Smt. Meera Devi vs Life Insurance Corporation of India and Others

Sibghat Ullah Khan, J.—Heard learned Counsel for the parties.

Sri Amar Nath late husband of the Petitioner took a policy from Life Insurance Corporation of India(L.I.C.) Respondent No. 1 under plan and term 133 - 20 triple cover. Number of the policy was 283344966 and it was taken on 30.9.2003. In less than three months i.e. on 22.12.2003 Sri Amar Nath died in District Hospital Ballia where he had been admitted a day before. It was a case of suspected food poisoning. In viscera report dated 9.11.2011, organic insecticide poison was found. Petitioner herself lodged F.I.R. on 1.8.2005 in PS Kotwali Ballia in which final report was submitted on 21.10.2005 and accepted on 19.11.2005 as it could not be ascertained by the police that who administered poison (para 5 of the writ petition).

Petitioner being nominee lodged the claim with the Branch Manager LIC Branch Ballia. The matter was referred to senior Divisional Manager who made the investigation and through his letter dated 3.3.2006/20.3.2006 rebutted the claim of the Petitioner on the ground that late Sri Amar Nath had committed suicide and suicide clause of the policy was operative.

Late Sri Amar Nath had taken two more policies from Life Insurance Corporation. In respect of both those policies due payments were made to the Petitioner. According to the Petitioner her husband had not committed suicide, some one else had administered poison and the officers concerned of the LIC invented the excuse of suicide to deny the claim in respect of policy in question taken on 30.9.2003 (para 6 of the writ petition). In respect of policy in question No. payment was made. Petitioner lodged the complaint with Insurance Ombudsman where it was registered as complaint No. L-743/21/001/06-07. The Ombudsman decided the matter on 18.5.2007 the copy of the said order is Annexure 2. Through Annexure 2 it was held that instead of triple the amount, only the amount for which policy was taken i.e. Rs. 5,50,000/- should be paid to the Petitioner while under the policy in question three times of the said amount i.e. total Rs. 16,50,000/-should have been payable in the normal course. Through this writ petition order contained in Annexure 2 has been challenged in so far as it is against the Petitioner. According to the learned Counsel for the Petitioner triple the amount i.e. Rs. 16,50,000/-should have been paid to the Petitioner.

As far as effect of payment in respect of earlier two policies is concerned it is not much material because suicide clause operates only if suicide takes place within a particular time of taking policy. Suicide had taken place after the said period in respect of the earlier two policies. One sentence of para 5 of the impugned order is quoted below:

The matter was investigated by the Police and by the I.O. of insurer who in their report say that it is not established whether the deceased has himself consumed poison or somebody administered the same.

Para 6 of the impugned order is quoted below:

In view of the above facts it is not clear nor it is established conclusively by the I.O. or by any other records about the nature of death. In the post mortem report (EX R-1) it is mentioned that "cause of death could not be ascertained". I see that from the available evidence there is only suspicion about the suicide aspect and mere suspicion however strong can not substitute proof. As per law of evidence of the Land a matter is said to be proved if it is completely established without any doubts. Similarly a fact is said to be disproved if it is established without any doubt to the contrary. But when a fact is neither proved nor disproved it is called merely "not proved". The above case falls into the definition of "not proved" and as such the advantage has gone to the complainant. Under these peculiar circumstances it is not fair to burden the Respondent company to honour the policy terms in toto i.e. the triple benefit basis.

Clause 6 of the conditions and privileges of the policy in question annexed as Annexure No. II along with written arguments filed by learned Counsel for LIC is quoted below:

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 bonafide 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 calendar month prior to death.

From the above quoted clause relating to suicide it is quite clear that it must be proved that suicide was committed by the insured. However, in the impugned order by the Ombudsman itself it is clearly mentioned that suicide was not proved. In such a situation benefit can not be denied on the ground of suspicion of suicide.

Accordingly, impugned order in so far as it is against the Petitioner is set aside and it is directed that Petitioner must be paid balance amount i.e. Rs. 11,00,000/-positively within three months. (In case the amount of Rs. 5,50,000/-awarded by the impugned order has not yet been paid to or withdrawn by the Petitioner then the same shall also be paid to or permitted to be withdrawn by the Petitioner within three months).

However, as there was genuine dispute regarding liability hence No. interest shall be payable to the Petitioner in case amount is paid within three months from today failing which 2% per month interest shall be payable since after three months till actual payment.

Writ petition is allowed accordingly.