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MAHARASHTRA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, MUMBAI
S.M. SHEMBOLE, K.B. GAWALI, UMA S. BORA, JJ.
Shahaji Janardan Kadam – Appellant
Versus
Life Insurance Corporation of India and Another – Respondents
F.A. No. 210 of 2012
Decided On : 05-08-2013
Advocate Appeared:
For the Appellant : Mr. S.A. Wakure.
For the Respondent: Mr. K.M. Bardapurkar.
In the absence of evidence supporting the insurance company's claim of suicide, the appellant was entitled to the accident benefit. Additionally, filing a complaint within the limitation period supported the appellant's claim.
Headnote:
Accidental Benefit - Insurance Claim - The court held that the appellant was entitled to the accident benefit as the evidence did not support the insurance company's claim that the deceased had committed suicide. The court also found that the complaint was filed within the limitation period, and therefore, the appellant was entitled to the benefit.
Fact of the Case:
The appellant filed a complaint against the insurance company for refusing to pay the accidental benefit claim after the death of the policyholder. The insurance company claimed that the deceased had committed suicide and therefore the appellant was not entitled to the benefit.
Finding of the Court:
The court found that the evidence did not support the insurance company's claim of suicide, and the complaint was filed within the limitation period. Therefore, the appellant was entitled to the accident benefit.
Issues: The main issue was whether the appellant was entitled to the accident benefit after the death of the policyholder, and whether the complaint was filed within the limitation period.
Ratio Decidendi: The court held that in the absence of proof of suicide by the deceased, the appellant was entitled to the accident benefit. Additionally, the complaint was filed within the limitation period, supporting the appellant's claim.
Final Decision: The court partly allowed the appeal and ordered the respondent to pay Rs.1 lakh for the accident benefit with interest from the date of repudiation of the claim.
ORDER :
1. Shahaji Janardan Kadam appellant herein original complainant challenge in this appeal dismissal of complaint Case No.164/2011 passed by District Consumer Forum Osmanabad on 5.3.2012.
2. The facts giving rise to this appeal are as under:
Complaint was filed against LIC Divisional Manager and Branch Manager of Osmanabad and Aurangabad for getting accidental benefit as per policy No.984919698 obtained in the name of Neeta Shahaji Kadam who was wife of complainant. 'Money Plus' policy was obtained in the name of Neeta Kadam for the period 13.4.2007 to 13.4.2026 for Rs.1 lakh with the accident benefit of Rs.1 lakh. It is further submitted that on 29.11.2008 while spraying insecticide in the sugarcane crop Neeta Kadam inhaled the insecticide namely Thaimet. Immediately she was admitted in the Government Hospital at Solapur by her husband. But she succumbed to the death on 3.12.2008. Accidental death was registered as per Cr.No.57/2008 U/s 174 of Cr.P.C. Accordingly, the claim was preferred with the insurance company. Insurance company paid Rs.1 lakh as policy amount on 31.3.2009 but refused to pay Rs.1 lakh for accidental benefit. The claim was repudiated by insurance company on 7.3.2009 on the ground that Neeta committed suicide therefore accident benefits will not be given. Therefore complainant approached to Forum.
3. Appellant LIC appeared before the Forum and resisted the claim on the ground that after the investigation about the policy claim it was found that Neeta Kadam died due to poisoning. As per policy terms and conditions, nominee is not entitled to accident claim in the event of suicidal death as Neeta Kadam died due to suicide, complainant is not entitled to accident benefit. Therefore his claim was rightly repudiated.
4. After hearing both the parties District Consumer Forum held that policy holder Neeta died due to suicide and therefore complainant is not entitled to claim amount.
5. Dissatisfied with the judgment and order original complainant came in appeal.
6. Adv. Sanjay Wakure appeared for appellant and Adv. K.M. Bardapurkar appeared for LIC. It is submitted by Adv. Wakure that accidental death was registered after inhalation of insecticide wrongly by the wife of complainant. She was admitted in the Government Medical Hospital, Solapur where she died on 3.12.2008. But no evidence to show that Neeta Kadam died due to suicide is brought on record by the insurance company. It is further submitted by Adv. Wakure that police recorded A-summary as there was no suspicion about her death. Even police recorded statement of mother and brother of deceased Neeta. They did not allege any suspicion about the complainant or anybody else. Therefore police recorded A-summary in the proceedings. It is further submitted by Adv. Wakure that District Consumer Forum without considering the documentary evidence produced on record wrongly held that Neeta Kadam committed suicide. Therefore appeal be allowed.
7. Adv. Bardapurkar at the outset took objection on the ground of limitation. He submitted that on 7.3.2009 claim was repudiated therefore complaint is not within limitation. He further submitted that District Consumer Forum rightly held that Neeta Kadam died due to suicide and rightly dismissed the complaint. In support of his contention he relied on Kandimalla Raghavaiah and Co. vs. National Insurance Co. Ltd. and Another, (2009) 4 CPR 17 (SC) wherein it is held by Apex Court that "As per Section 24 of the Act, it is mandatory on the complainant to file the complaint within two years from the date of cause of action."
8. We thus consider the statement of both the counsel and perused the record. Firstly, about the limitation. On 15.3.2011 the claim was repudiated by LIC in respect of accidental benefit. Thereafter complaint filed on 8.4.2011 which is well within limitation.
9. Accidental death under 174 of Cr.P.C. was registered after occurrence of incident of inhalation of insecticide by Neeta Kadam. No criminal complaint against
