IMPORTANT POINTS
(1) Private agency does not substitute for the police.
(2) State Commission erred in terming the accident as suicide placing reliance on the report of a private agency.

ORDER

Dinesh Singh, Presiding Member—This Appeal has been filed under Section 19 of The Consumer Protection Act, 1986, challenging the Order dated 20.12.2012 in C. C. No. 20 of 2011 passed by The State Consumer Disputes Redressal Commission, Haryana.

The Appellants, Mrs. Kamla Devi and Mr. Rajesh Bansal, the widow and son of the deceased assured, were the Complainants before the State Commission.

The Respondents No. 1 and No. 2, TATA AIG Life Insurance Corporation Ltd. and its Branch Manager, were the Opposite Parties No. 1 and No. 2 before the State Commission.

The Respondent No. 3, Mr. Raj Kumar, Agent of the Insurance Co., was the Opposite Party No. 3 before the State Commission.

The Respondents No. 4 and No. 5, Mr. Mukesh Bansal and Mr. Sandeep Bansal, sons of the deceased assured, were the Opposite Parties No. 4 and No. 5 before the State Commission.

2. Heard arguments from learned counsel for the Complainants and the learned counsel for the Insurance Co. and perused the material on record including inter alia the impugned Order dated 20.12.2012 of the State Commission and the Memorandum of Appeal.

3. Brief facts, shorn of unnecessary rhetoric, are that late Shri Jai Prakash, the life assured, husband / father of the Complainants had obtained four insurance policies from the Insurance Co. through its Agent. He met an unnatural death on 04.01.2010 on coming under a running train while crossing some railway tracks. The Insurance Co. did not query three of the four policies. In respect of the fourth policy, the subject policy in question here, it objected to the claim on ground that the death was not accidental but a case of suicide, falling under the exceptions to the policy, and declined the claim.

4. The first argument made by the Insurance Co. was that the other three policies were concealed while taking the fourth policy i.e. the subject policy.

The subject policy was taken through the same Agent. The details of the other three policies were in the records of the Insurance Co. The State Commission placed reliance on this Commission’s judgment rendered in Revision Petition No. 4502 of 2010 Life Insurance Corporation of India vs. Smt. Shahida Begum decided on 06.07.2011. This Commission’s said judgment inter alia quoted Hon’ble Supreme Court’s judgment in M/s Modern Insulators Ltd. Vs. Oriental Insurance Co. Ltd. – 1 (2000) CPJ 1 (SC). The State Commission, giving valid reasons for the same, concluded that “the non-disclosure of the previous policies by the life assured is not fatal to the claim of the complainants”.

The fourth policy, the subject policy, was taken through the same Agent, from the same Insurance Co., details of the other three policies were in the records of the Insurance Co., there is not an iota of evidence to suggest any malafide on the part of the life assured, the facts of the instant case are covered by Hon’ble Supreme Court’s judgment in M/s Modern Insulators Limited. Vs. Oriental Insurance Co. Ltd.

This Commission agrees with the appraisal and reasoning of the State Commission on this issue and endorses the State Commission’s findings that in the instant case non-disclosure of the previous policies by the life assured is not fatal to the claim.

5. The second argument made by the Insurance Co. was that the life assured had committed suicide, which falls under the exception clause of the policy, that it was not a case of accidental death.

The State Commission, in its appraisal, has principally relied on a medico-legal opinion dated 19.01.2011 from one Adroit Consultancy Medico Legal Services and concluded that the life assured had committed suicide, his death was not accidental.

Based on the papers and documents submitted on file by the Insurance Co. to this agency, the agency, a private agency, in its report to the Insurance Co., concluded that the injuries on the deceased are possible only in cases of suicide death. The relevant portion of its opinion, quoted by the State Commission in its impugne