State Consumer Disputes Redressal Commission
Divisional Manager, M/S.Royal ... vs Smt.Mangal S. Patil & Ors. on 16 July, 2008
CONSUMER DISPUTES REDRESSAL COMMISSION CONSUMER DISPUTES REDRESSAL COMMISSION MAHARASHTRA STATE, MUMBAI FIRST APPEAL NO. 396 OF 2008 Date of filing : 11/03/2008 @ MISC. APPL. NOS. 585 & 586 OF 2008 Date of order : 16/07/2008 IN CONSUMER COMPLAINT NO. 99 OF 2006 DISTRICT CONSUMER FORUM : KOLHAPUR Divisional Manager M/s.Royal Sundaram Alliance Insurance Co. Ltd. Rachna Trade Estate, 1st floor, Law College Road, Near S.N.D.T. Pune-4. Appellant/org. O.P.No.2 V/s. 1. Smt.Mangal S. Patil 2. Ms.Hemlata S. Patil 3. Master Hemant S. Patil All r/at 202, Nabar Sankul, 5th Galli, Rajarampuri, Kolhapur. Respondents/org. complainants 4. Manager M/s.Tessitura MKonti (I) Pvt. Ltd. Gat No.147, Village Tamgaon, Kolhapur-Hupari Road, Tal. Karveer, Dist. Kolhapur 416 234. Respondent/org. O.P.No.1 Corum : Justice Mr.B.B. Vagyani, Honble President Shri P.N. Kashalkar, Honble Judicial Member
Smt. S.P. Lale, Honble Member Present: Mr.S.R. Singh, Advocate for the appellant.
- : ORAL ORDER :-
Per Justice Mr. B.B. Vagyani, Honble President This appeal filed by M/s.Royal Sundaram Alliance Insurance Company Ltd. is directed against the order dated 29/12/2007 passed by District Consumer Forum Kolhapur.
We heard Mr.S.R. Singh, Advocate for the appellant/org. O.P.No.2.
There is delay of 16 days in filing appeal. Therefore, application for condonation of delay is filed. Delay is of few days. Delay is not intentional or deliberate. We are therefore inclined to condone the delay. Application is allowed and delay is condoned.
The insured met with an accident on 23/04/2005. He was admitted in the Hospital as an emergency case on 23/04/2005. He had following injuries :-
1) Contused Lacerated wound Lt. upper lid 3 x 1 x 1 cms.
2) Contusion Lt. Upper lid.
3) Lt. Sub conjuctival Haemorrage.
4) Contused lacerated wound Rt. Knee 3 x 1 x 1 cms.
5) Abrasion 1 x 1 cms. Over Rt. Shin.
He was discharged from the Hospital on 03/05/2005 and he died on 14/05/2005. The widow and children submitted claim to the Insurance Company. The Insurance Company repudiated the claim. Therefore, the heirs of the deceased insured filed consumer complaint before the Forum below. District Consumer Forum allowed the complaint and directed the Insurance Company to pay Rs.1,91,200/- to the complainants with interest @ 9% p.a. The Insurance Company has taken exception to this order and has come up in appeal.
It is tried to be argued that there was no nexus between the injuries caused in the accident and cause of death. It is not disputed that the insured died because of heart attack. In the Injury Certificate dated 17/05/2005 it is clearly mentioned that after admission the patient developed severe Chest pain and his ECG showed Antero septal myocardial infarction. Therefore, it is beyond doubt clear that because of injuries sustained in the accident, the patient had severe chest pain and had symptoms of heart attack.
The Certificate of Dr.Ajay Keni is on record. In the Certificate issued by Dr.Keni dated 19/05/2005 it is clearly mentioned that there was myocardial attack due to vehicle accident. Dr.Keni who is an expert has clearly clarified that there was nexus between the accidental injuries and heart attack. The complainants therefore discharged initial burden. Now the burden shifts on the Insurance Company to show that the death had no nexus with the injuries sustained by the insured in the accident. Nothing is placed on record to negative the Certificate issued by Dr.Keni. It is well settled legal position that the repudiation should not be done in a mechanical manner. The Insurance Company is expected to take utmost care and caution while repudiating the well justified claim. The impugned order under challenge therefore does not suffer from any illegality. No interference is required. In the result, we pass the following order :-
-: ORDER :-
1.
Misc. Appl. No.585/2008 is allowed and delay is condoned.
2. Appeal stands dismissed summarily.
3. No order as to costs.
4. Misc. Appl. No. 586/2008, which is for stay stands disposed of.
5. Copies of the order be furnished to the parties.
(S. P. Lale) (P.N. Kashalkar) (B.B. Vagyani) Member Judicial Member President dd.