L I C OF INDIA vs Karpagam

-THE opposite party in O. P. No. 153/96 on the file of the District Consumer Disputes Redressal Forum, Vellore, is the appellant herein. The case of the complainant was as follows: (a) Her husband had taken an insurance policy for Rs. 2,00,000 on 6. 5. 1992. The complainant was the nominee under the policy. The insured died on 26. 2. 1993 when he had gone to Salem for the purpose of repairing his tractor. The Salem town police registered a case under Section 174 of Cr. P. C. Post-mortem was also done at Government Hospital, Salem. The post-mortem certificate dated 27. 2. 1993 said that the opinion regarding the cause of his death would be reserved till the report of chemical anaysis was received from the Forensic Laboratory. The Regional Forensic Science Laboratory of Government of Tamil Nadu at Coimbatore gave a report on 10. 4. 1996 stating that no alcohol or other poison was detected in any of the samples received from the Government Hospital, Salem, relating to the insured. Thus, the death was a sudden one. The complainant approached the opposite party with a claim enclosing the post-mortem certificate and also the report of the Regional Forensic Science Laboratory. The opposite party however failed to pay the insured amount. She sent a lawyer notice. The opposite party refused to pay the insurance amount. The complaint therefore came to be filed.

THE opposite party took a stand that it was a case of suicide. As the F. I. R. had disclosed the life assured had died due to suspected consumption of poison mixed in alcohol, post-mortem was done and opinion reserved pending receipt of chemical examination report. The opposite party was justified in invoking the suicide clause as the material available clearly established that the life assured had committed suicide. Before the District Forum, on the side of the complainant Exs. A1 to A10 were marked while on the side of the opposite party, no document was marked.

The District Forum found that there was no proof by the opposite party that the insured had committed suicide and therefore the repudiation was bad. By order dated 19. 11. 2001, the complaint was allowed directing the opposite party to pay Rs. 2,00,000 towards the policy amount, Rs. 25,000 as damages for mental agony and Rs. 3,000 towards cost of the proceedings. It is as against that the present appeal has been filed.

THE learned Counsel for the appellant/opposite party submitted that it was a matter of admission that the life assured died within one year of taking the policy. As per the terms of the policy, if it was suicide, then the opposite party would be justified in repudiating the claim. The F. I. R. filed in Crime No. 196/1993 lodged by the employee of the life assured clearly stated that the life assured was found in a lodge lying unconscious after having vomited and that there were pesticide and alcohol nearby. He was taken to the hospital where he died. The opinion for cause of death had been reserved pending chemical examination report as there was no apparent indication for a normal death and on the contrary there was material to suspect suicide on account of consuming pesticide mixed with alcohol. The chemical examination report Ex. 15 stated that alcohol or other poison was not detected. However, the complainant had not produced the final opinion as to the cause of death of the life assured. The complainant also did not produce the result of the criminal proceedings. When cause of death was unknown and unnatural, the burden of proving that the death was due to natural cause lay heavily on the complainant. This was more so as there was no evidence of the life assured having complained of any medical ailment. There was prima facie evidence to show that when the employee who lodged the F. I. R. first saw the life assured he was lying unconscious after vomiting. Alcohol and pesticide were also found near him. This was further corroborated by the finding in the post-mortem report Ex. A4 that there was some brown colour liquid with pungent odour. It was established medical jurisprudence that traces of poison and alcohol could not be detected in all cases depending upon the chemical reaction, time and other factors. The District Forum was in error in ordering the complaint. Per contra, the learned Counsel for the complainant submitted as follows: The only reason given by the opposite party in his letter dated 30. 3. 1995 for refusing the payment of insured amount was that the deceased died by committing suicide during the operative period of the suicide clause. The post-mortem certificate dated 27. 2. 1993 given by the Government Mohan Kumaramangalam Medical College, Salem and the report of the Regional Forensic Science Laboratory of Government of Tamil Nadu at Coimbatore dated 10. 4. 1996 proved beyond any doubt that the death was not due to suicide. There was therefore no justification whatsoever for not paying the insurance amount. The presumption of the opposite party that the death was due to suicide was without any basis. The District Forum had rightly said that the post-mortem certificate and the chemical examination report marked respectively as Exs. A4 and A5 clearly proved that the death was not due to suicide. The said conclusion being legal and factually correct, it had to be upheld.

WE have gone through the materials on record. We are satisfied that the District Forum was perfectly justified in allowing the complaint in favour of the complainant. Indeed, there could have been some suspicion with regard to the circumstances under which the complainant''s husband died but there was no final conclusion that the death was due to suicide. In fact, the certificates given by the hospital and the lab showed that the death was not due to suicide. On the basis of mere suspicion, it would be highly improper to refuse relief to the complainant. We were also informed that criminal proceedings in Cr. No. 196/93 have been closed. Thus, there is absolutely no proof that it was a case of suicide. Ex. A5 chemical examination report clearly stated that alcohol or other poison was not detected. May be in the post-mortem report, it was found that there was some brown colour liquid with pungent odour. But that by itself would not be sufficient to conclude that it was a case of suicide particularly after the report from the lab that there was nothing to show that there was consumption of poison by the deceased. In the above circumstances, we confirm the decision of the District Forum and dismiss the appeal. No cost. Appeal dismissed.