State Consumer Disputes Redressal Commission
L.I.C. Of India. vs Sh. Rajinder Kumar. on 13 July, 2016
H.P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
SHIMLA.
First Appeal No.: 175/2016
Date of Presentation: 27.05.2016
Date of Decision: 13.07.2016
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Life Insurance Corporation of India,
Through its Divisional Manager,
Divisional Office, Block No.14-15,
SDA Complex, Kasumpti Shimla,H.P.
... Appellant.
Versus
Rajinder Kumar,
Son of Shri Sant Ram,
Resident of Village Runda Ghoron,
Post Office Kumarhatti,
Tehsil & District Solan,H.P.
...Respondent
...........................................................................................
Coram
Hon'ble Mr. Justice Surjit Singh, President.
Hon'ble Mr. Vijay Pal Khachi, Member.
Whether approved for reporting?1
For the Appellant: Mr. G.D. Sharma, Advocate.
For the Respondent: Mr. Navesh K. Badhan , Advocate
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O R D E R:
Justice Surjit Singh, President (Oral) Appellant has preferred this appeal against the order dated 12.04.2016, of learned District Consumer Disputes Redressal Forum, Solan, whereby it has been directed to pay a sum of `1.00 lac, on account of double accident benefit clause in the insurance policy, with interest at the rate of 9%, 1 Whether reporters of the local papers may be allowed to see the order? Life Insurance Corporation of India Versus Rajinder Kumar (F.A. No.175/2016) per annum, from the date of filing of complaint, to the date of payment of the aforesaid amount of money and also to pay `10,000/-, as compensation and `5,000/-, as litigation expenses.
2. Admitted facts are that deceased Lucky, son of respondent, Rajinder Kumar, had taken a policy on his life, in the sum of `1.00 lac. Policy contained a double accident benefit clause, per which, in the event of life assured dying in an accident, the appellant was to pay, in addition to the sum assured of `1.00 lac, an additional amount of `1.00 lac, to the person, named in the policy. Appellant being the father of deceased, was named as the person, entitled to receive money on account of double accident benefit. He lodged claim with the appellant, but nothing was paid on account of double accident benefit, though the basic sum assured of `1.00 lac, was paid. Respondent then filed a complaint, under Section 12 of the Consumer Protection Act, 1986, seeking a direction to the appellant to pay money, which according to him, was due on account of extra premium, having been paid for double accident benefit clause, in the policy.
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Life Insurance Corporation of India Versus Rajinder Kumar (F.A. No.175/2016)
3. Appellant contested the complaint and pleaded that deceased was driving a motorcycle when the accident took place, but he did not hold a licence to drive the same or for that matter, any type vehicle and, therefore, he committed breach of law. It was pleaded that per condition 10-2(b)(iv) of the policy, nothing was payable on account of double accident benefit, in case the death of life assured resulted from his committing any breach of law.
4. Learned District Forum has allowed the complaint. Plea of the appellant has been rejected with the observation that condition, relied upon by the appellant, does not make any reference to the life assured holding a valid and effective driving licence.
5. We have heard learned counsel for the parties and gone through the record.
6. Though we do not agree with the reasoning given by the learned District Forum that policy does not make any reference to the life assured, possessing a driving licence in case of his dying in a vehicular accident, while himself driving a vehicle, yet a bare reading of the condition 10- 2(b)(iv), which is reproduced below, shows that if 3 Life Insurance Corporation of India Versus Rajinder Kumar (F.A. No.175/2016) the life assured committed breach of law, which would include driving a vehicle without a driving licence, and the accident takes place because of his not holding a licence, then the insurer (the appellant) would not be liable.
10-2. 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 birthday of the Life Assured is 70, 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 agrees in the case of:
(a) Disability to the Life Assured
xxxx xxxx xxxx
(b) Death of 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 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 this policy together with any such additional sums payable in respect of this policy, together with any such additional sums payable under 4 Life Insurance Corporation of India Versus Rajinder Kumar (F.A. No.175/2016) other policies on the life of the Life Assured shall not exceed Rs. 50,00,000.
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) xxxx xxxx xxxx (ii) xxxx xxxx xxxx (iii) xxxx xxxx xxxx (iv) result from the Life Assured committing any breach of law;
7. However, in the present case, accident had not taken place because of the life assured not holding a licence to drive the motorcycle. The accident took place, as per First Information Report, copy Annexure C-1, because a truck that came from the opposite direction, was being driven rashly and negligently and it hit the deceased's motorcycle. Condition in the policy says that the insurer would not be liable, if the accidental death results from an act of breach of law, committed by the life assured. Here, though the life assured drove the motorcycle, without licence, the accident did not take place because of his driving the motorcycle without a licence. The accident took place, as per First Information Report, Annexure C-1, because of rash 5 Life Insurance Corporation of India Versus Rajinder Kumar (F.A. No.175/2016) or negligent driving of the truck that appeared from the opposite direction and hit deceased's bike. Life assured, as per First Information Report, was keeping to his left and was driving the bike properly.
8. In view of the above stated position, we see no merit in the present appeal. The same is, therefore, dismissed.
9. A copy of this order be sent to each of the parties, free of cost, as per Rules.
(Justice Surjit Singh) President (Vijay Pal Khachi) Member July 13, 2016.
GAURAV} 6