LIFE INSURANCE CORPORATION OF INDIA vs CHANDER SHEKHAR

THIS revision petition has been filed by the petitioner against the order dated 4.3.2008 passed by the State Consumer Disputes Redressal Commission, Delhi (in short, ''the State Commission '') in Appeal No. A -306/2005 - LIC of India Vs. Chander Shekhar by which, while dismissing appeal, order of District Forum allowing complaint was upheld.

BRIEF facts of the case are that complainant/respondent ''s wife Sangeeta obtained policy for Rs.1,00,000/ - from OP/petitioner on 28.8.1997 and Sangeeta died on 29.4.1999. Complainant being husband and heir of deceased Sangeeta submitted claim which was repudiated by OP on the ground of death of policyholder under mysterious circumstance. Alleging deficiency on the part of OP, complainant filed complaint before District Forum. OP resisted complaint and submitted that as death of complainant ''s wife was under mysterious circumstance, claim was not maintainable and was rightly repudiated and prayed for dismissal of complaint. Learned District Forum after hearing both the parties allowed complaint and directed OP to pay Rs.1,00,000/ - with 9% p.a. interest and further allowed cost of Rs.5,000/ -. Appeal filed by the petitioner was dismissed by learned State Commission vide impugned order against which, this revision petition has been filed. Heard learned Counsel for the parties and perused record.

LEARNED Counsel for the petitioner submitted that as per terms and conditions of policy death of assured did not occur in accident in public place, petitioner rightly repudiated the claim, but learned District Forum committed error in allowing complaint and learned State Commission further committed error in dismissing appeal; hence, revision petition be allowed and impugned order be set aside. On the other hand, learned Counsel for the respondent submitted that order passed by learned State Commission is in accordance with law, which does not call for any interference; hence, revision petition be dismissed.

IT is not disputed that deceased obtained policy on 28.8.1997 and she died on 28.4.1999 meaning thereby within two years of obtaining of policy. As per terms and conditions of policy, Clause 4B appended with the policy was applicable, which runs as under: ''''Notwithstanding anything within mentioned to the contrary, it is hereby declared and agreed that in the event of death of the life assured occurring as a result of intentional self -injury, suicide or attempted suicide, insanity, accident other than an accident in a public place or murder at any time on or after the date on which the risk under policy has commenced but before the expiry of three years from the date of this policy, the corporation ''s liability shall be limited to the sum equal to the total amount of premium (exclusive of extra -premiums, if any) paid under this policy without interest. '''' Provided that in case the life Assured shall commit suicide before the expiry of one year reckoned from the date of this policy, the provisions of the clause under the heading, ''''Suicide '''' printed on the back of the policy shall apply.

Perusal of aforesaid clause makes it crystal clear that if within a period of 3 years from taking policy, death of assured occurrs as a result of intentional self -injury, suicide, accident other than an accident in a public place, LIC ''s liability is limited to the sum equal to the total amount of premium paid under the policy without interest.

NOW , the core question to be decided in this matter is whether death occurred in an accident in public place or not. Complainant has not mentioned in the complaint under what circumstances death occurred. In support of his complaint, complainant and his father filed affidavit in which it was mentioned that complainant along with his wife Sangeeta were returning from marriage party in the intervening night of 28.4.1999 and 29.4.1999 and at 12.30 A.M. in the mid -night on account of accident both fell unconscious and some passers -by took them to Jaina Hospital, Meera Bagh, Delhi and on next day while shifting to Maharaja Agarsen Hospital , Sangeeta succumbed to death due to injuries. Neither this fact finds place in the complaint, nor complainant filed any FIR regarding accident. On the other hand, complainant submitted statement to LIC in which it was mentioned that Sangeeta fell down in the bathroom which caused immediate death due to neck bone fracture and this statement bears signatures of complainant. As per certificate of Jaina Hospital, Sangeeta was admitted in the hospital on 29.4.1999 at 1.30 A.M. She was having multiple lacerated cuts on face with bleeding wounds. She was advised to stay in the hospital for observation, but she left hospital against medical advice. From perusal of Jaina Hospital record, it becomes clear that nowhere it was mentioned that Sangeeta sustained injuries in any accident. Nowhere it has been reported that on account of neck bone fracture, she was admitted in the hospital. Not only this, Sangeeta was taken from hospital against the medical advice and she was brought to Maharaja Agarsen Hospital only after death. No post mortem was placed on record and in such circumstances, it cannot be believed that Sangeeta died due to injuries sustained in road accident and complainant was entitled to refund of only premium paid by the assured and not the policy amount as per Clause 4 -B of the policy. Learned District Forum committed error in allowing complaint fully and learned State Commission further committed error in dismissing appeal and imposing cost of Rs.25,000/ - and impugned order is liable to be set aside.

CONSEQUENTLY , revision petition filed by the petitioner is allowed and impugned order dated 4.3.2008 passed by the State Commission, Delhi in Appeal No. A -306/2005 - LIC of India Vs. Chander Shekhar and order of District Forum dated 2.4.2005 in Case No. OC/1240/01 - Chander Shekhar Vs. LIC of India are set aside and modified and complainant is held entitled to refund of premium paid by assured to OP with no order as to costs.