The present complaint has been filed by the titled complainant Smt. Nirmala Devi (duly accompanied by her affidavit Ex.C1 & Aadhar Ex.C6) against the titled opposite party insurers who have somehow been beholding/delaying the payment of D.A.B. (Double Accident Benefit) of death-claim of the Life Insurance Policy # 473750190 (Ex.C2) at the 'death' through 'murder' of her son Rahul Sharma for of the 'unresolved' issue of category/classification of 'murder'. (Sic!)
2. Classification: A Murder-simpliciter or a Murder-accidental?
We are bound by Article 141 of Constitution of India to follow the principles as laid down by the Supreme Court Ruling (II (2000) ACC 291) that observed, “?if the dominant intention of the act of felony is to kill any particular person then such killing is not an accidental murder but is a murder simpliciter, while if the cause of murder or act of murder was originally not intended and the same was caused in furtherance of any other felonious act then such murder is an accidental murder”.
3. The complainant states that her deceased son Rahul Sharma the DLI (Deceased Life Insured) during his life time had on 27.12.2013 purchased the 20 year-plan Money Back Bima Policy with DAB (Double Accident Benefit) LIP with profits having a Sum Insured of Rs.1.0 Lac from the OP2 LIC Branch. However, on 11.09.2019 her DLI son Rahul was attacked with 'Dattar' (A Big Sized Knife), in the presence of his father, by his Lottery Sale- Office Colleague Roshan Lal over a money-dispute as a result of which Rahul got injured & died in hospital prompting FIR # 97 (Ex.C3) - Murder U/s 302 IPC, against the accused. The related 'death-claim' under the related policy including the DAB (Double Accident Benefit) was duly filed (along with Ex.C4 – Post Mortem Report and Ex.C5 – Death Certificate) with the OP insurers who paid Rs.1,22,269/- being the sum assured with profits but had beheld the DAB amount, in abeyance, till the final orders of the competent court of law as to the classification of murder pertaining to the element of 'mens-rea' (criminal-intent) in the related criminal act. The complainant addressing the 'beholding of the Policy's DAB' as an act of 'deficiency-in-service' on the part of the OP insurers got them served 'legal-notice' (Ex.C7) through India-Post (Ex.C8 & Ex.C9) but even that could not make the OP review their impugned act and thus prompted the present complaint seeking directives to the OP insurers to release the claim in full with interest besides Rs.50,000/- as compensation and Rs.20,000/- as cost of litigation, in the interest of justice.
4. The titled opposite parties, in response to the commission’s summons appeared through their counsel and filed their common written reply stating therein preliminary as well as other objections (on merits, as well) as:
5. The OP insurers have admitted the facts of the complaint qua its contents and have also confirmed the release of Rs.1,22,269/- as payment of the policy's sum assured with profits and also the beholding of the policy's DAB payment awaiting the decision of the competent court of law as to the classification of the act of the 'murder' as accidental. The OP insurers have also expressed their opinion over the crime as a 'murder simpliciter'.
6. Lastly, the OP insurers have sought dismissal of the present complaint with costs being premature and bereft of any merit. The OP insurers have in support of their version/pleadings in their defense have produced the affidavit Ex.OP1/A by the OP1 Manger Legal deposing the contents of the written reply along with: i) Ex.OP1 – Copy of proposal form; ii) Ex.OP2 – Copy of the Policy; iii) Ex.OP3 - Copy of the claim payment voucher; iv) Ex.OP4 - Copy of of the FIR; v) Ex.OP5 – Copy of the the Post Mortem report; vi) Ex.OP6 – Copy of reply dated 29.11.2019; vii) Ex.OP7– Copy of the letter dated 21.02.2020.
7. We have examined the available documents/evidence on the records so as to statutorily interpret the meaning and purpose of each document and also the scope of adverse inference on account of some documents ignored to be produced by the contesting litigants against the back-drop of the arguments as placed-forth by the learned counsels for their respective sides. We find that the present dispute has arisen on account of the impugned 'beholding cum non-payment' of the DAB (Double Accident Benefit) proceeds of the related LIP to the complainant by the OP insurers who have kept the same in abeyance subject to release at the final pronouncement by the competent court of law classifying the criminal-offense into the category of murder-accident.
8. We wish the OP insurers to know and note that a criminal trial U/s 302 IPC is not held to determine classification of murder into the categories of murder-accident and/or murder-simpliciter although it may get deduced as a collateral finding during the trial. It is for the OP insurers to resolve a 'death-claim' DAB prompted out of the offense of murder qua the evidence available on records and/or that gathered during their self-investigation. They cannot keep the insured/nominee/complainant waiting endlessly for of their own inability (implying here, inefficiency/incompetence) to resolve a simple 'death-claim'. The so-called requisite classification of murder has been available on the body of the FIR filed by the father of the DLI victim and the circumstances leading to the unfortunate incident of murder. The absence of Men's-rea has been apparent throughout the evidence.
9. The accused and the victim had been colleagues working together in a Lottery Sale Shop. There's been some misunderstanding of embezzlement of funds on the accused that he wanted to clarify in the presence of the DLI victim's father. Both of them come to meet the victim's waiting father on one motorcycle and there during arguments in the heat of the moment the accused strikes the victim with the deadly 'Dattar' (Big Knife) of which he had and/or should have the knowledge that this Dattar's blow can grievously injure and even take a life/kill a person and that too amounts to murder (murder-accident) U/section 302 IPC and for which very offense the honorable court of the learned sessions judge Shri Mohammad Gulzar, District Courts, Pathankot has awarded 'Rigorous Imprisonment for Life' with a fine of Rs.20,000/- to the accused, to meet the ends of justice. So, the much-awaited competent court judgment by the OP insurers has also been placed on records on 25.08.2022 by the aggrieved complainant who has since been suffering throughout the intervening period for of the deficiency in service on the part of the OP insurers.
10. The OP insurers, by the time, must realize that their administrative acts/delays/deferments/decisions in settling insurance claims especially the death-claims are open to judicial review and thus need be taken with due application of mind and not arbitrarily and these should also be transparent/speaking in nature duly explaining the reason and logic of the act/decision as to how the same has been reached. The facts in issue need be appreciated while awarding sanctity to the current applicable law. 11. Finally, in the matter pertaining to the present complaint and in the light of the all above, we partly allow the present complaint and thus ORDER the opposite party insurers to pay the DAB proceeds of the related LIP 473750190, in full, along with all its accrued benefits etc with interest @ 6% PA from the date of release of the LIP 's Sum Assured proceeds till actual payment besides Rs.15,000/- as cost and compensation to the complainant within 45 days of receipt of the certified copy of these orders otherwise the total aggregated awarded amount shall carry additional interest @ 3% PA w.e.f. the date of the orders till actually paid.
12. The complaint could not be decided within the stipulated period due to heavy pendency of Court Cases, vacancies in the office and due to pandemic of Covid-19.
13. Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to record.
(Naveen Puri)
President.
ANNOUNCED: (R.S.Sukhija)
OCT. 06, 2022. Member.
YP.
