National Consumer Disputes Redressal
N. Kabilan vs New India Assurance Co. Ltd. & 3 Ors. on 29 April, 2015
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI REVISION PETITION NO. 1504 OF 2012 (Against the Order dated 01/02/2011 in Appeal No. 754/2008 of the State Commission Tamil Nadu) 1. N. KABILAN Narasimha Lyer Street Kondayampalli Gangavalli, (TK) Salme - 636120 Tamil Nadu ...........Petitioner(s) Versus 1. NEW INDIA ASSURANCE CO. LTD. & 3 ORS. Divisional Manager No-3 Santhosima Complex,RTX Cross Road Hyderabad - 500 020 A.P 2. Andhara Bank, Keeripathy Branch Rep By its manager, South Street,Keeripathy, Salem - 636 127 Tamil Nadu 3. United India Insurence Co Ltd., Regd and Head Office No:24 Whites Road, Chennai - 600 014 Tamil Nadu 4. United India Insurence Co Ltd., by its Divisional Manager, Divisional Office-IV,2nd floor Psnett Bhavan, Tilak Road Hyderabad - 500 001 A.P ...........Respondent(s)
BEFORE: HON'BLE MR. JUSTICE AJIT BHARIHOKE, PRESIDING MEMBER HON'BLE MRS. REKHA GUPTA, MEMBER For the Petitioner : Mr. Sabarish Subramanian, Advocate For the Respondent : For the Respondent No.1 : Mr. Navdeep Singh, Advocate For Respondent No.2 : Ms. Sanchi, Advocate For Respondent No.3 : Mr. M.N.Singh, Advocate Dated : 29 Apr 2015 ORDER This revision has been filed against the order of the State Commission Chennai dated 01.02.2011 in First Appeal No. 754 of 2008 whereby the State Commission allowed the appeal of the respondent insurance company, set aside the order of the District forum and dismissed the complaint.
2. Shorn off unnecessary details, the facts relevant for the disposal of the revision petition are that the petitioner filed a consumer complaint against respondent no.1 insurance company and others alleging deficiency in service on the part of respondent no.1 in repudiating the insurance claim of the petitioner in respect of the death of insured. The claim of the petitioner was resisted by opposite party no.1 by filing a written statement justifying the repudiation of the claim on the ground that death of the insured was not covered by the insurance policy. The District forum on appraisal of evidence allowed the complaint and directed as under:
"In the result, the complaint is allowed. The second, third and fourth opposite parties are directed to pay a sum of Rs.6,00,000/- being the sum assured and (2) the opposite parties are directed to pay a sum of Rs.1,00,000/- towards compensation for the mental agony and (3) to pay a sum of Rs.50,000/- towards punitive damages and (4) to pay a sum of Rs.5000/- towards costs. These awards shall be paid within a period of six weeks from the date of receipt of this order. Failure compliance entails interest at 9% p.a. thereafter till realisation."
3. Being aggrieved of the order of the District Forum, respondent no.1 preferred an appeal and the State Commission on the interpretation of insurance policy Ex. B1 took the view that death of the insured was not covered under the policy. Accordingly, the appeal was allowed and the complaint was dismissed.
4. We have heard learned counsel for the parties and perused the record.
5. The respondent has placed on record copy of the relevant Group Janta Personal Accident Insurance to the tune of Rs.5,00,000/- per person extending insurance cover to 9120 members of the scheme including the deemed insured. In order to find answer to the above noted question, it would be useful to have a look on relevant terms of contract of insurance. Relevant portion of the insurance policy dealing with death benefit is reproduced as under:
"PERSONAL ACCIDENT INSURANCE POLICY GROUP Now this Policy witness that subject to and in consideration of the payment made to the Company the premium for the period stated in the Schedule or for any further period for which the Company may accept payment for the renewal of this Policy and subject to the terms, provisions, exceptions and conditions herein expressed or contained or hereon endorsed, the Company shall pay to the INSURED to the extent and in the manner hereinafter provided that if any of the Insured Persons shall:
1. Sustain any bodily injury resulting solely directly from accident caused by external, violent and visible means, the sum hereinafter set forth in respect of any of the Insured persons specified in the Schedule.
(a) If such injury shall within Twelve calendar months of its occurrence be the sole and direct cause of the death of the Insured person, the Capital Sum Insured stated in the Schedule hereto, applicable to such insured person.
SPECIAL FREE BENEFIT In the event of the death of the Insured person due to accident as defined in the Policy outside his/her residence, the Company shall pay in addition to the amount payable under Sub-Clause (a) ( For transportation of Insured person's Dead Body to the place of residence) a lumpsum of 2% of Capital Sum Insured or Rs.2500/- whichever is less."
6. On bare reading of the above, it is clear that death benefit under the insurance policy is available to the legal heirs of the deceased insured only if the insured person dies as a direct result of injury sustained from an accident by external, violent and visible means. In the instant case, undisputedly, the deceased insured was murdered. This fact is evident from the copy of the judgment of Second Addl. Sessions Judge, Salem in the murder trial pertaining to the death of the insured wherein the late complainant M/s Jayalakshmi was chargesheeted as one of the accused. On reading of the above judgment, it is clear that the insured Nagarajan was murdered by hitting him on his head with a spade. Merely because the complainant was acquitted in the said trial by itself would not render the death due to murder into an accidental death. Since Nagarajan was murdered and did not die because of injury sustained in an accident, his death is not covered under the insurance policy, which covers only the accidental death or the injury. Therefore, we do not find any infirmity in the impugned order of the State Commission which may call for interference by this Commission in exercise of revisional jurisdiction. Revision petition is, accordingly, dismissed with no order as to costs.
......................J AJIT BHARIHOKE PRESIDING MEMBER ...................... REKHA GUPTA MEMBER