The south Mumbai district consumer dispute redressal forum on Wednesday, while directing an insurance firm to pay the accident cover claim of a deceased policy holder to his mother, held that both murder and accident are considered as unfortunate incidents and thus murder of a person also comes under the definition of accident. The forum in its order copy has mentioned that as per the dictionary meaning, accident is an unfortunate incident and so was the murder of the deceased. Thus, it is counted as an accident.
How did the policy holder die?
As per the order copy, deceased Dilip Prabhu had opted for an accident cover policy in June 1995, and it was active till June 1997. In 1996, Dilip was murdered while he was returning from work. The CID was investigating the case. Dilip and his wife, who were married in 1993, had sought for divorce in 1996. However, before the court could pass the final orders in the case, Dilip was killed.
Who sought the accident claim amount?
After Dilip's death, his mother Shamala Prabhu, a resident of Thane, had sought the accident claim amount. His estranged wife, on the other hand, had approached the Bombay high court and filed the claim on the property of the deceased on the grounds that the family court had not passed an order on their divorce petition and thus she was still the legal claimant to the property. The high court thus asked the police to file a report on Dilip's death.
What did the risk firm say?
Meanwhile, when Shamala approached the insurance firm, the firm maintained that they would need the police report to decide on the death. If the claimant failed to file the report, then the matter would be treated as closed. The claimant informed the firm that she had submitted all documents except the police report, and requested the firm to not to close the matter.
By 2007, she submitted all required documents to the insurance firm along with the high court's order on the petition filed by the estranged wife of the deceased. But even then the firm failed to issue the accident claim to the claimant. Thus, she approached the consumer forum in 2010.
What did the forum tell the firm?
The forum asked the insurance firm to file its reply. The firm claimed that the mother of the deceased and his estranged wife were in a tussle and had approached the high court claiming as successors of the deceased. Also, there was no proper documents of the accident submitted by the claimant before the insurance firm. Thus the firm claimed that it was not at fault.
The insurance firm also claimed that Dilip did not die in an accident, but he was murdered on September 18, 1996.
Why was the firm held guilty?
The forum after going through the evidence and arguments advanced by the complainant and the insurance firm maintained that the Dilip was killed and did not meet with an accident. However, Dilip did not have any knowledge of his death, nor did he purchase the insurance policy knowing that one day he would be killed. Thus, it was indeed an unfortunate incident. The insurance firm was held guilty of providing faulty services to its consumer.
The forum asked the firm to pay the claimant Rs2 lakh along with six per cent interest on the amount from 2010. It also directed the firm to pay additional amounts of Rs4,000 and Rs3,000 towards the complainant's mental agony and litigation cost, respectively.
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