State Consumer Disputes Redressal Commission
Rajinder Kaur vs United India Insurance Company Ltd. on 30 March, 2012
STATE CONSUMER DISPUTES REDRESSAL COMMISSION, PUNJAB,
DAKSHIN MARG, SECTOR 37-A, CHANDIGARH.
First Appeal No.657 of 2009
Date of institution : 11.5.2009
Date of decision : 30.3.2012
1. Rajinder Kaur widow of late S. Balwinder Singh son of S. Ajit Singh,
resident of Village Kaddon, Tehsil Payal, District Ludhiana.
2. Jaswant Kaur wife of Shri Ajit Singh,
3. Mandeep Kaur minor daughter
4. Sandeep Kaur minor daughter
5. Jagdeep Singh minor son
of late Shri Balwinder Singh son of Ajit Singh through their natural
guardian and next friend i.e. mother Smt. Rajinder Kaur wife of late Shri
Balwinder Singh.
All residents of Village Kaddon, Tehsil Payal, District Ludhiana.
.......Appellants
Versus
United India Insurance Company Ltd., Branch Office, Chandigarh Road, Samrla,
District Ludhiana through its Branch Manager.
......Respondents
First Appeal against the order dated 4.2.2009 of the
District Consumer Disputes Redressal Forum,
Ludhiana.
Before :-
Hon'ble Mr. Justice S.N. Aggarwal President.
Mr. B.S. Sekhon, Member.
Present :-
For the appellants : Shri R.D. Singh, Advocate for Shri Surekha Chauhan, Advocate.
For the respondents : Shri Munish Goel, Advocate. JUSTICE S.N. AGGARWAL, PRESIDENT:
This order will dispose of two appeals, namely, First Appeal No.656 of 2009 (Rajinder Kaur v. ICICI Prudential Life Insurance Company and anr.) and First Appeal No.657 of 2009. 2 First Appeal No.657 of 2009 (Rajinder Kaur and others v. United India Insurance Company Ltd.) as the questions of law and facts involved in both these appeals are identical. The facts are taken from First Appeal No.657 and the parties would be referred by their status in this appeal. VERSION OF THE APPELLANTS:
2. Rajinder Kaur appellant no.1 is the widow of Balwinder Singh while Jaswant Kaur appellant No.2 is the mother of Balwinder Singh. Mandeep Kaur, Sandeep Kaur and Jagdeep Singh are minor daughters and son of Balwinder Singh.
3. It was further pleaded that Balwinder Singh was the owner of scooter No.PB-5-A-7112, LML Vespa. It was got insured by said Balwinder Singh from the respondents. He had also made the additional fee of Rs.50/- and got himself insured for an amount of Rs.1,00,000/- against accidental death.
4. It was further pleaded that on 19.9.2004 at about 4.15 P.M. Balwinder Singh died in a road accident near barrier Doraha at G.T. Road, Ludhiana when he was going at Doraha Ludhiana G.T. Road. The accident had taken place due to sudden slip down of the scooter of Balwinder Singh. Balwinder Singh had suffered injury. He was got admitted in Sidhu Hospital, Doraha by one Sukhdev Singh and Ajit Singh (father of Balwinder Singh) but Balwinder Singh was declared dead at 4.15 P.M. in the evening on the same day.
5. It was further pleaded that the matter was reported to the police and DDR No.16 dated 19.9.2004 was registered in PS-Doraha. The final report was prepared by the police on 21.9.2006 and it was concluded that the death of Balwinder Singh had occurred due to accidental slip down of his scooter which he was driving. By the slip of the scooter, Balwinder Singh had also suffered injuries on his head. The injuries on the head and heart proved fatal.
6. It was further pleaded that appellant No.1 filed an application dated 20.1.2005 to the respondents lodging the insurance claim. It was repudiated by First Appeal No.657 of 2009. 3 the respondents vide letter dated 3.8.2006. Hence the complaint for insurance claim of Rs.1,00,000/-. Interest was also prayed.
VERSION OF THE RESPONDENTS:
7. The respondents filed the written reply. It was admitted that the appellants were wife, mother and children of Balwinder Singh. It was not denied that Balwinder Singh was the owner of scooter bearing registration certificate No.PB55-A-7112 which was insured with the respondents. It was also not denied specifically if Balwinder Singh had taken the personal insurance of Rs.1,00,000/-
against accidental death while driving the vehicle. It was, however, denied if Balwinder Singh had died in a road accident on 19.9.2004 at 4.15 near barrier Doraha or if the scooter had slipped down accidentally or if Balwinder Singh had suffered external heart injury or if he was got admitted in Sidhu Hospital or if the death of Balwinder Singh was due to accident.
8. It was further pleaded that a false and fake DDR No.16 dated 19.9.2004 was got registered by the appellants in PS-Doraha. It was also denied if the final report was made by the police on 21.9.2006. It was denied if Balwinder Singh had suffered fatal injuries on falling down from the scooter. This story made by the appellants was totally false.
9. It was further pleaded that the death of Balwinder Singh had taken place due to intake of aluminum phosphide insecticide (grain preserving pills) and not by accident. The post mortem report does not speak about the death. It revealed that the sample of the parts of the dead body of Balwinder Singh, namely, parts of the heart, small intestine, large intestine, liver, spleen and kidney were sent to the Chemical Examiner, Patiala for chemical examination. On the basis of the report of the Chemical Examiner, Patiala, Dr. Pradeep Mohindra, Medical Officer, Civil Hospital, Ludhiana had declared that the death of Balwinder Singh was caused by aluminum phosphide insecticide intake vide his letter dated 10.11.2004. Since Balwinder Singh had committed suicide, therefore, the repudiation was legal and First Appeal No.657 of 2009. 4 valid. It was also pleaded that the claim was barred by limitation. Dismissal of the complaint was prayed.
PROCEEDINGS BEFORE THE DISTRICT FORUM:
10. Rajinder Kaur appellant filed her affidavit as Ex.CW-1/A. The appellants also proved documents Ex.C-2 to Ex.C-13.
11. On the other hand, the respondents filed the affidavit of O.P. Kanawa, Deputy Manager of the respondents as Ex.RW1/A. The respondents also proved documents Ex.R-1 to Ex.R-6.
12. Learned District Forum dismissed the complaint vide impugned judgment dated 4.2.2009.
13. Hence the appeal.
14. The submission of the learned counsel for the appellants was that since Balwinder Singh had died in the accident, therefore, this appeal be accepted, impugned judgment dated 4.2.2009 be set aside and the complaint be allowed as prayed for.
15. On the other hand, the submission of the learned counsel for the respondents was that since Balwinder Singh had committed suicide, therefore, no claim is payable to the appellant. It was prayed that there was no merit in the present appeal and the same be dismissed.
FIRST APPEAL NO.656 OF 2009:
16. This complaint was filed by Rajinder Kaur appellant alone. It was pleaded that her husband Balwinder Singh had taken the life insurance policy for an amount of Rs.10,00,000/- from the respondents with the commencement date as 22.10.2003. Balwinder Singh died in a road accident on 19.9.2004 for which DDR No.16 dated 19.9.2004 was lodged in PS-Doraha. The appellant was the nominee. The insurance claim was lodged with the respondents. It was repudiated by the respondents. Hence the complaint for recovery of insurance claim of Rs.20 lakh with interest.
First Appeal No.657 of 2009. 5VERSION OF THE APPELLANTS:
17. The respondents filed the written reply. It was admitted by the respondents that Balwinder Singh had filled the proposal form on 22.9.2003 for insurance for an amount of Rs.10 lakh. He had chosen to pay half-yearly installments of Rs.25,000/- each. It was admitted that the appellant was the nominee. The life insurance policy was issued by the respondents on 13.11.2003 under the medical category at standard (ordinary) rates of premium.
18. It was further pleaded that the letter of the appellant dated 18.10.2004 was received for insurance claim but as per the medical attendant's certificate dated 4.4.2005 issued by Sidhu Hospital, Ludhiana, post mortem report dated 20.9.2004, Chemical Examiner's report dated 3.11.2004 and the letter of the Medical Officer, Civil Hospital, Ludhiana dated 10.11.2004 the life assured had died due to intake of aluminum phosphide insecticide and not due to accident related to head injury.
19. It was further pleaded that since Balwinder Singh life assured had committed suicide in the first policy year, the life insurance policy becomes void and only the unit value of the Valuation Date following the intimation of suicide was payable. Dismissal of the complaint was prayed.
PROCEEDINGS BEFORE THE DISTRICT FORUM:
20. The appellant filed her affidavit dated 24.9.2007. The appellant also proved documents Ex.C-1 to Ex.C-11, Ex.C-11/1, Ex.C-11/2 and Ex.C-12 to Ex.C-31.
21. On the other hand, the respondents filed the affidavit of Ms. Preeti Nahar, Senior Manager (Legal) as Ex.R-1. The respondents also proved documents Ex.RA to RH.
22. Learned District Forum dismissed the complaint vide impugned judgment dated 4.2.2009.
23. Hence the appeal.First Appeal No.657 of 2009. 6
24. The submission of the learned counsel for the appellants was that since Balwinder Singh had died in the accident, therefore, this appeal be accepted, impugned judgment dated 4.2.2009 be set aside and the complaint be allowed as prayed for.
25. On the other hand, the submission of the learned counsel for the respondents was that since Balwinder Singh had committed suicide, therefore, no claim is payable to the appellant. It was prayed that there was no merit in the present appeal and the same be dismissed.
DISCUSSION (FIRST APPEAL NO.657 OF 2009):
26. Record has been perused. Submissions have been considered.
27. The admitted facts are that Balwinder Singh husband of Rajinder Kaur appellant, son of Jaswant Kaur appellant and father of appellants No.3 to 5 had taken the insurance policy for his scooter bearing registration certificate No. PB-5-A-7112 LML Vespa and along with that he had also taken the Personal Accident insurance policy in the amount of Rs.1,00,000/-.
28. It is also not denied that the life assured had died on 19.9.2004 for which DDR No.16 dated 19.9.2004 was registered in PS-Doraha. A copy of the DDR has been proved as Ex.C-1 by the appellants. The dead body of Balwinder Singh was subjected to post mortem examination and the post mortem report has been proved as Ex.C-2. The statements recorded during those proceedings have been proved as Ex.C-3 to Ex.C-5.
29. It is also mentioned in the post mortem report Ex.C-2 that viscera was taken from different parts of the dead body of Balwinder Singh.
30. The respondents have also proved a copy of the post mortem report of Balwinder Singh as Ex.R-2. It contains the reference that viscera was taken from different parts of the internal body of Balwinder Singh. Each part was put in a jar. The jars were sealed and these were sent to Chemical Examiner, Patiala for analysis. The report of the Chemical Examiner, Patiala dated 3.11.2004 has been First Appeal No.657 of 2009. 7 placed on the file as Ex.R-3. This report reveals that one jar contained viscera from the stomach and the other jar contained viscera from large and small intestines, the third jar contained viscera from liver, spleen and kidney and the fourth jar contained sample of blood. It was opined by the Chemical Examiner in his report dated 3.11.2004 Ex.R-3 as under:-
"The result was as follows:- Aluminium phosphide insecticide detected in the contents of exhibits I and II. Phosphine a constituent of aluminium phosphide detected in the contents of exhibits III and IV. No poison detected in the contents of exhibit V."
31. It clearly revealed that aluminum phosphide insecticide was detected in the stomach and large and small intestines while phosphine a constituent of aluminum phosphide was detected in liver, spleen and kidney and in the sample of blood. It means, therefore, that Balwinder Singh had taken poisonous substance as per the report of the Chemical Examiner dated 3.11.2004 Ex.R-3.
32. After examining the report of the Chemical Examiner, Patiala, Dr. Pradeep Kumar, Medical Officer, Civil Hospital, Ludhiana had given his report dated 10.11.2004 Ex.R-4 as under:-
"Subject: Declaration of the cause of death of Balwinder Singh s/o S. Ajit Singh, 32 years, r/o Kaddon, P.S. Payal, District Ludhiana vide P.M.R. No.PMR/PK/49/2004 dated Sept. 20, 2004.
The viscera of the deceased were sent for chemical examination. On receipt of the chemical examiner's report from Patiala No.2513 dated Nov. 03, 2004 which is as follows:-
"Aluminium phosphide insecticide detected in the contents of exhibits I and II. Phosphine a constituent of aluminium phosphide detected in the contents of exhibits III and IV. No poison detected in the contents of exhibit V." First Appeal No.657 of 2009. 8
So the cause of death in this case in my opinion is due to aluminium phosphide insecticide which is sufficient to cause death in ordinary course of nature. This is for your information and necessary action."
33. This report of Medical Officer, Civil Hospital, Ludhiana, therefore, clearly reveals that Balwinder Singh had died due to aluminum phosphide insecticide which was sufficient to cause death in the ordinary course of nature. He had not died by an accident.
34. In these facts and circumstances, reference can be made to the judgment of this Commission dated 29.2.2012 passed in First Appeal No.140 of 2009 (The New India Assurance Company Limited and anr. v. Mrs. Seema) in which also the circumstances were almost similar. It was held by this Commission as under:-
"13. Admittedly, Rajesh Mehta husband of Seema respondent had taken the Individual Personal Accident insurance policy from the appellants by which risk of accidental death of Rajesh Mehta was covered to the tune of Rs.1,00,000/-. The proposal form was filled by Rajesh Mehta on 22.12.2003. It is also admitted between the parties that Rajesh Mehta had died under mysterious circumstances on the night of 6.5.2003 for which FIR No.32 dated 7.5.2003 was registered in PS-Sadar, Phagwara. The dead body of Rajesh Mehta was got subjected to post mortem examination and proceedings under Section 174 Cr.P.C. were also recorded. The inquest report revealed that cause of death was due to intake of alcohol and wound mark (injury) was found on the dead body of Rajesh Mehta. The cause of death was kept pending till the report of Chemical Examiner, Government of Punjab, Patiala was received. A copy of the First Appeal No.657 of 2009. 9 post mortem report has been proved by the respondent as Ex.C-10. The report of the Chemical Examiner, Patiala has been proved as Ex.R-8.
14. As per the report of the Chemical Examiner, Government of Punjab, Patiala Ex.R-8 aluminium phosphide insecticide was detected in the liver, spleen and half of each kidney. It was also found in the sample of blood taken from the body of Rajesh Mehta. It means, therefore, that Rajesh Mehta had died due to the intake of alcohol and also due to the taking of poisonous substance. Obviously therefore, it was a case of death by suicide. Condition No.5 of the Individual Personal Accident Insurance policy reads as under:-
"5. Payment of compensation in respect of Death, injury of Disablement of the Insured person (a) from intentional self- injury, suicide or attempted suicide, (b) whilst under the influence of intoxicating liquor or drugs (c) whilst engaging in Aviation or Ballooning whilst mounting into, dismounting from or traveling in any balloon or aircraft other than as a passenger (fare paying or otherwise) in any duly licensed standard type of aircraft anywhere in the world, (d) directly or indirectly caused by venereal diseases, aids or insanity, € arising or resulting from the insured person committing any breach of First Appeal No.657 of 2009. 10 law with criminal intent, (Standard type of Aircraft means any aircraft duly licensed to carry passengers (for hire or otherwise) by appropriate authority irrespective of whether such an aircraft is privately owned OR chartered OR operated by a regular airline OR whether such an aircraft has a single engine or multi engine."
15. Since in the present case, the death of Rajesh Mehta had taken place due to intake of alcohol and due to intake of poisonous substance, therefore, obviously it was a calculated suicide and the payment of insurance claim is barred by condition No.5 of the terms and conditions of the Individual Personal Accident insurance policy.
35. It was also observed in para 19 of the aforesaid judgment as under:-
"19. It is not the case of the respondent if someone else had forcibly put poisonous substance in the mouth of Rajesh Mehta. Therefore it is a clear-cut case of suicide which bars the claim for insurance.
36. Similar view was taken by this Commission in the judgment dated 12.9.2008 passed in First Appeal No.1644 of 2003 "Life Insurance Corporation of India and another v. Mukhtiar Kaur" in which it was held as under:-
"10. It is not disputed that Mithu Singh had died on 22.11.2001 an unnatural death. The matter was reported to the police for which DDR No. 8 dated 22.11.2001 was registered in the PS-Longowal. The dead body of Mithu Singh was subjected to the post mortem examination and PMR has been proved as Ex. R1. The First Appeal No.657 of 2009. 11 viscera of the dead body of Mithu Singh was duly sealed and was sent to Chemical Examiner of the Government of Punjab. It was analysed by the Chief Chemical Examiner and he submitted the report Ex.R2. As per report Ex.R2, chloro compound, a group of insecticides was found in the stomach etc. of the dead body of Mithu Singh.
11. Now, it has to be determined if chloro compound a group of insecticides can find entry in the stomach of Mithu Singh by inhaling through the nose or by consumption through the mouth. We are of the opinion that by inhaling only the poisonous air would go inside the body and no substance can reach the stomach by inhaling. The existence of group of insecticides in the stomach of the dead body of Mithu Singh could only find entry when it was consumed through the mouth. It means, therefore, that Mithu Singh has consumed chloro compound, a group of insecticides, through the mouth and he did not die because of inhaling of poisonous insecticides.
12. It is not the version of the respondent if somebody had forcibly thrust the chloro compound, a group of insecticides, in the mouth of Mithu Singh. Therefore, it clearly leads to the presumption that Mithu Singh had himself consumed chloro compound, a group of insecticides. It leads to the conclusive presumption that Mithu Singh had committed suicide.
13. The impugned judgment of the learned District Forum has been perused. We do not agree with the findings recorded by the learned District Forum. First Appeal No.657 of 2009. 12 Accordingly this appeal is accepted and the impugned judgment dated 21.10.2003 is set aside."
37. In the present case also, the death of Balwinder Singh had not taken place by an accident. Although the reference to accident has been made in the DDR No.16 dated 19.9.2004 but the Medical Officer, Civil Hospital, Ludhiana has specifically reported that the cause of death is due to the intake of poisonous substance. Obviously the poisonous substance was taken by Balwinder Singh of his own because it is not the version of the appellants if somebody else had thrust the aluminum phosphide insecticide in the mouth of Balwinder Singh. Therefore it is clearly proved to be a case of suicide. Therefore the appellants are not entitled to any insurance claim.
38. There is no illegality in the impugned judgment dated 4.2.2009 passed by the District Forum.
39. There is no merit in the present appeal and the same is dismissed. FIRST APPEAL NO.656 OF 2009:
40. Since Balwinder Singh had committed suicide, therefore, the appellants are not entitled to any insurance claim in this case also.
41. There is no illegality in the impugned judgment dated 4.2.2009 passed by the District Forum.
42. There is no merit in the present appeal and the same is also dismissed.
43. The arguments in these cases were heard on 21.3.2012 and the orders were reserved. Now, the orders be communicated to the parties.
44. The appeals could not be decided within the statutory period due to heavy pendency of court cases.
(JUSTICE S.N. AGGARWAL)
PRESIDENT
March 30 , 2012 (BALDEV SINGH SEKHON)
Bansal MEMBER
First Appeal No.657 of 2009. 13