National Consumer Disputes Redressal
Maya Devi vs Life Insurance Corpn. Of India on 21 May, 2008
ORDER
M.B. Shah, J. (President)
1. The State Commission held that death of the insured was due to murder and, therefore, the heirs of the insured were not entitled to any benefit under the policy. Hence, allowed the Appeal and dismissed the complaint. On being aggrieved and dissatisfied by judgement and order dated 21.5.2007 passed in Appeal No. 2675/03 by State Consumer Disputes Redressal Commission, U.P., the original complainant has filed this Revision Petition.
2. It is evident from the FIR dated 17.7.1996 that the insured went to the shop of one, Jagdish, for purchasing bidi. Upon being refused, some altercation between the insured and the shopkeeper took place. On the next day, the brother of the shopkeeper shot the insured at his forehead with his country made revolver, which resulted in the death of the insured. Before the State Commission, the insurance company contended that the death of the insured occurred due to murder and, hence, the insurance company was not bound to pay the sum assured.
3. Hence, the only question which requires consideration in this Revision Petition is - whether the death caused due to murder of the insured can be held to be 'accidental death'?
4. In our view, it is absurd to contend that, a 'murder' of an insured would not be treated as an accidental death in view of the terms of the policy. The relevant terms of the said Money Back Policy is as under:
10(b) Death of the life assured : To pay an additional sum equal to the Death Benefit 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 180 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 all the policies taken under this plan and under Bima Kiran Plan (Table No. 111) on the same life to which this benefit will apply shall not exceed Rs. 5,00,000/-.
5. The Corporation shall not be liable to pay the additional sum referred in (a) or (b) above, if the disability of the death of the life assured shall -
i) be caused by intentional self injury, attempted suicide, insanity or immortality or whilst the life assured in under the influence of intoxicating liquor, drug or narcotic or....
iv) result from the life assured committing breach of law, or....
6. The main part of the policy specifically provides that if the life assured sustains any bodily injury resulting solely and directly from the accident caused by outward violent and visible means, which results in the death of the life assured, heirs would be entitled to get accidental benefit. It is apparent that in case of murder, bodily injury is caused by outward violent and visible means which results in the death.
7. Further Exclusion Clauses would not be applicable in such cases.
8. In case of murder of assured, Clause (i) which provides that if the death is caused by intentional self injury, attempted suicide or insanity etc. would not be applicable. Secondly, Exclusion Clause (iv) would also not be applicable because it has not resulted from any breach of law committed by the life assured. The policy does not exclude death due to murder for any reason. In that set of circumstances, exclusion clause which deprives the complainant from accidental benefit would not be applicable in the present case.
9. Further, it is to be stated that the insurance company has not repudiated the claim on the ground that the death of the assured was due to murder, but solely on the ground that before taking the insurance policy, the insured, who was a Grade-IV employee in Nav Bharat College in Ghaziabad, suppressed the fact that he had taken some leave on medical ground. The so-called leave on medical ground has no connection with the murder of the assured.
10. Further, in England law on the subject is settled. In Halsbury's Laws of England Vol. 25 Pg.307 Para 569, 4th Edition (2003 reissue), as to the meaning of the word 'accident', it is stated as under:
569. Meaning of 'accident'. The event insured against may be indicated in the policy solely by reference to the phrase 'injury by accident' or the equivalent phrase 'accidental injury', or it may be indicated as 'injury caused by or resulting from an accident'. The word 'accident', or its adjective 'accidental', is no doubt used with the intention of excluding the operation of natural causes such as old age, congenital or insidious disease or the natural progression of some constitutional physical or mental defect; but the ambit of what is included by the word is not entirely clear. It has been said that what is postulated is the intervention of some cause which is brought into operation by chance so as to be fairly describable as fortuitous. The idea of something haphazard is not necessarily inherent in the word; it covers any unlooked for mishap or an untoward event which is not expected or designed, or any unexpected personal injury resulting from any unlooked for mishap or occurrence. The test of what is unexpected is whether the ordinary reasonable man would not have expected the occurrence, it being relevant that a person with expert knowledge, for example of medicine, would have regarded it as inevitable. The stand point is that of the victim, so that even willful murder may be accidental as far as the victim is concerned.
11. From the above quotation, it is clear that 'even the willful murder' of the assured is accidental as far as insured is concerned and such murder is to be described as 'by chance' or 'fortuitous'.
12. Now, the question is, under which circumstances the 'willful act' of the third party can be held to be 'accidental'?
13. This is discussed in Halsbury's Laws of England Vol. 25 Pg.311 Para 575, 4th Edition (2003 reissue), as under:
575. Injury caused by a willful act. An injury caused by the willful or even criminal act of a third person, provided the insured is not a party or privy to it, is to be regarded as accidental for the purpose of the policy, since from the insured's point of view it is not expected or designed. Injuries sustained by gamekeeper in a criminal attack upon him by poachers, by a chashier who was murdered by a robber, and by a master at an industrial school who was murdered by the boys, have been held to be accidental. However, if the immediate cause of the injury is the deliberate and willful act of the insured himself, there would seem to be no accident, and no claim will lie under the policy, at any rate if the insured is not mentally disordered at the time of his act.
14. In the present case:
(i). As per the postmortem report, the insured was shot dead by the assailant who appeared from nowhere;
(ii). the insured is not party to the 'murder', i.e. he did not give rise to provocation. After appearing before a Panchayat, he was going somewhere, when this attack was made at him. Hence, he is not a party or privy to the event of murder.
(iii). the immediate cause of injury (bullet injury) is not the result of the deliberate or willful act of the insured.
(iv). this event is an unlooked for mishap or an untoward event which was not expected or designed by the insured nor the insured had expected the occurrence.
15. Hence, it is to be held that death of the insured was accidental.
16. However, learned Counsel appearing on behalf of the LIC relied upon the decision rendered by the two-Member Bench of this Commission in the case of Prithvi Raj Bhandari v. Life Insurance Corporation of India and Ors. III(2006)CPJ 213, wherein reliance was placed upon the judgement rendered by the Apex Court in the case of Rita Devi v. New India Assurance Co. Ltd. 2000 ACJ 801 : (2000) 5 SCC 113.
17. Firstly, it is to be stated that in the case of Rita Devi (supra), the Apex Court considered and interpreted a phrase providing "death due to accident arising out of the use of motor vehicle". Thereafter, the Court referred to various decisions and arrived at a conclusion that they have no hesitation in coming to a conclusion that the deceased, Dashrath Singh, was employed to drive an auto rickshaw for ferrying passengers on hire. On the fateful day the auto-rickshaw was parked at auto-rickshaw stand and unknown passengers engaged the said auto-rickshaw for their journey and during that journey, it was alleged that the passengers caused murder of Dashrath Singh. The Apex Court held that death in such case was due to accident. The Court further observed that the difference between 'murder which is not an accident' and 'murder with is an accident' depends on the proximity of the cause of such murder. If the cause of murder or act of murder was originally not intended and the same was caused in furtherance of any felonious act then such murder is an accidental murder arising out of the use of motor vehicle and held that the insurance company was liable to reimburse the claimant.
18. The Court referred to the decision in the case of Nisbet v. Rayne and Burn (1910) 1 KB 689, where a cashier, while traveling in a railway to a colliery with a large sum of money for the payment of his employer's workmen, was robbed and murdered. The Court of Appeal held that murder was an accident from the standpoint of the person who suffered from it and that it arose 'out of' an employment which involved more than the ordinary risk and consequently the widow was entitled to compensation under the Workmens Compensation Act.
19. Despite the aforesaid two judgements, in the case of Prithvi Raj Bhandari (supra), the Commission observed that 'the important point which required notice was whether murder was an accident would depend upon proximity of cause of such murder' and held on facts that the complainant has suppressed the fact that various complaints against the deceased were filed under various Sections of the IPC, and concluded that there was no doubt that this was a murder by design and intent rather than a case of accidental murder.
20. In our view, the said reasoning cannot be justified by any standard. LIC policy excludes death due to limited causes mentioned in Exclusion clauses under para 10(b) and, therefore, it is totally irrelevant to find out the background of the deceased. Further, even in case where there is a criminal background of the assured, it would be difficult to hold that his murder was not accidental unless he has taken up the quarrel and that the immediate cause of injury was deliberate and willful act of the insured himself.
21. Hence, this Revision Petition is allowed. Impugned order passed by the State Commission is set aside. Order passed by the District Forum is restored. The insurance company shall pay the policy amount including Bonus with accidental benefit with interest at the rate of 12% per annum. The insurance company shall also pay Rs. 5000/- as costs of litigation to the complainant.
22. Learned Counsel appearing on behalf of LIC states that LIC has deposited a sum of Rs. 2 lakh with the State Commission, Lucknow on 29.10.2003. It would be open to the complainant to withdraw the amount deposited with the State Commission with accrued interest thereon. The State Commission is directed to pay the said amount to the complainant with accrued interest by an account payee cheque, and to see that the amount reaches in the hands of the complainant. It is clarified that on the sum of Rs. 2 lakh, LIC shall pay interest till its deposit with the State Commission. Remaining amount, if payable, shall be paid by the LIC with interest till the date of payment, within a period of 8 weeks from today.
23. Revision Petition stands disposed of accordingly.