K PADMAVATHI Vs. BRANCH MANAGER LIC OF INDIA

JUDGEMENT

(1.) The complainant is the appellant. The complainant's husband M. R. Krishnamoorthy had insured his life with the opposite party Life Insurance Corporation of India [lic] for a sum of Rs.1,00,000/-. It is an endowment policy with accident benefits. The policy commenced from 20.9.1988 and the premiums have been paid regularly. While so, the insured died on 10.2.1995 whereupon a claim was preferred by the widow of the deceased to the LIC. The LIC paid the assured sum of Rs.1 lakh with a bonus of Rs.46,500/- and settled the claim. The complainant's case is that the policy being one with accident benefits, she is entitled to an equal sum by way of accident benefit.

(2.) The District Forum dismissed the complaint. It erred in holding that a sum of Rs.46,500/- paid in excess of Rs.1 lakh must be taken as the compensation for the accident claim and, therefore, there is no deficiency in service and dismissed the complaint.

(3.) Before we consider the case of the appellant and proceed with the matter, necessary it is to consider the terms and conditions of the policy. We have, to in this context, mainly consider the condition No.10 which reads as follows : "if at any time when this Policy is in force for full sum assured, the Life Assured before the expiry of the period for which the premium is payable or before the policy anniversary on which the age nearer birthday of the Life Assured is 65, whichever is earlier, is involved in an accident resulting in either permanent disability as hereinafter defined or death and the same is proved to the satisfaction of the Corporation, the Corporation agrees in the case of : (a) xxx xxx xxx (b) Death of the Life Assured-to pay an additional sum equal to the Sum Assured under this policy, if the Life Assured shall sustain any bodily injury resulting solely and directly from the accident caused by outward violent and visible means and such injury shall within 90 days of its occurrence solely, directly and independently of all other causes result in the death of the Life Assured. However, such additional sum payable in respect of this policy, together with any such additional sums payable under other policies on the life of the Life Assured shall not exceed Rs.5,00,000/-. The Corporation shall not be liable to pay the additional sum referred in (a) or (b) above, if the disability or the death of the Life Assured shall- (i) be caused by intentional self-injury, attempted suicide, insanity or immorality or whilst the Life Assured is under the influence of intoxicating liquor, drug or narcotic; or (ii) take place as a result of accident while the Life Assured is engaged in aviation or aeronautics in any capacity other than that of a fare-paying, part paying or non-paying passenger in any aircraft which is authorized by the relevant regulations to carry such passengers and flying between established aerodromes, the Life Assured having at that time no duties on board the aircraft or requiring descent therefrom; or (iii) be caused by injuries resulting from riots, civil commotion, rebellion, war (whether war be declared or not), invasion, hunting, mountaineering, steeple-chasing or racing of any kind; or (iv) result from the Life Assured committing any break of law; or (v) arise from employment of the Life Asured in the armed forces or military service of any country at war (whether war be declared or not) or from being engaged in police duty in any military, naval or police organization. The extra premium for this benefit will not be required to be paid after all premiums under this Policy have been paid or on and after the Policy anniversary on which the age nearer birthday of the Life Assured is 65 years, whichever is earlier. "