Personal Accident Insurance
has been in existence for long. This policy offers compensation in case of
death or bodily injury to the insured person, directly and solely as a result
of an accident, by external, visible and violent means. The policy operates
worldwide and is a 24 hours cover. Different coverages are available ranging
from a restricted cover of Death only, to a comprehensive cover covering death,
permanent disablements and temporary total disablements. This policy is basically designed to offer
some sort of compensation to the insured person who suffers bodily injury solely
as a result of an accident which is external, violent and visible. Hence death
or injury due to any illness or disease is not covered by the policy.
In a city beset with
traffic problems, road accidents are on the increase. People certainly need insurance
protection to take care of the contingencies.
Yesterday, in yet another instance of violence targeted at senior
citizen in the city, Rohini Premkumari (67), a well-known oncologist, was found
murdered at her home in Egmore. Dr.
Rohini was apparently hit on her head with an iron rod, and her hands and legs
were tied with a rope; her mouth was closed with a medical tape, according to
police officials investigating the case. The victim’s relatives alleged that
Dr. Rohini had an argument a few days ago with a contractor who had reportedly
overcharged her for refurbishing her basement. The police is looking in to all probable
aspects of the gruesome murder, which has shocked the residents.
Murder is the killing of
another human being without justification or valid excuse, and it is especially
the unlawful killing of another human being with malice aforethought. This
state of mind may, depending upon the jurisdiction, distinguish murder from
other forms of unlawful homicide, such as manslaughter. Most societies, from
ancient to modern, have considered murder a very serious crime deserving harsh
punishment. In most countries, a person convicted of murder is typically given
a long prison sentence, possibly a life sentence or when it is very gruesome,
death penalty.
There have been decisions
that a murder cannot be treated as an accidental death unless there are facts
to show that the perpetrators had no intention of killing the person. Often the Q (especially in Insurance
parlance) has been – is murder an accident ? By some explanations, the difference between a 'murder' which is not an
accident, and a 'murder' which is an accident depends on the proximity of the
cause of such murder. If the dominant
intention of the act of felony is to kill any particular person, then such
killing is not an accidental murder but is a murder simpliciter, while if the
cause of murder or the act ofmurder was originally not intended and the same
was caused in furtherance of any other felonious act then such murder is
accidental murder.
A couple of years back, in
Sept 2013, neurosurgeon Dr S D Subbiah was murdered in September 2013, it made
city headlines for weeks. Times of India Chennai edition dt 8.5.16 reported on
its 1st page an article titled ‘Insurers show fineprint, refuses to
pay’ stating - what has so far gone unreported is his family's struggle to get
an insurance claim. Here is the article
reproduced :
The insurance
company with whom the doctor had taken a personal accident policy refused to
pay up, citing murder as an exclusion in the fine print. After more than two
years of fighting, the surgeon's widow got the insured sum of Rs 10 lakh in
November 2015 after the insurance ombudsman ruled in her favour. On September 14, 2013, Dr Subbiah was hacked
outside his workplace, Billroth Hospitals in RA Puram over a land dispute.He
died nine days later. While the case dragged on, the private General Insurance Company not only refused to pay the insured sum of Rs
10 lakh, it also asked the doctor's wife to pay the insurance premium.
The only
solace was that Subbiah had taken another policy, from LIC. "LIC paid the
money within15 days," Shanti said. In August 2015 she took up the matter
with the insurance ombudsman of India.
The ombudsman
observed that the company was acting in contravention of the Insurance
Regulatory and Development Authority of India's (IRDAI) rules with its Rs
murder exclusion.' The General Insurer was asked to produce the IRDAI approval for
the policy . "It was found they had modified the policy without IRDAI's
approval," said outgoing ombudsman Virander Kumar. Since it was a personal
accident claim, the insurer tried to repudiate on the grounds that death of the
insured was not due to an accident. "Their contention was that the
dominant and primary intention of the attackers was to murder the insured and
it therefore comes within the ambit of ‘murder simplicitor' which is excluded
under clause 4(g) relating to - culpable homicide' of the policy . We told them
the above mentioned exclusion clause was removed from current PA policies.
However, they refrained from informing the same to the policyholder," said
the ombudsman in his report.
While people
talk about fineprints in Insurance contracts, have you ever tried to read (if
not understand) the conditions on your air ticket – in earlier days, it was on
glossy paper, where eyes would get
strained in reading a line or two – now it is more of stating that the
conditions are available on web – the same would be the case of many many
commercial contracts.
With regards – S.
Sampathkumar
9th May 2016.