State Consumer Disputes Redressal Commission
Life Insurance Corporation Of India And ... vs Smt. Rajni Sharma And Others on 26 November, 2013
STATE CONSUMER DISPUTES REDRESSAL COMMISSION UTTARAKHAND
DEHRADUN
FIRST APPEAL NO. 15 / 2009
1. Life Insurance Corporation of India
Branch Code No. 25 A, Branch Office Dakpathar
Vikas Nagar, Dehradun and one of its Divisional Office at
Jeewan Prakash Building, Haridwar Road
Dehradun through its Authorised Signatory
2. Divisional Office, Life Insurance Corporation of India
Prabhat Nagar, Post Box No. 69
Meerut
......Appellants / Opposite Parties
Versus
1. Smt. Rajni Sharma W/o late Sh. Rakesh Kumar Sharma
R/o C-95, Tons Colony, Dakpathar
District Dehradun
2. Master Tushar Sharma S/o late Sh. Rakesh Kumar Sharma
through his mother and natural guardian Smt. Rajni Sharma
R/o C-95, Tons Colony, Dakpathar
District Dehradun
3. Smt. Sarla Sharma W/o late Sh. Ved Prakash Sharma
R/o C-95, Tons Colony, Dakpathar
District Dehradun
......Respondents / Complainants
Sh. T.S. Bindra, Learned Counsel for the Appellants
Sh. Vaibhav Jain, Learned Counsel for Respondents
Coram: Hon'ble Mr. Justice B.C. Kandpal, President
Mr. C.C. Pant, Member
Dated: 26/11/2013
ORDER
(Per: Justice B.C. Kandpal, President):
This is insurer's appeal under Section 15 of the Consumer Protection Act, 1986 against the order dated 18.12.2008 passed by the District Forum, Dehradun in consumer complaint No. 183 of 2007.2
By the order impugned, the District Forum has allowed the consumer complaint and directed the appellants - opposite parties to pay a sum of Rs. 2,50,000/- to the respondents - complainants together with interest @9% p.a. from 06.01.2003, i.e., the date of death of the insured till payment.
2. Briefly stated, the facts of the case as mentioned in the consumer complaint, are that late Sh. Rakesh Kumar Sharma, the deceased husband of the complainant No. 1 - Smt. Rajni Sharma, deceased father of the complainant No. 2 - Master Tushar Sharma and deceased son of the complainant No. 3 - Smt. Sarla Sharma, during his lifetime, had purchased an Endowment Assurance Policy with profits plus accidental benefit from Life Insurance Corporation of India for assured sum of Rs. 2,50,000/-. The date of commencement of the policy was 28.11.2002 and the date of maturity was 28.11.2023. On 06.01.2003 at about 1:00 p.m., two persons, namely, Sh. Monu alias Vijay S/o late Sh. Puran Chand Sharma and Sh. Pappu alias Narendra S/o Sh. Ranveer Singh Rawat, took the insured from his house. After search and inquiry, the life insured could not be found. On 07.01.2003, the dead body of the life insured was recovered from behind the shop of one Sh. Guddu Negi. The FIR was lodged with the police and a case was registered under Section 302 IPC bearing Case Crime No. 05 of 2003. The postmortem of the life insured was done and thereafter the dead body was handed over to the complainants. It is alleged that in regard to the death of the life insured, a Sessions Trial is pending in the court of District and Sessions Judge, Dehradun bearing Sessions Trial No. 141 of 2003; State Vs. Monu and another. The complainants lodged the claim with the insurance company. The insurance company paid a sum of Rs. 2,61,885/- towards sum assured under the policy with profits, but denied the accidental benefit on the ground that the life assured had died on account of excessive 3 consumption of alcohol and as per condition No. 10(2)(b)(i) of the policy, the accidental benefit was not payable. Alleging deficiency in service on the part of the insurance company, the complainants filed a consumer complaint before the District Forum, Dehradun.
3. The insurance company filed written statement before the District Forum and pleaded that from the postmortem report of the life insured, the cause of his death could not be ascertained and, as such, viscera was preserved for chemical analysis; that on examination of the viscera of the life insured, Aluminium Phosphide and Alcohol was found in the body of the life insured; that the presence of Aluminium Phosphide and Alcohol in the body of the life insured indicate that he was murdered or committed suicide; that the life insured did not meet an accidental death and, as such, the accidental benefit was not payable and the claim in that regard was rightly rejected and that there is no deficiency in service on their part.
4. The District Forum, on an appreciation of the material on record, allowed the consumer complaint vide impugned order dated 18.12.2008 in the above terms. Aggrieved by the said order, the insurance company has filed this appeal.
5. We have heard the learned counsel for the parties and have also perused the record.
6. The ground taken by the insurance company for denying the accidental benefit to the complainants is that on examination of the viscera of the life insured, Aluminium Phosphide and Alcohol was found in his body, which indicated that he had committed suicide and in which case, the accidental benefit under the policy was not payable and the claim in that regard was rightly turned down under condition 4 No. 10(2)(b)(i) of the policy and by doing so, no deficiency in service was made by the insurance company.
7. The complainants have alleged that the life insured late Sh. Rakesh Kumar Sharma was taken by two persons Sh. Monu alias Vijay S/o late Sh. Puran Chand Sharma and Sh. Pappu alias Narendra S/o Sh. Ranveer Singh Rawat from his house on 06.01.2003 and after search and inquiry, he could not be found and his dead body was found on 07.01.2003. The insurance company has paid sum of Rs. 2,61,885/- under the concerned policy, but has denied the accidental benefit taking shelter of condition No. 10(2)(b)(i) of the policy, which provides that the Corporation shall not be liable to pay the additional sum if the disability or the death of the life assured shall be caused by intentional self injury, attempted suicide, insanity or immorality or whilst, the life assured in under the influence of intoxicating liquor, drug or narcotic. It is important to mention here that in regard to the death of the life insured, an FIR was lodged and a case has been registered under Section 302 IPC against bearing Case Crime No. 05 of 2003 and a Sessions Trial is pending bearing Sessions Trial No. 141 of 2003; State Vs. Monu and another. Merely because on examination of the viscera of the life insured, Aluminium Phosphide and Alcohol was found in his body, it can not be held that the life insured had committed suicide, more so, when in regard to his unnatural death, a case has been registered under Section 302 IPC and a Sessions Trial is also pending. The complainants have specifically alleged in their consumer complaint that the life insured was taken from his home by the above two persons and on search, he could not be found and his body was recovered the next day. There is nothing on record to show that the life insured had committed suicide and for that purpose, had consumed poison and he wanted to willingly end his life and on account thereof, he consumed poison. It is a possibility 5 that when poisonous material was mixed by the above two persons or any other person in the meal or drink of the life insured and on account thereof, he breathed his last. But in the given facts and circumstances of the case, it can not be said that the death of the life insured was as a result of suicide or he intentionally wanted to kill himself. It is also important to mention that the Branch Manager of the insurance company in his letter dated 30.11.2004 (Paper No. 10kha/1 of the original record) has specifically written that in his investigation report dated 13.10.2004, he has clearly mentioned that it is a genuine case of accident. He has further mentioned in the said letter that it was an accidental death and there was no clue of suicide and he had also taken the statements of neighbourers. The said letter sets at rest the entire controversy and demolishes whole of the case of the insurance company and it can safely be held that the death of the life insured was accidental in nature and not a natural or suicidal death and there was no justification on the part of the insurance company in denying the accidental benefit under the policy and rejecting the claim in that regard.
8. Learned counsel for the appellant - insurance company cited a decision dated 21.07.2003 of the Hon'ble Apex Court rendered in Civil Appeal No. 5153 of 2003; LIC of India Vs. Shanta @Radhika Lagama Dolli. In the said case, the medical attendant's certificate showed that an inquest or formal inquiry was held regarding the death of the life assured and the finding was "organo phosphorous poisoning". In the said case, the complainant had herself stated that the insured had committed suicide by consuming poison. In the present case, as is stated above, there is no evidence on record to show that the life insured had himself voluntarily consumed poison with a motive to end his life. Even otherwise, a criminal case has been registered in regard to the unnatural death of the deceased and a 6 person has been charged for causing the death of the life insured. Learned counsel also cited a decision of the Hon'ble National Commission in the case of Life Insurance Corporation of India and others Vs. Devinder Kaur; IV (2004) CPJ 13 (NC). In the said case, the deceased was injured with service revolver of D.S.P. and died. The accidental benefit was denied as the death was not accidental and the deceased committed suicide. In the instant case, there is nothing on record to show that the life insured had willingly consumed poison in order to end his life and that he had committed suicide. The Branch Manager of the insurance company has also specifically mentioned in his above letter dated 30.11.2004 that he had taken the statement of the neighbourers and it was found that it was an accidental death and there was no clue of suicide. Learned counsel also cited another decision of the Hon'ble National Commission in the case of Prithvi Raj Bhandari Vs. Life Insurance Corporation of India and others; III (2006) CPJ 213 (NC). In the said case, the insured was murdered and there was an intentional killing. It was held that the murder is not an accident. In the present case, the death of life insured was caused under suspicious circumstances and it is yet to be decided whether he was murdered or not. In the said case, it was held that the important point which required notice was whether murder was an accident would depend upon proximity of cause of such murder. Even otherwise, learned counsel for respondents has cited a decision of the Hon'ble National Commission rendered in the case of Maya Devi Vs. Life Insurance Corporation of India; III (2008) CPJ 120 (NC), wherein it was held that the murder is not excluded from policy and that even wilful murder of insured is accidental and to be described as 'by chance' or 'fortuitous'. In the said decision, the earlier decision of the Hon'ble National Commission in the case of Prithvi Raj Bhandari (supra), was also discussed. Learned counsel for the appellant has also cited another 7 decision of the Hon'ble National Commission in the case of R.T. Latha @ J. Suvarnalatha Vs. Life Insurance Corporation of India; I (2008) CPJ 253 (NC). In the said case, the life assured had committed suicide, but the same is not the position in the present case.
9. Learned counsel for respondents also cited a decision of Rajasthan State Consumer Disputes Redressal Commission, Jaipur rendered in the case of Sheela Vs. LIC of India and others; [2010] 4 CPR 264. In the said case, the life assured died in riots and treating the incident that of murder, the complaint was dismissed. It was held that such kind of death comes within the definition of accidental murder and the benefit of this accident should be given to the complainant. Learned counsel also cited a decision of Chhattisgarh State Consumer Disputes Redressal Commission, Raipur rendered in the case of Radhabai Sahu Vs. Branch Manager (Narendra Sahu) and another; 2010 (1) CPR 152, wherein it was held that all murders are accidental deaths and that the insurance company can not avoid its liability for payment of amount by saying that murder was not accidental death.
10. The District Forum has considered all the facts and circumstances of the case and has rightly allowed the consumer complaint, by directing the appellants to pay the accidental benefit to the respondents. However, we are of the view that the interest awarded by the District Forum @9% p.a. is on the higher side and in our considered opinion, the same need to be reduced to 7% p.a. This apart, the District Forum has directed payment of interest from the date of death of the life assured till payment. In our considered opinion, the respondents are entitled to interest from the date of filing of the consumer complaint till payment and not prior to that. To this 8 extent, the order impugned of the District Forum is liable to be modified and the appeal is to be partly allowed.
11. For the reasons aforesaid, appeal is partly allowed. Order impugned dated 18.12.2008 of the District Forum is modified and the appellants are directed to pay sum of Rs. 2,50,000/- to the respondents together with interest @7% p.a. from the date of filing of the consumer complaint till payment. No order as to costs.
(C.C. PANT) (JUSTICE B.C. KANDPAL) K