National Consumer Disputes Redressal
Swaranjit Kaur & Anr. vs Icici Lombard General Insurance Co. ... on 13 October, 2015
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI REVISION PETITION NO. 2541 OF 2015 (Against the Order dated 01/04/2015 in Appeal No. 997/2012 of the State Commission Punjab) 1. SWARANJIT KAUR & ANR. Wd/o. Late S. Mohinder Singh Sidhu, R/o. Gandha Singh Basti Road, Near Punjab Co-Education School, Bagha Purana, Moga Punjab 2. GURPREET SINGH S/o. Late S. Mohinder Singh Sidhu, R/o. Gandha Singh Basti Road, Near Punjab Co-Education School, Bagha Purana, Moga Punjab ...........Petitioner(s) Versus 1. ICICI LOMBARD GENERAL INSURANCE CO. LTD. & 3 ORS. Through its Manager, SCO 24-25, Sector - 8, Chandigarh 2. ICICI Lombard General Insurance Company Ltd. Through its Manager, Registered Office at ICICI Bank Towers, Bandra Kurla Complex, Mumbai - 400051 Maharashtra 3. ICICI Home Finance Company Ltd. Through its Branch Manager, Moga Punjab 4. Branch Manager, Arms A Division of Arcil, 668-A, 2nd Floor, New Lajpat Nagar, Pakhowal Road, Ludhiana Punjab ...........Respondent(s)
BEFORE: HON'BLE MR. JUSTICE AJIT BHARIHOKE, PRESIDING MEMBER HON'BLE MRS. REKHA GUPTA, MEMBER For the Petitioner : MR. GAGAN GUPTA & MR. SAURABH GUPTA For the Respondent :
Dated : 13 Oct 2015 ORDER This revision petition is directed against the order of Punjab State Consumer Disputes Redressal Commission, Chandigarh (in short, "State Commission") dated 1.4.2015 in FA No.997 of 2012 whereby the State Commission allowed the appeal preferred by the insurance company against the order of the District Forum, Moga and dismissed the complaint.
2. Briefly stated facts relevant for the disposal of revision petition are that Late Shri Mohinder Singh Sidhu had taken Accident Insurance Policy from the respondent/ICICI Lombard General Insurance Co. Ltd. According to the complainant, on 17.8.2006, the complainant died of heart attack suffered due to an accident. The petitioners/complainants at the relevant time were not aware of the insurance policy. As soon as the complainants came to know about the insurance policy, they filed the insurance claim in the year 2010. The insurance claim was processed and ultimately repudiated on the ground that the insured had died in natural death because of heart attack.
3. Being aggrieved of the repudiation of the claim, the petitioner filed a consumer complaint in the District Forum, Moga. The complaint was resisted by the respondents on the ground that the insurance claim was rightly repudiated as it was not a case of accidental death. The District Forum vide its order dated 27.2.2012, allowed the complaint and directed the respondents/opposite parties as under:-
"In view of the aforesaid facts and circumstances of the case, the present complaint is partly accepted. Ops 1 and 2/ICICI Lombard is directed to make the payment upto the extent of Rs.5 lakhs being as insured amount to OP-3/ Home Finance, within 30 days from the date of receipt of copy of this order. However, the OP-3/Home Finance has a right to claim the remaining outstanding, if any due, from the complainant, under the law. The complaint against OP-4, Arcil Division stands dismissed. Keeping in view the peculiar circumstances of the case, the parties are left to bear their own costs. Copies of the order be sent to the parties free of cost and thereafter the file be consigned to the record room."
4. Being aggrieved of the order of the District Forum, the respondents approached the State Commission and the State Commission vide impugned order, took the view that the petitioner had failed to establish that the insured has died as a result of accident and accordingly, allowed the appeal resulting in dismissal of the complaint.
5. Shri Gagan Gupta, Advocate for the petitioner has taken us to the report of the investigator and submitted that on perusal of the report, it would be seen that as per the statement of the petitioner recorded by the investigator on the relevant date, late insured was going on the scooter and due to heart attack, he fell from the scooter and died on the spot. It is contended that from the said statement, it is obvious that the death was result of accident as such, order of the State Commission being against the facts is not sustainable.
6. We do not find merit in the above contention. On perusal of the copy of repudiation letter, it is clear that the respondents repudiated the insurance claim on the ground that cause of death of insured was heart attack. On perusal of the report of the investigator, we find that the stand of the petitioners in the statement made before the investigator on 17.8.2006 was that while driving the scooter insured suffered a heart attack, consequently, he fell down from the scooter and died. From this, it is clear that the accident took place after the insured had suffered heart attack. Otherwise also, in order to succeed in the insurance claim, the onus of proving that the insured had died as a result of accident was on the petitioners. Undisputedly, incident was not reported to the police nor post mortem to establish cause of death was done. No evidence has been produced by the petitioners to prove the cause of death of the insured. There is nothing in the statement of the petitioners as recorded by the investigator that the insured had suffered any bodily injuries due to fall fell from the scooter. Thus, under the circumstances, the conclusion of the State Commission that cause of death of the insured was heart attack and not an accident cannot be faulted. No jurisdictional error has been pointed out by the learned counsel for the petitioners.
7. In view of the discussion above, we do not find any infirmity or material irregularity in the impugned order of the State Commission, which may call for interference in exercise of revisional jurisdiction. Revision petition is dismissed accordingly.
......................J AJIT BHARIHOKE PRESIDING MEMBER ...................... REKHA GUPTA MEMBER