PUSHPA AGRAWAL Vs. INSURANCE OMBUDSMAN

JUDGEMENT

(1.) Heard Sri S.D.Singh, learned Counsel for the petitioner and Sri Prakash Padia, learned Counsel for the opposite parties.

(2.) Through the instant writ petition under Article 226 of the Constitution of India, the petitioner challenges the award dated 30.6.2008 passed by the Insurance Ombudsman, Uttar Pradesh & Uttarakhand, Lucknow (opposite party No.1) [hereinafter referrred to as the "Ombudsman" for the sake of brevity], in complaint No. LP-117/21/001/07-08 contained in Annexure 5 to the writ petition, whereby the Ombudsman disposed of the complaint by confirming the orders of the authority of Life Insurance Corporation of India whereby the claim for Double Accident benefit was denied as well as the accrued bonus. However, the liberty was granted by the Ombudsman to the complainant/petitioner to approach the forum directly after the trial was concluded with a certified copy of the judgment of the session's court within two months from the date of judgment and the forum was at liberty to reopen the case, if so warrants.

(3.) Factual matrix of the case are that the petitioner's son Sri Neeraj Kumar Agarwal, aged about 26 years, who was engaged in business, took two policies i.e. Policy No. 3116783632 and 312042657, on his own life under plan/term 14/49 from Life Insurance Corporation of India with Double Accident benefit. Unfortunately, her son was murdered on 19.11.2006, as a consequence of which, petitioner being nominee and mother of the deceased claimed the insured amount, to which Life Insurance Corporation of India [hereinafter referred to as "the Insurance Company"] asked the petitioner to furnish the requisite information in the prescribed claim forms. In pursuance thereof, the petitioner submitted her claim in the prescribed claim forms. The In-house Investigating Officer of the Insurance Company investigated the claim and submitted report. On the basis of the said report, the Senior Divisional Manager, Allahabad of the Insurance Company accepted the petitioner's claim for Basic Sum Assured but repudiated/rejected the claim for Double Accident Benefit vide letter dated 28.12.2007 on the grounds that death of the deceased is due to murder after kidnapping and not by an accident and as such, Double Accident Benefit is not payable to her. However, petitioner received the Basic Sum Assured amount, under protest.