Murder can be treated as accident National Consumer Forum order
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Murder can be treated as accident, insurance company ordered to pay compensation

Royal Sundaram Alliance Vs Pawan Balram Mulchandani on 25.9.2018

The relevant brief facts of the case are that Balram Mulchandani (since deceased, “the insured”) took personal accident shield insurance policy from M/s Royal Sundaram Alliance Insurance Co. Ltd. for the period 05-11-2008 to 04-11-2009 for an assured sum of Rs.20,00,000/-. For several years he had been taking the insurance policy and getting it renewed without any break.

The deceased had gone to his office on 21-01-2009, but he did not return home till 10 P.M. The complainant and his family members got worried and they made several inquiries and telephone calls. Thereafter the relatives lodged a complaint of ‘missing person’ at the Police Station, Ulhas Nagar. The police investigated the matter and arrested some persons who revealed that they had murdered Balram Mulchandani. The complainant filed a death claim with the OP-insurance co., but it was repudiated on the ground that the death was not due to ‘accident’, but was a case of ‘murder simplicitor’.

Being aggrieved by the repudiation, the complainant, Pawan Mulchandani, the son of the deceased first filed a complaint on 01-02-2011 before the District Forum, which was dismissed on the ground of territorial jurisdiction on 5.8.2011. Subsequently, he filed a complaint before Maharashtra State Consumer Disputes Redressal Commission (for short “the State Commission”).

The OP-insurance company contested the complaint by filing a written statement before the State Commission. The first contention raised was that since the complaint had been filed after two years from the date of repudiation, the complaint was barred by limitation under Section 24A of the Consumer Protection Act, 1986. The claim was repudiated on 26-05-2009, whereas the complaint was filed on 31-08-2012 after a considerable delay. Thus, the complaint was not maintainable. Secondly, as per the terms & conditions of the policy, the OP was not liable to pay the claim because the complainant had waived his right to sue by not filing the claim within 12 months from the date of cause of action. (However, the limitation for complaint under the Act 1986 is 24 months from the cause of action.) The OP further submitted that the murder took place because of property dispute between the parties. Balram Mulchandani was first kidnapped and then murdered on 21-01-2009. Therefore, it was clear that it was a case of ‘murder simplicitor’, and did not fall within the definition of ‘accident.’ The claim was not covered under the said personal accident shield policy.

After appraising the pleadings and evidence, the State Commission allowed the complaint and directed the OP to pay the insured amount of Rs.20,00,000/- with interest at the rate of 9% per annum from the date of repudiation along with cost of Rs.25,000/-

Aggrieved by the order of the State Commission, the OP insurance company filed an appeal vide FA/1357/2016 on 21-10-2016.

After analyzing the facts and circumstances in both these cases, and by referring to other legal precedents, the Commission reached the conclusion that in case the immediate cause of injury was not the result of any deliberate or willful act of the insured and that the occurrence of the accident was not expected on the part of the insured, the murder was to be counted as an ‘accident’. The Commission categorically stated that unless the immediate cause of injury was deliberate and wilful act of the insured himself, it was difficult to hold that the murder was not an ‘accident’.

The Commission further stated that the terms and conditions of the insurance policy in question, under the heading ‘Exceptions’. Nowhere under the said clause it has been stated that the insurance company was not liable to pay the claim in case of murder. It has been stated that if there was an intentional self injury, suicide or attempted suicide the claim was not payable.

It stated that the death of the insured took place due to injuries caused by external, violent, visible means.

With regard to questions of limitation and territorial jurisdiction, the National Commission referred to para 5 of the State Commission’s Order.

“In the present case, our attention is also invited to the order passed by the District Consumer Disputes Redressal Forum, Central Mumbai, Parel, whereby earlier by order dated 05/08/2011 the complaint was disposed of on the ground that it was not within the territorial jurisdiction of the said District Forum. However, specifically it was made clear that right of the complainant to approach appropriate forum was kept unaffected. In other words, complainant had liberty to approach the State Commission.”

The limitation period under the Act, 1986 is two years from the date on which the cause of action arose. The claim was repudiated on 26.05.2009. The complaint was filed in the District Forum on 01.02.2011. It was disposed of on 05.08.2011 on ground of territorial jurisdiction with the right of the complainant to approach appropriate forum kept unaffected. Objections on limitation and territorial jurisdiction are erroneous and lack merit. In any case, seeing the facts of the case, seeing that the complainant was running to police, sessions court, insurance company, District Forum, State Commission, seeing that it was a case of unexpected murder, seeing that it is reasonable to conclude that the complainant and the deceased’s close family were in continuous shock and grief, continuous harassment and difficulty, therefore, in the totality of the case, any imperfection on limitation or territorial jurisdiction (though we see none) merits to be condoned in the interest of justice and to prevent miscarriage of justice.

Upholding the State Commission’s order for …………………, the National Commission further added that it felt just and appropriate that a reasonable compensation of Rs.2,00,000/- shall also be paid by the insurance co. to the nominee(s) within four weeks of this Order, failing which it shall attract interest at the rate for fixed deposit of any one scheduled nationalized bank. (The said rate of interest shall be ascertained by the insurance co.)

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
25-09-2018



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