Kerala High Court
Lekha G P vs The Manager, Life Insurance ... on 4 July, 2024
Author: P Gopinath
Bench: P Gopinath
IN THE HIGH COURT OF KERALA AT ERNAKULAM
PRESENT
THE HONOURABLE MR. JUSTICE GOPINATH P.
THURSDAY, THE 4TH DAY OF JULY 2024 / 13TH ASHADHA, 1946
WP(C) NO. 20011 OF 2015
PETITIONER/S:
LEKHA G P, AGED 40 YEARS
W/O. LATE SUNILKUMAR P.P., SHOBHALAYAM,
NEAR POOVADAN GATE, VATAKARA,
KOZHIKODE DISTRICT.
BY ADVS.
SRI.P.V.KUNHIKRISHNAN
SRI.P.V.ANOOP
RESPONDENT/S:
1 THE MANAGER, LIFE INSURANCE CORPORATION,
KALPATTA, WAYANAD-673 121.
2 SENIOR DIVISION MANAGER
LIFE INSURANCE CORPORATION OF INDIA,
DIVISIONAL OFFICE, KOZHIKODE-673 001.
3 ZONAL MANAGER, LIC OF INDIA,
SOUTHERN ZONAL OFFICE, LIC BUILDING,
ANNASSALAI, CHENNAI-600 002.
4 INSURANCE OMBUDSMAN
REPRESENTED BY ITS ASSISTANT DEPUTY SECRETARY,
OFFICE OF THE INSURANCE OMBUDSMAN,
PULINAT BUILDING,2ND FLOOR, OPP. COCHIN
SHIPYARD, M.G.ROAD, KOCHI-682 015.
BY ADVS.
SRI.LAL GEORGE
KEERTHIVAS GIRI, SC - LIC
THIS WRIT PETITION (CIVIL) HAVING BEEN FINALLY HEARD
ON 04.07.2024, THE COURT ON THE SAME DAY DELIVERED THE
FOLLOWING:
WP(C) NO. 20011 OF 2015 2
C.R
JUDGMENT
A short but interesting question arises for consideration in this case. The Writ Petitioner is the wife of late Sunil Kumar P.P who was murdered on 06.05.2009 by one Mathew Antony ('the accused'). By Ext.P4 judgment of the Additional Sessions Court (Adhoc)-II, Kalpetta, Wayanad district, aforesaid Mathew Antony was convicted for the offence under Section 302 of the Indian Penal Code for the murder of late Sunil Kumar. At the time of his death, the late Sunil Kumar was holding three life insurance policies bearing Nos.792075377, 793732239 and 791166804 with the Life Insurance Corporation (hereinafter referred to as 'the LIC'). These policies were, admittedly, in force at the time of the death of Sunil Kumar. In addition to other benefits, all the above three policies had identical terms [Clause 10.2] providing what is called 'accident benefit'. It is not disputed before me that the terms providing for such a benefit were identical in all the three policies issued to the late Sunil Kumar. However, the LIC denied the claim for WP(C) NO. 20011 OF 2015 3 'accident benefit' in terms of the aforesaid policies, upon the ground that the claim for accident benefit could not be granted on account of the exclusion clause forming part of Clause 10.2(b) of each of the policies issued to the late husband of the petitioner which to the extent relevant reads thus:-
"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.............'' {Note:- This clause is referred to as the exclusion clause hereafter} It is the case of the LIC that the motive behind the murder of late Sunil Kumar by the aforesaid Mathew Antony was that late Sunil Kumar was allegedly having an illicit relationship with the wife of the aforesaid Mathew Antony and therefore, the claim for accident benefit cannot be considered in terms of the exclusion clause, as it was an immoral act that led to the death of Sunil Kumar.WP(C) NO. 20011 OF 2015 4
2. The claim for accident benefit was repudiated by Ext.P5 communication, which reads as follows:-
''Re: Policy No. 791166804, 792075377 & 793732239
- Sunil Kumar PP (decd)
- Claim for Accident Benefit With reference to your claim for the accident benefit under the policies on the life of your deceased husband, we may inform you that your claim was considered by us and it has not been found possible to us to admit the claim.
As you might have noted, it is clearly stated in the judgment by the Court of the Additional Sessions Judge Kalpetta, that the death of the assured was an intentional murder, as he had been involved in immoral activities. Your kind attention is invited to the exclusion clause of Double Accident Benefit as per policy condition 10(2)(b)(i) (copy of policy bond attached) which states that ''The Corporation shall not be liable to pay the additional sum assured if the death of the life assured shall 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.
However, if you disagree with our decision, you may send in your written representation stating therein the specific grounds on which reconsideration is needed to the higher authority whose address is as given below, within three months positively after receipt of this letter.
The Zonal Manager, LIC of India, Southern Zonal Office, LIC Building, Anna Salai, Chennai- 600002'' WP(C) NO. 20011 OF 2015 5 Being aggrieved by the repudiation of the claim through Ext.P5, the petitioner preferred a representation to the Zonal Manager. However, the Zonal Manager through, Ext.P6 communication upheld the repudiation of the claim for accident benefit prompting the petitioner to approach the Insurance Ombudsman, constituted in terms of the Redressal of Public Grievances Rules, 1998. The Insurance Ombudsman, by Ext.P8 Award, relied on Ext.P4 judgment of the Additional Sessions Court (Adhoc) II, Kalpetta, Wayanad (convicting the aforesaid Mathew Antony) and held that there is sufficient indication that the death of late Sunil Kumar was on account of some immoral activity and therefore, the LIC was not bound to make payment under the head of 'accident benefit' in terms of the policies held by the aforesaid Sunil Kumar. It is thus that the petitioner is before this Court by filing the above writ petition.
3. Learned counsel appearing for the petitioner would submit that, by no stretch of imagination could it be said that the death of Sunil Kumar was on account of some immoral activity, even if it were to be assumed that the WP(C) NO. 20011 OF 2015 6 alleged illicit relationship between late Sunil Kumar and the wife of the aforesaid Mathew Antony was the motive for the murder. It is submitted that, in order to apply the exclusion clause, the death must have been on account of some immoral activity or while engaging in some immoral activity and since this is not the case here, the repudiation of the claim for accident benefit, as above, is illegal and unsustainable. Learned counsel places considerable reliance on the judgment of the Supreme Court in Rita Devi V. New India Assurance Co. Ltd.; 2000 KHC 400 to contend that even a claim in respect of a person who committed a felony and committed theft of an autorickshaw and died thereafter in an accident was maintainable before the Motor Accident Claims Tribunal. Considerable emphasis is placed on paragraph No.12 of the aforesaid judgment in support of the contention that whatever be the motive behind the murder of late Sunil Kumar, from the point of view of his family, it was an accidental death and claim for accident benefit under the policies in question was therefore maintainable. Learned counsel also submitted that the policies were taken out intending that the family be WP(C) NO. 20011 OF 2015 7 adequately compensated if the insured dies (including accidental death) when the policy was alive, and the denial of the claim under the head of 'accident benefit' was, therefore, illegal and unsustainable. It is submitted that the Insurance Ombudsman ought not to have relied on Ext.P4 judgment of the Sessions Court to hold that the matter was covered by the exclusion clause.
4. Sri. Keerthivas Giri, the learned Standing Counsel appearing for the LIC vehemently opposes the grant of any relief to the petitioner. It is submitted that benefits other than benefits payable under the head 'accident benefit' have been paid to the petitioner. It is submitted that it is clear from a reading of Ext.P4 judgment that the motive for the murder of late Sunil Kumar was clearly the illicit relationship maintained by late Sunil Kumar with the wife of the accused in that case. It is submitted that, the Sessions Court had come to this conclusion on the basis of evidence led before it and thus there was good reason to conclude that the late Sunil Kumar had lost his life as a result of an immoral activity. It WP(C) NO. 20011 OF 2015 8 is submitted that this is a case which clearly falls within the exclusion clause. Learned Counsel placed considerable emphasis on the findings of the Sessions Court in Paragraph No.21 of Ext.P4 judgment to show that there was good reason for the LIC and for the Ombudsman to conclude that the exclusion clause would apply in the facts and circumstances of this case. Learned Counsel also places reliance on the judgment of the Supreme Court in Rita Devi (supra) and in particular to paragraph No.10 thereof to emphasize that it is not always that a murder becomes an accident. In other words, it is his submission that since the murder was an intentional act of the accused, it can never be classified as an accident to hold that the petitioner was entitled to the accident benefit in terms of the policies issued to her late husband. Lastly it is submitted that the petitioner is entitled to receive the benefit only in respect of two out of the three policies and she is not the nominee in respect of one of the policies taken out by her late husband.
5. Having heard the learned counsel appearing for the petitioner and the learned Standing Counsel appearing WP(C) NO. 20011 OF 2015 9 for the LIC, I am of the view that the petitioner is entitled to succeed. The exclusion clause indicates that the accident benefit will not be payable if the accident was on account of any intentional self-injury, attempted suicide, insanity or immorality or whilst the Life Assured was under the influence of intoxicating liquor, drug or narcotic. A reading of the exclusion Clause would, no doubt, indicate that where the insured suffers injury or dies while engaging in an immoral act, the LIC is not liable to make any payment under the head ''accident benefit''. Now what is meant by the word immorality in the exclusion clause? In Gherulal Parakh v. Mahadeodas Maiya, AIR 1959 SC 781 it was observed:-
"In the book on the Indian Contract Act by Pollock and Mulla it is stated at p. 157:
"The epithet "immoral" points, in legal usage, to conduct or purposes which the State, though disapproving them, is unable, or not advised, to visit with direct punishment."
The court went on to hold:-
"30. The word "immoral" is a very comprehensive word. Ordinarily it takes in every aspect of personal conduct deviating from the standard norms of life. It may also be said that what is repugnant to good WP(C) NO. 20011 OF 2015 10 conscience is immoral. Its varying content depends upon time, place and the stage of civilization of a particular society. In short, no universal standard can be laid down and any law based on such fluid concept defeats its own purpose. The provisions of Section 23 of the Contract Act indicate the legislative intention to give it a restricted meaning. Its juxtaposition with an equally illusive concept, public policy, indicates that it is used in a restricted sense; otherwise there would be overlapping of the two concepts. In its wide sense what is immoral may be against public policy, for public policy covers political, social and economic ground of objection. Decided cases and authoritative text-book writers, therefore, confined it, with every justification, only to sexual immorality. The other limitation imposed on the word by the statute, namely, "courts consider immoral", brings out the idea that it is also a branch of the common law like the doctrine of public policy, and, therefore, should be confined to the principles recognized and settled by Courts. Precedents confine the said concept only to sexual immorality and no case has been brought to our notice where it has been applied to any head other than sexual immorality. In the circumstances, we cannot evolve a new head so as to bring in wagers within its fold."
However, in the facts of the present case, it cannot be said that the late husband of the petitioner had died while he was engaging in any immoral activity. It is no doubt true that the Sessions Court in Ext.P4 judgment has come to the conclusion that the motive behind the murder of the late Sunil Kumar was that the accused in the case had WP(C) NO. 20011 OF 2015 11 suspected that the late husband of the petitioner was having an illicit relationship with the wife of the accused. This is no reason to hold that such a relationship between the deceased and the wife of the accused was established. The fact that the Sessions Court had found that the motive to murder the husband of the petitioner was the suspicion harboured by the accused that the deceased was having a relationship with his wife is no ground to hold that any act of immorality had been proved against the deceased. In National Insurance Company Ltd V. Vedic Resorts And Hotels Pvt. Ltd; 2023 KHC 6581, is authority for the proposition that, wherever there is an exclusionary Clause contained in a policy of insurance, it would be for the insurer to show that the case strictly falls within the purview of such Clause and in the case of any ambiguity, the Clause must be construed in favour of the insured. It was held:-
"14. It is trite to say that wherever such an exclusionary clause is contained in a policy, it would be for the insurer to show that the case falls within the purview of such clause. In case of ambiguity, the contract of insurance has to be construed in favour of the insured.WP(C) NO. 20011 OF 2015 12
15. Beneficial reference of the decision in National Insurance Company Limited vs. Ishar Das Madan Lal (2007) 4 SCC 105 be made in this regard, in which it has been held that: -
"8. However, there may be an express clause excluding the applicability of insurance cover. Wherever such exclusionary clause is contained in a policy, it would be for the insurer to show that the case falls within the purview thereof. In a case of ambiguity, it is trite, the contract of insurance shall be construed in favour of the insured."
16. The Constitution Bench in case of General Assurance Society Ltd. Vs. Chandumull Jain and Another AIR 1966 SC 1644 had also observed as back as in 1966 that: -
"11.......there is no difference between a contract of insurance and any other contract except that in a contract of insurance there is a requirement of uberrima fides i.e. good faith on the part of the assured and the contract is likely to be construed contra proferentem that is against the company in case of ambiguity or doubt".
Therefore, in the facts of the present case, I have no doubt that the exclusionary clause did not cover a situation where the late husband of the petitioner was murdered on account of a suspicion harboured by the accused that his wife was having an illicit relationship with the deceased. In that view of the matter, the writ petition is allowed. Exts.P5, P6 and P8 are quashed. Respondent Nos.1 to 3 shall consider WP(C) NO. 20011 OF 2015 13 the claim of the petitioner for accident benefit in terms of the policies issued to the late husband of the petitioner, in accordance with her eligibility and by not treating the case as one covered by the exclusion Clause contained in Clause 10.2 referred to above. Taking into consideration the submission of the learned Standing Counsel for LIC that the petitioner is not the nominee in one of the policies, it is clarified that the benefits payable will be paid in accordance with the usual terms.
Sd/-
GOPINATH P. JUDGE ajt WP(C) NO. 20011 OF 2015 14 APPENDIX OF WP(C) 20011/2015 PETITIONER EXHIBITS P1 : COPY OF THE STATUS REPORT DTD.17.12.2013 POLICY BEARING NO.792075377.
P2 : COPY OF THE STATUS REPORT DTD.17.12.2013 OF POLICE BEARING NO.793 732239.
P3 : COPY OF THE STATUS REPORT DTD.17.12.2013 OF POLICY BEARING NO.791166804.
P4 : COPY OF THE JUDGMENT DTD.19.7.2013 IN SC NO.168/2010 ON THE FILE OF ADDITIONAL SESSIONS JUDGE (ADHOC)-II, KALPATTA, WAYANAD.
P5 : COPY OF THE ORDER BEARIG NO.CLAIMS/DO/79B DTD.20.1.2014 OF THE 2ND RESPONDENT.
P6 : COPY OF THE BEARING NO.CLAIMS/DO/79B DTD.16.7.2014 FROM THE 2ND RESPONDENT, ABOUTH THE REJECTION OF THE APPEAL BY THE ZONAL OFFICE CLAIMS DISPUTE REDRESSAL COMMITTEE.
P7 : COPY OF THE APPEAL DATED SEPTEMBER 2014 FILED BEFORE THE HON'BLE INSURANCE OMBUDSMAN. P8 : COPY OF THE AWARD NO.IO/KOC/AL1/0551/2014-15 DTD.2.3.2015.