ORDER

(Per: Mrs. Veena Sharma, Member):

This appeal, under Section 15 of the Consumer Protection Act, 1986, has been preferred by Insurance Company against the order dated 07.09.2010 passed by the District Forum, Haridwar in consumer complaint No. 83 of 2009, whereby the District Forum has allowed the consumer complaint against the opposite party No. 1-insurance company and directed insurance company to pay to the complainant an insured amount and        Rs. 5,000/- towards damages, within one month from the date of this order.

2.       Briefly stated the facts of the case, as mentioned in the consumer complaint, are that the complainant’s father Late Sh. Devi Chand was   farmer and he supplied sugar cane to the opposite party No. 2-Sehkari Ganna Vikas Samiti Ltd., Laksar, Haridwar. To increase yield of his crop, complainant’s father usually purchased chemicals and fertilizers from the opposite party No. 2 and he was the member of the Sehkari Ganna Vikas Samiti.  The opposite party    No. 2- Sehkari Ganna Vikas Samiti provides insurance of Rs. 1,00,000/- to its members through opposite party No. 1-The Oriental Insurance Company Ltd.  The complainant’s father was also insured for Rs. 1,00,000/- for the year 2007-08, and the premium of the said policy was paid to the insurance company.  On 16.03.2008, the complainant’s father died in road accident.  F.I.R. was lodged with the Police Station Pathri, Ferupur. No charge sheet was submitted against any person, as the accident took place due to sudden appearance of Neelgai (Blue Bull).  The complainant had produced all the documents to the insurance company-opposite party No. 1 for insurance claim of his father, but the insurance company without any reason has repudiated the claim of the complainant.

3.       The opposite party No. 1-The Oriental Insurance Co. Ltd. has filed its written statement before the District Forum and has pleaded that the complainant has not paid any amount, as premium, to the answering opposite party, through opposite party No. 2- Sehkari Ganna Vikas Samiti.  There is no agreement between the complainant and the answering opposite party. The complainant is not a consumer of the answering opposite party. The answering opposite party denied in para 4 of the written statement that the complainant’s father Sh. Devi Chand has died on 16.03.2008 in a road accident.  In para 5 of the written statement the answering opposite party stated that there is no F.I.R. lodged by complainant about his father’s death.  F.I.R. was lodged on 24.03.2008 much after complainant’s father’s death. The police of Police Station, Pathri, Ferupur had not filed any case regarding this. No panchnama was done by the police and no post-mortem of the complainant’s father-insured was conducted.  So it is suspected that Sh. Devi Chand, complainant’s father, died due to road accident.  According to the insurance policy’s terms and conditions, F.I.R., panchnama and post-mortem is essential to obtain insurance claim. So there is no deficiency in service on the part of the answering opposite party.

4.       The opposite party No. 2-Sehkari Ganna Vikas Samit Ltd., through its Secretary, has filed its written statement before the District Forum and has pleaded that facts stated by the complainant in para Nos. 1 to 5 and 9 to 11 are true. It is denied that the answering opposite party has received any notice sent by the complainant through his counsel. Insurance company has not paid the claim amount to the complainant timely.  Answering opposite party has recommended the matter for claim amount.

5.       The District Forum, after an appreciation of the facts of the case, allowed the consumer complaint vide order dated 07.09.2010 in the above manner. Aggrieved by the said order, the opposite party No. 1-insurance company has filed this appeal.

6.       We have heard Sh. M.N. Mishra, learned counsel for the appellant-insurance company and have also perused the record.  None appeared on behalf of the respondent.

7.       In the appeal, the appellant contested the case on the ground that respondent-complainant has not produced any proof of occurring the death of his father in road accident and in absence of any such evidence like copy of F.I.R., charge sheet, post-mortem report and panchnama duly verified by police, as such, the appellant is not responsible for any liability.  The court below has not considered the evidence filed by the appellant-insurance company. The court below has wrongly awarded Rs. 1,00,000/- towards the policy sum insured value without any evidence of death due to road accident. So it is prayed that the appeal may kindly be allowed and order passed by the District Forum be set aside and the consumer complaint filed by the complainant be dismissed.

8        After perusal of the record and evidence filed by the parties, it is evident that the insured Sh. Devi Chand has died on 16.03.2008, while he was going to Haridwar by a car. He met an accident due to sudden appearance of Neelgai (Blue Bull) in front of his car. The car was overturned due to accident and the insured was died on the spot.  It is evident by panchnama, which is made by Smt. Santosh Devi, Gram Pradhan, Mundakheda Kalan, Laksar, Haridwar and the same was duly signed by Gram Pradhan and other persons (paper No. 50). In the repudiation letter, which is addressed to Secretary, Sehkari Ganna Vikas Samiti Ltd., Laksar, Haridwar, it was mentioned that the claim of the insured is repudiated due to FIR, post-mortem report and police panchnama was not conducted, which are essential after insured’s death (paper No. 45).  F.I.R. was lodged by the complainant Sh. Brij Pal Saini S/o Late Sh. Devi  Chand at Police Station, Ferupur on 25.03.2008, eight days’ delay after death of insured. It is specially mentioned in F.I.R. that the deceased was insured by the insurance company through Sehkari Ganna Vikas Samiti, Laksar, Haridwar and to obtain the claim from the opposite party No. 1-insurance company, police investigation report is necessary.

9.       There is no dispute with regard to the fact that the deceased, father of complainant, Sh. Devi Chand was insured by the insurance company through Sehkari Ganna Vikas Samiti. The only dispute is that whether the complainant has fulfilled the formalities and conditions of insurance company or not.  It is a case of complainant that his father has died, as a result of road accident, due to vehicle was overturned and the insured was died on the spot. The claim was preferred to insurance company, but it was repudiated on the ground that the death is not covered under the terms and conditions of the insurance policy.  It is also admitted position that the F.I.R. was lodged after a delay of eight days. Due to delay in information to the police, the police could not investigate the matter, as it is accidental insurance policy and no post mortem was conducted, which is essential for claim of accidental insurance policy. While in the F.I.R., the complainant specially indicated that the investigation report is must for taking the claim from insurance company.  So it is very much clear that the          complainant was aware about the terms and conditions of the said insurance policy. The respondent-complainant has not brought any admissible evidence in support of the fact that there was an accident. Even he did not file any affidavit of his brother Sh. Ashok Kumar and driver    Sh. Surajbhan, who were also travelling in the vehicle at the time of accident.

10.     Learned counsel for the appellant has placed reliance on the case of Shakuntala Solanki vs. Oriental Insurance Co. & Ors.; I (2006) CPJ 135 (NC).  In this case, the Hon’ble National Commission has held that it is admitted position that in the present case no F.I.R. was lodged with the police.  It is admitted position that the deceased died on account of “cardiac arrest”.  In view of the above, we are unable to satisfy ourselves that the petitioner has brought any admissible evidence in support of the fact that there was an accident and he died as a result of this accident and injuries caused by the accident. This citation is fully applicable in the instant case.

11.     From the above discussion, we are of the view that the District Forum has not properly considered the facts and circumstances of the case and, hence erred in allowing the consumer complaint per impugned order, which cannot legally be sustained and is liable to be set aside and the consumer complaint is also liable to be dismissed. Resultantly, the appeal deserves to be allowed.

12.     For the reasons aforesaid, the appeal is allowed.  Impugned judgment and order dated 07.09.2010 passed by the District Forum, Haridwar is set aside and the consumer complaint No. 83 of 2009 is dismissed.  No order as to costs. The amount of Rs. 25,000/- deposited by the appellant at the time of filing the appeal be released in its favour.