State Consumer Disputes Redressal Commission
1.The United India Insurance Co.Ltd. ... vs 1.G.Rajyalakshmi, D/O.Late G.Venkata ... on 16 March, 2011
BEFORE THE A BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION : HYDERABAD F.A.1276/2009 against C.C.No.80/2009, Dist Forum, Kadapa. Between: 1.The United India Insurance Co.Ltd., Rep. by its Sr. Divisional Manager, D.O.IX, 206 and 207 , Sapthagiri Towers, Begumpet, at Hyderabad. 2. The United India Insurance Company Ltd., Rep. by its Sr. Divisional Manager, Divisional Office, Kadapa Town, Kadapa. Appellants 1 and 2 are rep. by authorized signatory Sri C.V. Nagaraju. Appellants/ Opp.parties 1 and 2 And 1.G.Rajyalakshmi, D/o.late G.Venkata Subba Reddy, R/o.Malepadu Village, Yerraguntla Mandal, Kadapa District. Respondent/ Complainant 2. The Andhra Pradesh State Trading Corpn.L:td., Rep. by its General Manager, Fateh Maidan Road, Hyderabad. (R2 is not necessary party in this appeal) Respondent/ Opp.party no.3 Counsel for the Appellants : Mr.V.Sambasiva Rao Counsel for the respondents : M/s.J.Seshagiri Rao CORAM: THE HONBLE JUSTICE SRI D.APPA RAO, PRESIDENT, AND SMT. M.SHREESHA , HONBLE MEMBER .
WEDNESDAY, THE SIXTEENTH DAY OF MARCH, TWO THOUSAND ELEVEN.
Oral Order(Per Smt. M.Shreesha, Honble Member) *** Aggrieved by the order in C.C.No.80/2009 on the file of District Forum ,Kadapa , opp.parties 1 and 2 preferred this appeal.
The brief facts as set out in the complaint are that the complainants father during his life time obtained an insurance policy cum certificate cum receipt under tailor made Personal Accident Scheme for Engineering students and parents and to that effect a certificate dt.31.8.2006 was issued at Kadapa with policy no.10865/2006 commencing from 2006-2007 with expiry clause upto 2009-2010 or commencement of final year examination for the batch which ever is earlier. Under the certificate of policy in the event of accidental death of parent/guardian an amount of Rs.3 lakhs is to be paid to the nominee + Tuition fees upto Rs.25,000/- + Boarding charges upto Rs.25,000/- p.a. for the balance period of study. The said facility can be availed by the complainant in the event of death of parent. The third opp.party is the General Manager of Andhra Pradesh State Trading Corporation Ltd. and the Tailor Made policy was introduced in collaboration with it and therefore it is jointly and severally liable to pay the compensation. The complainants father by name G.Venkata Subba Reddy was murdered on 16.5.2007 and at that time the complainant is prosecuting III rd year B.Tech course at Mekapati Raja Mohan Reddy Institute of Technology & Sciences, Udayagiri. After the murder of her father, the complainant became entitled to claim for the benefit covered under the policy and hence she made a claim to opp.party no.1 on 29.11.2007 requesting to settle the benefit available under the policy. The opp.parties did not settle the claim on the ground that the murder is not an accidental death and the complainant was further advised to approach Insurance Ombudsman, Hyderabad. The complainant made a representation before Ombudsman who passed an award on 16.5.2008 confirming the repudiation of the claim on the ground that the respondent company shall not be liable under the policy as the death of the insured was as a result of murder. The complainant submits that the reasons shown for repudiation of claim is not legally valid as the murder is an accident and therefore she is entitled for the assured sum of Rs.5 lakhs i.e. Rs.3 lakhs towards compensation , Rs.25,000/- towards boarding, Rs.25,000/- towards tuition fee together comes to Rs.50,000/- per year with total eligible claim of Rs.2 lakhs for 4 years since the course of B-Tech is of 4 years. Alleging deficiency in service on the part of opp.parties in not settling the claim, the complainant approached the District Forum to direct the opp.parties to pay compensation of Rs.5 lakhs by virtue of Tailor Made Personal Accident Scheme and to grant Rs.25,000/- towards mental agony and Rs.3000/- towards costs.
Opp.party no.2 filed counter and opp.parties 1 and 3 filed a memo adopting the counter filed by opp.party no.2. Opp.party admits that the complainant took policy at the time of joining Engineering College which covers both the complainant and her father for a period of 4 years. The complainant claimed the policy amount after her fathers murder.
According to the policy the complainant would be entitled to claim the compensation in case of death of her father accidentally. Opp.party submits that they have repudiated the claim of the complainant as the murder was not an accident. Insurance Ombudsman also confirmed the repudiation of the Policy . The opp.party states that there is no deficiency in service on their behalf and seeks for dismissal of the complaint with costs.
The District Forum based on the evidence adduced i.e. Exs.A1 to A9 and pleadings put forward allowed the complaint directing the opp.parties 1 and 2 jointly and severally liable to pay Rs.3,50,000/- towards compensation, Rs.5000/- towards mental agony and Rs.1000/- towards costs payable within 60 days from the date of receipt of the order. The case against opp.party no.3 is dismissed without costs.
Aggrieved by order of the Dist Forum , opp.parties 1 and 2 preferred this appeal.
It is the complainants case that she is a first year B.Tech student (Ex.A1) and during the year 2006-2007, an Insurance Policy cum Certificate under Tailor Made Personal Accident Scheme for engineering students was obtained for the complainant and her father namely G.Venkata Subba Reddy, evidenced under Ex.A4. This policy envisages that in the case of the accidental death of the parent an amount of Rs.3 lakhs, tuition fee of Rs.25,000/-, boarding charges of Rs.25,000/- per year would be paid for the balance period of study to the student as a nominee and in the case of the accidental death of the student Rs.2 lakhs would be paid to the insured parent or guardian. The complainants father G.Venkata Subba Reddy was murdered on 16.5.2007 and an FIR was registered vide Ex.A5. Ex.A6 is the copy of the inquest report and Ex.A7 is the Postmortem Report which clearly states that the complainants father died due to shock and hemorrhage on account of head injury caused due to a Hit by sharp edged weapons. The complainant made a claim and the opp.party repudiated it vide Ex.A3 dt.23.1.2008 stating that the policy exception no.1(F) clearly states that the death due to murder is not covered under the policy.
It is the case of appellants/opp.parties who also filed written arguments, that in the instant case murder cannot be construed as accidental death and moreover murder is not covered under the policy. They rely on the decision of the Apex Court reported in AIR 2000 SC page 1930 in Smt.RITA DEVI and others vs. NEW INDIA ASSURANCE CO.LTD. and another in which the Apex Court distinguished between Murder Simplicitor and Accidental Murder. The learned counsel for the opp.parties contended in his arguments that if the dominant intention of the act of felony is to kill any particular person then such killing is not an Accidental Death but is a Murder Simplicitor.
We observe from the record that the issuance of the policy, period of coverage and the death per se is not in dispute. The main point that falls for consideration herein is whether the death is an Accidental Death or should be construed as Murder Simplicitor. The post mortem report evidences that there were external, violent and visible injuries as the deceased died due to shock and hemorrhage caused due to Hit by sharp edged weapons.
In Ex.A8 letter dt. 5.10.2007 the appellant/opp.parties have stated that this death is a Murder Simplicitor as the accused confessed during the interrogation that they have killed the complainants father to gain supremacy over the village. Since basically the repudiation of the appellants /opp.parties is confined to their allegation that the death is a Murder Simplicitor and not an Accidental Death, we rely on the decision of the Apex Court in RITA DEVI and others vs. NEW INDIA ASSURANCE CO. LTD. and another wherein the Apex court observed as follows :
The difference between a murder which is not an accident and a murder which is an accident , depends on the proximity of the cause of such murder. 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 simplicitor, 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.
In the instant case the deceased neither had a long criminal record nor did the opposite party filed any material to evidence that there were any criminal cases filed against the deceased/insured to prove that it was a murder by design and intent rather than a case of accidental murder. The facts in the instant case can be construed that 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. The Apex Court has clearly distinguished between Murder Simplicitor and Accidental Murder. Based on the material on record we are of the considered view that the death in the instant case is an Accidental Murder. Therefore we see no reason to interfere with the well considered order of the District Forum.
In the result this appeal fails and is accordingly dismissed. Time for compliance four weeks.
PRESIDENT MEMBER Dt.16.3.2011 Pm*