State Consumer Disputes Redressal Commission
United India Insurance Company Ltd. ... vs Sangeetham Padma And Others ... on 27 May, 2009
BEFORE THE A BEFORE THE A.P STATE CONSUMER DISPUTES REDRESSAL COMMISSION AT HYDERABAD. F.A. 302/2006 against C.D. 163/2002, Dist. Forum, Karimnagar. Between: United India Insurance Company Ltd. Rep. by its General Manager Divisional Office at 11/1582 M. G. Road, Warangal Now represented by The Asst. Manager. *** Appellant/ Opposite Party And 1) Sangeetham Padma W/o. Chandramouli Age: 36 years 2) Sangeetham Hari S/o. Chandramouli Age: 23 years. 3) Sangeetham Rajesh S/o. Chandramouli Age: 22 years. 4) Sangeetham Vanaja D/o. Chandramouli Age: 19 years. 5) Sangeetham Yamini D/o. Chandramouli Age: 27 years. 6) Sangeetham Sai Eswar S/o. Chandramouli Age: 5 years. All are being R/o. D.No. 79, A.R. Headquarters Karimnagar. (R5 being minor rep by his Mother & Guardian R1) *** Respondents/ Complainants Counsel for the Appellant: Mr. N. V. Jagannath. Counsel for the Respondent: M/s. C. Hari Preeth HONBLE SRI JUSTICE D.APPA RAO, PRESIDENT. SMT.M.SHREESHA, LADY MEMBER. & SRI K. SATYANAND, MEMBER WEDNESDAY, THIS THE TWENTY SEVENTH DAY OF MAY TWO THOUSAND NINE ORAL ORDER:
(Per Honble Sri Justice D. Appa Rao, President) ***
1) This is an appeal preferred by the insurance company against the order of the Dist. Forum directing it to pay the amount covered under the policy together with interest and costs.
2) The case of the complainants in brief is that complainant No. 1 is the wife and complainant Nos. 2 to 6 are children of deceased Chandramouli, a Head Constable. During his life time, he took Janata Personal Accident Insurance Policy for Rs. 3 lakhs valid from 5.2.1999 to 4.2.2009. While so, on
14. 1. 2001 at about 10.00 a.m. he came to his house and while trying to take his kit box, he accidentally fell on a rope due to which the neck of the deceased was pressed by the rope, and consequently he died on the spot. On report by his son, the police registered a case in Crime No. 12/2001 u/s 174 Cr.P.C. The doctor opined that the death was due to asphyxia. When the amount was claimed, the insurance company avoided on one ground or the other. Therefore they filed the complaint claiming Rs. 3 lakhs with interest @ 12% p.a., from the date of death of the deceased till payment.
3) The insurance company resisted the case. While admitting issuance of policy it denied that the death was due to accidental fall. It was a case of suicide. The contents in FIR, Post Mortem report as well as final report of the police were contradictory. An investigator was appointed, who after investigation opined that the death was suicidal. Suicide is not covered by the terms of the policy, and therefore prayed that the complaint be dismissed.
4) The complainants in proof of their case filed the affidavit evidence of complainant No. 2 and got Exs. A1 to A7 marked, while the insurance company filed the affidavit evidence of its Divisional Manager and got Exs. B1 to B3 marked.
5) The Dist. Forum after considering the evidence placed on record opined that that the death was accidental and the complainants were entitled to the amount covered under the policy and directed the appellant to pay Rs. 3 lakhs together with interest and costs.
6) Aggrieved by the said decision, the insurance company preferred the appeal contending that the Dist. Forum did not appreciate the facts in correct perspective. The deceased being the Head Constable, the police manipulated the entire record. The injury on the neck would undoubtedly show that the death was suicidal and the death as explained by the complainant was against commonsense, and therefore prayed that the appeal be allowed.
7) The point that arises for consideration is whether the death of the deceased was suicidal or accidental?
8) It is an undisputed fact that the deceased worked as a Head Constable and he took Janata Personal Accident Insurance Policy Ex. B1 for an amount of Rs. 3 lakhs covering the period from 5.2.1999 to 4.2.2009. It is also not in dispute that he died on 14.1.2001 during the subsistence of the policy period. Complainant No. 2 his son informed the death of the deceased to the insurance company alleging that on 14.1.2001 at about 10.00 p.m. after his father returned from duty, while taking out the kit bag from out of hanging basket, he fell down from the chair, and accidentally fell on a wire used for drying clothes, sustained injury on the neck , fell unconscious and when they took him to the hospital, the doctor declared him dead evidenced under FIR Ex.
A1. Basing on which the police registered a case in Crime No. 12/2001 u/s 174 Cr.P.C.
Inquest was conducted. Inquestdars were of the opinion that it was an accidental death vide inquest report Ex.
A2.
The medical officer conducted the post mortem examination at 11.30 a.m. and found ligature marked as 5 x present on the front of the neck above the thyroid cartilage and hyoid bone is in mouth, semi open, salivary stains present on right angle of mouth, blunt, A.M. Finally, he was of the opinion that the death was due to Asphyxia due to hanging vide Ex. A3. Basing on this, police filed final report Ex. A4 requesting to close the case as accidental death. When the insurance company did not settle the claim, complainants got issued a legal notice under Ex. A6 for which the insurance company got issued a reply under Ex. A7 alleging that their investigator Sri M. V. Subba Reddy investigated the matter and opined that the death was suicidal.
9) The investigator in his report stated that he visited Karimnagar, and made discrete enquiries and was of the opinion that the assured was a drunkard and was spending lot of his income on drinks and there were misunderstandings between him and his family members. All this led to suicidal death on the night of day of incident. He visited the house, noted the height of the deceased, height and length of the rope etc. and opined that the statement of the complainant that seeing the incident, he went to his neighbors instead of saving the deceased and with so many people in the house would establish that the version of the complainant was incorrect. He observed that the deceased had hung himself to the rope and committed suicide, intentionally, and his death was not at all accidental. The investigator found fault with the police investigation as to the nature of the death. As asphyxia due to hanging equally could be suicidal death, he was of the opinion that the report was fabricated as the assured being the Head Constable.
11) In one of the grounds of appeal the insurance company alleged that subsequent to his report the surveyor died and they could not file his affidavit evidence. The contention is that at any rate, falling on a rope could not have resulted in asphyxia leading to his death.
12) The insurance company or for that matter the investigator ought to have examined or recorded the statement of the doctor suggesting that his report was false and it was given at the instance of complainant since the deceased being the Head Constable. The very same material could have been placed before an expert doctor to prove that the doctor who gave the opinion that the death was due to asphyxia due to hanging was false. The report of the surveyor is undoubtedly based on surmises. He did not place statement of any of the witnesses whom he examined. In fact he surmised that the death could not have been due to accidental fall and it was a case of suicide. Learned counsel for the appellant contended that the reports of the doctor as well as police officers are against commonsense. The death cannot be caused due to fall on a rope. It would not cause asphyxia. We may state that there was no basis for such argument. We do not intend to state that the truth is stranger than fiction. At times wield unexpected things would happen. When the complainant alleges that his father while taking the kit box from over hanging basket by standing on a chair slipped, fell on the rope resulting in asphyxia leading to his death, the death cannot be termed as supernatural or unnatural. The deaths do occur as alleged by the complainant. The doctor who conducted the post-mortem examination has noted that it was an accidental death. Had it been strangulation by hanging, hyoid bone would not have been intact. Obviously the doctor considered all these circumstances and opined that it was not a suicidal death. It was supported by the report of the inquestdars as well as investigation of the police.
13) In the teeth of positive evidence the claim cannot be rejected on surmises or by applying so called commonsense.
14) Learned counsel for the complainants relying a decision in Narendra Kumar Jain Vs. Oriental Insurance Company Ltd. reported in 2003 (1) CPR 318 contended that the report of the investigator is of no evidence. It ought to have filed the statements recorded during investigation to prove those statements. The claim could not be repudiated on surmises. There is no quarrel as to the above proposition.
15) Coming to the facts, in the light of un-controverted medical evidence together with police report etc. that the death was accidental, necessarily the insurance company was liable to pay compensation claimed under the policy. We do not see any mis-appreciation of fact by the Dist. Forum in this regard. We do not see any merits in the appeal.
16) In the result the appeal is dismissed with costs computed at Rs. 5,000/-. Time for compliance four weeks.
1) _______________________________ PRESIDENT
2) ________________________________ MEMBER
3) _________________________________ MEMBER Dt. 27. 05. 2009.
*pnr UP LOAD O.K.