J&K and Ladakh High Court | FIR is not a sine qua non for processing a case under a life insurance policy if there are sufficient evidence demonstrating accidental death


Jammu and Kashmir and Ladakh High Court: While deciding the instant appeal filed by the Life Corporation of India (LIC) against the order of J&K State Consumer Disputes Redressal Commission whereby it had held that the respondents were entitled to claim the amount due to them as per the “Double Accident Claim Cover” in their deceased father’s life insurance policy; the Division Bench of Sanjeev Kumar and Moksha Khajuria Kazmi, JJ., held that the J&K SCDRC correctly held that in the case of such nature where the death of the insured has occurred due to injuries suffered from a fall, the registration of FIR is not a sine qua non for processing the case under the policy of life insurance, when there is other evidence in abundance to demonstrate that the deceased insured had died in an accident.

Father of the respondents had obtained a life insurance policy with Rs. 3 lacs as sum assured. The policy was issued by LIC on 28-03-2006. The life insurance policy contained a clause of “Double Accident Benefit Cover”, which provided that in case, the life insured, would die due to accident during existence of the policy, the insurer i.e., LIC would be liable to pay double the sum assured.

During the validity of the insurance policy, the insured i.e., the father of accidently fell from veranda of his house and sustained fatal head injuries and succumbed to the injuries on his way to the hospital. The respondents informed the LIC about the accidental death of their father and provided them the medical certificate issued by the Medical Officer, copy of the death certificate issued by Police Station, Kupwara and other relevant documents.

The claim put forth by the respondents for payment of double the sum assured i.e Rs. 6 lacs under the “Double Accident Benefit Cover” clause, was repudiated by LIC on the ground that the claim was submitted by the respondents without any copy of the registered FIR.

The respondents took their grievance to the J&K SCDRC, which considered the entire matter and concluded that filing of FIR in respect of an accidental death of a person in all cases is not a sine qua non for lodging a claim. The Commission rejected the stand of the LIC and allowed the complaint filed by the respondents.

Perusing the facts of the case and the impugned order of the State Commission, the High Court held that the State Commission’s view is without fault and in complete conformity with the legal position. The High Court agreed with the findings of the Commission that in cases such as the instant matter, the registration of FIR may not be required. The Division Bench pointed out that on the date the father of the respondents met accidental death, he was covered by an insurance policy issued by the LIC. Since the accident was not attributable to any act or omission of any person, 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”.

[Life Insurance Corporation of India v. Hamida Bano, 2022 SCC OnLine J&K 1003, decided on 19-12-2022]

Advocates who appeared in this case :

Appellant-Shabaz Sikander, Advocate;

Respondent-Tufail Qadri, Advocate.

*Sucheta Sarkar, Editorial Assistant has prepared the report.

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