NATIONAL CONSUMER DISPUTES REDRESSAL
COMMISSION
NEW DELHI
(CIRCUIT BENCH AT PUNE, MAHARASHTRA)
REVISION PETITION NO. 689 OF 2006
(From the order dated 7.12.05 in
Appeal No.717/05 of the State Commission, Maharashtra)
Branch Manager,
Ambajogai Branch No.95 E
Distt. Beed, Maharashtra
Through:
Assistant Secretary,
Northern Zonal Office
(L & HPF), LIC
Jeevan Bharti, Connaught
Circus,
New Delhi .. Petitioner
Versus
Smt. Surekha Rudranath Autade
W/o Rudranath Autade
R/o Bansilala Nagar
Ambajogai, Distt. Beed,
Maharashtra .. Respondent
BEFORE :-
HONBLE
MR. JUSTICE M.B. SHAH, PRESIDENT
HONBLE
DR. P.D. SHENOY, MEMBER
For the Petitioner : Mr. A.U. Luktuke, Advocate
For the Respondent : Mr.
K.R. Tekwani, Advocate.
Dated 22.02.2008
O R D E R
M.B.SHAH, J.,
PRESIDENT:
The Complainant, Smt.Surekha Rudranath Autade, and her husband, Mr.Rudranath (deceased) were serving as Teachers. Her husband was also the agent of Life Insurance Corporation of India. He died on 27.12.2001. Before his death, he has taken the following L.I.C. policies.
|
Sl.
No. |
Policy
No. |
Sum
assured (In Rs.) |
P&T |
Instalment
premium mode |
DOC |
|
1. |
981694481 |
1,00,000 |
11-30 |
94/SSS |
28.3.99 |
|
2. |
981603546 |
50,000 |
88-30 |
153/SSS |
15.23.97 |
|
3. |
981850563 |
50,000 |
75-20 |
273/SSS |
28.7.99 |
|
4. |
980451525 |
10,000 |
75-20 |
55/SSS |
15.1.93 |
|
5. |
981600503 |
25,000 |
74-15 |
174/SSS |
15.11.95 |
|
6. |
980456651 |
20,000 |
75-20 |
111/SSS |
28.10.94 |
|
7. |
981600570 |
50,000 |
113-25 |
247/SSS |
28.11.95 |
|
8. |
981694788 |
50,000 |
113-26 |
238/SSS |
28.3.99 |
|
9. |
981963029 |
1,00,000 |
111-29 |
103/SSS |
28.3.01 |
After the death of
the assured, the LIC paid the assured sum in respect of first six policies.
However, the LIC
repudiated the claim for the payment of accidental benefit for the policy shown
at serial number 9 stated above, for a sum of Rs.1,00,000/- which was taken on
28th March, 2001.
Hence, complaint
No.141 of 2003 was filed before the District Forum, Beed. Before the District
Forum the LIC contended that the husband of the Complainant committed suicide
and, therefore, she is not entitled to receive accidental benefit. For this
purpose, reliance was placed on the postmortem report as well as the chemical
analysis.
The District Forum
by its judgment and order dated 21.12.2005 allowed the complaint on the ground
that chemical analysis report dated 9.7.2002 clearly reveals that no poison was
detected in the viscera. The District Forum further relied upon the affidavit
of the Complainant and held as under:
.1. the Complainant is
allowed;
.2. that,
after deducting basic claim of policies the double accidental benefit of six
policies such as 981600503; 980451525; 980456681; 981603546; 981850563 and,
981694581 and other benefits be given to the Complainant by the Respondent;
.3. double
accidental benefit in respect of policies Nos. 981963029; 981694788; and,
981600570 and other benefits be given to the Complainant by Respondent;
.4. the
Respondent to pay Rs.82,500/- (eithty two thousand five hundred) towards group
insurance;
.5. that
the Respondent do pay Rs.5,000/- (Five thousand) towards mental agony and
Rs.1,000/- (Rs.One thousand) towards cost;
.6. that,
the Complainant is entitled to receive 6% interest per annum from the
Respondent on entire claim from the date of filing the complaint till its
realization.
That
appeal was partly allowed by the State Commission by its judgment and order
dated 7.12.2005.
For arriving at the
said conclusion, the State Commission observed that for the first six policies
there was no dispute. LIC had paid basic sum assured to the widow of the
diseased. The policies at Sl. Nos.7 and
8 were money back policies and the
District Forum erroneously directed to pay the sum assured to the widow of the
deceased. But, as per the terms of the policy the sum is not liable to be paid
to the widow of the insured immediately, and they become due and payable after
the maturity period and the heirs of the deceased are not required to pay any
premium for those policies till their maturity. Hence, the operative part of the
order in clause (3) in the order passed by the District Forum was modified
accordingly.
Similarly, for the
DM Club, the LIC has already paid a sum of Rs.37,500/- to the widow of the
insured and the State Commission set aside the direction that the LIC was
required to pay Rs.1,20,000/-. To that effect Clause (4) was modified.
With regard to
double accident policy, the State Commission relied upon chemical analysis
report and held that no poison was found in the viscera. And, therefore, it
cannot be held that the deceased committed suicide by consuming poison, and
rejected the contention of the LIC that the FIR filed by the Complainant would
indicate that the deceased committed suicide by taking poison.
Submissions:
The
learned Counsel appearing for the L.I.C. submitted that the L.I.C. has no dispute with regard to
payment of the sum assured to the Complainant, as directed by the District
Forum and the State Commission. But
accident benefit cannot be granted to the heirs of the deceased. He heavily relied upon the
postmortem report wherein it is stated:
Stomach
and its contents : contained about 200 ml. of semi solid food material. Smell
of OP Poison, strongly.
As against this, CA
report specifically states that general and specific chemical testing does not
reveal any poison in exhibit Nos. (1) and (2).
Hence,
the question would be, in this set of
circumstances, can it be said that the insured committed the suicide.
In our view, there is no evidence to establish that the assured committed suicide.
However, for getting the double accident benefit, the term of the policy provides as under:
8(b).Death of the life assured: To pay an additional sum equal to the death
benefit under this policy, if the life assured shall sustain any bodily
injury resulting solely and directly from the accident caused by outward,
violent and visible means and such injury shall within 120 days of its
occurrence solely, directly and independently of all other causes result in the
death of the life assured.
In this case there is no evidence that the deceased had died because of any bodily injury from the accident caused by outward, violent and visible means. Hence, the heirs of the deceased are not entitled to get the accident benefit. Hence, the order granting accidental benefit requires to be set aside.
In
the result, the Revision Petition is partly allowed to the aforesaid
extent. There shall be no order as to
costs.
Sd/-
.
.J.
( M.B.SHAH )
PRESIDENT
.
(P.D. SHENOY)
MEMBER