State Consumer Disputes Redressal Commission
Icici Prudential Life Insurance ... vs Bhupinder Singh Dhillon on 27 May, 2014
FIRST ADDITIONAL BENCH
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB
SECTOR 37-A, DAKSHIN MARG, CHANDIGARH.
First Appeal No.707 of 2011.
Date of Institution: 27.04.2011.
Date of Decision: 27.05.2014.
1. ICICI Prudential Life Insurance Company Limited, 2047/2-1,
Crown Plaza, 1st Floor, The Mall, Bathinda, 151 001, through its
Manager/Competent Authority.
2. ICICI Prulife Towers,1089, Appasaheb Marathe Marg,
Prabhadevi, Mumbai-4000 25 (India), through its
Manager/Competent Authority.
3. ICICI Prudential Life Insurance Company Limited, Central Claims
Department Vinod Silk Mills Compound, Chakravarti Ashok
Road, Ashok Nagar, Kandivali (East), Mumbai 400 101, through
its Manager/Competent Authority.
.....Appellants/Opposite Parties.
Versus
Bhupinder Singh Dhillon, aged about 54 years, S/o Tara Singh Dhillon,
R/o Garden Colony, Shri Muktsar Sahib.
...Respondent/Complainant.
First Appeal against the order dated
03.01.2011 passed by the District
Consumer Disputes Redressal Forum,
Bathinda.
Before:-
Shri Baldev Singh Sekhon, Presiding Member.
Shri Jasbir Singh Gill, Member.
...................................
Present
For the appellants : Sh. K.S. Cheema, Advocate.
For the respondent : Sh. A.K. Khunger, Advocate.
First Appeal No.707 of 2011 2
BALDEV SINGH SEKHON, PRESIDING MEMBER:-
This appeal has been filed by the appellants/opposite parties against the order dated 03.01.2011 passed by the learned District Consumer Disputes Redressal Forum, Bathinda (in short, "the District Forum), vide which the complaint filed by the respondent/complainant was accepted with costs of Rs.10,000/- as compensation and costs. The opposite parties were directed to pay Rs.3,50,000/- to the complainant. Compliance of the order was to be made within 45 days from the receipt of copy of the order failing which the said amount was to carry interest @ 9% p.a.
2. Briefly stated, the facts of the case are that Sh. Abheyjeet Singh, son of the complainant, purchased an insurance policy from the opposite parties vide policy No.07240298. He deposited Rs.70,000/- as premium on 03.01.2008 and the sum assured against the policy was Rs.3.50 lacs. Sh. Abheyjeet Singh died on 27.10.2008. It was pleaded that he was suffering from mental tension and was taking medicines daily and on 27.10.2008, he took Sulphos instead of his medicine and as a result, he died. In this way, he had mistakenly consumed Sulphos and had not committed suicide. The complainant received a letter dated 18.02.2010 vide which the opposite parties informed him that only Rs.33,943.70p, being the value of the unit under the policy would be paid to him and he was not entitled for the total sum assured as mentioned in the policy. It was further stated in this letter that the poison reached in considerable quantity in the body of deceased life assured (in short, "the DLA") and such quantity cannot be ingested accidently. So, it was a case of suicide. It was further pleaded that as per letter dated 18.02.2010, it was mentioned in the laboratory report First Appeal No.707 of 2011 3 dated 28.04.2009 that Aluminum Phosphide was detected in viscera of DLA but it was wrongly held that he committed suicide and had taken large quantity of poison because this much quantity of poison can only be ingested intentionally and not accidentally. The opposite party had wrongly disallowed the claim regarding the death cover. Hence the complaint by the complainant, seeking directions to the opposite parties to pay him Rs.3.50 lacs as insurance claim besides costs and compensation.
3. The opposite parties filed written statement, taking preliminary objections that the District Forum had no jurisdiction as the office of opposite parties was situated in Muktsar and the complainant was also residing at Muktsar. He had not produced any proof of the doctor or any other authority to the effect that life assured died mistakenly after taking sulphos as alleged in the complaint. During the investigation, which was carried out, it was discovered that the complainant died of poison. Since the death had occurred within the first policy year and the amount of Rs.33,943-70p, being the fund value of policy, was payable. This amount was duly transferred in his account No.14181000020563 of HDFC Bank and intimation to this effect was given to the complainant vide letter dated 18.02.2010. A DDR was also registered to this effect and proceedings u/s 174 Cr.P.C. were initiated by the police. The contents of the DDR clearly show that the life assured was suffering from mental tension and was undergoing medical treatment at Adesh Hospital, Muktsar. It was also mentioned in that report that sometimes, life assured used to lose his senses and sensation and, in this respect, the family members were very vigilant towards him. The Forensic Science Laboratory Report dated First Appeal No.707 of 2011 4 28.04.2009 mentioned that Aluminum Phosphide Insecticide was detected in stomach and parts of small and large intestines. Phosphide was detected in parts of Lungs, Heart, Spleen, liver and kidneys and Blood. As per the medical opinion any ingested poison to have reached all these organs must have been consumed in considerable quantities. Detection of poison in the stomach, in the blood as well as in the solid organs like liver, spleen, lungs, heart and kidney denote that life assured consumed large quantity of poison and large quantity of poison can only be ingested intentionally and not accidentally. Thus, it was clearly a case of suicide and the complainant had concocted a false story to take undue benefit. It was further pleaded that as per the proposal form submitted to the opposite parties, the life assured was an employee of ICICI Bank earning Rs. 1,00,000/- per annum and did not appear to be suffering from any medical problem nor the same was disclosed to the company at the time of taking the policy.
4. Parties led their evidence in support of their respective contentions by way of affidavits and documents and the District Forum after going the same as well as after hearing counsel for the parties, allowed the complaint, in aforesaid terms.
5. Aggrieved by this order, the appellants/opposite parties have come up in the present appeal, on the ground that the District Forum has erred in holding that the repudiation of the claim of the complainant on the ground that there was no evidence to prove that the death of the deceased was an unnatural death, is wholly perverse and untenable. It had been proved that deceased committed suicide by consuming large quantity of poisonous substance. Specific evidence in this regard was brought forward by the appellants in the form of Ex.R-5, First Appeal No.707 of 2011 5 Ex.R-6 and Ex.R-7. DDR clearly stated that the life assured was suffering from mental tension and was undergoing medical treatment from Adesh Hospital. Acceptance of appeal and setting aside of impugned order was prayed.
6. We have thoroughly gone through the pleadings of the appeal and have perused the record of the learned District Forum as well as heard the learned counsel for parties.
7. Admittedly, the death of DLA occurred on 27.10.2008 i.e. within 10 months of start of insurance policy. Since the death of the life assurance occurred within one year of the issuance of the policy and the claim filed by the complainant was required to be investigated. The opposite parties after conducting the investigation, conveyed to the complainant vide letter dated 18.02.2010 (Ex.C-3) as under:-
"As per the First Police investigation dated October 28, 2008, it is noted that Life Assured was suffering from mental tension from last 2 years and was taking medicine daily and on October 27, 2008, he mistakenly took Sulphos instead of his medicines. The Post mortem report dated October 28, 2008 mentions that "Cause of death would be declared after receipt of chemical examiner's report.
The Final Police investigation report dated June 05, 2009 confirms the above stated fact as mentioned in the First Police Investigation. The report also mentions that the cause of death is due to Aluminum Phosphide Insecticide Poisoning on the basis of report of Chemical examiner, Patiala vide his report No. 992 dated April 28, 2009 and the death has occurred due to taking Aluminum Phosphide.
It is also confirmed in the report that there is no role of any person in causing the death of Abhayjeet Singh rather his death has been caused due to taking poisonous matter/medicine.First Appeal No.707 of 2011 6
The Forensic Science Laboratory's report dated April 28,2009 mentions that Aluminum Phosphide insecticide was detected in stomach and its contents, in parts of small and large intestines, Phosphine, a constituent of Aluminum Phosphide, detected in the contents of parts of Lungs, Heart, Spleen, liver and kidneys and Blood.
We have obtained medical opinion to the effect that any ingested poison to have reached all these organs considerable quantities must have been ingested. Detection of poison in the stomach, in the blood as well as also in the solid organs like liver, spleen, lungs, heart and kidney denotes that Life Assured consumed large quantity of poison and large quantity of poison can only be ingested intentionally and not accidentally.
In view of the above, we are therefore satisfied that the death of Mr. Abhayjeet Singh is a result of suicide.
In the event of death as a result of suicide during the first policy year, the above mentioned policy, vide general condition No. 4 provides for return of the value of units. As in the instant case the death has occurred within the first policy year, an amount of Rs. 33,943.70 (Value of Units under the policy) becomes payable to you."
8. The opposite parties have proved on record police report Ex.R-7 in which it was stated that the cause of death will be declared after the receipt of report from Chemical examiner, Punjab, which has also been proved as Ex.R-6. As per this report, the death was caused due to poisoning and result of Chemical Analysis was as under:-
"Aluminum Phosphide insecticide detected in the contents of Exhibit II. Phosphine, a constituent of Phosphide detected in the contents of exhibits III, IV & V No. poison detected in the contents of exhibit."First Appeal No.707 of 2011 7
9. Since the contents of Aluminum Phosphide were found in all the vital organs of the body, it cannot be said that the life assured could have taken the Sulphos insecticide mistakenly by taking it as medicine. Quantity of Aluminum Phosphide which was sufficient to cause death in normal course, could only have been ingested intentionally and not accidentally. The final police investigation report dated 05.05.2009 (Ex.R-6) confirmed the above stated facts as mentioned in the Chemical Examination. The report mentions that the death was due to Aluminum Phosphide insecticide poison on the basis of report of Chemical Laboratory, Patiala vide report No.992 dated 28.04.2009 and death has occurred due to taking Aluminum Phosphide. Police report (Ex.R-8) also confirmed that there was no role of any person in causing the death of DLA, rather his death has been caused due to taking poisonous matter/medicine.
10. The Forensic Science Laboratory Report dated 28.04.2009 mentions that Aluminum Phosphide insecticide was detected in Exhibit II (stomach and its contents, parts of small and large intestines). Further Phosphine, a constituent of Aluminum Phosphide, detected in the contents of Exhibit III, IV and V i.e. parts of Lungs, Heart, Spleen, liver and kidneys and Blood. Thus, Detection of poison in the stomach, in the blood as well as also in the solid organs like liver, spleen, lungs, heart and kidney denotes that Life Assured consumed large quantity of poison and such large quantity of poison can only be ingested intentionally and not accidentally. The District Forum has wrongly held that Chemical Examination report does not reveal that how much quantity of Sulphos was life threatening when the quantity taken by First Appeal No.707 of 2011 8 DLA was enough to cause death, it proves that he took Sulphos more than what was life threatening.
11. The policy document has been proved by the opposite parties as Ex.R-3 in which general condition no.4 provides that in the event of death as a result of suicide during first year, return of value of units is provided. Thus, the opposite parties had rightly paid the amount of Rs.33,943.70p, to the complainant as per the policy terms and conditions.
12. In view of above discussion, the appeal is allowed and the impugned order is set aside. Consequently, the complaint filed by the respondent/complainant is dismissed.
13. The appellants had deposited an amount of Rs.25,000/- with this Commission at the time of filing of the appeal. This amount with interest accrued thereon, if any, be remitted by the registry to the appellant no.1/opposite party no.1 by way of a crossed cheque/demand draft after the expiry of 45 days.
14. Arguments in this appeal were heard on 15.05.2014 and the order was reserved. Now the same be communicated to the parties.
15. The appeal could not be decided within the stipulated timeframe due to heavy pendency of court cases.
(Baldev Singh Sekhon) Presiding Member (Jasbir Singh Gill) Member May 27, 2014.
(Gurmeet S)