Insured shot dead by miscreants – claim paid but double accident benefit not paid – contention of insurer – documents not deposited – not justified – claim allowed


The insured was covered with a LIC policy for a sum of Rs.50, 000/- with Double Accident benefit. During the insurance policy cover the insured was shot dead by some miscreants. The nominee/wife of the insured filed a claim with the insurer, she was asked to deposit certain documents like copy of post-mortem report, F.I.R etc. which could not be deposited by her. The insurer paid Rs.60, 700/- (sum assured along with vested bonuses) but repudiated the claim under double accident benefit. Aggrieved by this the nominee/wife of deceased filed a complaint before the district forum where the contention of the insurer was that the claim was rejected due to non filing of the documents like post mortem report etc. The court ordered LIC to pay double accident benefit of Rs.50,000/- along with interest @9% p.a. . The insurer filed an appeal before the state commission.
Before the appellate court the contention of the insurer was that since under para-10 of the policy bond the life assured was to furnish these documents to avail the double accident benefit to the satisfaction of the LIC the district forum had erred in its decision. The appellate court observed that while making enquiries by its own agent about the death and cause of death of the complainant’s husband it must have come to the finding that he was shot dead. The ground of repudiation of double accident benefit appeared to be flimsy since the insurer had also made enquiries through its own agent. In such enquiry it must have come to the notice of LIC that the deceased was shot dead. Hence repudiation of claim under double accident benefit was not justified.

Held: Claim allowed for double accident benefit Rs.50, 000/- along with interest @9% p.a..