A bench of Justices Sanjeev Kumar and Moksha Khajuria Kazmi, dismissed an appeal filed by Life Insurance Corporation of India (LIC) against the order of J&K State Consumer Grievance Redressal Commission, Srinagar.
The appeal was filed by LIC against the consumer forum’s order.
on the ground that the claim submitted by the respondents was without copy of FIR, if any, registered in the matter.
In the case, [Life Insurance Corporation of India & Anr. V/s Hamida Bano & Anr.]. the bench noted that the insured during the validity of the insurance policy, accidently fell from the veranda of his house and sustained fatal head injuries. He was taken to the nearest hospital where he succumbed to injuries on his way.
The respondents informed the LIC about the accidental death of their father and furnished the medical certificates issued by the medical officer, copy of death certificate issued by the police station at Kupwara, and also one issued by the patwari of the patwar halqa concerned.
However, the respondents put forth the claim for payment of double the sum assured i.e., ₹6 lakh under the policy of insurance, which further was refused by the Life insurance company (LIC).
A recent judgment was made by the Jammu and Kashmir and Ladakh High Court wherein the court concluded that that in cases where the death of the insured has occurred due to injuries suffered from a fall, the registration of FIR may not be required for processing the life insurance claim.
“We are entirely in agreement with the Commission that in the case of this nature, the registration of FIR is not a sin qua non for processing the case under the policy of life insurance. Moreso, when there is other evidence in abundance to demonstrate that the deceased insured had died in an accident,” said the court.
In the appeal made by the Life Insurance Corporation (LIC) of India against the order of J&K State Consumer Grievance Redressal Commission, Srinagar whereby the Commission had allowed the complaint and awarded a sum of Rs. 6 lacs along with 9% interest in favour of the next of kin of a man, who had died after falling from his house’s veranda.
Life insurance company (LIC) made an appeal on the ground that the claims, submitted by the respondent without copy of FIR, if any, registered in the matter. Therefore, (LIC) was not satisfied from the ruling of the J&K State Consumer Grievance Redressal Commission and made an appeal.
However, the High Court said that the commission correctly held that in case of such nature where the death of the insured has occurred due to injuries suffered from a fall, the registration of the FIR may not be required.
As the insured-deceased had obtained a life insurance policy with ₹3 lakh as sum assured. The policy was issued by LIC in favour of the father of the respondents on March 28, 2006 and contained a clause of ‘double accident benefit’ cover, which provided that in case the insured dies in an accident during currency of the policy, the insurer would be liable to pay double the sum assured.
As a consequence of the decision of LIC to repudiate the claim, the next of kin filed a complaint before the Commission at Srinagar which after considering the matter came to the conclusion that filing of FIR in respect of an accidental death of a person in all cases is not a sin qua non for lodging a claim. LIC approached high court against the order.
‘Sin qua non’ is a legal maxim which is originally, a Latin legal term for “a condition without which it could not be.” It is a circumstance in which a certain act is a material cause of a certain injury or wrongdoings, without which the injury would not have occurred. In the law of torts, a casual connection exists between a particular act and an injury. This is known as the rule of sine qua non.
The division bench observed that the view taken by the Commission is “unexceptionable” and in complete conformity with the legal position.
the bench further enunciates and recorded that since the accident was not attributable to any act or omission of any person as such, the respondents in their wisdom did not lodge an FIR in the matter.
“As a matter of fact, in the accidents of the nature that claimed the life of the father of the respondents, there is hardly any necessity to lodge an FIR. This is so because for such accident like a person falling from veranda and sustaining fatal injuries, nobody can be held responsible,” the bench said.
The Court further said that the plea of counsel appearing for LIC that the insured did not correctly disclose his age and had submitted a false date of birth certificate at the time of insurance cannot be accepted at appellate stage.
Therefore, the appeal filed by LIC was dismissed by the High Court.
Case Title: Life Insurance Corporation Of India & Anr Vs Hamida Bano & Anr.
BY: AYUSHI BHUSHAN, 1ST YEAR, BA.LLB(INTEGRATED), BANASTHALI UNIVERSITY, RAJASTHAN,
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