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2012 DIGILAW 735 (AP)

P. Laxmi v. Life Insurance Corporation of India, Represented by its Senior Divisional Manager

2012-08-17

L.NARASIMHA REDDY

body2012
Judgment :- The petitioner is the wife of one Sri P.Ravinder Reddy. On 05.04.2011, Ravinder Reddy died in an accident He held two policies bearing Nos.603906389 and 602624316 issued by the Life Insurance Corporation of India (for short ‘the Corporation’) covering sums of Rs.1,25,000/-and Rs.1,00,000/-respectively. After the death of Ravinder Reddy, the petitioner and her children submitted claims before the respondent for payment of the amount covered by the policies. Through letter, dated 30.07.2011, the respondent informed the petitioner that her claims cannot be accepted. It was mentioned that one of the conditions incorporated in the policy is that the Corporation would not be liable, if the death or injury is the result of the ‘life assured’, committing breach of law, and that in the instant case, the clause is attracted since the deceased died while making an attempt to do a prohibited act of putting a fuse wire in 11KV Transformer. The petitioner challenges the said letter. It is pleaded that the clause relied upon by the respondent would get attracted, if only an insured person has resorted to any act prohibited by law and the death or the injury is the result thereof. According to the petitioner, the respondent did not cite any provision of law, which, the deceased can be said to have violated, and that the view taken by the respondent is contrary to the guidelines issued by it. The respondent filed a counter-affidavit. It is stated that Condition No.11(b)(iv) incorporated in one policy, which is similar to condition No.10(b)(5) incorporated in other policy (for short ‘the Condition’), is to the effect that the liability under the policy does not arise in case the death or injury is caused on account of committing breach of law and that the deceased in this case performed an act which is prohibited under the Regulations issued by the Andhra Pradesh Southern Power Distribution Company Limited (for short ‘the Company’). According to the respondent, the Company informed them that the deceased died when he was attempting to provide a 11 KV HG fuse wire and that such a step cannot be taken up by any person other than the employees of the Company. Heard Sri N.Vijay Kumar, learned counsel for the petitioner and Sri Srinivas Karra, learned Standing Counsel for the respondent. Heard Sri N.Vijay Kumar, learned counsel for the petitioner and Sri Srinivas Karra, learned Standing Counsel for the respondent. The undisputed facts are that the deceased took two policies covering amounts of Rs.1,25,000/-and Rs.1,00,000/-and that he died on 05.04.2011 due to electric shock. The Company issued a certificate in Form-A, which is specified for reporting electrical accidents stating that P.Ravinder Reddy died at about 14.30 p.m. at Wadi Village while he was providing 11 KV HG fuse wire on SS-7 (HVDS) DTR without any intimation to the Electricity Department. The petitioner submitted the claim for payment of the amount covered by the policies. The respondent, however, rejected the benefit placing reliance upon the Condition, which reads: “The Corporation shall not be liable to pay the additional sum referred to in (a) or (b) above, if the disability or the death of the Life Assured shall (i)….. (ii)….. (iii)…. iv) result from the Life Assured committing any breach of law.” Therefore, it needs to be seen as to whether the death of the deceased was the result of his committing any act of breach of law. The insurance, is a social security measure, aimed at helping the dependents of the life assured, if any untoward incident occurs. In case of injuries, the beneficiary may be the policy holder himself. Therefore, the Courts have been adopting in such matters an approach that would translate the concept and policy of insurance, into reality. While payment of amount under a policy should be the rule, repudiation can be an exception. Denial of benefit can be countenanced, only when there does not exist any doubt, whatever, as to the provision, which leads to such repudiation. The respondent can repudiate the policy and avoid its liability under the Condition referred to above, if only it proves that the life assured committed any act, which is prohibited under a specific provision of law and the same resulted in an injury or the death, as the case may be. Not only the provision must be cited, but also the alleged breach must be shown to be the immediate cause of the injury or death. If loosely employed, the clause would be an excellent source for the respondent to avoid liability almost in every case, by citing one violation or the other, and calling it as breach of law on the part of the life assured. If loosely employed, the clause would be an excellent source for the respondent to avoid liability almost in every case, by citing one violation or the other, and calling it as breach of law on the part of the life assured. For instance, if a life assured suffered injuries while crossing the road, on being hit by a motor vehicle or succumbed to them, the liability can be avoided by citing that the life assured had committed breach of traffic rules. In a society, where laws of one category or the other, exist to regulate almost every facet of life, attempt can be made to link the death or injury, to the violation of one provision of law or the other. It is a different matter, that such law can be the one, made by the highest law making authority, or the lowest subordinate or delegatee. The Corporation did experience, the instances of its officials indiscriminately repudiating the claims, by citing reasons of breach of law. Being the State owned and the State sponsored Insurance Company, the Corporation issued guidelines under the heading “Legal Aspects of Life Assurance”. Paras 48 and 49 are devoted to the interpretation of the clause, which is now relied upon. The paragraphs read as under: Where it is established that an event is an ‘accident’ it cannot cease to be so merely because it has been caused by breach of law. But any such event caused by breach of law may be excluded from the purview of ‘accident’ by specific provision in the contract. Sub-Clause (d) however, excluded death resulting from breach of law and does not refer to death resulting from accident, which in turn, may have been caused by breach of law. This sub-clause is attracted only if death is the direct consequence of breach of law and not merely when breach of law causes accident and the injuries sustained thereby produce death. This does not mean that death in such a case should not be preceded by injury, nor does it mean that death should be immediate, it does not also mean that breach of law should be the proximate cause of death. This does not mean that death in such a case should not be preceded by injury, nor does it mean that death should be immediate, it does not also mean that breach of law should be the proximate cause of death. Death is the direct consequence of breach of law when, from the nature and circumstances of the case, it can be said that death or the event resulting in death, ceases to be an ‘accident’ because of breach of law. Accident benefit is not allowed in such a case, not because death is the result of breach of law but because death in that case is not an ‘accident’ or the result of an ‘accident’. The sub-clause (d) is attracted only if the breach of law complained of shall render the epi-thet ‘accident’ in applicable to a case of resulting death. An obvious example is conviction of the life assured by a Court of law for murder, and his execution. Death in that case is the consequence of breach of law and though it is not caused by disease, it is not an accident and hence Accident Benefit is not admissible. Another example is where a burglar or dacoit, while committing burglary or dacoity, is killed either by the police of house owner. It is not a case of death by accident. Even the normal expression used in such a case is that the dacoit has been killed and not that he died in an accident. Even if he is only injured in the encounter and the injury shall result in death, it is not a case of death by accident. On the other hand, if the resulting injury or death could continue to be classified as an ‘accident’, as in the case of foot board travel or over-speeding, this sub-clause is not attracted. If there is an accident, that is, an event which may be properly called an accident, claim cannot be rejected merely on the ground that the accident has been caused or preceded by breach of law. If, in spite of breach of law, it is a case of accident, sub-clause (d) is not attracted, for it refers to death by breach of law and not death resulting from an accident caused by breach of law.” There could not have been a better statement of the concept, or interpretation of the provision, than this. If, in spite of breach of law, it is a case of accident, sub-clause (d) is not attracted, for it refers to death by breach of law and not death resulting from an accident caused by breach of law.” There could not have been a better statement of the concept, or interpretation of the provision, than this. Even Courts would have hesitated or felt not so free, in enunciating the principle, reflecting the spirit of the concept of insurance. It appears that the Officer who passed the impugned order did not have the benefit of reading such an excellent interpretation made by the Corporation itself. The illustrations cited in the passages would not leave any doubt as to the manner in which the provision must be understood. In a way, a note caution was sounded against indiscriminate invocation of clause and denial of the benefit under the policies. The learned Standing Counsel for the respondent made an attempt to satisfy this Court that the deceased was guilty of breach of the conditions of supply of power. That, however, was not even the case of the Power Supplying Company. The certificate issued by it; does not disclose that the deceased has violated any conditions. The only mention in it was that he provided a fuse wire, without intimation to the Electricity Department. Though there exists prohibition against the handling of the electricity equipments by the consumers, it is not uncommon that on account of lack of proper arrangements on the part of the Electricity Supplying Companies and lack of adequate man power with them, attempts are made by the consumers to restore supply, if any breakdown of supply occurs on account of any minor lapse. Unless such acts are done with an intention to commit crime, the clause cannot be invoked. There does not exist any criminal intention in making an attempt to put a fuse wire, though, that may be the function of the employee of the Power Supplying Company. The expression “breach of law” employed in the clause must be understood with reference to provisions of law, which prohibit any crimes and criminal acts. Breach of any and every provision cannot, by itself constitute a crime, nor can it attract serious consequences. The said expression must be understood with the help of the illustrations provided for in paras 48 and 49 of the guidelines issued by the respondent. Breach of any and every provision cannot, by itself constitute a crime, nor can it attract serious consequences. The said expression must be understood with the help of the illustrations provided for in paras 48 and 49 of the guidelines issued by the respondent. Another way of understanding the issue is, to see whether the person who is accused of committing “breach of law” was liable to be imposed any punishment of fairly serious nature, in contradistinction to imposition of fines of small amounts, such an for violation of traffic regulations. Viewed in this context, the impugned letter cannot be sustained in law. Hence, the writ petition is allowed and the impugned letter is set aside. The respondent is directed to extend the benefit under the policies to the petitioner and other legal heirs of the deceased forthwith. There shall be no order as to costs. The miscellaneous petition filed in this writ petition also stands disposed of.