The central legal point established is that the terms and conditions of a life insurance policy must be strictly construed, and the violation of law by the insured can lead to the rightful repudiation of an accidental claim by the insurer.

ORDER

C.C. Pant, Member - This is insurer's appeal against the order dated 27.4.2005 passed by the District Forum, Udham Singh Nagar, partly allowing the consumer complaint No. 44 of 2004 and directing the insurer to pay to the complainant sum of Rs. 50,000 together with bonus and interest @ 9% p.a. from the date of filing of the consumer complaint till payment and Rs. 1,000 towards litigation expenses, within a month from the date of the order.

2. Briefly stated, the facts of the case which led the complainant Smt. Balvinder Kaur to file a consumer complaint, are that her husband Sh. Baldev Singh was insured with the Life Insurance Corporation of India ("LIC" for short) against a policy with accidental benefit. In this policy, the insured had nominated his wife, the complainant, as the nominee in the event of his death. The insured died in an accident on 11.5.2002 while driving a tractor. The LIC paid to the complainant the insured amount of Rs. 50,000, but in respect of the accidental claim of an equal amount of Rs. 50,000, her claim was repudiated on the ground that the insured was driving the tractor without holding a driving licence. On filing a consumer complaint before the District Forum, the District Forum partly allowed the same in the above terms. Aggrieved by the said order, the LIC has filed this appeal.

3. We have heard the learned Counsel for the parties and perused the material placed on record.

4. The learned Counsel for the Insurance Company submitted that the insured was driving the tractor without a licence for driving the same. While driving the tractor, it got overturned, causing the death of the insured. The learned Counsel pointed out to the policy condition No. 10(2)(b), which stipulates that the LIC shall not be liable to pay the additional sum if the death of the life assured was caused by intentional self injury or whilst the life assured was under the influence of intoxicating liquor, drug or narcotic and also if the life assured's death was a result of committing any breach of law. The learned Counsel's submission was that driving a tractor without a driving licence, amounts to intentional self injury. Also, according to the report of the police, the insured was found under the influence of liquor at the time of the accident. The learned Counsel further argued that driving a tractor without a driving licence, is a gross violation of the provisions of the Motor Vehicles Act, 1988 and, thus, the death of the life assured was a result of committing breach of law. For these reasons, the Insurance Company has rightly repudiated the accidental claim and has, thus, not made any deficiency in service. The District Forum without appreciating this legal aspect of the case, has erred in holding the Insurance Company liable to pay the additional amount to the complainant against accidental benefit.

5. The learned Counsel for the complainant-respondent submitted that the accident causing the death of the life assured had no direct nexus with the driving licence. If the death is a result of an accident, the Insurance Company is bound to pay the accidental benefit also.

6. We considered the respective submissions. A life insurance policy is a contract between the LIC and the insured and, therefore, the terms and conditions of the policy must be strictly construed with while deciding a claim. In the present case, the insured was driving the tractor without holding a driving licence for that purpose. He was entitled to drive a motorcycle only, with or without gear and no other vehicle. Therefore, this act of the insured was certainly a violation of the provisions of the Motor Vehicles Act, 1988. Further, the police report (Paper Nos. 32 to 33) states that:

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7. The learned Counsel for the complainant submitted that the post-mortem report did not state the presence of liquor in the body of the deceased and, therefore, it cannot be said that the deceased/ insured was under the influence of liquor. But