State Consumer Disputes Redressal Commission
Manager, Health Administrator Team, ... vs Ravinder Kaur on 12 March, 2010
STATE CONSUMER DISPUTES REDRESSAL COMMISSION, PUNJAB,
S.C.O. NO. 3009-10, SECTOR 22-D, CHANDIGARH.
Misc. Application No.270 of 2010
In/and
First Appeal No.171 of 2010
Date of institution : 5.2.2010
Date of decision : 12.3.2010
Manager, Health Administrator Team, Bajaj Allianz General Insurance Co.
Limited, Ground Floor, Ashoka Plaza next to Weikfield Company, 32/2, Nagar
Road, Pune-411 014 (through Praman Preet Singh Sr. Exe. (legal), Bajaj Allianz
General Insurance Co. Limited, SCO No.139-140, Sector 8-C, Ist Floor,
Chandigarh).
.......Appellant
Versus
1. Ravinder Kaur aged about 38 years wife of Late Shri Raghvir Singh son
of Shri Mohinder Singh,
2. Gurjot Singh minor son of Late Shri Raghvir Singh, under the
guardianship of his mother Smt. Ravinder Kaur,
Both residents of Village Katron, Tehsil Dhuri, District Sangrur (Punjab).
3. Bharat Sanchar Nigam Limited, Sangrur through its General Manager.
......Respondents
First Appeal against the order dated 11.11.2009 of
the District Consumer Disputes Redressal Forum,
Sangrur.
Before :-
Hon'ble Mr. Justice S.N. Aggarwal President.
Mrs. Amarpreet Sharma, Member.
Present :-
For the appellants : Shri Rajneesh Malhotra, Advocate. JUSTICE S.N. AGGARWAL, PRESIDENT:
Misc. Application for condonation of delay:
This appeal was filed with the delay of 44 days. An application for condonation of delay was filed in which reasons have been given for not filing the appeal within time. Accepted subject to just all exceptions and the delay of 44 days in filing the present appeal is condoned. First Appeal No.171 of 2010. 2
2. We have condoned the delay without issuing notice to the respondents for the view we are taking in the main case.
Main Case:
3. Raghvir Singh husband of Ravinder Kaur respondent No.1 and father of Gurjot Singh respondent No.2 (in short "the respondents") had a telephone connection bearing number No.233134 at his house. Respondent No.3 launched insurance scheme on running connection i.e. insurance cover P.A. (personal accident) death, in which, the appellants insured Raghvir Singh for a sum of Rs.50,000/-. On 11.6.2008 said Raghvir Singh was spraying insecticide in his sugarcane fields. Suddenly the insecticide got inhaled by said Raghvir Singh. He fell down in his fields. Ravinder Kaur respondent was present there. She started crying. Shamsher Singh and Gurbachan Singh ran to the place of incident. Raghvir Singh was taken to P.H.C. Sherpur where he was declared dead.
4. It was further pleaded that the insurance claim was lodged with the appellants. It was repudiated. Alleging deficiency in service on the part of the appellants, the respondents filed the complaint against them in the District Consumer Disputes Redressal Forum, Sangrur (in short "District Forum") for the payment of insurance claim. Compensation, interest and costs were also prayed.
5. The appellants filed the written reply. It was not denied that Raghvir Singh had taken the life insurance policy from the appellants. He has died and the insurance claim lodged by the respondents has been repudiated.
6. It was pleaded that the insurance claim was payable in case the death took place by accident. There was no evidence if Raghvir Singh died by inhaling of insecticide. Therefore repudiation of the insurance claim was legal and valid. Dismissal of the complaint was prayed.
7. Parties produced affidavits/documents in support of their respect versions.
8. Learned District Forum considered the pleadings of the parties and the affidavits/documents placed on file by them and accepted the complaint with First Appeal No.171 of 2010. 3 costs of Rs.3,000/- vide impugned judgment dated 11.11.2009. The appellants were directed to pay the insurance claim of Rs.50,000/- with interest at the rate of 9% per annum.
9. Hence the appeal.
10. The submission of the learned counsel for the appellants was that there was no evidence if Raghvir Singh assured had died by accident. Hence it was prayed that the appeal be accepted and the impugned judgment dated 11.11.2009 be set aside.
11. Record has been perused. Submissions have been considered.
12. The version of the respondents was that Raghvir Singh assured was spraying insecticide in his sugarcane fields and in the process he happened to inhale the insecticide which proved fatal for him.
13. This version of the respondent is supported by the affidavit of Raj Singh Ex.C-2, affidavit of Sarabjit Singh Ex.C-3 and the affidavit of Shamsher Singh Ex.C-4. Besides that Ravinder Kaur respondent who was an eye witness also filed her affidavit Ex.C-1.
14. Besides that the respondents have also filed certificates from Gram Panchayat Ex.C-9 and the certificate of Senior Medical Officer Ex.C-10. The reading of these documents clearly prove that Raghvir Singh had died by inhaling of insecticide which took place on 11.6.2008.
15. The submission of the learned counsel for the appellants was that neither the matter was reported to the police nor the dead body of Raghvir Singh was subjected to post-mortem examination. Therefore the death by accident or by inhaling of insecticide is not proved.
16. This submission has been considered. When a man dies the family is caught of by crisis and it is not always, it happens many times that the family members forget to report the matter to the police about this unnatural death and the dead body is also not subjected to post-mortem examination. First Appeal No.171 of 2010. 4
17. Moreover the report to the police as well as the post mortem report are the only documents which prove that the death of assured has taken place by accident. These were not essential documents in themselves, the non-production of which leads to automatic repudiation of the insurance claim.
18. If the death by accident or by inhaling of insecticide is clearly proved by other means the repudiation of insurance claim cannot be sustained.
19. In this context, reference may be made to judgment of Hon'ble National Commission reported as "Maya Devi v. Life Insurance Corporation of India"
2008 CTJ 1075 (CP) (NCDRC) where the death by accident was defined as under:-
"Further, in England law on the subject is settled. In Halsbury's Laws of England Vol. 25 Pg.307 Para 569, 4th Edition (2003 reissue), as to the meaning of the word 'accident', it is stated as under :
"569. Meaning of 'accident'. The event insured against may be indicated in the policy solely by reference to the phrase 'injury by accident' or the equivalent phrase 'accidental injury', or it may be indicated as 'injury caused by or resulting from an accident'. The word 'accident', or its adjective 'accidental', is no doubt used with the intention of excluding the operation of natural causes such as old age, congenital or insidious disease or the natural progression of some constitutional physical or mental defect; but the ambit of what is included by the word is not entirely clear. It has been said that what is postulated is the intervention of some cause which is brought into operation First Appeal No.171 of 2010. 5 by chance so as to be fairly describable as fortuitous. The idea of something haphazard is not necessarily inherent in the word; it covers any unlooked for mishap or an untoward event which is not expected or designed, or any unexpected personal injury resulting from any unlooked for mishap or occurrence. The test of what is unexpected is whether the ordinary reasonable man would not have expected the occurrence, it being relevant that a person with expert knowledge, for example of medicine, would have regarded it as inevitable. The stand point is that of the victim, so that even willful murder may be accidental as far as the victim is concerned."
20. In view of the law reproduced above and the facts of this case it is clearly proved that the death of Raghvir Singh assured husband of the respondent was an accidental death.
21. In view of the discussion held above, we do not find any merit in the present appeal and the same is dismissed in limine.
22. The appellants had deposited an amount of Rs.25,000/- with this Commission at the time of filing of the appeal i.e. on 5.2.2010. This amount of Rs.25,000/- with interest accrued thereon, if any, be remitted by the registry to the respondents by way of a crossed cheque/demand draft after the expiry of 45 days under intimation to the learned District Forum and to the appellants.
23. The interest on the amount of Rs.25,000/- shall stop running with effect from the date the appellants had deposited the same in this Commission. Interest on this amount of Rs.25,000/- shall be what has accrued on this amount when it remained deposited by this Commission in the Bank.
First Appeal No.171 of 2010. 6
24. Remaining amount shall be paid by the appellants to the respondents immediately.
25. The arguments were heard in this case on 5.3.2010 and the order was reserved. Now, the order be communicated to the parties.
(JUSTICE S.N. AGGARWAL)
PRESIDENT
March 12 , 2010 (MRS. AMARPREET SHARMA)
Bansal MEMBER