FIR Not Mandatory To Prove Accidental Death For Claim Settlement, Bihar State Commission Holds HDFC Standard Life Insurance Co. Liable

Brief Facts:

The Complainant's son, Prince Kumar (“Deceased”), had purchased a life insurance policy from HDFC Standard Life Insurance Co. Ltd. (“Insurance Company”). It was purchased for a sum assured of Rs. 20,00,000/- as a death benefit. During the subsistence of the policy, the Deceased was struck by lightning near Dharamsala village and died instantly. The Complainant rushed to the scene and brought his body back to the native village, where the cremation was conducted in the presence of local people. Believing the incident to be a natural calamity, the Complainant did not lodge a First Information Report (FIR) regarding the death.

After the incident, the Complainant promptly informed the Head Office of the Insurance Company. He submitted all required documents including the policy document, a death certificate issued by the competent authority, a certificate from the Block Pramukh, records from the Circle Officer, a memorandum signed by villagers, and an affidavit. The Insurance Company did not accept these documents and repudiated the claim. It reasoned that the cause of death was unnatural and accidental, and thus it should have been reported to the police before the cremation.

In response to the rejection, the Complainant submitted another set of documents, but no action was taken by the Insurance Company. He then approached the Insurance Regulatory and Development Authority (IRDA) and sent a legal notice to the Insurance Company, but these efforts were also in vain. Consequently, the Complainant filed a consumer complaint before the State Consumer Disputes Redressal Commission, Bihar (“State Commission”). The Insurance Company did not appear for the proceedings before the State Commission.

Observations by the Commission:

The State Commission perused the documents presented by the Complainant. The documents confirmed that his son's death was a result of lightning. The State Commission held that the absence of an FIR or post-mortem did not undermine the evidence provided. Therefore, the rejection of the claim by the Insurance Company was unjustified.

As a result, the State Commission allowed the complaint. It directed the Insurance Company to pay the insured amount of Rs. 20,00,000/- to the Complainant with interest at 6% per annum from the date of filing the complaint until the actual payment. Additionally, the Insurance Company were directed to pay Rs. 10,000/- as litigation costs within two months from the date of the order.

Case Title: Gopal Verma vs HDFC Standard Life Insurance Company Limited and Others

Case No.: Complaint Case No. 39 of 2016

Date of Pronouncement: 21st June 2024