STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA
Date of Institution: 06.12.2017
Date of final hearing: 16.05.2023
Date of pronouncement: 19.07.2023
First Appeal No.1480 of 2017
IN THE MATTER OF:-
- Reliance Life Insurance Company Ltd. 9th and 10th Floor, R-Tech Park, Nirlon Compound Goregoan (East) Mumbai-400063 through its General Manager.
- Reliance Life Insurance Company Ltd., Ist Floor, SCF-35, Appu Ghar Complex, Opposite IndusInd Bank-Rohtak through its Divisional Manager. ....Appellants
Versus
- Smt. Indu Wd/o Sh. Sudhir.
- Eklavaya minor son of Late Sh. Sudhir through its mother Smt. Indu, Petitioner No.1 being natural guardian and next friend of minor.
- Smt. Sheela W/o Sh. Krishan all R/o VPO Bohar, P S Urban Estate, Rohtak.
…..Respondents
CORAM: Naresh Katyal, Judicial Member
Argued by:- Sh. Rohit Goswami, counsel for the appellants.
Respondent No. 1 and 2 already exparte.
Sh. Rohit Saroha, counsel for respondent No.3.
ORDER
NARESH KATYAL, JUDICIAL MEMBER:
Challenge in this appeal No.1480 of 2017 is invited by Reliance Life Insurance Company Ltd. to the legality of order dated 30.10.2017 passed by District Consumer Disputes Redressal Forum-Rohtak (In short “District Commission”) in complaint case No.375 of 2015.
2. Complainants are: Indu, Eklavaya and Smt. Sheela i.e. widow, minor son and mother respectively of life assured Sudhir, who was holding two insurance policies viz. No. 51873274 and 51873807. Sum assured for his death was Rs.8,84,000/- & Rs.4,38,000/-. Half yearly premium amount was Rs.99,838.54/- and Rs.49,896.59/- respectively. Policy term was for 15 years and premium payment term was 10 years. Life assured had paid amount of Rs.1,49,735.13/- as premium. As per pleadings; Sudhir met with tragic accident on 24.11.2014 at about 09:30 pm when he was pouring Diesel into engine and some diesel fell on his cloths. When, he was lighting, ‘Bidi with match box’; his cloth caught fire and he suffered 80% burns on his body. He was shifted to PGIMS-Rohtak. His MLR was conducted on 24.11.2014 at 10:14 PM. He was shifted at Safdarjung Hospital-Delhi where he was hospitalized for treatment, but he succumbed to burn injuries on 28.11.2014. Police verified the facts and submitted “unnatural death report” vide UDR No. 59 dated 12.12.2014. Police verified the facts from: Ram Kumar S/o Risal Singh, Prem Singh S/o Diwan Singh, Dilbagh S/o Bhim Singh, Ved Pal S/o Sher Singh, Satish S/o Nafe Singh, Tanuj S/o Satpal and Pardeep S/o Om Parkash, all residents of Village:Ghanour, District:Rohtak. Deceased’s father moved application regarding accidental death of his son Sudhir in Police Station:Safdarjung Enclave, New Delhi. Proceedings, under Section 174 Cr.P.C show that: death of Sudhir was accidental. Sudhir did not sign any statement. OPs/appellants wrongly and without any basis rejected the claim by mentioning that ‘company will not pay any claim on death if life assured commits suicide whether sane or insane within 12 months from the date of policy or the date of any reinstatement of policy’. Sudhir did not commit suicide. He died due to fire injuries, caused accidentally. Max Life Insurance passed claim regarding death of Sudhir and paid Rs.2,48,701/- to complainant No. 1 in February-2015 by accepting accidental death of Sudhir. Likewise, LIC also released insured amount for death of Sudhir in favour of Smt Indu. Registered notice was issued on 18.05.2015 to OPs through counsel for settlement of case within 30 days, but no reply was given. On these pleas: complaint has been filed for issuance directions to OPs to pay Rs.13,22,000/- with interest to complainants, Rs.1,00,000/- for damages mental harassment and Rs.30,000/- as litigation expenses.
3. Upon notice, appellants/OPs raised contest. In defence; it is pleaded that: life assured Sudhir expired on 24.11.2014 as intimated by complainants and supported by death certificate. It is pleaded that: story regarding life assured Sudhir having met with accident, while pouring diesel and in that process diesel fell on his cloths, and while lighting of “Bidi”; his cloths caught fire and he suffered burn injuries resulting into his death, is false and fabricated. It is admitted that Sudhir was shifted to PGIMS-Rohtak and then at Safdarjung Hospital-Delhi. It is pleaded that: statements of co-villagers/relatives had been taken favorably, just to get false enrichment and statements do not inspire confidence, as they are not eye witnesses to alleged incident. It is pleaded that it is hard to believe that any prudent man with diesel poured on his cloths will light “Bidi”. During treatment at Safdarjung Hospital-Delhi; Dr. Pardeep Dhaka had recorded history/mode of injury which confirmed that suicide was committed by life assured. On receipt of medical documents and claim form; the same were scrutinized and claim was repudiated, as life assured committed suicide within 12 months from date of issuance of policy. Thus, complainants are not entitled to any compensation. Primarily on these pleas; dismissal of complaint has been prayed.
4. Parties to this lis led evidence, oral as well as documentary.
5. On subjectively analyzing the same; learned District Consumer Commission-Rohtak vide order dated 30.10.2017 has allowed the complaint and directed that: Ops shall pay Rs.8,84,000/- of policy No. 51873274 and Rs.4,38,000/- of policy No. 51873807 (total Rs.13,22,000/-) with interest @9% from filing of complaint i.e. 20.08.2015, till actual realization and shall also pay Rs.5,000/- as litigation expenses, within one month from date of decision, failing which, Ops shall pay interest @12% on awarded amount from date of decision. It is observed that 1/3rd share of awarded amount be paid to complainant No. 1 Indu-wife of deceased Sudhir and remaining awarded amount be paid to complainant No. 2-minor son of deceased and complainant No. 3-mother of deceased, in equal shares. It is observed that amount after disbursement, on account of minor son (complainant No. 2-Eklavaya) should be deposited in any nationalized bank, till his majority and be paid to him on attaining majority.
6. Feeling aggrieved; OPs/insurer have filed this appeal.
7. Learned counsel for appellants and respondent No. 3 has been heard at length. With their able assistance; record of learned District Consumer Commission too has been perused.
8. Learned counsel for the appellants has urged that impugned order dated 30.10.2017 passed by learned District Consumer Commission-Rohtak is erroneous, legally as well factually. Evidence, brought on record has not been appreciated in proper legal perspective. District Consumer Commission has wrongly arrived at conclusion that death of life assured was accidental as there was no direct evidence led by appellant to prove that life assured committed suicide. It has failed to appreciate the express fact recorded by doctor of Safdarjung Hospital-Delhi in death summary that deceased could not control his anger under influence of liquor. As per contention gross, obvious and manifest injustice has been caused to appellants. On these submissions, learned counsel for appellants/insurer has urged for acceptance of appeal by urging that complainant’s claim has been rightly repudiated and repudiation has been conveyed to complainants vide letter dated 03.04.2015.
9. Per contra, learned counsel for respondent No. 3/complainant No.3 has supported the impugned order dated 30.10.2017 passed by learned District Consumer Commission-Rohtak by urging that it is outcome of proper appreciation of facts and evidence and same warrant no interference.
10. It is undisputed that life assured Sudhir had held two insurance policies of the collective value of Rs.13,22,000/-. Risk, in furtherance to these policies had commenced from 18.10.2014. It is admitted that; premium amount of Rs.1,49,735.13/- has also been paid to OPs/appellants, in relation to the above mentioned two insurance policies. It is also admitted that; life assured died on 28.11.2014 and on his death respondents/complainants had submitted claims through their letters Ex.C-4 & C-5. Basis of denial of insurance claim by OPs/appellants is that: life assured-Sudhir had committed suicide within 12 months from the date of issuance of insurance policies. The stance of complainants is that: life assured-Sudhir had met with tragic accident which resulted when he was pouring diesel into engine and in that process some diesel fell on his cloths. When life assured Sudhir was igniting “Bidi” with match box, then his cloths caught fire and he suffered 80% burn injuries which ultimately proved fatal. Learned counsel for appellants has stressed upon recital recorded in death summary Ex. R4 by Doctor of Safdarjung Hospital-Delhi. The operative part of death summary runs in following manner:-
“A/h/o thermal burn, secondary to self infliction with diesel and matchstick. According to the patient, he did this because he could not control his anger under the influence of alcohol. No h/o chronic illness or chronic drug intake.”
Identical is the recital of concerned doctor contained in medico legal report Ex. R3 which too reads as under:-
“A/H/O Thermal burn secondary to self infliction is Diesel and Matchsticks. According to the patient, patient did this because he could not control his anger under the influence of Alcohol.
No h/o Chronic illness or chronic drug intake.”
11. On above basis, insurer has categorized this case, as of voluntary suicide by life assured thereby declining death claim in furtherance to both policies, to complainants. Both, in death summary as well in medico-legal report there is specific recital that: life assured had no past history of any Cronic illness or being Cronic drug intake. MLR Ex. R3 does not reflect that any alcoholic smell was emitting from mouth of deceased life assured, when he initially landed in PGIMS-Rohtak. Therefore, the text recorded in death summary Ex. R4 by concerned doctor of Safdarjung Hospital-Delhi that: according to patient, he did this, because he could not control his anger under influence of alcohol, stood traumatized. It is also bereft of credence for another reason that: as per phraseology of the death summary; it is inferred that patient Sudhir alone had told to concerned doctor that he could not control his anger under influence of alcohol. Curiously enough, no separate statement of patient was recorded in this regard by any doctor who had conducted his MLR on 24.11.2014 & who treated him at Safdarjung Hospital-Delhi. MLR Ex. R3 recites that patient was conscious an oriented to time space and person. Once, the patient was conscious, then concerned doctor conducting MLR on 24.11.2014 could have safely recorded statement of patient-Sudhir, but for the reasons best known to him, he (concerned doctor conducting MLR), had not done so. Further there is no evidence that any statement of patient-Sudhir was recorded under Section 164 Cr.P.C. by Judicial Magistrate. Hence, factually there was no fundamental base before the concerned doctor of Safdarjung Hospital-Delhi and before concerned of PGIMS-Rohtak to record in death summary Ex. R4 and in MLR Ex. R3 respectively that: patient-Sudhir had committed suicide as he could not control his anger under influence of liquor, particularly when, same was not supported by any affidavit of concerned doctor who conducted MLR on 24.11.2014 at PGIMS-Rohtak or who treated patient-Sudhir at Safdarjung Hospital-Delhi. Consequently, the contention of learned counsel for the appellants that learned District Commission has not considered and appreciated the phraseology of death summary, stood repelled. On the other hand, Ex.C-12 is the unnatural death report of Sudhir. This report has been founded on the basis of verification conducted by police from co-villagers/neighbourers of life assured. May be, any prudent man in normal circumstances, with no exception to deceased life assured Sudhir, could not had ignited “Bidi” while consciously realizing that some diesel which is highly inflammable, had fallen on his cloths, yet even if, any “Bidi/cigarette” is lightened with match box/stick which may cause burns to cloths, and in turn, any person suffer extensive fatal burn injuries then, on these given facts; the resultant death will not be categorized as a case of voluntary suicide. It will remain an accidental death. This being so, there is no manifest error, legal or factual in the impugned order dated 30.11.2017 passed by District Consumer Commission-Rohtak. It is affirmed and maintained. OPs/appellants have been rightly non-suited. Present appeal, being devoid of merits is hereby dismissed.
12. Statutory amount of Rs.25,000/- deposited by appellant at the time of filing of this appeal be refunded to it, after due identification and verification as per rules and on expiry of period meant for further appeal /revision, if any.
13. Application(s) pending, if any stand disposed of in terms of the aforesaid judgment.
14. A copy of this judgment be provided to all the parties free of cost as mandated by the Consumer Protection Act, 1986/2019. The judgment be uploaded forthwith on the website of the Commission for the perusal of the parties.
15. File be consigned to record room.
Date of pronouncement: 19thJuly, 2023
Naresh Katyal
Judicial Member
Addl. Bench-II
