{"id":324853,"date":"2024-06-21T11:00:54","date_gmt":"2024-06-21T05:30:54","guid":{"rendered":"https:\/\/www.scconline.com\/blog\/?p=324853"},"modified":"2024-06-27T17:54:04","modified_gmt":"2024-06-27T12:24:04","slug":"consumer-protection-examining-homicide-in-the-context-of-accidental-death-insurance","status":"publish","type":"post","link":"https:\/\/www.scconline.com\/blog\/post\/2024\/06\/21\/consumer-protection-examining-homicide-in-the-context-of-accidental-death-insurance\/","title":{"rendered":"Consumer Protection – Examining Homicide in the Context of Accidental Death Insurance"},"content":{"rendered":"
\n

Introduction<\/h4>\n

Accidental death is an insurable event. Accidental death coverage is sold either as a standalone product or as a rider in term life insurance policies, which, in both cases, entitles the insured to an extra payout in case of death due to an accident.<\/p>\n

An “accident” is typically defined by policy terms as a sudden, unexpected, and involuntary incident caused by external, visible, and forceful means. This definition is generically worded and can encompass a wide range of occurrences. Generally, policy terms do not exhaustively outline every scenario that would constitute an accident, though certain exclusions are specified to define the scope of coverage. These exclusions include death by suicide but usually not death by homicide. Many consumers knocked on the doors of the Consumer Forum seeking accidental death benefits in cases of death by homicide. This article shall examine, from the angle of consumer protection, whether a murder constitutes an accident.<\/p>\n

Difference between “accidental murder” and “murder simpliciter”<\/h4>\n

In the year 2000, the Supreme Court in Rita Devi<\/span> v. New India Assurance Co. Ltd.<\/span>1<\/sup><\/a>, created a distinction between an “accidental murder” and a “murder simpliciter” as follows:<\/p>\n

1. It is an accidental murder if the act of murder was originally not intended but was caused in the furtherance of any other felonious act.<\/p>\n

2. It is a murder simpliciter if the dominant intention of the act was to kill a person.<\/p>\n

Thus, the motive and intention of the perpetrator were the deciding factors in concluding whether a murder was accidental or not. The distinction between accidental murder and murder simpliciter was not a definite position of law, rather it warranted an examination of the specific facts of each case. Consequently, this approach resulted in varied rulings based on subjective judgment. In certain cases, it was held that the murder of an insured with criminal antecedents,2<\/sup><\/a> the murder of the deceased insured for being involved in a faction fight between two groups of his village,3<\/sup><\/a> and the killing of an insured due to political rivalry,4<\/sup><\/a> would not constitute accidental murders as they are pre-planned, intentional killings. Conversely, the murder of a kidnapping victim was deemed an accidental death.5<\/sup><\/a><\/p>\n

Reviewing the aforementioned rulings would reveal numerous contrasting opinions based on individual judgment. In one matter, it was held that even if the murder accused was acquitted by the trial court, the murder would still be classified as a murder simpliciter.6<\/sup><\/a> In another matter, the insurance company was directed to await the ruling of the criminal court on the charge of murder before adjudicating the claim.7<\/sup><\/a> In a third instance, findings of murder in the charge-sheet were considered insufficient to classify the killing as murder simpliciter.8<\/sup><\/a> Thus, different Benches of the National Consumer Disputes Redressal Commission (NCDRC) rendered equivocal rulings leading to multiple interpretations of the same legal issue. This necessitated a more precise criterion to distinguish accidental murder from a non-accidental one.<\/p>\n

Test of proximate cause<\/h4>\n

The ratio in Rita Devi case<\/span>9<\/sup><\/a> overlooked the perspective that regardless of the intentions of the offender, every murder is an accident from the viewpoint of the victim.10<\/sup><\/a> No person can expect or contemplate his homicide. The distinction between accidental murder and murder simpliciter primarily focused on the perpetrator’s motive while it ought to have considered the victim’s perspective.<\/p>\n

This stance was discussed by a three-member Bench of the NCDRC in Maya Devi<\/span> v. LIC<\/span>11<\/sup><\/a>, wherein the insured was murdered by the shopkeeper’s brother with whom he had had an altercation a day before. Whilst holding such a murder to be an accident, the NCDRC observed that even wilful murder would be an unforeseen event from the standpoint of the victim12<\/sup><\/a>, unless the immediate cause of injury is the deliberate and wilful action of the insured himself.13<\/sup><\/a><\/p>\n

With a similar observation, the principle established in Rita Devi case<\/span>14<\/sup><\/a> was also rejected by the High Court of Andhra Pradesh which remarked that determining the true intention of the perpetrator would be exceedingly challenging and would fall within the purview of criminal jurisdiction. Additionally, it was noted that for contractual matters, a murder must be regarded as an accident.15<\/sup><\/a><\/p>\n

The aforementioned rulings introduced the test of proximate cause as a new criterion to determine which murder would constitute an accident. In the author’s opinion, this test provided a better standard of assessment as it aligns with the definition of an accident. An accident postulates a mishap or an untoward happening,16<\/sup><\/a> devoid of any design on part of the victim.17<\/sup><\/a> Therefore, for an incident to qualify as an accident, it has to satisfy three ingredients i.e. it has to be sudden, unforeseen and involuntary. According to Maya Devi case<\/span>18<\/sup><\/a>, a murder will not be an accident if the immediate cause of the same is an act on part of the victim himself, as in that eventuality, the murder would neither be involuntary nor unforeseen.<\/p>\n

Incorporation of exclusion clause in insurance policies<\/h4>\n

An exclusion clause in a contract of insurance limits or exempts the liability of the insurer. Particularly in policies covering accidental death benefits, common exclusions consist of death resulting from suicide or self-harm, military service, involvement in war or rebellion, intoxication from alcohol or drugs, participation in attempted felonies, and operating an aircraft, among others.<\/p>\n

These activities\/situations are excluded from coverage because the occurrence of a death in the undertaking of the same would ordinarily be expected and hence, would not constitute an accidental death.19<\/sup><\/a> The element of foreseeability of death in such situations excludes such death from the purview of an accident.<\/p>\n

When the issue of murder as an accident was considered by the NCDRC from the angle of exclusion clauses, it was observed that if an exclusion clause does not exempt liability in case of homicide, the contra proferentem rule of interpretation would apply and insurance companies will be not be allowed to evade liability.20<\/sup><\/a><\/p>\n

This view was recently reiterated by the NCDRC to hold that when an insurance policy does not exclude murder but explicitly excludes self-inflicted injuries, and by no stretch of imagination can murder be self-inflicted, a homicide shall constitute an accident under the policy.21<\/sup><\/a><\/p>\n

Thus, the position of law on the issue has been settled as unless the terms of an insurance policy specifically exclude homicide from the scope of coverage, beneficiaries of such policies are entitled to payout unless it can be demonstrated that the murder was directly caused by the actions of the deceased victim himself.<\/p>\n

Conclusion<\/h4>\n

Under the realm of consumer protection law, the consumer fora are not only equipped with the judicial power to adjudicate and decide consumer disputes but also wield the power to issue directives to the service providers to effect policy alterations or cease unfair trade practices.22<\/sup><\/a><\/p>\n

While this prerogative is much underutilised, in the present context, the NCDRC has censured insurance companies for continuing the arbitrary adjudication of accidental death claims of such nature whilst failing to amend the wordings of the policy concerned despite being involved in numerous litigations on the same issue.23<\/sup><\/a> Such cognizance by the NCDRC has significantly contributed towards securing the rights of consumers and fostering their confidence in the consumer protection system.<\/p>\n<\/div>\n\n

*Senior Associate at Magnus Legal Services LLP. Author can be reached at: chandorkarnamrata@gmail.com<\/a>.<\/span><\/strong><\/p>\n

1.<\/a> (2000) 5 SCC 113.<\/a><\/p>\n

2.<\/a> Prithvi Raj Bhandari<\/span> v. LIC<\/span>, III (2006) CPJ 213 (NC).<\/p>\n

3.<\/a> K. Sarojamma<\/span> v. LIC<\/span>, Revision Petition Nos. 865-866 of 2011, decided on 13-7-2011.<\/p>\n

4.<\/a> LIC<\/span> v. Chinthareddy Vijayamma<\/span>, 2016 SCC OnLine NCDRC 734.<\/a><\/p>\n

5.<\/a> Ganga Ram Rai<\/span> v. LIC<\/span>, 2015 SCC OnLine NCDRC 562.<\/a><\/p>\n

6.<\/a> N. Kabilan<\/span> v. New India Assurance Co. Ltd.<\/span>, 2015 SCC OnLine NCDRC 164.<\/a><\/p>\n

7.<\/a> Sanrakshita Kumari<\/span> v. LIC<\/span>, 2018 SCC OnLine NCDRC 1675.<\/a><\/p>\n

8.<\/a> LIC<\/span> v. Penti Aruna<\/span>, 2017 SCC OnLine NCDRC 677.<\/a><\/p>\n

9.<\/a> (2000) 5 SCC 113.<\/a><\/p>\n

10.<\/a> Nisbet<\/span> v. Rayen & Burn<\/span>, (1910) 2 KB 689<\/a>.<\/p>\n

11.<\/a> III (2008) CPJ 120 (NC).<\/p>\n

12.<\/a> Halsbury’s Laws of England<\/span>, Vol. 25 (4th Edn., 2003 reissue) p. 307, para 569. See also, Pawan Kumari<\/span> v. LIC<\/span>, First Appeal No. 535 of 2015.<\/p>\n

13.<\/a> Halsbury’s Laws of England, Vol. 25 (4th Edn., 2003 reissue) p. 311, para 575.<\/p>\n

14.<\/a> (2000) 5 SCC 113.<\/a><\/p>\n

15.<\/a> United India Insurance Co. Ltd.<\/span> v. Ummadi Shakunthala<\/span>, 2004 SCC OnLine AP 604.<\/a><\/p>\n

16.<\/a> Alka Shukla<\/span> v. LIC<\/span>, (2019) 6 SCC 64<\/a>.<\/p>\n

17.<\/a> ESI Corpn.<\/span> v. Francis De Costa<\/span>, 1993 Supp (4) SCC 100<\/a>.<\/p>\n

18.<\/a> III (2008) CPJ 120 (NC).<\/p>\n

19.<\/a> Union of India<\/span> v. Sunil Kumar Ghosh<\/span>, (1984) 4 SCC 246<\/a>.<\/p>\n

20.<\/a> Royal Sundaram Alliance Insurance Co. Ltd.<\/span> v. Pawan Balram Mulchandani<\/span>, 2018 SCC OnLine NCDRC 377.<\/a><\/p>\n

21.<\/a> LIC<\/span> v. Gaurav Verma<\/span>, Revision Petition No. 716 of 2020. case can’t be traced- author to be consulted.<\/p>\n

22.<\/a> Consumer Protection Act, 2019, S. 39(1)(g)<\/a>.<\/p>\n

23.<\/a> 2018 SCC OnLine NCDRC 377.<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

by Namrata Chandorkar*<\/p>\n","protected":false},"author":8808,"featured_media":324856,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[42503,1191],"tags":[70087,25534,11241,70084,70083,70086,70085],"class_list":["post-324853","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-legal-analysis","category-op-ed","tag-accidental-murder","tag-consumer-forum","tag-consumer-protection","tag-context-of-accidental-death-insurance","tag-examining-homicide","tag-murder-simpliciter","tag-term-life-insurance-policies"],"yoast_head":"\nConsumer Protection - Examining Homicide in the Context of Accidental Death Insurance | SCC Times<\/title>\n<meta name=\"description\" content=\"Accidental death is an insurable event. 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Kantikar and Dinesh Singh, Members, while dealing with an appeal filed against the order of State Commission, held that murder of an insured person must be treated as an accidental death if the same is not the result of\u2026","rel":"","context":"In "Case Briefs"","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"National Consumer Disputes Redressal Commission","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":249811,"url":"https:\/\/www.scconline.com\/blog\/post\/2021\/06\/15\/death-insurance-claim\/","url_meta":{"origin":324853,"position":1},"title":"NCDRC | In a case of death insurance claim, can police investigation be replaced by private agency investigation engaged by insurance company? Commission spells out","author":"Bhumika Indulia","date":"June 15, 2021","format":false,"excerpt":"National Consumer Disputes Redressal Commission (NCDRC): Dinesh Singh (Presiding Member) addresses matter regarding claiming of insurance cover. Instant appeal was filed under Section 19 of the Consumer Protection Act, 1986 challenging the decision of the State Consumer Disputes Redressal Commission. Factual Matrix Late Jai Prakash, husband\/father of the Complainant met\u2026","rel":"","context":"In "Case Briefs"","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"National Consumer Disputes Redressal Commission","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":280781,"url":"https:\/\/www.scconline.com\/blog\/post\/2022\/12\/31\/jammu-and-kashmir-ladakh-high-court-fir-not-sine-qua-non-processing-case-life-insurance-policy-sufficient-evidence-demonstrating-accidental-death-legal-updates\/","url_meta":{"origin":324853,"position":2},"title":"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","author":"Editor","date":"December 31, 2022","format":false,"excerpt":"J&K and Ladakh High Court upheld the decision of the J&K State Consumer Disputes Redressal Commission, allowing the respondents to claim the payment of double the sum assured, as per their deceased father's life insurance policy, which had a \u201cDouble Accident Benefit Cover\u201d clause","rel":"","context":"In "Case Briefs"","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2022\/12\/MicrosoftTeams-image-443.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":6382,"url":"https:\/\/www.scconline.com\/blog\/post\/2015\/02\/18\/repudiation-of-claim-on-ground-that-complainant-failed-to-prove-that-cause-of-death-was-a-result-of-accidental-injuries-upheld\/","url_meta":{"origin":324853,"position":3},"title":"Repudiation of claim on ground that complainant failed to prove that cause of death was a result of accidental injuries, upheld","author":"Sucheta","date":"February 18, 2015","format":false,"excerpt":"National Consumer Disputes Redressal Commission (NCDRC): NCDRC has upheld a repudiation of claim by an insurance company on the ground that complainant failed to prove that the cause of death of the insured was the injury caused by the accident. Earlier, complainant\u2019s mother obtained insurance cover from HDFC Ergo General\u2026","rel":"","context":"In "Tribunals\/Commissions\/Regulatory Bodies"","block_context":{"text":"Tribunals\/Commissions\/Regulatory Bodies","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/tribunals_commissions_regulatorybodies\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2015\/10\/scc-blog_Page_9.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2015\/10\/scc-blog_Page_9.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2015\/10\/scc-blog_Page_9.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2015\/10\/scc-blog_Page_9.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2015\/10\/scc-blog_Page_9.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":291869,"url":"https:\/\/www.scconline.com\/blog\/post\/2023\/05\/12\/calcutta-high-court-death-mosquito-bite-not-accident-insurance-scc-blog-legal-research-news\/","url_meta":{"origin":324853,"position":4},"title":"Death due to mosquito bite not \u2018accident’; Calcutta High Court upholds Insurance Company’s decision","author":"Ritu","date":"May 12, 2023","format":false,"excerpt":"\u201cThe (buzz) word is that Mosquitoes are simply everywhere \u2014 in pools, parks, movie theatres and convention centres \u2014 pests! Perhaps the time has finally come to use cannons to kill mosquitoes.\u201d","rel":"","context":"In "Case Briefs"","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"calcutta high court","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2023\/04\/calcutta-high-court.webp?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2023\/04\/calcutta-high-court.webp?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2023\/04\/calcutta-high-court.webp?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2023\/04\/calcutta-high-court.webp?resize=700%2C400&ssl=1 2x"},"classes":[]},{"id":27691,"url":"https:\/\/www.scconline.com\/blog\/post\/2015\/11\/30\/condition-of-45-days-usage-extended-to-90-days-for-rupay-classic-cardholders-to-claim-an-inbuilt-accident-insurance-cover-of-rs-1-lakh\/","url_meta":{"origin":324853,"position":5},"title":"Condition of 45 days usage extended to 90 days for RuPay Classic cardholders to claim an inbuilt accident insurance cover of Rs.1 lakh","author":"Sucheta","date":"November 30, 2015","format":false,"excerpt":"Prime Minister Shri Narendra Modi in his Independence Day Speech 2014 announced Pradhan Mantri Jan Dhan Yojana (PMJDY) with an objective to cover all households with at least one bank account per household across the country. The Scheme also provided RuPay Debit Card with an inbuilt accident insurance cover of\u2026","rel":"","context":"In "Hot Off The Press"","block_context":{"text":"Hot Off The Press","link":"https:\/\/www.scconline.com\/blog\/post\/category\/news\/hot_off_the_press\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]}],"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/posts\/324853","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/users\/8808"}],"replies":[{"embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/comments?post=324853"}],"version-history":[{"count":0,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/posts\/324853\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/media\/324856"}],"wp:attachment":[{"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/media?parent=324853"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/categories?post=324853"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/tags?post=324853"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}