ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA Date of Institution: 26.10.2023 Date of final hearing: 07.10.2024 Date of pronouncement: 07.01.2025 First Appeal No.1213 of 2023 IN THE MATTER OF:-

1. Life Insurance Corporation of India, Jind Branch, through its Branch Manager.

2. LIC Divisional Office, P.O. Box No.106, Jeevan Parkash, 489, Model Town, Karnal, through its Divisional Officer.

.....Appellants Versus Sarina Devi (Aadhar No.6740-9502-1043) W/o Late Shri Pardeep, R/o Village Budain, Tehsil Uchana, District Jind.

…..Respondent CORAM: Sh. Naresh Katyal, Judicial Member.

Sh. S.C. Kaushik, Member Argued by:- Mr. Piyush Sharma, counsel for appellants.

Mr. Suresh Ahlawat, counsel for respondent.

ORDER

NARESH KATYAL, JUDICIAL MEMBER:

Challenge in this Appeal No.1213 of 2023 filed by appellants/Life Insurance Corporation of India (LIC) has been invited to legality of order dated 01.09.2023 passed by District Consumer Disputes Redressal Commission-Jind (In short “District Consumer Commission”) in complaint case No.393 of 2019, vide which complainant’s complaint has been allowed.

2. Factual matrix: Complainant’s husband Pardeep got himself insured vide policy of appellant/insurer against insured sum of Rs.5,00,000/-. He paid premium of Rs.2303/- on 03.08.2017. Complainant was nominee under policy. As per plea, on 18.09.2017, her husband after spraying pesticides in his fields came back home and started vomiting. He was got admitted in hospital where he died on 19.09.2017 due to effect of pesticides spray. His postmortem was conducted. DDR No.31 dated 20.09.2017 was also registered with police. Complainant, being nominee under policy, applied to the appellant/insurer for claim and submitted documents to insurer/appellant. Her claim was repudiated by insurer vide its letter dated 01.08.2019 mentioning “death of husband of complainant falls under Suicide Clause in Para No.4 (i) in the Policy Bond as he committed Suicide within one year from the date of policy”. However, 80% of paid premium so deposited by complainant’s husband i.e. Rs.3430/- has been paid by insurer vide cheque No.0009207 dated 31.07.2019 to complainant. Complainant submitted representation before insurer on 18.09.2019 to reconsider the claim. Vide letter dated 24.09.2019; complainant was informed that matter was not reviewed as her death claim was rejected. It is pleaded that complainant’s husband was a constable in CRPF. He was hale and hearty; not suffering from any disease and economically sound. Her husband’s death did not fall under definition of Suicide, as it was the result of effect of pesticides spray, while he was working in field. It is also pleaded that her husband, during his life time on 14.11.2014, purchased another life insurance policy from SBI Life Insurance for insured sum of Rs.2,00,000/-. After his death; complainant filed application for taking benefit of policy from SBI Life Insurance and her claim was settled by SBI Life Insurance. Rs.2,36,062.50 were transferred in bank account. By pleading that she is entitled to full policy benefit of Rs.5,00,000/- with interest from OPs and her claim was illegally repudiated which amounted to deficiency in service of OPs and resulted her to face mental tension, harassment and physical pain; she filed complaint by asserting cause of action.

3. Upon notice; OPs/insurer raised contest. In its defense, it is pleaded that: complaint is not maintainable. Policy was taken on 14.08.2017 and life assured was admitted in hospital on 18.09.2017 due to consuming ‘celphos tablets’ and he expired on 19.09.2017. Chemical examination report showed that ‘aluminum phosphide’ was found in his stomach, small and large intestine, lung, liver, spleen, kidney and blood taken from heart of life assured. Duration was only of one month and five days from date of commencement of risk. Hence, as per plea, suicide clause was operative and nothing was payable as per terms and conditions of policy. OPs have stressed upon