Decided on January 11,2004

L I C OF INDIA Appellant
RINKU PANDEY Respondents


- (1.) THIS appeal has been filed against the order dated 20.5.2003 passed by District Forum, Ara in Complaint Case No. 243/2003 whereby and whereunder the Forum has directed the O.P. -appellant to pay the complainant a sum of Rs. 50,000/ - towards the double accident benefit claim with interest @ 9% from 16.3.2001 till the date of payment and Rs. 1,000/ - has been awarded towards the cost of litigation.
(2.) THE brief fact of the case is that complainant s husband had a insurance with the O.P. -appellant. The insurance was for Rs. 50,000/ - under the double accident benefit scheme. The life assured was shot dead by miscreants on 16.3.2001. His wife, the complainant filed claim before the L.I.C. The Insurance Company asked for copy of the F.I.R. Post -mortem Report, Police Report and other documents but the complainant did not submit the papers. The L.I.C. paid the complainant Rs. 60,700/ - (Rs. 50,000/ - as the sum assured and Rs 10,700/ - as bonus) but repudiated the claim of further payment under double accident benefit scheme. The complainant filed the case before the District Forum claiming Rs. 50,000/ - as of double accident benefit scheme besides interest and compensation. The O.P. -Insurance Company appeared and filed written statement. The fact of insurance for Rs. 50,000/ - under double accident benefit scheme by the complainant s husband is admitted. The payment of Rs. 60,700/ - as detailed above is also admitted. The contention of the L.I.C. was that complainant failed to submit required papers such as F.I.R., Post -mortem Report, Police Final Report, etc., therefore, she was not entitled for Rs. 50,000/ - more under double accident benefit scheme and on this ground this amount was repudiated.
(3.) THE learned Lawyer of the L.I.C. submitted before us that the document which were asked for by the Insurance Company were necessary for consideration of accident benefit scheme because the satisfaction of the L.I.C. was essential to come to the conclusion that life assured had died due to an accident. The double accident benefit cannot be claimed as a matter of right. Under paragraph -10 of the policy bond the life assured was to furnish these documents for the satisfaction of the L.I.C. for making payment under double accident benefit scheme. The District Forum has wrongly held that non -payment of claim of the complainant was a deficiency. The respondent -complainant s lawyer submitted that L.I.C. has wrongly withheld Rs. 50,000/ - plus bonus thereupon on the flimsy ground of non -supply of F.I.R., Post -mortem Report, etc. only on being satisfied that complainant s husband died in an accident as he was shot dead, Rs. 60,700/ - were paid to her. The complainant has informed the L.I.C., about the cause of accidental death of her husband but L.I.C. slept over the matter.;

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