JUSTICE V.K.JAIN, PRESIDING MEMBER (ORAL)

1.             Late Sh. Rochi Ram Santani was the beneficiary of a Group Insurance Policy issued by the respondent Bajaj Allianz General Insurance Company Limited.  Under the said policy, a sum of Rs.5,00,000/- was payable in case he was to die due to an accident.  The complainant/petitioner was the nominee under the said policy.  Late Sh. Rochi Ram Santani having died on 13.10.2007, a claim for payment in terms of the insurance policy was lodged by the complainant with the respondent.  The claim however, was rejected on the ground that the deceased had not died in an accident and therefore, no benefit under the said policy was payable to the complainant.  Being aggrieved from the rejection of the claim, the complainant/petitioner approached the concerned District Forum by way of a Consumer Complaint. 

2.      The complaint was resisted by the respondent primarily on the ground that the deceased had died on account of being a chronic alcoholic and not in an accident. 

3.      The District Forum vide its order dated 25.03.2015, allowed the complaint.  Being aggrieved from the order passed by the District Forum, the respondent approached the concerned State Commission by way of an appeal.  Vide impugned order dated 26.04.2016, the State Commission allowed the appeal filed by the insurer and consequently, dismissed the complaint.  Being aggrieved, the petitioner/complainant is before this Commission by way of this revision petition. 

4.      The only question which arises for consideration in this petition is as to whether the deceased had died in an accident or not.  The petitioner, in order to prove that the deceased had died in an accident, has relied upon some affidavits of the neighbours of the deceased. The neighbours namely Mr. Neelkanth Pareek, Mr. Nandlal Jethwani and Mr. Prabhu Dayal Rana have inter-alia stated that the deceased had died on 13.10.2007 when he fell from the roof of his house and sustained serious injuries.  They have also stated in their respective affidavits that the deceased was not an alcoholic and was not under the influence of liquor at the time he died.  They have further stated that since the death occurred all of a sudden, no report with the police was lodged.  None of the aforesaid affidavits however, indicates the time at which the deceased had allegedly fallen from the roof of his house on 13.10.2007.  The complaint does not explain how, at what time and under what circumstances, the deceased fell from the roof of his house.  Admittedly, he was not taken to a hospital nor was any doctor was called when he allegedly fell from the roof on 13.10.2007.  Such a conduct, in my opinion, would be against the natural course of human conduct since in case a person falls from the roof of his house, the first reaction would be to take him to the nearby hospital or doctor in order to give him the requisite medical aid.  Even if the family members or the neighbours feel that he is no more alive, they would, in the normal course of human conduct, still take him to the nearby hospital or call a doctor in order to confirm their suspicion.  That admittedly, was not done in this case.

5.      The respondent has placed on record the record relating to admission and discharge of the deceased at SMS Medical College and Hospital, Jaipur.  The said record shows that the deceased was admitted to the hospital on account of sudden loss of consciousness when he was found unconscious in his room in the morning hours of 08.10.2007.  The relatives who brought him to the hospital also informed the doctors that he was a chronic alcoholic and a chronic smoker.  The record further shows that despite his condition being serious, he was got discharged by his relatives.   When viewed in the background of the aforesaid admission in SMS Medical College and Hospital on 08.10.2007, the story of the alleged accident on account of fall from the roof of the house becomes highly suspicious and in the absence of any police report or post mortem, the said story cannot be accepted.  The view taken by the State Commission therefore, does not call for any interference by this Commission in exercise of its revisional jurisdiction.  The revision petition is hereby dismissed with no order as to costs.