State Consumer Disputes Redressal Commission
Divisional Manager, National ... vs Paramjit Kaur Widow Of Malkiat Singh on 9 November, 2012
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB, DAKSHIN MARG, SECTOR 37-A, CHANDIGARH.
First Appeal No.1096 of 2008
Date of institution : 29.9.2008
Date of decision : 9.11.2012
1. Divisional Manager, National Insurance Company, Divisional Office,
The Mall, Bathinda.
2. Branch Manager, National Insurance Company, Bareta.
3. Branch Manager, National Insurance Company, Mansa.
All through National Insurance Company Limited, Regional Office-I,
Sector 34-A, Chandigarh.
.......Appellants
Versus
1. Paramjit Kaur widow of Malkiat Singh s/o Shri Thakur Singh, resident
of Village Anadian Wali, Tehsil Budhlada, District Mansa.
2. Makhan Singh son of Shri Malkiat Singh,
3. Balwinder Singh s/o Malkiat Singh,
4. Jaswinder Kaur d/o Shri Malkiat Singh, all residents of Village
Anandian Wali, Tehsil Budhlada, District Mansa.
5. District Manager, Mansa Central Cooperative Bank, Mansa.
6. The Mansa Central Cooperative Bank Limited, Branch Bareta.
...Respondents
First Appeal against the order dated 21.8.2008
of the District Consumer Disputes Redressal
Forum, Mansa.
Before :-
Shri Piare Lal Garg, Presiding Member.
Shri Jasbir Singh Gill, Member.
Present :-
For the appellants : Shri Rajneesh Malhotra, Advocate. For respondents No.1-4 : Shri R.V.S. Chugh, Advocate. For respondents No.5 & 6 : Shri A.S. Khaira, Advocate. SHRI JASBIR SINGH GILL, MEMBER:
This is an appeal filed by the appellants-OPs No.1 to 3 (hereinafter called 'the appellants') against the order dated 21.8.2008 of District Consumer Disputes Redressal Forum, Mansa (hereinafter called 'District Forum') by which the complaint of respondent Nos.1 to 4 was allowed by the District Forum.
2. Brief facts of the case are that Malkiat Singh son of Thakur Singh had opened account No.2408 on 23.5.2000 in the Mansa Central Cooperative Bank Ltd. i.e. with respondents No.5 and 6 by depositing Rs.1100/-. Respondents First Appeal No.1096 of 2008. 2 No.5 and 6 had floated a scheme that the account holder who would keep at least Rs.1100/- in his or her savings account would be got insured under Group Personal Accident policy and under that policy the insured would be entitled to Rs.1,00,000/- in case of his or her death in an accident. Accordingly insurance policy was purchased by respondents No.5 and 6 from the appellants in respect of its account holders who were keeping at least Rs.1100/- as minimum balance in their savings bank account. The said insurance policy was valid from 1.6.2002 to 31.5.2003.
3. It was further pleaded that aforesaid Malkiat Singh was murdered on 18.10.2002. A criminal case vide FIR No.107 dated 18.10.2002 was registered in PS-Boha. Respondents No.1 to 4 informed respondent No.6 that the insured had been murdered which amounts to accidental death. Therefore, the claim under the policy be paid to them. Respondent No.6 forwarded the claim of respondents No.1 to 4 to respondent No.5 vide letter dated 12.2.2003. Thereafter legal notice dated 19.3.2007 was got served upon respondents No.5 and 6. However the insurance claim was repudiated by the appellants on the ground that the insured was murdered and his death was not accidental. Hence the complaint was filed by respondents No.1 to 4 for payment of insurance amount of Rs.1,00,000/- along with interest at the rate of 18% per annum from the date of death till payment. Rs.20,000/- as compensation and Rs.5000/- as costs of litigation were also prayed.
4. On the notice, the appellants filed their version taking legal objections that respondents No.1 to 4 have got no locus standi and cause of action to file the present complaint. They have suppressed material facts from the District Forum and the complaint was not filed in time as Malkiat Singh was murdered on 18.10.2002 and the complaint was filed on 1.10.2007. They also denied that the death of Malkiat Singh was an accidental death and the insurance claim is payable only in case the death occurs in an accident. Murder is not an accident and as such was not covered under the Group Insurance Policy. First Appeal No.1096 of 2008. 3 Denying any deficiency in service a prayer for dismissal of the complaint was made.
5. Respondents No.5 and 6 filed a separate written reply. It was admitted that Malkiat Singh had opened savings bank account with respondent No.6. It was also admitted that they had floated an insurance scheme for the customers who had opened savings bank account and were keeping at least Rs.1100/- in their account as minimum balance. It was also admitted that they had purchased the insurance policy from the appellants i.e. National Insurance Company Ltd. for their customers. It was also admitted that Paramjit Kaur was nominated as nominee by deceased Malkiat Singh. It was further admitted that the claim documents which were submitted by respondents No.1 to 4 with respondents No.5 and 6 the same were forwarded to the appellants. There was no deficiency in service on the part of respondents No.5 and 6. As such the complaint qua respondents No.5 and 6 may be dismissed.
6. The parties filed affidavits/documents in support of their respective versions.
7. After considering the pleadings and hearing the learned counsel for the parties, learned District Forum accepted the complaint with costs of Rs.1000/- vide impugned order dated 21.8.2008 and directed the appellants to pay the insurance claim of Rs.1,00,000/- to respondents No.1 to 4 along with interest at the rate of 9% per annum.
8. Aggrieved by the impugned order dated 21.8.2008 passed by the learned District Forum, the appellants have come in appeal before us on the grounds that the order passed by the District Forum is illegal and against the terms and conditions of the policy. The death of the life assured was not due to accident. As such the appellants were not liable to pay the claim and the order of the District Forum is based upon conjectures and surmises which is not sustainable in the eyes of law and is liable to be set aside.
9. Record has been perused. Submissions have been considered. First Appeal No.1096 of 2008. 4
10. It is the pleaded case of the parties that it is not the version of the appellants that they had not received the claim papers from respondents No.5 and 6 which were submitted by respondents No.1 to 4 to respondent No.5 and 6 and it is also the pleaded case of respondents No.5 and 6 that the claim documents were forwarded by respondents No.5 and 6 to the appellants. The appellants had nowhere pleaded in its reply or affidavit when the claim of respondents No.1 to 4 was repudiated. The cause of action was to accrue to respondents No.1 to 4 only from the date of repudiation. It is also not disclosed by the appellants that any intimation was given to respondents regarding the repudiation of the claim as the same was not covered under the terms and conditions of the policy. So the version of the appellants that the complaint was not filed within limitation and barred by time is not correct and the same is turned down.
11. It is admitted case of the parties that the life assured was murdered on 18.10.2002 and FIR No.107 was registered at PS-Boha, District Mansa. The only version of the appellants for the repudiation of the claim is that the claim of respondents No.1 to 4 was not payable as the murder was not covered under the terms and conditions of the police but it was held by our own Commission in First Appeal No.844 of 2007 "Oriental Insurance Company Limited and anr. vs. Sukhdev Kaur and others" on 30.5.2008 in which the life assured was murdered and a criminal case for murder was registered in the police station. It was observed by this Commission in the aforesaid judgment as under:-
"10. The judgement of the Hon'ble National Commission in Prithvi Raj Bhandari's case (supra) and the judgement of the Hon'ble Supreme Court in Rita Devi's case (supra) relied upon by the learned counsel for the appellants came up for consideration before the Hon'ble National Commission in the latest judgement in Revision Petition No.2824 of 2007 (Maya Devi Versus Life Insurance First Appeal No.1096 of 2008. 5 Corporation of India) decided on 21.5.2008 in which the Hon'ble National Commission was pleased to observe as under:-
"Firstly, it is to be stated that in the case of Rita Devi (supra), the Apex Court considered and interpreted a phrase providing "death due to accident arising out of the use of motor vehicle".
Thereafter, the Court referred to various decisions and arrived at a conclusion that they have no hesitation in coming to a conclusion that the deceased, Dashrath Singh, was employed to drive an auto rickshaw for ferrying passengers on hire. On the fateful day the auto-rickshaw was parked at auto-rickshaw stand and unknown passengers engaged the said auto-rickshaw for their journey and during that journey, it was alleged that the passengers caused murder of Dashrath Singh.
The Apex Court held that death in such case was due to accident. The Court further observed that the difference between 'murder which is not an accident' and 'murder which is an accident' depends on the proximity of the cause of such murder. If the cause of murder or act of murder was originally not intended and the same was caused in furtherance of any felonious act then such murder is an accidental murder arising out of the use of motor vehicle and held that the insurance company was liable to reimburse the claimant.
First Appeal No.1096 of 2008. 6
The Court referred to the decision in the case of Nisbet Vs. Rayne and Burn - (1910) 1 KB 689, where a cashier, while traveling in a railway to a colliery with a large sum of money for the payment of his employer's workmen, was robbed and murdered. The Court of Appeal held that murder was an accident from the standpoint of the person who suffered from it and that it arose 'out of' an employment which involved more than the ordinary risk and consequently the widow was entitled to compensation under the Workmens Compensation Act.
Despite the aforesaid two judgements, in the case of Prithvi Raj Bhandari (supra), the Commission observed that 'the important point which required notice was whether murder was an accident would depend upon proximity of cause of such murder' and held on facts that the complainant has suppressed the fact that various complaints against the deceased were filed under various Sections of the IPC, and concluded that there was no doubt that this was a murder by design and intent rather than a case of accidental murder.
In our view, the said reasoning cannot be justified by any standard. LIC policy excludes death due to limited causes mentioned in Exclusion clauses under para 10(b) and, therefore, it is totally irrelevant to find out the First Appeal No.1096 of 2008. 7 background of the deceased. Further, even in case where there is a criminal background of the assured, it would be difficult to hold that his murder was not accidental unless he has taken up the quarrel and that the immediate cause of injury was deliberate and willful act of the insured himself."
11. The Hon'ble National Commission also discussed the meaning of the word 'accident' in this judgement as under:-
"Further, in England law on the subject is settled. In Halsbury's Laws of England Vol. 25 Pg.307 Para 569, 4th Edition (2003 reissue), as to the meaning of the word 'accident', it is stated as under :
"569. Meaning of 'accident'. The event insured against may be indicated in the policy solely by reference to the phrase 'injury by accident' or the equivalent phrase 'accidental injury', or it may be indicated as 'injury caused by or resulting from an accident'. The word 'accident', or its adjective 'accidental', is no doubt used with the intention of excluding the operation of natural causes such as old age, congenital or insidious disease or the natural progression of some constitutional physical or mental defect; but the ambit of what is included by the word is not entirely clear. It has been said First Appeal No.1096 of 2008. 8 that what is postulated is the intervention of some cause which is brought into operation by chance so as to be fairly describable as fortuitous. The idea of something haphazard is not necessarily inherent in the word; it covers any unlooked for mishap or an untoward event which is not expected or designed, or any unexpected personal injury resulting from any unlooked for mishap or occurrence. The test of what is unexpected is whether the ordinary reasonable man would not have expected the occurrence, it being relevant that a person with expert knowledge, for example of medicine, would have regarded it as inevitable. The stand point is that of the victim, so that even willful murder may be accidental as far as the victim is concerned."
12. In view of the judgement of the Hon'ble National Commission, neither the judgement of the Hon'ble National Commission in Prithvi Raj Bhandari's case (supra) nor the judgement of the Hon'ble Supreme Court in Rita Devi's case (supra) are of any assistance to the appellants.
13. On the other hand, the judgement of this Commission in Bimla Rani Grover's case (supra) is fully applicable to the facts of the present case. In the said judgement, the insured was murdered by a third person by giving a fatta blow and it was held by this Commission that the death of the insured amounted to First Appeal No.1096 of 2008. 9 death by accident. It was held by this Commission as under:-
"8. It is now to be determined as to whether the injuries caused to Krishan Lal Grover, which resulted into his death were solely and directly the result from Accident caused by outward, violent and visible means or it was the result of any breach of law with criminal intent on the part of the deceased. Krishan Lal Grover was given a 'fatta' blow by Mukhtiar Singh, which resulted into his death. Sh.Krishan Lal Grover did not die of natural causes. He was done to death in a violent manner. The premature termination of life of Krishan Lal Grover took place because of injuries inflicted upon him by Mukhtiar Singh. It cannot be said that the death of Krishan Lal Grover resulted from natural consequences of events in the life of the deceased. His death was caused due to the injuries inflicted on him by Mukhtiar Singh."
12. In view of the settled law as discussed above, it is held that the death of Malkiat Singh insured was accidental. Therefore exclusionary clause would not apply and, therefore, the appellants are liable to pay the insurance claim to the claimants.
13. In view of the discussion held, we do not find any merit in this appeal and the same is dismissed with costs of Rs.10,000/- which will be paid by the appellants to respondents 1 to 4 within one month from the date of receipt of copy of this order.
First Appeal No.1096 of 2008. 10
14. However the amount of Rs.1,00,000/- with interest as directed by the District Forum shall be divided in equal shares among respondents No.1 to 4. If respondents No. 2 to 4 are minors, then the amounts of their respective share shall be got deposited in some nationalized bank in the shape of FDRs and the same shall be paid to them after they attain the age of majority.
15. The appellants had deposited an amount of Rs.25,000/- with this Commission at the time of filing of the appeal on 29.9.2008. This amount of Rs.25,000/- with interest accrued thereon, if any, be remitted by the registry to respondent No.1 to 4 by way of a crossed cheque/demand draft after the expiry of 45 days under intimation to the learned District Forum and to the appellants.
16. Remaining amount as per the order of the District Forum shall be paid by the appellants to respondent Nos.1 to 4 within one month from the date of receipt of the order.
17. The arguments in this case were heard on 5.11.2012 and the order was reserved. Now, the order be communicated to the parties.
18. The appeal could not be decided within the statutory period due to heavy pendency of court cases.
(PIARE LAL GARG)
PRESIDING MEMBER
November 9 , 2012 (JASBIR SINGH GILL)
Bansal MEMBER