K. Vaithilingam vs LIFE INSURANCE CORPORATION

THE complainant in OP No. 176/98 on the file of the District Consumer Disputes Redressal Forum, Tiruchirapalli is the appellant in this appeal. THE facts leading to the appeal are as under: THE complainant''s son one Kaliaperumal was insured with the opposite party on 17.5.1993. It was a double benefit policy and the sum insured was Rs. 50,000. Under this double benefit policy, the nominee of the insured person would be entitled to Rs. 1 lakh in case of death. However, the additional sum would not be payable if the disability or the death of the life assured was caused. (i) by intentional self-injury, attempted suicide, insanity or immorality or whilst the Life Assured is under the influence of intoxicating liquor, drug or narcotic; or (ii) it took place as a result of accident while the Life Assured is engaged in aviation or aeronautics in any capacity other than that of a fare-paying, part-paying or non-paying passenger in any aircraft which is authorised by the relevant regulations to carry such passengers and flying between established aerodromes, the Life Assured having at that time no duties on board the aircraft or requiring descent therefrom ; or (iii) be caused by injuries resulting from riots, civil commotion, rebellion, war (whether war be declared or not), invasion, hunting, mountaineering, steeple-chasing or racing of any kind ; or (iv) result from the Life Assured committing any breach of law; or (v) arise from employment of the Life Assured in the armed forces or military service of any country at war (whether war be declared or not). THE complainant''s son Kaliaperumal was attacked by a group of people as a result of which he sustained grievous injuries. He was admitted in the Thanjavur Medical College Hospital where he breathed his last. While the Insurance Corporation paid the complainant a sum of Rs. 53,350 being the basic sum assured and accrued bonus, it refused to pay the additional sum of Rs. 50,000, stating that the injuries sustained by the said Kaliaperumal were caused as a result of a riot and, therefore, the complainant was not entitled to the accident benefit. It was also contended by the Insurance Corporation that the complainant had received Rs. 53,350 in full satisfaction and the complaint was, therefore, not maintainable.

CERTAIN more facts are necessary to appreciate the background in which the complaint came to be filed. On 11.3.1994, there was a festival at the Droupathi Amman Temple at Manapathur village. People from the nearby village of Mathur had come to attend the festival. Some of the boys who had come there indulged in eve-teasing. The elders there took them to task and sent them home to their village Mathur, 2 kms. away. The next day, some of boys from Mathur village came to Manapathur village, picked up quarrel with the people of Manapathur village and attacked them with logs, repers, in which several were wounded one of whom was the aforesaid Kaliaperumal who, as already stated, was taken to the Thanjavur Medical College Hospital for treatment where he succumbed to the injuries sustained by him. There was a criminal complaint against several persons and in the criminal case they were acquitted giving them the benefit of doubt. The main contention of the Insurance Corporation before the District Forum was that the deceased Kaliaperumal was the victim to riots which had sparked in the village and, therefore, as per the terms of the policy, the double benefit would not be available to the nominee of the Life Assured.

Before the District Forum, Exs. A-1 to A-8 were marked on the side of the complainant and Exs. B-1 and B-2 were marked on the side of the opposite party.

THE District Forum, on the basis of the materials produced, held that it was a case of riot and the policy having provided that the double benefit would not be available if the death or injury was caused as a result of riots, rejected the claim of the complainant by order dated 22.2.1999. The sole question is whether the death of Kaliaperumal was a result of the riot alleged to have taken place in the village.

IN the criminal proceedings, the accused were given the benefit of doubt. The judgment in the criminal proceedings has been marked as Ex. A-2. A careful reading of Ex. A-2 shows that the accused were not charged with causing any riot. They were charged only with assaulting some persons in the village and causing injury to those persons. One of the persons injured was Kaliaperumal. On the previous day to the date of the incident, there was a festival in the temple in the village and some boys from Mathur village had indulged in eve-teasing. The elders of the village took them to task, reprimanded them and sent them home. So, we can safely assume that there were no riots on the date of the temple festival. On the next day, i.e., the date of the incident also, there is nothing on record to show that there were riots and during those riots the deceased sustained grievous injuries. Before the District Forum, the complainant relied on a judgment of the National Commission in Smt. Manda Savarna v. Branch Manager, LIC of INdia & Anr., IV (2006) CPJ 135 (NC)=1998 (6) CTJ 485 (NC). IN that case, one Ganga Reddy was dragged out of his house on 24/25.4.1995 by a group of naxalites at 1 a.m., beaten with butt-ends of the guns and also with sticks. He was ultimately taken to the Government Hospital, Kamareddy. On the advice of the Doctor there, he was taken to Gandhi Hospital, Secunderabad where he was pronounced dead. His widow submitted claims for payment under two policies which were endowment policies with profits (accident benefit) to the Branch Manager and the Divisional Manager of LIC of INdia. The Corporation paid a total sum of Rs. 1,53,749 which was accepted by the widow under protest. On 23.6.1993, a letter was addressed to the Local Branch Manager of LIC stating that she was entitled to a further sum of Rs. 1,53,749 under the two policies because the death had taken place by accident. The claim was not entertained by LIC resulting in the widow filing the complaint before the District Forum. The District Forum allowed the claim. The appeal was dismissed by the State Commission and the matter went to the National Commission at the instance of the L.I.C. L.I.C. contended that whatever was payable under the policy had been paid to the complainant on account of the untimely death of her husband; that the double benefit could not be given in that case as the death was not accidental but was caused by naxalites who came with a plan to attack the deceased who was actually apprehending an attack like that and that was the reason why he had taken a double benefit policy. The National Commission concurred with the decision of the lower Fora that the death of Ganga Reddy was accidental and the INsurance Corporation was liable to pay the double benefit to the complainant. It was contended before us that the deceased in our case was attacked by a number of persons and he died due to that attack; that a case was filed under Sections 302, 147 (punishment for rioting), 341 (punishment for wrongful restraint) and Section 323 (punishment for voluntarily causing hurt); that the Sessions Court had categorically found that there was rioting due to which the deceased/ life assured died ; that it was only due to the lapses on the part of the prosecution that the accused were acquitted ; and that mere acquittal could not by any stretch of imagination disprove the fact that there was a rioting on 12.3.1994. The learned Counsel sought to distinguish the decision in Smt. Manda Savarna''s case already referred to by submitting that in that case the deceased was dragged out of his house by ten persons belonging to the People''s War Group and thereafter inflicted injury upon him out of which he died and the National Commission came to the conclusion, that one isolated case of rioting will not fall within the mischief of this clause and that the injury suffered was not due to rioting. But in the instant case, the circumstances would clearly show that the deceased was injured in a riot and, therefore, would directly come under the exceptional clause under 10.2(b). The District Forum in the instant case held that if there was a riot between two groups and the death occurred, then, it would amount to riots as defined in the policy. A reading of Ex. A-3 would clearly show, as already noted, that there is no finding that there was a riot. There were really no two camps or two sides indulging in the attack of each other. It was a case where a group of persons belonging to Mathur village had come to the neighbouring village viz., Manapathur with the clear intention of causing hurt to the inhabitants there for having reprimanded them the previous evening. There is absolutely nothing to indicate that the persons who were injured were thus, armed and they counter -attacked. In our view, the decision of the National Commission in Smt. Manda Savarna''s case would squarely apply to the facts of the present case.

IT would be appropriate to extract paragraphs 11 and 12 of the judgment of the National Commission in Smt. Manda Savarna v. Branch Manager, LIC of India & Anr. (supra): "11. We are unable to uphold the contention. We are of the view that the word "riot" has not been used strictly in the legal sense. The benefit of the double payment will be lost if death was caused, inter alia, by "Injuries, resulting from riots, civil commotion, rebellion, war (whether war be declared or not), invasion, hunting, mountaineering, steeple-chasing or racing of "any kind." Civil commotion, rebellion, invasion, hunting, mountaineering, steeple-chasing or racing are not technical or legal terms. In this context, it is not right to assume that "riots" have to be understood in any technical legal sense, and when ten persons forcibly dragged the deceased out of his house and inflicted bodily injuries upon him, a riot had taken place. According to the New Webster''s Dictionary and Thesaurus of the English Language, 1992 Edition, (page 858), "riot" means : A public tumult, often in defiance of authority and the law and some times destructive of life or property." If death is caused by injuries suffered in civil commotion, rebellion, war, invasion etc., the double benefit will not be given by the L.I.C. IT means that if any unusual disturbance was going on in any area and the deceased was caught in that disturbance and died, the L.I.C. will not make the double payment. The word "riot" has to be understood in the context of the other words in that clause like civil commotion, rebellion, war, invasion. All these words denote some sort of public tumult which is also the dictionary meaning of riot. In this case there was no public disturbance. The assured was dragged out of his house by a group of persons and thereafter beaten to death. This was an isolated individual case. There was no general disturbance in this locality. This may constitute rioting by the guilty person under Section 146 of the Indian Penal Code because five or more persons were involved in the incident. But it will not be so in common par-lance.

IT is also important to note that the language used in the exception clause is "resulting from riots". ''Riots'' has been used in the plural unlike civil commotion, war or rebellion. This means that when riots were taking place in any particular area and the assured died as a result of injuries suffered in such riots, he will come within the exception clause. But one isolated case of rioting will not fall within the mischief of this clause. In the instant case, it cannot be said that the assured died of injuries "resulting from riots"."

THE National Commission has expressed the view that "having regard to the wording of exception clause", "the word ''riots'' has to be understood in the general sense and not in the sense in which it has been used in the Indian Penal Code. Otherwise, strange consequences will follow". That is to say that "If only four persons came and killed the assured, the Insurance Company will be liable to make double payment. But, if five persons came and killed the assured the Insurance Company will not be so liable. This construction leads to absurdity and has to be avoided". We are convinced that the deceased was not a victim of any riots alleged to have taken place in the village. THE attack on the deceased and some others was by some of the villagers of the neighbouring village who had been reprimanded the previous evening by the elders for indulging in eve-teasing. THEre was no rioting on that evening nor was there any rioting on the subsequent evening. It would also be pertinent to refer to a news item that had appeared in "Daily Thanthi" dated 20.3.1994 saying that there was an incident of eve-teasing which resulted in exchange of harsh words and during the festival in the temple in the village that on the next day some people from R.S. Mathur came with scythes, logs and attacked Kaliaperumal as a result of which he sustained head injury and two others sustained injuries; that he was treated in the Thanjavur Medical College Hospital which was of no avail. THE Insurance Act is a Welfare Legislation and the terms have to be interpreted to advance the cause of the insured. It is not also open to the Corporation to say that the appellant/ complainant had received the amount of Rs. 53,350 without demur and had given full satisfaction. THE Insurance Company cannot take advantage of the illiteracy and the ignorance of the complainant. Having regard to what is stated above, the decision of the District Forum cannot be sustained. In the result, the appeal shall stand allowed, the order of the District Forum is set aside and the complaint is allowed. The complainant would be entitled to the double benefit as claimed by him. The Insurance Corporation is directed to pay the amount with interest at 9% p.a. from the date of death of the insured till realisation, within a period of two months from today. There will be no order as to costs in the appeal. Appeal allowed.