Can Murder by Gangsters Be Considered an Accidental Death? Punjab Consumer Commission Clarifies Insurance Claims
The plea was moved by a family whose father was allegedly killed by gangsters in Punjab.
The Punjab State Consumer Disputes Redressal Commission recently said that gangsters killing somebody with a pre-planned intention cannot be ruled out from accidental death benefits coverage under an insurance policy only because murder was committed intentionally.
Presiding Judicial Member HPS Mahal and Member Kiran Sibal said, “The fact that the assailants might have had a premeditated intention to murder the deceased and cause injury to him does not answer the question as to whether his death by their act is an accident which is covered under the policy terms.”
“The mere fact that the deceased died due to a pre-planned criminal act and attack by the assailants cannot lead to the obvious conclusion that the claim sought is not payable under the policies (excluding the basic sum assured), particularly when there is no term and condition brought on record,” the commission added.
One Tajinder Singh had allegedly been killed by some unknown persons when he was sitting in his shop in Moga district’s Samrala in Punjab on July 14, 2020.
Singh had purchased four life insurance policies with double accident covers from LIC. The sum assured in all the four policies was ₹26.6 lakh.
LIC had paid the basic death benefits, but denied the extra accidental death benefit coverage.
The insurer had during the proceedings submitted that based on social media posts and the police closure report, it found that Singh had been murdered by gangster Sukhpreet Singh alias Sukha Gill Lamme in a planned manner to spread terror in the locality.
“In other words, even if the assailants had killed the deceased with the intention to murder him, the cause of death cannot be said to be an accident. Since the death of the deceased was planned, the accidental death benefit cannot be said to have been attracted in this case,” LIC had contended.
However, the State commission noted that LIC has not proved that Singh was involved in any activity which led to his murder.
The commission further said, “To buttress their case, respondent no. 1 (LIC) is also relying upon a purported Facebook post by the accused gangster claiming that he had some differences with the deceased. This fact has neither been mentioned in the FIR nor found in the police report.”
It added that LIC has also issued a circular dated 2007 which states that insurers cannot deny accidental death benefits coverage in cases of murder when the records with the police do not at all give rise to any suspicion that the deceased had committed suicide or provoked somebody else to murder him/herself or there is some suspicion about the involvement of the claimant.
“The insurer thus appears to have relied upon a hyper-technical analysis without placing on record any exclusion clause in the policy to prove that the death of the deceased did not fall within the coverage of the policy,” the commission said.
It allowed the complaint and setting aside the order of the district commission. It ordered LIC to pay additional accident benefits under all four policies along with 6% per annum interest from April 30, 20 21.
It also awarded ₹50,000 as compensation and litigation costs.
Advocate Liza Bansal appeared for the complainants.
Advocate Sandeep Bhardwaj appeared for LIC.
