Registration Of FIR Not Sine Qua Non For Processing Life Insurance Policy Claim In Cases Of Accidental Fall Deaths: J&K&L High Court

The Jammu and Kashmir and Ladakh High Court recently upheld a Consumer Commission order wherein it was held that in cases where the death of the insured has occurred due to injuries suffered from a fall, the registration of FIR may not be required for processing the life insurance claim.

"We are entirely in agreement with the Commission that in the case of this nature, the registration of FIR is not a sin qua non for processing the case under the policy of life insurance. Moreso, when there is other evidence in abundance to demonstrate that the deceased insured had died in an accident," said the court.

The observations were made by Justices Sanjeev Kumar and Moksha Khajuria Kazmi in their decision on an appeal filed by the Life Insurance Corporation (LIC) of India against the order of J&K State Consumer Grievance Redressal Commission, Srinagar whereby the Commission had allowed the complaint and awarded a sum of Rs. 6 lacs along with 9% interest in favour of the next of kin of a man, who had died after falling from his house's veranda. 

The life insurance policy obtained by the father of the respondents contained a clause of "Double Accident Benefit" cover, which provided that in case the life insured would die due to an accident during the course of the policy, LIC would be liable to pay double the sum assured.

From the pleadings of the matter, the bench noted that the insured during the validity of the insurance policy, accidently fell from the veranda of his house and sustained fatal head injuries. He was taken to the nearest hospital where he succumbed to injuries on his way. 

Subsequently his children informed the LIC about the accidental death and also provided them the medical certificate issued by the Medical Officer, copy of the death certificate issued by Police Station Kupwara, and also one issued by the Patwari of the Patwar Halqa concerned.

However, the LIC rejected the claim, saying that it could not be processed and paid due to unavailability of FIR registration in respect of accidental death of the insured.

As a consequence of the decision of LIC to repudiate the claim, the next of kin filed a complaint before the Commission at Srinagar which after considering the matter came to the conclusion that filing of FIR in respect of an accidental death of a person in all cases is not a sin qua non for lodging a claim. LIC approached high court against the order.

The division bench observed that the view taken by the Commission is "unexceptionable" and in complete conformity with the legal position.

Elaborating further, the bench recorded that since the accident was not attributable to any act or omission of any person as such, 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. This is so because for such accident like a person falling from veranda and sustaining fatal injuries, nobody can be held responsible," the bench said.

Commenting on the contention raised by Adv Shahbaz Sikander Mir for the appellant that the insured had not correctly disclosed his age and had submitted a false date of birth certificate at the time of insurance, the bench said that the DoB certificate produced by the insured at the time of insurance can not be unilaterally declared by the insurance company as fake and forged unless the person who has submitted such certificate or his legal heirs in the case of his death are given an opportunity of being heard.

In view of the aforesaid discussion, the bench found the appeal devoid of any merit and dismissed the same.

Case Title: Life Insurance Corporation Of India & Anr Vs Hamida Bano & Anr.

Citation: 2022 LiveLaw (JKL) 264

Coram: Justice Sanjeev Kumar and Justice Moksha Khajuria Kazmi

Counsel For Appellant: Mr Shahbaz Sikander Mir.

Counsel For Respondent: Mr Tufail Qadri

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