Life Insurance Corporation of India Through Its Authorized Officer Manager (Land Hpf) Chandigarh Vs. Virsa Singh and Another - Court Judgment

SooperKanoon Citationsooperkanoon.com/1107668
CourtPunjab State Consumer Disputes Redressal Commission SCDRC Chandigarh
Decided OnJan-24-2013
Case NumberFirst Appeal No. 567 of 2008
JudgeTHE HONOURABLE MR. INDERJIT KAUSHIK, PRESIDING MEMBER & THE HONOURABLE MR. BALDEV SINGH SEKHON, MEMBER
AppellantLife Insurance Corporation of India Through Its Authorized Officer Manager (Land Hpf) Chandigarh
RespondentVirsa Singh and Another
Excerpt:
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inderjit kaushik, presiding member 1. life insurance corporation of india, appellant (in short “the appellant”) has filed this appeal against the order dated 22.04.2008 passed by the learned district consumer disputes redressal forum, ludhiana (in short “the district forum”). 2. facts in brief are that sh. virsa singh and another, respondents/complainants (hereinafter called as “the respondents”) filed a complaint under section 12 of the consumer protection act, 1986 (in short, “the act”), alleging that respondent no.1 is the father of sarwan singh, who had taken the lic policy from op-3 (not made party in the appeal) vide policy no.300276140 and paid all the installments of the policy upto date. the policy contained two benefits in case of death of.....
Judgment:
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Inderjit Kaushik, Presiding Member

1. Life Insurance Corporation of India, appellant (In short “the appellant”) has filed this appeal against the order dated 22.04.2008 passed by the learned District Consumer Disputes Redressal Forum, Ludhiana (in short “the District Forum”).

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2. Facts in brief are that Sh. Virsa Singh and another, respondents/complainants (hereinafter called as “the respondents”) filed a complaint under section 12 of the Consumer Protection Act, 1986 (in short, “the Act”), alleging that respondent no.1 is the father of Sarwan Singh, who had taken the LIC policy from OP-3 (not made party in the appeal) vide policy No.300276140 and paid all the installments of the policy upto date. The policy contained two benefits in case of death of the insured in the accident. Respondent no.2 is the mother of the deceased insured Sarwan Singh. Sh. Sarwan Singh was unmarried and respondents no.1 and 2 are his only legal heirs.

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3. On 21.05.2006, said Sarwan Singh met with an accident while driving the car bearing registration No.PB-08-G (Temp) 8507 in the area of Peer Jain, P.S. Sirhind, District Fatehgarh Sahib and died due to the injuries sustained in the accident. DDR No.22 dated 21.05.2006 was registered in Police Post Peer Jain, P.S. Sirhind, District Fatehgarh Sahib. The deceased Sarwan Singh had a valid and effective driving licence at the time of accident.

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4. Respondent no.1 gave intimation to OP-3 about the death of Sh. Sarwan Singh in the accident and supplied all the requisite documents and visited the office of OP-3 to make the payment of compensation. Respondents no.1 and 2 were surprised when a cheque of Rs.6,02,799/- was sent by OP-3 and the forwarding letter showed that the accident benefit was not given to respondents no.1 and 2. As per the terms and conditions of the policy, respondents no.1 and 2 were entitled to double benefits. A registered notice dated 14.04.2007 was sent to the appellant and OP-2 (not made party in the appeal) and OP-3 for the payment of compensation, but vide letter dated 19.04.2007, OP-3 stated that the accident occurred due to over speed of the vehicle and the death occurred due to intentional self injuries and the claim was repudiated. The claim has been rejected illegally. The appellant and OPs no.2 and 3 processed the claim of respondents no.1 and 2 in almost one year which shows their malafide and they are finding ways to repudiate the claim, which amounts to deficiency in service. Respondents no.1 and 2 suffered lot of mental tension, agony and harassment.

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5. It was prayed that the appellant and OPs may be directed to pay the sum insured of Rs.5.00 lacs, Rs.50,000/- as compensation and Rs.10,000/- as litigation expenses.

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6. In the written reply filed on behalf of the appellant and OPs, the preliminary objections were taken that the complaint is not maintainable. The deceased life assured (hereinafter called as “DLA”) purchased the policy no.30027614 for the sum assured of Rs.6.00 lacs, commencing from 28.03.2003 and the first premium receipt was issued on 31.03.2006 for Rs.20.601/-, being half yearly premium. The DLA, after paying one half yearly premium, died on 21.05.2006. On receipt of the claim, the insurance company paid the sum assured of Rs.6.00 lacs plus bonus amounting to Rs.6,02,799/- to nominee Sh. Virsa Singh. The claim of accident benefit was rightly repudiated after considering all the documents and on the basis that the driving licence was issued on the basis of misstatement by DLA regarding the date of birth as 10.01.1984, whereas as per the policy, he has stated the date of birth as 15.04.1987, according to which he was minor on the date of issuance of the driving licence. The accident took place due to over speed driving and it was violation of the policy condition no.10 (b) (i) which becomes operative in the present case. The claim of double accident benefit was repudiated with reasons given in the letter dated 19.04.2007.

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7. On merits, it was admitted that the DLA was holder of policy no.3000276140. In the present case, respondent no.1 Virsa Singh was entitled to death claim of basic sum insured, but he was not entitled to accidental benefit claim as per the policy conditions. The DLA was driving the car at a very high speed and he died at the spot and it was so confirmed by the panchnama dated 21.05.2006 as well as by the statement of other local people. The DDR dated 21.05.2006 also prove so. The driving licence was obtained by anti-dating the date of birth by the DLA and he was minor at that time. Other similar pleas as taken in preliminary objections were repeated and denying allegations of the complaint, it was prayed that the complaint may be dismissed with costs.

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8. Parties led evidence in support of their respective contentions by way of affidavits and documents.

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9. After going through the documents and material placed on file and after hearing the learned counsel for the parties, the learned District Forum observed that the DLA was not driving the vehicle rashly and negligently, with the intention to commit suicide. There is no condition in the policy Ex.R-14 that death due to driving of the vehicle by a person, not holding effective driving licence, would deprive him from benefit of double amount of the insurance in case of accidental death. The complaint was allowed and the appellant was directed to release the amount of Rs.5.00 lacs to respondents no.1 and 2 on account of death of their son DLA Sh. Sarwan Singh under the insurance policy Ex.R-14, as Under clause 10 (b) (i) of the policy, the amount was limited to Rs.5.00 lacs irrespective of the amount of the insurance policy.

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10. Aggrieved by the impugned order dated 22.04.2008, the appellant has come up in appeal.

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11. We have gone through the pleadings of the parties, perused the record of the learned District Forum and have heard the arguments advanced by the learned counsel for the appellant as well as perused the brief note of submissions filed on behalf of the appellant.

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12. Neither the counsel for the respondents nor anybody else on their behalf appeared at the time of arguments.

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13. In the brief note of submissions submitted on behalf of the appellant, grounds of repudiation mentioned are that the DLA was not having a valid driving licence, as is evident from the proposal form and school leaving certificate. The actual date of birth is 19.01.1987, but in the driving licence he mentioned it as 10.01.1984. As per the actual date of birth, the DLA was not entitled to have driving incense, being a minor. The vehicle was being run rashly and under clause 10 (b) of the policy conditions, the claim is not payable. The District Forum has not taken notice of all these facts and the appeal may be accepted and the impugned order may be set aside.

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14. We have considered the brief note of submissions filed behalf of the appellant and have thoroughly scanned the entire documents and other material placed on the record.

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15. The claim of the respondents was repudiated by the appellant on the grounds that the DLA was not having a valid driving licence, as he gave the wrong date of birth in the driving licence, wherein the policy the actual date of birth was mentioned. The other plank of the arguments was that the vehicle was being run rashly and under clause 10 (b) of the policy conditions, the claim was not payable.

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16. Perusal of the DDR Ex.R-5 shows that the accident had already occurred before the statement of Jaspal Singh S/o Mohinder Singh, R/o Peer Jain, P.S. Sirhind, District Fatehgarh Sahib, was recorded. As per the statement of the informant Jaspal Singh, the vehicle in question after hitting the trees has fallen in the ditches and was badly damaged and when he saw after going near the driver seat, one Hindu boy was lying dead and in the front seat, one girl was lying unconscious in injured condition. No one has seen whether the car was in high speed or was being driven rashly or negligently and it was only his guess work that the accident occurred due to car speed.The District Forum has rightly come to the conclusion that the DLA has not driven the vehicle in question rashly and negligently at high speed just to commit suicide.

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17. Clause-10 of the policy Ex.R-14 deals with accidental benefit and 10(b) (relevant portion) reads as under:-

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“Death of the Life Assured:- To pay an additional sum equal to the Sum Assured 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 180 days of its occurrence solely, directly and independently of all other causes result in the death of the Life Assured. However, such additional sum payable in respect of this policy, shall not exceed Rs.5,00,000/-.

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The Corporation shall not be liable to pay the additional sum referred in (a) or (b) above, if the disability or death of the Life Assurance shall:-

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(i) be caused by intentional self injury, attempted suicide, insanity or immorality or whilst the Life Assured is under the influence of intoxicating liquor, drug or narcotic”.

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The case of the DLA does not fall in any of the above categories.

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18. Entire reading of Clause-10 shows that the disability does not include about the driving licence and definitely at the time of accident, the DLA was major. Although, the terms and policy conditions are silent, but even if the argument of the counsel for the appellant is considered in this regard, then at the most, it is violation of Section-4 of the Motor Vehicle Act, 1988 and not of the terms and conditions of the policy. The order of the District Forum is vivid, clear and detailed and there is no ground to interfere with the same.

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19. In view of above discussion, the appeal is dismissed and the impugned order under appeal dated 22.04.2008 passed by the District Forum is affirmed and upheld. No order as to costs.

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20. The appellant had deposited an amount of Rs.25,000/- with this Commission at the time of filing of the appeal. This amount with interest accrued thereon, if any, be remitted by the registry to the respondents/ complainants in equal shares by way of a crossed cheque/demand draft after the expiry of 45 days under intimation to the learned District Forum and to the appellant.

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21. Remaining amount as per the impugned order shall be paid by the appellant to the respondents/complainants within 45 days of the receipt of copy of the order.

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22. The arguments in this appeal were heard on 15.01.2013 and the order was reserved. Now the order be communicated to the parties.

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23. The appeal could not be decided within the stipulated timeframe due to heavy pendency of court cases.

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