National Consumer Disputes Redressal
Life Insurance Corporation Of India And ... vs Devinder Kaur on 21 July, 2004
Equivalent citations: IV(2004)CPJ13(NC)
ORDER
M.B. Shah, J. (President)
1. By judgment and order dated 7.3.1996, the Punjab State Consumer Disputes Redressal Commission, Chandigarh, in O.C. No. 41 of 1995 directed the Life Corporation of India to make the payment, due by granting accident benefit under the policies with interest at the rate of 18% p.a. on the sum assured w.e.f. 16.8.1991 till its payment as well to pay Rs. 20,000/- as compensation and Rs. 1,000/- as costs. That order is challenged by the Insurance Company by filing this appeal.
Payment of sum assured is not disputed.
2. The only question which requires determination in this appeal is whether the death of the assured, namely, Shri Baljinder Singh on 16.8.1991, was accidental or suicidal because, if it is accidental, the heirs are entitled to get additional sum assured.
3. It is contended by the complainant that they are entitled to have accident benefit as provided in Clause 10 of the terms of the insurance policy:
"10. Accident benefit--If at any time when this policy is in force for the full sum assured, the life assured before the expiry of the period for which the premium is payable or before the policy anniversary on which the age nearer birth day of the life assured is 65, whichever is earlier is involved in an accident resulting in either permanent disability as hereinafter defined or death and the same is proved to the satisfaction of the Corporation, the Corporation agreed in the case of--
(a) Disability to the life assured.....
(b) Death of the life assured--To pay an additional sum equal to the sum assured under this policy, if the life assured shall sustain any bodily injury resulting solely and directly from the accident caused by outward, violent and visible means and such injury shall within 90 days of its occurrence solely, directly, and independently of all other causes result in the death of the life assured. However, such additional sum payable in respect of this policy, together with any such additional sum payable under other policies on the life assured shall not exceed Rs. 5 lacs.
the Corporation shall not be liable to pay the additional sum referred to in (a) or (b) above, if the disability or the death of the life assured shall:
(i) be caused by intentional self injury, attempted suicide, insanity or immorality or whilst the life assured is under the influence of intoxicating liquor, drug or narcotic; or..."
4. From the aforesaid term it is apparent that if it is a suicide, the heirs of the deceased are not entitled to the double benefit under the policy.
5. For deciding the crucial question as to whether the death was accidental or suicidal, we would refer to the statement given by Mohinder Singh, D.S.P., the brother-in-law of the deceased. He made the following statement before the S.P.O.:
"I, Mohinder Singh, D.S.P., s/o S. Bela Singh, hereby submit that on 13.8.1991, I was posted at Anandpur Sahib as Deputy Superintendent of Police. On that day my brother-in-law (wife's brother) Sh. Baljinder Singh, s/o Sh. Jagjit Singh Jat resident of Talwandi Wirk, Distt. Gurdaspur along with his family as also along with his brother-in-law (wife's brother) Sh. Gurdial Singh resident of Gakhual, came to my residence at Gaowal to meet us. All of us were exchanging pleasantries, when I chanced to go out in my corridor to give Instructions to my men on duty. It is there that I heard the gun shots and I hurried back in the room. I found that Sh. Baljinder Singh was injured with my service revolver lying nearby under the pillow cover, which he had picked up from there and started itching his head with it, thinking that the revolver was not loaded. In the process the revolver went off injuring him. It was all by chance. He was first removed to Civil Hospital, Anandpur Sahib and then to PGI, Chandigarh, where he succumbed to the injuries on 16.9.1991. Since the death was accidental, I requested the S.D.M., Anandpur Sahib verbally that the dead body of Sh. Baljinder Singh be handed over to the legal heir without post-mortem to which he agreed and allowed to lift dead body without post-mortem verbally. There was neither any written request nor any written permission in response thereto. I once again affirm that Baljinder Singh died with sudden and accidental gun-shot. Nobody is doubtful about it.
Signed (Mohinder Singh) D.S.P. Ropar : 20.12.1992"
6. The statement was verified by Nathu Ram, ASI, PS APS, who stated that he had received a wireless message from the PP PGI, Chandigarh and reached the PGI along with three others. There he verified the matter and found that the mishap had occurred as per recorded statement which is as under:
"..............I verified the matter and found that the mishap had occurred as per recorded statement due to sudden fire from the revolver by pressing of the trigger thereof at the time when scratching of the head was being done. No one is to be blamed for the mishap and nor the heirs want to initiate any action against any one. From the above statement no cognizable offence found to be committed."
7. From the aforesaid statements it appears that the deceased Baljinder Singh was injured with the service revolver of Mohinder Singh who was the D.S.P. The incident took place in the premises of D.S.P. when he along with the deceased was exchanging pleasantry and when he went out in his corridor he heard a gun shot. He came back and found that Baljinder Singh was injured with his service revolver lying nearby under the pillow cover. It is consistently stated that the deceased had taken up the service revolver and was scratching on his head where he had itching sensation. In the process, the revolver went off and injured him.
8. At this stage, we would mention that ASI Nathu Ram has recorded the statement of the complainant wherein she has narrated the same story. According to her, her husband used to take treatment from Dr. Inderjit Singh Bhatia for mental strain. However, he was all right on the date of the incident. She along with her husband and brother had gone to the house of Mohinder Singh, D.S.P. There, her husband started scratching his head with revolver and suddenly due to pressure of trigger there was a fire shot which caused injury on the right side of the head. Thereafter, her husband was taken to hospital at Anandpur Sahib from where doctors referred him to PGI, Chandigarh. It is her say that she was not suspecting anyone for the death, as the mishap occurred in natural cause due to sudden pressing of trigger of the revolver by her husband.
9. In our view, it is difficult to gulp down the aforesaid story that for itching purpose the deceased had taken out the service revolver which was lying under the pillow cover, that too in the presence of family members. The story is improbable.
10. Secondly, the deceased was taken to Civil Hospital, and, thereafter, to PGI, Chandigarh, where he succumbed to the injury on 16.9.1991. Admittedly, and we would state that unusually, the post-mortem was not carried out.
11. It is contended by the learned Counsel for the Insurance Company that the deceased committed suicide because of psychological problem and that the Insurance Company had produced on record medical certificates wherein mention is made that the deceased was taking medical treatment for reactive psychosis. In view of the finding recorded above, it is not necessary to decide cause for committing suicide.
12. From the aforesaid version, it is apparent that the deceased committed suicide for reasons best known to him in case of death, there are three possibilities.
(i) accidental death; (ii) suicide; and (iii) murder.
Murder is ruled out, because there is nothing on record to indicate the same. Accidental death cannot be believed, merely because it would be difficult for us to believe that due to itching for scratching on head service revolver would be taken out which was lying under the pillow. Therefore, the only alternative which is left is suicidal death.
13. Admittedly, the deceased had taken four policies for a total sum of Rs. 6 lakhs -- 1st policy was taken on 14.12.1987 for a sum of Rs. 1 lakh; 2nd policy was taken on 28.5.1989 for a sum of Rs. 1 lakh; 3rd policy was taken on 14.12.1990 for a sum of Rs. 2 lakhs; and the fourth policy was taken on 20.11.1990 for a sum of Rs. 2 lakhs. For payment of assured amount the L.I.C. has not raised any dispute in this appeal. Dispute, as stated, is confined to payment of additional sum on the basis of Condition No. 10, i.e., accidental benefit.
14. Mr. Suri, learned Counsel for the respondent, submitted that the State Commission has appreciated the entire evidence at length and, therefore, it does not require any interference.
15. It is true that the State Commission has written a lengthy order. However, when a number of points were raised with regard to the jurisdiction of the State Commission, the State Commission was required to deal with the same and decided it. In any case, the State Commission missed the relevant aspect in deciding the dispute and that is--whether the story sought to be pronounced by the complainant and the D.S.P. Mohinder Singh, brother-in-law of the deceased, that the service revolver which was lying beneath the pillow was taken out by him for scratching the head, was at all credible? This is not touched or dealt with by the State Commission.
16. Learned Counsel Mr. Suri submitted that there was unreasonable delay on the part of the Insurance Company in setting the claim and, therefore, the contention raised by the Insurance Company does not require any consideration.
17. In our view, in such circumstances, if the Insurance Company doubts or suspects the story sought to be given for cause of death of the deceased, it cannot be said that delay itself would be a ground in directing the Insurance Company to pay the amount claimed by the complainants.
18. In this view of the matter, we hold that the Insurance Company is not liable to pay the accident benefit to the respondent/complainant, on the basis of Condition No. 10 of the policy. In the result, the impugned order passed by the State Commission in O.C. No. 41 of 1994 is set aside. If any additional amount after taking into consideration is paid to the complainant in compliance with the order passed by the State Commission, the same shall be refunded. We also set aside the order directing the Insurance Company to pay the amount with interest at the rate of 18% p.a. If there is any delay in payment of sum assured, the Insurance Company will be liable to pay the same with interest at the rate of 9% p.a. from 16.8.1991 till its payment. The order passed by the State Commission directing payment of Rs. 20,000/- for mental harassment is set aside.
19. The impugned order passed by the State Commission is modified accordingly. There shall be no order as to costs.