DIVISIONAL MANAGER LIC OF INDIA REP. BY ITS BRANCH MANAGER ONGOLE Vs. Y. VIJAYA KUMARI

JUDGEMENT

(1.) This is an appeal preferred by the opposite party insurance company against the order of the Dist. Forum directing it to pay Rs. 2,27,531/- with interest @ 9% p.a., from 28.3.2006 till the date of realization together with compensation and costs of Rs. 1,000/- each.

(2.) The case of the complainant in brief is that she is the wife of late Samuel who worked as Headmaster of Elementary School, Kandivaripalle of Markapur mandal in Prakasham Dist. He took the following four policies keeping his wife the complainant as his nominee. Table While so, he died on 11.4.2005 in a train accident. When the claim was made the insurance company gave only death benefits without giving accidental death benefit, which was covered by the policies. It amounts to deficiency in service and therefore prayed that the accidental benefit plus, bonus amounting to Rs. 2,27,531/- be paid with interest, compensation and costs.

(3.) The appellant insurance company resisted the case. While admitting that it had issued four polices as mentioned in the complaint alleged that her claim was admitted for basic sum assured since the cause of death was suicide an amount of Rs. 2,81,624/- was paid under the above policies. The assured was in the habit of taking alcohol. Two of the policies were treated as early claims basing on the duration of the policies up to death. Suicide clause- Section 45 of the Insurance Act is applicable and nothing is payable as if it was an accident. She was not granted benefits due to the death of the assured under suspicious circumstances. She was paid ex-gratia amount on humanitarian grounds under Chairmans discretionary jurisdiction and the inquest report shows that he died by standing opposite to the coming train, having consumed alcohol. After explaining these things to the complainant she having agreed for the same issued valid vouchers towards full and final settlement of the claims. She was not entitled to any amount whatsoever and therefore prayed that the complaint be dismissed.