Late Baburaj had died only because of the negligence of the driver of the offending vehicle Maheendra Jeep which was driven in a rash and negligent manner.  The accident took place when the driver of the offending vehicle tried to overtake another vehicle and hit with the two-wheeler on which Late Baburaj was driving.  It is proved beyond doubt that Baburaj died due to the negligence of the driver of the offending vehicle.  F.I.R., Ext.B1 is proof enough.  Hence the question whether Late Baburaj was under the influence of alcohol does not arise.  In our opinion we need not look into the matter whether Baburaj was under the influence of Alcohol at the time of the accident, because it is proved beyond doubt that Baburaj died because of the negligence of the driver of the offending vehicle. Hence we are of the opinion that the complainants are entitled for the Double Accident Benefit because Baburaj was paying the premium for all the four life insurance policies regularly.  Hence in our opinion the complainants are entitled for the relief sought in the petition.

            In the result the petition is allowed and opposite parties are directed to dispose the Double Accident Benefit to the complainants in respect of all the four policies along with a compensation of Rs.1000/- (Rupees One thousand only) and cost of Rs.500/- to the complainants within one month from the date of receipt of the copy of the order.

Pronounced in the open court this the 11th day of May 2009.

                                  Sd/-                                               Sd/-

                        PRESIDENT                                      MEMBER

APPENDIX

Documents exhibited for the complainant.

A1.  Photocopy of Death Certificate.

A2.  Photocopy of letter dt. 29-8-06.

A3.  Photocopy of Promisary note dt. 24-1-05.

A4.  Agreement dt. 25-3-05.

A5.  Photocopy of the receipt dt. 19-4-08.

A6.  Photocopy of the Loan passbook from Vengeri Service Co.Op. Bank.

A7.  Photocopy of receipts.

Documents exhibited for the opposite party.

B1.  Photocopy of F.I.R.

B2.  Photocopy of certificate of Chemical Analist dt. 18-4-05.

B3.  Photocopy of certicicate of Chemical of Dr. Rajendra Prasad.

B4.  Photocopy of Postmortem report.

B5.  A.M.V.I. Report of KL-11/L5185 vehicle.

B6.  A.M.V.I. Report of KL-11/S 4811 vehicle

B7.  Insurance policy.

Witness examined for the complainant.

PW1.  Snehalatha (Complainant)

Witness examined for the opposite party.

RW1. Siddique, 19/1548, Aysha, P.O. Chalappuram, Calicut-2.

                                                                                                Sd/- President

                        // True copy //

                                                (Forwarded/By order)

                                                                                    SENIOR SUPERINTENDENT.