National Consumer Disputes Redressal
Ajmeri Khatun vs National Insurance Company Ltd. on 9 January, 2015
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI REVISION PETITION NO.828 OF 2010 (Against the order dated 1.10.2009 in First Appeal No.234/2008 of the Jharkhand State Consumer Disputes Redressal Commission, Ranchi) Mrs. Ajmeri Khatun ........ Petitioner (s) W/o Mohd. Rustam D/o Late Marium Bibi R/o Khaini Whole Sale Near Swastik Cinema Hall P.O. Katras Garh, Distt. Dhanbad Jharkhand Vs. 1. General Manager National Insurance Company Ltd. .Respondent (s) (A Govt. of India Enterprises) Division III, National Insurance Building Ground Floor, 8, India Exchange Place Kolkata-700001 2. Manager Golden Multi Services Club of Golden Trust Financial Service Bank More P.O & Distt. Dhanbad Distt. Dhanbad State of Jharkhand 3. Sr. Divisional Manager Golden Multi Services Club Limited 16, R.N. Mukherjee Road Kolkata-700001 Regd Office: 3, Midditon Street Kolkata-700001 BEFORE: HON'BLE MR. JUSTICE V. B. GUPTA, PRESIDING MEMBER HON'BLE MR. SURESH CHANDRA, MEMBER For the Petitioner : Mr. A. K. Mishra, Advocate with Mr. Arun Pathak, Advocate For the Respondent No.1 : Mr. Yogesh Malhotra, Advocate For the Respondent Nos.2-3 : Mr. Kunal Chatterji, Advocate Pronounced on : 09th January, 2015 ORDER
PER SURESH CHANDRA This revision petition has been filed by the complainant challenging the order dated 1.10.2009 passed by the Jharkhand State Consumer Disputes Redressal Commission, Ranchi in F.A No.234 of 2008. By the impugned order, the State Commission allowed the appeal of the OP-3 Insurance Co./respondent No.1 in this revision petition. Opposite party Nos.1 & 2 are Respondent Nos.2 & 3 herein respectively.
2. Brief facts of this case which are relevant for its disposal are that the mother of the petitioner, namely, Marium Bibi purchased a Janta Personal Accident Policy from the respondent Insurance Co. The said policy was obtained by the deceased Marium Bibi through respondent Nos.2 & 3. As per the allegation in the complaint, the said Marium Bibi died on 2.2.2003 due to snake bite. The petitioner claimed compensation which was rejected by the OP Insurance Co. on the ground that the claim was not inconformity with the conditions of the policy. So the petitioner filed a consumer case before the District Forum which allowed the same in her favour by its order dated 7.5.2008 in complaint case No.159 of 2007. Vide its order, the District Forum directed the respondent No.1/OP No.3 Insurance Co. for payment of insured amount of Rs.3 lakhs with interest @ 8% p.a. in addition to Rs.10,000/- as compensation and Rs.1,000/- as cost. Aggrieved of this order of the District Forum, the OP Insurance Co. filed an appeal before the State Commission mainly on the ground that the claimant had failed to comply with the conditions of the insurance policy inasmuch as she failed to prove the factum of accidental death by not submitting the Postmortem Report, the Panchnama of the body, a copy of the diary of the police station relating to the accidental death. It was submitted that whatever papers the claimant had submitted were contradictory in themselves. In spite of this, the District Forum allowed the claim and passed the impugned order accepting the complaint without properly appreciating the documents and conditions of the policy and as such the impugned order was bad in law. The State Commission after examining the documents and hearing the parties, allowed the appeal, set aside the order of the District Forum and dismissed the complaint. It is against this order of the State Commission that the present revision petition has been preferred by the petitioner/complainant.
3. We have heard Shri A.K. Mishra and Shri Arun Pathak, Advocates for the petitioner, Shri Yogesh Malhotra, Advocate for respondent No.1 and Shri Kunal Chatterji, Advocate for respondent Nos. 2 & 3 and perused the record.
4. Learned counsel for the petitioner contended that the State Commission has failed to appreciate that the petitioner had already filed whatever documents were available with her which undoubtedly indicated that the death of the insured had occurred due to snake bite and since it was at her residence in the Jhuggi Colony where she was residing, the claim of the petitioner could not have been repudiated by the Insurance Co. simply because there was no formal Postmortem Report. He argued that in this case what is important is that the death was by snake bite which is nothing but an accidental death and the same should not be rejected only on the ground that there was no Postmortem report. In this context, learned counsel submitted that it cannot be ignored that the insured person was an extremely poor person and being poor and illiterate person, their first and foremost duty to take the person bitten by the snake to the nearby doctor who on examination found that she had been injured by snake bite. When she was declared dead, her last rites were performed and report about her death was also submitted to the local Municipal Office. He pointed out that these facts are duly reflected in the Death Certificate dated 2.2.2003 issued by Dr. Ashok Sharma of the Sharda Medical Centre in the nearby Jhilmil Colony. Learned counsel contended that simply because the deceased was shown to a doctor who is located close to the place of residence but the same is in Delhi near border should not necessarily raise doubt about the death and the certificate certifying the same issued by the doctor. He further said that the police report apparently recorded the name of the Medical Centre as Shahadra instead of Sharda which might be on account of hearing the word wrongly which is quite common during the course of narration in the case of such incidents. This, however, should not lead to depriving the petitioner of her legitimate claim and as such a mistake which is quite common can be corrected and the word read as per the document on file. In view of this, it was established that the death of the insured had taken place as a result of the snake bite which undoubtedly is an accident as held by the National Commission in the case of Dharmisetty Srinivas Rao Vs. New India Assurance Co. Ltd. [ I (2006) CPJ 11 (NC) ]. In this case, it has also been held that death due to snake bite could be proved by doctors certificate and the certificate issued by Village Administrative Officer if the Postmortem had not been conducted. Learned counsel, therefore, pleaded that keeping in view these aspects which emanate from the documents filed by the petitioner with the insurance Co. and are placed on record, the impugned order passed by the State Commission was misconceived and based on erroneous appreciation of facts and as such cannot be sustained in the eye of law being a perverse order. The revision petition, therefore, deserves to be allowed and the impugned order be set aside by restoring the order of the District Forum.
5. Per contra, learned counsel for the OP Insurance Co. supported the impugned order and submitted that because of non-compliance of the conditions of the policy, the claim could not be established and as such was rightly repudiated and the District Forum committed grave error in accepting the complaint in spite of the loopholes which eventually was corrected by the State Commission by passing the impugned order which deserves to be maintained and the revision petition set aside.
6. We have given our anxious thought to the rival contentions. We may note that the State Commission has reversed the order of the District Forum mainly on two grounds, namely, the difference in the names of the Medical Centre as mentioned in the Police Report and in the death certificate and secondly, the doubt arisen on account of the deceased person being taken to Delhi for treatment of snake bite when the occurrence took place at Ghaziabad because in such a case the victim should have been taken to the nearest medical centre in the shortest possible time at Ghaziabad itself. We do not agree with the view taken by the State Commission because both the reasons given are rather based on conjectures and as such it would be erroneous to deny the claim of the petitioner simply on this basis. Both the aspects have been satisfactorily explained by learned counsel for the petitioner. Learned counsel also pointed out that the letter dated 29.4.2004 referred to by the OP Insurance Co. in its letter of repudiation dated 26.12.2006 was never received by the petitioner but except the Postmortem Report, all the necessary documents had already been submitted to the Insurance Co. Keeping in view the status of the insured and the claimant petitioner, we accept the explanation put forth by learned counsel in this regard. In this view of the matter, the only aspect which remains to be considered is as to whether the Insurance Co. was justified to reject the claim for want of Postmortem Report. In this context, we find that the view taken by this Commission in the case of Dharmisetty Srinivas Rao (supra) is squarely applicable to the facts and circumstances of the present case. While accepting the appeal in that case, the National Commission observed thus:
3. In this case, it is an admitted fact that the deceased had taken a Long Term Janta Personal Accident Policy for 3 years. For that there is no dispute. There is also no dispute that the present complainant is the nominee of her aunt (the deceased) for receiving the amount as per the policy. Limited question is, whether the complainant is entitled to get the benefit of the said policy, as he failed to produce on record the post-mortem report.
4.
In our view, as stated by Dr. N. Prasad Rao, Civil Assistant Surgeon, Govt. Hospital, Anakapalli, post-mortem was not conducted on the dead body, because usually, in snake bite cases postmortem examination is not conducted. Further, there is a certificate on record issued by him on 27.7.1996 that the deceased was admitted in the Community Hospital, Anakapalli on 23.7.1996 at 11 a.m. for snake-bite and the patient expired on the same day at 4 p.m. The certificate is signed by the Civil Assistant Surgeon, Community Hospital. Thereafter, there is a certificate issued by the Village Administrative Officer of Anakapalli Mandal to the effect that Gorli Appala Narasamma, widow of late Nookaraju, died because of snake bite on 23.7.1996 at about 10 a.m., while she was cutting grass. This information was conveyed to him by the neighbouring farmers. In our view, there is no justifiable ground to disbelieve the Village Administrative Officer and the doctor who treated the deceased.
[Emphasis provided]
7. In view of the above, we are convinced that the District Forum had rightly accepted the complaint and allowed the claim vide its order dated 7.5.2008 and the State Commission apparently failed to appreciate the evidence available before it properly in the given facts and circumstances of the case. We, therefore, accept the revision petition, set aside the impugned order and uphold the order of the District Forum with cost of Rs.10,000/- to be paid by the respondent Insurance Co. to the petitioner within a period of four weeks by way of Demand Draft in her name to be sent to the petitioner directly on her address.
Sd/-....
(V.B. GUPTA, J.) PRESIDING MEMBER Sd/-.
(SURESH CHANDRA) MEMBER SS/