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2009 DIGILAW 23 (CHH)

BRANCH MANAGER, LIC OF INDIA v. SEETA BAI SORI

2009-01-20

S.C.VYAS, V.K.PATIL, VEENA MISRA

body2009
ORDER As per Hon 'hIe Shri S.C. Vyas, President : 1. This is an appeal filed by unsuccessful Life Insurance Corporation of India who has been ordered to pay Rs. 51,000/- along with interest @ 9% p.a. to the complainant as accidental benefit on account of death of her husband in a road accident, vide order dated 10-8-07 passed in Complaint Case No. 31/06 by District Consumer Disputes Redressal Forum, Kanker (hereinafter called "District Forum" for short). 2. It is not in dispute that deceased Gurbind Singh Sori was having insurance policy issued by the appellant on 6-1-02 and was in force up to 6-22011. In the meantime he died in a road accident on 2-6-07. Merg intimation was given to the concerning police and merg inquiry was conducted. Death intimation was given to the Insurance Company and claim for sum assured as well as accidental benefit was preferred. Sum assured was paid by the Insurance Company but the accidental benefit was denied on the ground that deceased was not having a driving license at the time of accident and so complainant is not entitled for any accidental benefit. 3. Learned District Forum, after considering the material placed before it passed an award in favour of the complainant which is under challenge before this Commission, by way of this appeal. 4. Learned Counsel for the appellant Shri Shrivastava has argued only one point. He submit that driving licence of the deceased was demanded from the widow of the deceased Smt. Seeta Bai Sori complainant, but the same was not produced in the office of the Insurance Company and on account of this failure it was presumed by the Insurance Company that the deceased was not having any driving licence and therefore, accidental benefit was denied. Learned Counsel submitted that as no driving licence was produced, therefore, there was breach of term 10 (b) (iv) of the insurance policy and therefore, complainant was not entitled to have any claim of accidental benefit. 5. Learned Counsel for the respondent has opposed these arguments and submitted that complainant was widow of the deceased and she was not in possession of driving licence of the deceased. There is nothing on record to show that the deceased was not having any driving licence and in considering this fact learned District Forum has not committed any mistake. 5. Learned Counsel for the respondent has opposed these arguments and submitted that complainant was widow of the deceased and she was not in possession of driving licence of the deceased. There is nothing on record to show that the deceased was not having any driving licence and in considering this fact learned District Forum has not committed any mistake. He submitted that the award passed by the District Forum is just and proper and be maintained. 6. O.P. Annexure 2 is the photocopy of letter which was issued by the Insurance Company, whereby it was informed that Head Office has demanded attested or original driving licence for the purpose of settlement of claim. O.P. Annexure 3 is the letter written by the Insurance Company to learned Counsel for the respondent. Similarly, letter O.P. Annexure 5 has also been written. These letters shows that appellant was demanding driving licence of the deceased from the complainant and her Counsel. 7. Condition 10 (b)(iv) of the insurance policy is with regard to the death of Life Assured which was "result from the Life Assured committing any reach of law". In case of accident which was result of any act of Life Assured, which was breach of law, Insurance Company can deny the benefit of additional sum payable in case of accidental death under the policy. The language of his clause clearly shows that the Corporation can only be said to be not liable to pay additional sum of accidental benefit on the disability or death of the Life Assured which was the result from the Life Assured committing any breach of law. The terminology used in this clause, ultimately shows that there should be positive, concrete and cogent evidence to show that the accident was result of any act of the deceased amounting to breach of law. In the facts of present case, the LIC is alleging that the Life , Assured was not having driving licence, so it was an act, which was amounting to breach of law. In the facts of present case, the LIC is alleging that the Life , Assured was not having driving licence, so it was an act, which was amounting to breach of law. The allegations made against the insured and the provisions of " Clause 10 (b) (iv) indicates that standard of proof of breach of law which is required for the purpose of this clause should be like a proof of criminal charge on an accused and therefore, it was duty of the Insurance Corporation to prove by cogent evidence, above all reasonable suspicions, that the deceased was not having driving licence. No evidence has been led by the Insurance Corporation to indicate that any effort was ever made by the Insurance Corporation to have a search or to obtain a search report from the Office of any RTO in respect of driving licence of the deceased. No report has been obtained from the concerning police station also, though it was a case of a road accident and it could have been verified, if, any offence has been registered in respect of any breach of law against the deceased by the concerning police. There is also no report of the police after merg enquiry to show that accident was result of any breach of law committed by the deceased including not having driving licence. 8. We are of the view that simply making a demand of driving licence from widow of the deceased and when the demand was not fulfilled, the drawing presumption that deceased was not having driving licence, was not enough for the Insurance Corporation to prove its plea against the complainant that the accident was on account of some breach of law on the part of the deceased himself. In the facts of the present case, we find that sole burden was on the Insurance Corporation to prove the facts of breach of law but no evidence has been led to discharge this burden. Unless any evidence is produced by the Insurance Corporation, this cannot be held that accident was result of any breach of law committed by the deceased himself including not having driving licence. We find that necessary evidence is not available to justify plea for refusing claim, taken by the Insurance Corporation. 9. Unless any evidence is produced by the Insurance Corporation, this cannot be held that accident was result of any breach of law committed by the deceased himself including not having driving licence. We find that necessary evidence is not available to justify plea for refusing claim, taken by the Insurance Corporation. 9. Therefore, as discussed above we come to the conclusion that District Forum has not committed any mistake in passing award against the Insurance Corporation. The appeal has no force and is dismissed with cost. Appeal Dismissed.