Sebastian. C. vs Union of India (UOI) and Branch Manager, L.I.C.

S. Siri Jagan, J.—The petitioner''s brother Rojomon C.C. took a life insurance policy from the 2nd respondent for a sum of Rs. 50,000/- on 15-12-2004 with double accident benefit. The said Rojomon died in an accident at Goa on 17-11-2005. As a nominee as per the policy, the petitioner was paid a sum of Rs. 52050/- as the sum assured and allowable bonus. However, as per that policy, since the death was by an accident, a further sum of Rs. 50,000/- was also due to the nominee by way of double accident benefit. The petitioner''s grievance in this writ petition is that the said amount by way of double accident benefit is not being paid to the petitioner on the ground that the petitioner has not produced the final report of the Police and the judgment of the Magistrate in the case arising from the accident. The petitioner therefore seeks the following relief:

To call for the records leading to Ext.P1 to P7 and to issue a writ of mandamus, or any other writ, order or direction to the 3rd and 4th respondents to disburse the Double Accident Benefit (D.A.B) claim amount to the petitioner forthwith, without making any further insistence as mentioned in Ext. P6 and P7.

According to the petitioner, in so far as, admittedly, the death was in an accident, for releasing the policy amount by way of double accident benefit, the said documents are unnecessary. Therefore, the petitioner submits that the petitioner cannot be denied the amount by way of double accident benefit under the policy on the ground that the petitioner has not produced those documents.

A counter affidavit has been filed on behalf of respondents 2, 3 and 4. In the same, the policy and the death by accident are admitted. But, according to them, the double accident benefit is excluded if the death results on account of the life assured committing any breach of law. They would submit that as per Ext. P1 complaint, the police have stated that the life assured was driving the vehicle at the time of accident in a rash and negligent manner and at a high speed. According to them, it is also borne out from the records that the life assured was carrying two pillion riders in violation of the Motor Vehicles Act and Rules. Therefore, according to them, as per Clause 10(2) of Ext. R2 (A) policy, the eligibility for double accident benefit is clearly excluded. They would submit that, therefore, unless the petitioner produces the final report of the Police and the judgment by the Magistrate proving that the life assured has not violated any condition of law, the petitioner cannot claim the amount under the double accident benefit clause.

I have considered the rival contentions in detail.

In the counter affidavit itself, the respondents 2 to 4 do not dispute the policy and the eligibility of the petitioner to get double accident benefit also, if the conditions of the policy are satisfied. If the respondents have a case that on account of any act of the life assured the eligibility is excluded, it is for them to prove the same and repudiate the contract on account of the same. Admittedly, they have not yet repudiated the claim under the policy. Their only contention is that in the absence of the documents called for to decide the eligibility, the the petitioner cannot be paid the amount.

Admittedly, the life assured died in a road accident on 17-11- 2005 at Verna in Goa. It would be very very difficult, if not impossible, for the petitioner to go over to Goa and get those documents. On the other hand, it would be easy for respondents 2 to 4 to get those documents since they have branches all over India including Goa. When it is respondents 2 to 4 who allege violation of the policy conditions, the onus is on them to prove such violation. That being so, the respondents 2 to 4 cannot simply sit back and say that since the petitioner failed to produce the records called for, they will not process the claim under the policy. It is unbecoming of the instrumentality of the State to take such an attitude. That being so, I am of opinion that respondents 2 to 4 cannot simply refuse to consider the claim of the petitioner on the ground that the petitioner has not produced the documents called for. In the above circumstances, the writ petition is disposed of with the following directions:

Respondents 2 to 4 shall get the documents called for, from the appropriate authority at Goa and based on that documents decide the eligibility of the petitioner for the double accident benefit also. If the respondents 2 to 4 still decides to repudiate the claim of the petitioner they shall issue a reasoned order to the petitioner supplying the relevant documents relied upon for that purpose to the petitioner. This shall be done within three months from the date of receipt of a copy of this judgment. If the respondent are unable to find any document in support of their contention regarding violation of the policy conditions by the life assured within the said three months, the amounts under the double accident benefit shall also be disbursed to the petitioner within one month therefrom.