Life Insurance Corporation of India vs AMRIKABAI

THIS is an appeal against order dated 16.2.1995 passed by District Consumer Disputes Redressal Forum, Raipur in their Case No. 155/94, wherein the Forum has directed the appellant-L.LC. to pay to the complainant-assured sum of Rs. l0,000/- alongwith interest at the rate of 12% w.e.f. 18.2.1994 and Rs. 250/- as proceeding expenses.

NONE appeared for the respondent Smt. Amrika Bai. An application bearing her thumb impression has been received in which it is stated that she is an illiterate poor adivasi widow having only minor children and can''t afford to appear before us either in person or through an Advocate. She however sent written arguments prepared by her Advocate. Heard the arguments of the appellant''s Counsel and perused the records of the case.

The appellant''s argument is that deceased policy holder died within one year of the date of issue of policy and investigation revealed that the death was due to suicide by consuming some kind of poisonous insecticide. Therefore, the claim was repudiated as per policy conditions in respect of suicide which are as under : "Suicide : This policy shall be void if the Life Assured commits suicide (whether sane or insane at the time) at any time on or after the date on which the risk under the policy has commenced but before the expiry of one year from the date of this policy and the Corporation will not entertain any claim by virtue of this policy except to the extent of a third party''s bona fide beneficial interest acquired in the policy for valuable consideration of which notice has been given in writing to the office to which premiums under this policy were paid last, at least one calender month prior to death."

THE undisputed facts of the case are as under: (i) That the husband of the complainant Late Shri Jhadu Ram Diwan had taken insurance policy No. 381216214 for Rs. 10,000/- on his life and the date of the commencement of the policy was 28.3.1992. That Late Jhadu Ram was found lying dead on a field on 2.2.1993. (ii) That his post-mortem was conducted at Government Hospital Mahasamund on 2.2.1993 at 3.30 p.m. and the conclusion report recorded by Dr. D.K. Jha, Asstt. Surgeon is as under: "In my opinion the mode of death is "Asphyxia". THE asphyxia may be due to ingestion of poisonous substance. THE exact nature of poison may be detected by chemical analysis of visceras and contents. THE time lapsed since death is 0-12 hours." In the preceding para it was mentioned that "lungs, liver, heart, kidneys are preserved for chemical analysis".

(iii) That vide their letter No. Claims/25 dated 18.2.1994, the LIC repudiated the claim stating that since the insured had committed suicide within one year from the date of commencement of the policy, nothing was payable as per policy conditions. In view of what has been stated above, the only point for consideration before us is whether the LIC while repudiating the claim on the ground of "Suicide", has ensured that the finding arrived at, of the cause of death being "Suicide", is conclusive and based on complete and authentic documents.

AFTER presentation of the claim by the complainant, the sequence of events, details of facts regarding inquiry got conducted into by the LIC, and records produced before the District Forum are as under : (i) That after the complainant filed her claim form, the LIC issued a letter to her on 13.8.1993, asking her to file an affidavit of a person, who knew the deceased but was not a relative and must have attended his funeral and the affidavit should contain the details of health at the time of death, and name of the Doctor who was treating him. (ii) The complainant in compliance filed an affidavit dated 6.9.1993 of one Thakurram, duly attested by a notary on a five rupee non-judicial stamp paper, as directed by LIC. (iiii) Hereafter, on 5.10.1993 the LIC issued another memo dated 5.12.1993 to the complainant, now asking her to file following documents: (a) Attested copy of FIR filed with police. (b) Attested copy of post-mortem report. (c) Attested copy of final investigation report of the police. (iv) Post-mortem report was furnished to the LIC by the complainant as has been admitted by LIC in para 6 of their reply dated 16.1.1995. (v) Copy of FIR was not furnished by her as in para 10 of their reply the LIC has stated that the opposite party requests the production of FIR dated 2.2.1993 by the complainant. (vi) The final investigation report of the police is not on record nor is there any mention to the effect whether it was obtained or not either by the complainant or by investigating officer of LIC, nor is there any mention about it anywhere in either the reply or in any other documents filed by LIC. (vii) The name of the Assistant Branch Manager (Sales), Branch Office, Mahasamund, who conducted an enquiry into the cause of death is not mentioned anywhere on record before us. (viii) Copy of inquiry report of ABM (Sales) has not been filed. (ix) It is not mentioned anywhere in any record as to how the ABM (Sales) conducted his enquiry and who are the persons whom he contacted or recorded their statements. It is also not mentioned anywhere as to which medical authorities or police authorities he contacted or which records he perused at the police station or at the hospital where the deceased was immediately taken after death. (x) The note sheet dated 16.1.1995 of the file of District Forum mentions that the opposite party filed reply and list of documents that day. The list of documents furnished on 16.1.1995, filed at page No. 24 of the file of the District Forum is as under : (a) Police Bond copy. (b) Copies of statements of three villagers. (c) Letter from LIC to complainant dated 5/12.10.1993. Documents listed at Serial Nos. (a) and (c) have already been discussed earlier and commented upon and call for no fresh comments. (xi) Documents listed at Serial No. (x) (b) are unattested photocopies of statements of three villagers. There is nothing on record before us to indicate/ who obtained these statements, on which date, at which spot, in what connection, in whose handwriting, etc. except that in the statement of Amarsingh Diwan, he noted down the date as 26.5.1993. Full name and addresses of witnesses in whose presence recorded, are also not given. (xii) Interestingly enough out of these three villagers, two of them namely Laloram and Vastulal Diwan have given affidavits dated 27.1.1995 that after few days the death of Jhadu Ram, two persons had come stating that they were Government officials and they asked us to write that Jhadu Ram committed suicide and we did accordingly but we do not know as to how Jhaduram died or what was the cause of his death.

Photocopy of post-mortem report and affidavit of Thakurram were procured by the complainant herself and submitted to LIC. Hence except for obtaining statement of three villagers, LIC made no other enquiries. So far as the quality, authenticity and validity of these statements are concerned, the position has been explained by us in paras 7(xi), (xii) and (xiii) above. Photocopy of these three statements are filed at pages 28, 29 and 30 of the District Forum''s file. And LIC took complete one year in conducting this sketchy enquiry and repudiated the claim after more than a year. Post-mortem was also not obtained by LIC but was procured and submitted in good faith by the complainant. The post mortem report does state that the cause of death could be due to ingestion of poisonous substance. What kind of poison it was, has not been stated on the other hand, it was stated that exact nature of poison would be detected by chemical analysis for which lungs, liver, heart, kidneys were preserved. What was the report of chemical analysis is not known. What happened of lungs, liver, heart, kidneys preserved at the Hospital is not known. What was the FIR recorded is not known? What was the final investigation report is not known ?

SECTION 174 of Criminal Procedure Code makes special provision for police to enquire and report on "Suicide" or death in suspicious circumstances. Therefore, the police must have definitely made detailed investigation obtained chemical analysis, and forensic expert''s report etc. But the LIC does not appear to have collected any information whatsoever from police, which is the most competent agency next to a Magistrate, to conduct an inquest.

THERE is nothing on record, from enquiry conducted by police. Even the copies of FIR and police final investigation report have not been filed, what to say of chemical analysis, police spot inspection report, panchnama, statement recorded by the police. Even a concise report of the police has not been filed that the police closed the investigation suspecting this to be a case of "Suicide" only. Simply death due to consumption of poisonous substance, with no marks of external injury, does not automatically establish the mode of death as "Suicide". Nexus has to be established to prove that the mode of death was "Suicide" only and not "Murder" or anything of the kind. Possibility of murder by poisoning has to be ruled out. The finding arrived at has to be conclusive, beyond reasonable doubt and based on complete and authentic documents. We find that the enquiry conducted by LIC is neither conclusive nor based on complete and authentic documents, to establish that the mode of death was nothing but "Suicide".

In the instant case, since the deceased insured was member of aboriginal tribe and the beneficiary was an illiterate adivasi widow, repudiation required greater attention by officials at all levels. Whereas, we find that on the other hand there has been height of callousness and gross negligence. The burden lay heavily on the LIC to establish that the repudiation was made in good faith on valid and justifiable grounds (1993 CCJ 534 N.C.) (I 1996 CPJ 13 N.C). The repudiation of the claim by the officers of LIC cannot be said to be decision taken in good faith after due exercise of case and proper application of mind, rather it was arbitrary and oppressive.

AS such we uphold the order passed by District Forum and dismiss the appeal. We further order that the appellant shall pay Rs. 500/- as Advocate''s fee to the respondent for written arguments filed by her. Appeal dismissed with costs.