State Consumer Disputes Redressal Commission
Sbi General Insurance Co. Ltd. vs Smt. Kanta Devi. on 8 August, 2022
H. P. STATE CONSUMER DISPUTES REDRESSAL
COMMISSION SHIMLA.
First Appeal No. : 188/2019
Date of Presentation : 21.05.2019
Order Reserved on : 22.07.2022
Date of Order : 08.08.2022
......
SBI General Insurance Company Ltd., Branch Shimla, District
Shimla HP having its Corporate and registered office, Natraj
101, 201 and 301, Junction of Western Express Highway and
Andheri-Kurla Road, Andheri (East), Mumbai-400069, Present
address :- Office at 7-B Ground Floor, Pusa Road, Opposite
to Metro Pillar No.153, Rajendra Park, New Delhi-110060
through Legal Manager
...... Appellant/Opposite Party
Versus
Smt. Kanta Devi w/o Late Sh. Chaman Lal Resident of Village
Kolka, PO Danoghat, Tehsil Arki, District Solan, HP
.......Respondent/Complainant
Coram
Hon'ble Justice Inder Singh Mehta, President
Hon'ble Ms. Sunita Sharma, Member.
Hon'ble Mr. R.K. Verma, Member
Whether approved for reporting?1 Yes
For Appellant: Mr. Chandan Goel, Advocate
For Respondent: Mr. Yadvender Thakur, Advocate
Justice Inder Singh Mehta, President
ORDER
Instant appeal is arising out of the order dated 14.03.2019 passed by the Learned District Consumer Redressal 1 Whether reporters of the local papers may be allowed to see the order?
SBI General Insurance Versus Smt. Kanta Devi (FA No.188/2019) Forum, Solan in Consumer Complaint No.77/2018 titled Smt. Kanta Devi versus SBI General Insurance Company Ltd. Brief facts of Case:
2. Briefly, the case of the complainant is that in the year 2017 her husband namely Sh. Chaman Lal since deceased, had obtained an accidental insurance policy from opposite party valid from 23.8.2017 to 22.8.2018 on payment of Rs. 500/- as premium for the insured sum of Rs.10.00 lacs. During the subsistence of the insurance policy unfortunately on 09.12.2017, the above named husband of the complainant while cutting grass in his land suffered a slip and fell on hard surface and succumbed to the injuries suffered by him. After the incident, persons working in the 2 adjacent lands came to the spot and thereafter they intimated this incident to the complainant as well as her other family members. Since it was a clear cut case of accident, so the complainant or her family members did not report the matter to the police nor the dead body was subjected to post mortem examination as such was cremated.
Per the complainant, she and family members were not having knowledge with respect to the aforementioned insurance policy. However, after some time of death of her husband, the complainant found the insurance policy certificate in the belongings of the deceased and thereafter it was transpired that the deceased had obtained the aforementioned accidental 2 SBI General Insurance Versus Smt. Kanta Devi (FA No.188/2019) policy. In this policy, he had made the complainant as his nominee.
Thereafter the complainant contacted State Bank of India Arki, banker of the husband through which he had obtained the policy in question. She was advised by the aforementioned officials of the bank to submit her claim with the opposite party at its office at Shimla. Accordingly, she contacted the opposite party and the latter vide its letter dated 10.1.2018 asked her to complete certain formalities. She accordingly filled and furnished the necessary documents and submitted the same to the opposite party. In response thereto, the opposite party vide its letter dated 09.3.2018 asked her to furnish some more documents. Again vide letter dated 12.4.2018, the opposite party directed the complainant to furnish documents which she had already submitted. In compliance thereto, she again supplied all the necessary documents to the opposite party. However, 12.6.2018, the opposite party vide its letter illegally and arbitrarily repudiated her claim on the ground that she had failed to establish death of her husband on account of accident as she had failed to furnish documents like police report, post mortem report etc.
3. The complaint was resisted and contested by the opposite party by filing reply. In the reply, it is admitted that the deceased husband of the complainant had obtained accidental insurance policy in question and that the complainant had 3 SBI General Insurance Versus Smt. Kanta Devi (FA No.188/2019) approached it with a claim for payment of the sum insured under the policy. It is contended that since the complainant had failed to furnish necessary documents like police report and post mortem report to support her claim regarding accidental death of her husband, so it had rightly rejected the claim of the complainant. There is no deficiency in service.
4. A rejoinder denying the contents of the reply and reiterating those of the complaint was filed.
5. Thereafter both the parties led evidence in support of their pleadings.
6. After hearing the parties, the Ld. District Commission partly allowed the complaint against opposite party.
7. Feeling aggrieved by the order of the Ld. District Commission, the Appellant/Opposite Party has preferred the instant appeal before this Commission.
8. We have heard learned counsel appearing on behalf of the parties and have also perused the entire record carefully.
9. Learned counsel for the appellant has submitted that the complainant has lodged the personal accident claim with the opposite party/appellant. The insured, the husband of the complainant died due to fall from hill top. No FIR has been registered regarding the incident and no post-mortem was conducted. He further submitted that personal accident claim could be given only in the event if person dies due to accident. 4
SBI General Insurance Versus Smt. Kanta Devi (FA No.188/2019) Since in the instant case, no FIR has been registered and no post mortem was conducted upon the body of deceased/insured, claim lodged by complainant cannot be termed as personal accident claim and he relied upon the judgments, i.e. Smt. Harinder Anand Versus Life Insurance Corporation of India, in F.A.No.181/2004 decided on 16.02.2010 by State Commission Uttarakhand, Dehradun and Harvinder Pal Versus SBI, in consumer complaint No.48 of 2021, decided on 24.03.2015 by State Commission, Punjab, Chandigarh and prayed that appeal of the appellant be allowed and impugned order be set aside.
10. On the other hand, learned counsel of the respondent has submitted that District Forum below has rightly passed the order in favour of the complainant/respondent and same does not require any interference and relied upon judgments, New India Assurance Co. Ltd. Versus Gulabi Devi, F.A.No.75/2010, decided on 29.09.2010, National Insurance Co. Ltd. Vs. Chamundehwari & Ors., Civil Appeal No.615 of 2021 decided on 01.10.2021 and National Insurance Co. Ltd. Vs. Venkata Swamy Nagana, in revision petition No.2852/2013, decided on 06.02.2014.
FINDING
11. Admitted facts emerging out of the pleadings are that the deceased husband of the complainant had obtained an accidental insurance policy from the opposite party. The husband 5 SBI General Insurance Versus Smt. Kanta Devi (FA No.188/2019) of the complainant died during the subsistence of the insurance policy due to fall on a steep rock.
12. Simpliciter argument of the learned counsel for the appellant/Opposite party that since the deceased husband of the complainant died due to fall from top and since no FIR was lodged and post mortem conducted, the claim lodged by the complainant cannot be termed as personal accident claim loses its significance in view of the cogent and reliable evidence adduced by the complainant i.e. the affidavits of S/Sh. Pawan Kumar and Bhoop Singh and Smt. Sarita Rani, the then Pradhan of Gram Panchayat, Kotli.
13. Both the above named witnesses of the complainant clearly deposed that when they reached the spot i.e. grass land of the deceased, they found the deceased fallen on a steep rock. He was smeared with blood. He infact had sustained head injury. He was found dead. Thereafter they called the people who were having houses near to the place of incident and with their help; they lifted the dead body of the deceased and brought it to his house. Pardhan of concerned Panchayat was also intimated. Since the deceased had died due to an accidental death, so the dead body of the deceased had been cremated on the next day.
13. Smt. Sarita Rani, the then Pradhan of the concerned Gram Panchayat has also deposed that on 09.12.2017, Sh. Bhoop Singh telephonically informed her that Sh. Chaman Lal had 6 SBI General Insurance Versus Smt. Kanta Devi (FA No.188/2019) died due to a fall suffered by him in his grass land. Since the parents and wife of the deceased were simpleton villagers had declined to get the post mortem conducted on the dead body of the deceased, so the dead body of the deceased was cremated by the villagers on the next morning.
14. The depositions made by aforesaid witnesses of the complainant remained un-corroborated on record as they were not cross-examined by the opposite parties. No ill-will or enmity has been alleged or proved by the opposite party against the aforesaid witnesses. So we have reasons to believe the depositions of the aforesaid witnesses.
15. Therefore, the factum of deceased having been fallen on a steep rock and that thereafter he was taken from the place of accident to his house and his identification is proved on record through the affidavits of above named witnesses namely S/Sh. Pawan Kumar & Bhoop Singh. Since the death of the deceased has not been disputed by the opposite party and deceased died due to fall on a steep rock is proved through affidavits of above named persons, therefore, the registration of FIR remains only a formality and non-registration of FIR, ipso fact could not come in the way for the relief claimed.
16. Further, the complainant in her affidavit Ex. CW-1 has specifically pleaded that she and her family members were simple rustic persons and were not aware about the fact regarding 7 SBI General Insurance Versus Smt. Kanta Devi (FA No.188/2019) any insurance policy of her husband. After the death of her husband, she had found policy in the belongings of the deceased and that thereafter approached the concerned officials of the opposite party. This aspect of her statement has not been specifically controverted on behalf of opposite party. There is also nothing on record to show that the complainant was having knowledge with the respect to the policy and that to claim compensation under the policy, she and her family members had deliberately tried to suppress cause of death of the deceased.
17. Since, the complainant admittedly is a rustic villager, therefore, the repudiation of the claim of the complainant on the ground that there is lack of documentary evidence like police report or post mortem etc., in our opinion is unjust and against the principles of natural justice as the witnesses of the complainant have specifically deposed that late Sh. Chaman Lal had died due to fall in his grass land. Therefore, non-passing of the insurance claim so far, is deficiency in service. There is no illegality or irregularity in the impugned order, which warrants interference of this Commission.
18. The case law relied upon by the learned counsel for appellant/opposite party is not applicable to the facts and circumstances of the instant case.
19. Consequently, the appeal fails and the same is hereby dismissed.
8
SBI General Insurance Versus Smt. Kanta Devi (FA No.188/2019)
20. Certified copy of this order be sent to District Forum below and file of State Commission be consigned to record room after due completion. Certified copy of order be sent to the parties and their counsel(s) strictly as per rules. Pending applications, if any, also disposed of.
Justice Inder Singh Mehta President Sunita Sharma Member R.K. Verma Member 08.08.2022 Pkw 9