State Consumer Disputes Redressal Commission
Smt. Triveni Bai & Others vs Golden Multi Service Club & Anr. on 23 April, 2014
CHHATTISGARH STATE
CONSUMER DISPUTES REDRESSAL COMMISSION
PANDRI, RAIPUR (C.G.)
Appeal No.FA/13/660
Instituted on : 10.12.2013
1. Smt. Triveni Bai, W/o Late Sakharam Sahu,
2. Phaleshwar Sahu, S/o Late Sakharam Sahu,
3. Ku. Rupa Sahu, D/o Late Sakharam Sahu,
4. Pomesh Sahu, S/o Late Sakharam Sahu.
Appellant Nos.3 & 4 through Vali Guardian
Mother Smt. Trivine Bai W/o Sakharam Sahu,
All R/o : Village Kolda, Post Koma (Khallari),
Block & Tehsil Bagbahra, Dist. Mahasamund (C.G.) ... Appellants
Vs.
1. Golden Multi Service Club,
G.T.F.S. Through : Competent Officer,
Near Gurudwara, Arihant Complex, Station Road,
Raipur, Tehsil & District Raipur (C.G.)
2. National Insurance Company Limited,
Through : Divisional Manager,
Beside Lalganga Shopping Mall, G.E. Road,
Raipur (C.G.) .... Respondents
PRESENT: -
HON'BLE JUSTICE SHRI R.S. SHARMA, PRESIDENT
HON'BLE MISS HEENA THAKKAR, MEMBER
COUNSEL FOR THE PARTIES :-
Shri R.K. Bhawnani, for appellants.
Shri P.K. Paul, for respondent No.1.
Shri Ishwar Lal Sahu, for respondent No.2.
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ORDER
Dated : 23/04/2014 PER: - HON'BLE JUSTICE SHRI R.S. SHARMA, PRESIDENT This appeal is directed against order dated 18.11.2013, passed by District Consumer Disputes Redressal Forum, Mahasamund (C.G.), in Complaint Case No.04/2013. By the impugned order, learned District Forum has dismissed the complaint of the appellants (complainants).
2. Briefly stated, the facts of the complaint of the appellants (complainant), before the District Forum are : that deceased Sakharam Sahu was husband of the appellant No.1 (complainant No.1) Smt. Triveni Bai and father of appellant Nos.2 to 4 (complainant Nos.2 to 4). Deceased Sakharam Sahu had purchased Group Janta Personal Accident Policy No.100300/47/01/9600022/01/96/30180 for the period from 01.09.2002 to 31.08.2017 from the respondent No.2 (O.P.No.2) National Insurance Company Limited and the insured amount is Rs.1,00,000/-. The appellant No.1 (complainant No.1) Smt. Triveni Bai was made nominee in the policy. On 28.05.2012, deceased Sakharam Sahu, was threatened by Yograj Sahu for payment of loan amount and due to threaten given by Yograj Sahu, Sakharam Sahu, consumed poison. Due to consuming poison, he died. The matter was reported to the Police Station, Tumgaon where merg intimation No.25/12 and First Information Report 184/12 for offence under // 3 // Section 306 of IPC was registered against Yograj Sahu. Inqust was prepared on the dead body of Sakharam Sahu and dead body was sent to Community Health Centre, Bagbahra for postmortem examination. Dr. V. P. Singh conducted postmortem on the dead body of deceased and gave his report in which he opined that the cause of death was Cardio respiratory Arrest due to poisoning and death is suicidal in nature. Being legal heir of the deceased Sakharam Sahu, the appellant No.1 (complainant No.1) Smt. Triveni Bai made claim before the respondent No.2 (O.P.No.2) for insured amount under the policy, but the respondent No.2 (O.P.No.2) did not pay the claim amount to the appellants (complainants), hence the appellants (complainants) filed consumer complaint before the District Forum seeking sum insured under the policy along with interest.
3. The respondent No.1 (O.P.No.1) filed written statement before the District Forum and denied the allegations made by the appellants (complainants) in the complaint.
4. The respondent No.2 (O.P.No.2) also filed written statement before the District Forum and admitted that deceased Sakharam Sahu purchased an insurance policy from it as mentioned in para 2 of the complaint. The respondent No.2 (O.P.No.2) pleaded that the cause of death of Sakharam Sahu was due to consuming poison, which is not accidental in nature. Therefore, the appellants (complainants) are not // 4 // entitled for any compensation or insured amount and the respondent No.2 (O.P.no.2) has rightly repudiated the claim of the appellants (complainants).
5. Learned District Forum, after having considered the material placed before it by the parties dismissed the complaint.
6. Shri R.K. Bhawnani, learned counsel appearing for the appellants (complainants) argued that the deceased Sakharam Sahu was abetted by the person, whose name is mentioned in the First Information Report and due to abetment, deceased Sakharam Sahu consumed poison and so far as death of Sakharam Sahu is concerned, the death is accidental in nature and death was covered within purview of the insurance policy issued by the respondent No.2 (O.P.No.2), therefore the appellants (complainants) are entitled for the insured amount as mentioned in the insurance policy and learned District Forum has illegally dismissed the complaint without going through the terms and conditions of the insurance policy. The impugned order passed by the District Forum, suffers from infirmity and illegality and is liable to be set aside.
7. Shri Ishwar Lal Sahu, learned counsel appearing for the respondent No.2 (O.P.No.2) National Insurance Company Limited argued that the death of the deceased Sakharam Sahu was on account // 5 // of consuming poison and the death does not fall within the purview of the accidental benefit under the policy and learned District Forum has rightly dismissed the complaint of the appellants (complainant). He supported the impugned order.
8. Shri P.K. Paul, learned counsel appearing for the respondent No.1 (O.P.No.1) also supported the above arguments advanced by learned counsel for the respondent No.2 (O.P.no.2) and supported the impugned order.
9. We have heard counsel for the parties and have also perused the record of the District Forum.
10. Now the question to be decided by this Commission whether death of Sakharam Sahu, was due to consuming poison and his death falls within purview of terms & conditions of the policy issued by the respondent No.2 (O.P.) for obtaining accidental benefit.
11. The respondent No.2 (O.P.No.2) filed insurance policy along with terms and conditions of the policy. In the terms and conditions it is mentioned that :
"Provided always that the Company shall not be liable under this policy for :
(1) .....................
(2) Payment of compensation in respect of death, injury or disablement of the Insured from (a) intentional self injury suicide // 6 // or attempted suicide (b) whilst under the influence of intoxicating liquor or drug (c) directly or indirectly caused by insanity (d) arising or resulting from the insured committing any breach of the law with criminal intent. (e) Service on duty with any armed force. (3) .....................
(4) ....................."
12. In the case of Life Insurance Corporation of India vs. Anita Shekhawat, I (2014) CPJ 65 (NC), Hon'ble National Commission observed thus :-
"6. Now, the question to be decided by this Commission is whether death due to consumption of sulphos tablets fall within the purview of Clause 10(b) of the policy for grant of accident benefits. Clause 10(b) runs as under :-
"10 (b) Death of the Life Assured - To pay an additional sum equal to the Sum Assured shall sustain any bodily injury resulting solely and directly from the accident caused by outward, violent and visible means and such injury shall within 120 days of its occurrence solely, directly and independently of all other causes result in the death of the Life Assured. However, such additional sum payable in respect of this policy, together with any such additional sums payable under other policies on the life of the Life Assured shall not exceed Rs.5,00,000/-.
7. Perusal of this clause clearly reveals that death must occur on account of sustaining bodily injury resulting solely and directly from the accident caused by outward, violent and visible means. In the case in hand, there is no question of bodily injury due to outward violent means as death had occurred due to consumption of sulphos tablets. In such circumstances, merely because assured consumed sulphos tables under the mistaken belief of Zarda, complainant was not entitled // 7 // to get accident benefits and learned District Forum rightly dismissed complaint.
8. Learned Counsel for the respondent submitted that death occurred due to unforeseen and unplanned event which falls within purview of accident. We do not agree with this submission as grant of accident benefits has been specifically defined under Clause 19(b) of the policy and death must occur on account of bodily injury caused by outward and violent action. This Commission in II (1997) CPJ 45 (NC) = 1997 (2) CPR 8 (NC) LIC of India v. Ramesh Chandra, has held that District Forum and State Commission had no jurisdiction to go beyond terms and conditions of policy which are to be strictly complied with and in such circumstances, as death of the assured did not occur due to outward, violent or bodily injury, complainant was not entitled to get accident benefits and learned State Commission has committed error in allowing appeal and allowing accident benefits which is liable to be set aside".
13. The appellants (complainants) filed documents i.e. Annexure P-1 Police Antim Sameeksha Report by Superintendent of Police, District Mahasamund (C.G.). Document Annexure P-2 Final Report (Under Section 173 Cr. P.C.), Annexure P-3 First Information Report (Under Section 154 Cr. P.C.), document Annexure P-4 Merg Intimation, document Annexure P-5 Inquest Report, document Annexure P-6 requisition for postmortem examination along postmortem report, document Annexure P-7 is insurance policy, document P-8 is death certificate of Sakharam Sahu,.
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14. In document Annexure P-3 i.e. First Information Report, it is mentioned that deceased Sakharam Sahu was abetted by the person whose name is mentioned in the FIR, for payment of the loan amount and due to abetment, the deceased consumed poison. The doctor, who conducted postmortem examination on the dead body of deceased Sakharam Sahu reported that the cause of death of Sakharam Sahu was Cardio Respiratory Arrest due to poison and the death is suicidal in nature.
15. We have perused the documents filed by the parties and terms and conditions of the policy. The policy clause clearly prevails that death must occur on account of sustaining bodily injury resulting solely and directly from the accident caused by outward, violent and visible means.
16. In the instant case, there is no question of bodily injury due to outward, violent and visible means as death of Sakharam Sahu had occurred due to consumption of poison. In such circumstances, merely because the assured consumed pesticides under influence or abetment given by other person, the appellants (complainants) are not entitled to get compensation under the policy.
17. In view of above discussions, we are of the firm view that the learned District Forum has rightly held that the appellants // 9 // (complainants), are not entitled to get accidental benefit under the policy on the basis of terms and conditions of the policy and finding recorded by the District Forum does not suffer from any infirmity or illegally and does not call for any interference by this Commission.
18. Hence, the appeal filed by the appellants (complainants) being devoid of any merits, is liable to be and is hereby dismissed. No order as to the cost of this appeal.
(Justice R.S.Sharma) (Ms.Heena Thakkar)
President Member
/04/2014 /04/2014