DIVISIONAL MANAGER LIC OF INDIA Vs. RINA DAS

JUDGEMENT

(1.) The opposite parties in C. D. Case No.35 of 1995 before the District Forum, Bolangir are the appellants in this appeal challenging the final order passed by the said Forum in the aforesaid case. Shortly stated the case of the complainant is that the nominee and the widow of late Rabinarayan Dash claimed the accident benefit with respect to a policy of her late husband which being repudiated, the aforesaid case was filed by her. Admittedly, the husband of the complainant was a holder of Money Back Policy with profits and accident benefits. During the validity of the policy, the husband of the complainant died in a scooter accident on 15.9.93. The sum assured under the policy was Rs.1,00,000/- which was paid to the complainant. The accident benefit of a similar amount was repudiated on the ground that the policy-holder was under intoxication while driving his scooter which met with an accident. The repudiation was on the basis of the Police report which mentioned that the deceased husband of the complainant was under intoxication while driving the scooter. The District Forum did not accept the basis on which the claim was repudiated and has directed that the accidental benefit of Rs.1,00,000/- together with interest at the rate of 18% per annum be paid to the complainant. Hence this appeal.

(2.) We have heard the learned Counsel for the appellants at length and so also the Counsel appearing for the respondent who has in addition to the oral submissions submitted a written note of arguments.

(3.) The policy of insurance provides that in case of accidental death, the policy will carry accidental benefit of the sum assured under the policy in addition to assured amount. There is no dispute that the policy-holder died in an accident and the Insurance Corporation has also paid the amount which he would have been entitled to on maturity of the policy. But the accidental benefit was refused on the ground that under the terms of the policy, the policy- holder will not be entitled to such benefit if the accident occurs while the policy-holder would be driving under intoxication. The learned Counsel appearing for the appellants strenuously argued that in the police report it has been specifically mentioned that the policy-holder was under intoxication while driving the scooter and the police has stated that they have recorded the statement of certain persons who had seen the policy-holder taking the liquor. Some affidavits were filed denying the aforesaid fact. Admittedly after the death of the policy-holder, his dead body was subjected to post-mortem examination. The post-mortem examination does not record that the deceased had taken liquor or any intoxicating substance was found from his stomach. In the absence of anything being mentioned in the post-mortem report and in the absence of any report by any specialist, it is improper to rely on the report of the police. To add to that neither the Investigating Officer has been examined nor the source of his information is before the Adjudicating Forum to examine the truth or otherwise of much a report. In the aforesaid circumstances, we do not find any justification to take a view different from that of the District Forum. We, therefore, confirm the direction of the District Forum that the Insurance Corporation is to pay the accidental benefit of Rs.1,00,000/- (Rupees on lakh) to the complainant.