State Consumer Disputes Redressal Commission
United India Insurance Co. Ltd. vs Smt.Shakuntala Uttam Wagh & Ors. on 7 January, 2010
CONSUMER DISPUTES REDRESSAL COMMISSION CONSUMER DISPUTES REDRESSAL COMMISSION MAHARASHTRA STATE, MUMBAI FIRST APPEAL NO. 947 OF 2006 Date of filing : 18/05/2006 IN CONSUMER COMPLAINT NO. 183 OF 2002 Date of order : 07/01/2010 DISTRICT CONSUMER FORUM : PUNE United India Insurance Co. Ltd. DO-III, Kubera Chambers, Jangali Maharaj Road, Shivaji Nagar, Pune-411 009. Appellant/org. O.P.No.1. V/s. 1. Smt.Shakuntala Uttam Wagh 2. Master Shailesh Uttam Wagh 3. Ku.Karishma Uttam Wagh All r/o. S.No.165, Adarsh Vasahat, Malwadi, Hadapsar, Pune-411 009. Respondents/org. complainants 4. Pune Mathadi, Hamal and other Manual Workers Board, Unique House, 180, Bhabani Peth, Pune 411 042. Respondent/org. O.P.No.2. Quorum : Shri P.N. Kashalkar, Honble Presiding Judicial Member
Mrs.S.P. Lale, Honble Member Appearance : Mr.H.G. Misar, Advocate for the appellant.
Ms.Janaki Dave, Advocate for respondent Nos.1to3.
-: ORAL ORDER :-
Per Mrs.S.P. Lale, Honble Member This appeal is filed against the order dated 20/10/2005 passed by District Consumer Forum Pune in consumer complaint No.183/2002 whereby Forum below ditected O.P.No.1 to pay Rs.2 Lakhs together with interest @ 9% p.a. from 07/06/2000 till realization to the complainants. Forum below further directed O.P.No.1 to pay Rs.1,500/- towards cost of the complaint. Complaint against O.P.No.2 was dismissed.
Deceased Uttam Wagh was one of the members of O.P.No.2. He was covered under Group Accident Policy. Policy was issued in the name of O.P.No.2 through O.P.No.1. Deceased Uttam Wagh had paid requisite amount of the insurance policy to O.P.No.2. O.P.No.2 had taken insurance cover from O.P.No.1 and paid premium to O.P.No.1. On 19/10/1999 deceased Uttam Wagh fell on the ground and sustained injuries to his head. He dies due to accident. Postmortem report revealed that late Uttam Wagh died due to head injury. Complainants were not aware of said insurance policy. When complainant No.1 came to now about insurance policy she intimated fact to O.P.Nos.1&2. Complainant No.1 also furnished all the necessary documents to O.P.No.2. O.P.No.2 submitted all the documents and claim form to O.P.No.1. However, O.P.No.1 repudiated the claim on the ground that Uttam Wagh was under influence of alcohol, there was breach of terms and conditions of policy. They closed the claim file as No claim. Therefore, complainants filed consumer complaint in the Forum below for deficiency in service.
O.P.No.1 filed its written statement and contested the claim of the complainants. It pleaded that death of deceased was due to accident and the accident occurred since the deceased was under influence of alcohol and hence, as per terms of the policy, claim was rightly repudiated by O.P.No.1. O.P.No.1 further pleaded that Honble Session Judge in case No.71/2000 held that late Uttam Wagh was under influence of liquor on 19/10/1999 and hence findings of Session Judge was against Uttam Wagh. Therefore, claim of the complainant could not be allowed as per terms of the policy.
After considering documents and affidavits, Forum below partly allowed the complaint and passed the impugned order.
We heard Mr.H.G. Misar, Advocate for the appellant and Ms.Janaki Dave, Advocate for respondent Nos.1to3.
We perused the impugned order, memo of appeal and documents placed on record and we are finding that the order passed by the Forum below is just, proper and sustainable in law. Postmortem report has mentioned that cause of death is head injury and it has no where mentioned that death is caused due to alcohol. In the postmortem report, it is also no where mentioned that late Uttam WAgh was under influence of alcohol. However, appellant has taken a stand that Honble Session Judge in case No.71/2000 has given finding that Uttam Wagh was under influence of alcohol on 19/10/1999. However, we perused copy of the judgement wherein it is mentioned that it is equally possible that when deceased was proceeding to his house at that time he had consumed liquor and due to that he fell on the rough surface of the ground. Thus, possibility of the accidental death of the deceased. In the judgement, the Session Court has not at all specifically mentioned that fact of consuming alcohol is proved by the prosecution by cogent evidence. The Session Judge came to conclusion only on the circumstantial evidence. As per medical evidence, the deceased died due to head injury. Therefore, repudiation of the claim by the appellant is not at all legal and therefore, the Forum below rightly allowed the complaint. Appeal is devoid of any merits. In the result, we pass the following order:-
-: ORDER :-
1. Appeal stands dismissed.
2. No order as to costs.
3. Copies of the order be furnished to the parties free of costs.
(S.P. Lale) (P.N. Kashalkar) Member Presiding Judicial Member