(As per A.A.Jain , Honorable Member)

 

            The Complainant filed this complaint against Opposite Party for seeking various reliefs as per prayer clause.

 

1.                  The complainant is widow and legal heirs/widow of deceased Yadorao Patle retired Govt. employee who  died on dt. 7-9-2006.He was died on dt. 7.9.2006 due  to fall in well which is in his agricultural field. The death of deceased Yadorao Patle was accidental in nature. Hence matter was informed to Police Department and Police has done investigation of this accidental death. But initially it was observed that the deceased Patle could have consumed liquor or poison etc. therefore the visara was sent to Regional Forensic Science Laboratory, Nagpur by Police Department. That,as per report of Laboratory, received on 19-05-2007 no liquor or poison was found in Viscera of deceased Yadorao Patle.

 

2.                  Deceased Yadorao Patle was D.A.B.Policy holder of Life Insurance Corporation of India (i.e. O.P.) bearing Policy No. 971685128 of Rs.Fifty Thousand.. As per the condition of D.A.B. Policy , if Policy holder died by any accident then O.P. has to pay double of the insured amount . The D.A.B. claim of the complainant was rejected by the O.P. so complainant filed this complaint praying that O.P. is directed to pay Rs.50,000/- Rs.Fifty Thousand extra as Double Accident Benefit plus (Rs.40,000/- @18% from 7-9-2006 interest, Rs.20,000/- towards expenses, Rs. 10,000/- mental harassment plus Rs.5000/- costs of complaint. Total Rs.1,30,000/- (Rs. One Lakh, ThirtyThousand only (Exh.1).

 

3.                  In response to notice under Section 13 of C.P.Act 1986 O.P. appeared and filed his reply (Ex.6) O.P.submitted that this Forum has no jurisdiction.O.P. specifically denied that Shri Yadavrao Patle died accidental death or his death was accidental in nature. O.P. also submitted that these allegations are made deliberately, with an intension to claim double accident benefit under the Policy.  Hence denied that legal heirs of deceased are entitled to claim double accident benefit now . O.P. also denied that D.A.B. claim of complainant was denied without reason.

 

 

4.                  That, O.P.denied that in the report dated 19-05-2007 it was mentioned that there was no poison or liquor in the visara of deceased Yadavrao Patle. It is  submitted that the deceased policy holder was under total intoxication and the investigation revealed that at the time of death Shri Yadavrao Patle was fully drunk and left his house after quarrelling and due to heavy intoxication he was not in a position to walk straight and  because of intoxication, he fell in to the well in the filed and died . O.P. further submitted that D.A.B. claim of complainant was rightly rejected by him. O.P. further submitted that the policy issued to the deceased has a exclusion clause and D.A.B. can not be given to the policy holder if the accident occurs due to negligence or due to intoxication on the part of policy holder.

5.                  O.P. further submitted that the report was called from S.D.M. under Section 174 of Cri. P.C. to know as to whether the deceased policy holder died due to natural death or otherwise. In this background the S.D.M. has given a report saying that deceased did not died natural death but he died accidental death. It means that S.D.M. has stated that he has not committed suicide. O.P. clearly submitted that deceased Yadavrao died due to losting balance on account of heavy drinking and falling in the well as he was habitual drunkard. Thus as per the condition of Clause 10, D.A.B. was not payable to his nominee. Finally O.P. has submitted that   the complaint is liable to be dismissed with cost in the interest of justice.

 

6.                  On verifying all the records thoroughly and hearing arguments of both the parties, the only point arises for our consideration whether complainant is entitled for any relief as prayed and our finding is in affirmative due to following reasons :-

 

 

7.                  The complainant is a beneficiary of the D.A.B.Policy of her husband, issued by the O.P. on getting the premium. It comes under the definition of ‘Consumer’ under Section 2 (d) (ii) and 2(b)(v) of Consumer Protection Act, 1986. Hence this Forum is well capable to try this case under C.P.Act 1986.

8.                  O.P. has repudiated the D.A.B. claim on the ground of police report. Police Report made on the statement of panch and inquiry done by Police Department. Police Station Officer, Salekasa has sent his report to Sub-Divisional Magistrate, Deori on 28-11-2006 by letter No.26/06. Police Department reported to S.D.M. Deori that deceased was habitual drunkerd. On the date of death i.e. 7-9-2006 at Karutola he fell down in the well as he had taken heavy drinks. Deceased was passing through the farm (field) and fell down in the well as he could not balance himself. As per the condition 10 (b) of Policy, the deceased was not fit in ‘Double Accident Benefit Policy’. So O.P. has repudiated the D.A.B. claim on dated 07-01-2008.

9.                  Police department and had sent viscera of deceased to Regional Forensic Science Laboratory, Nagpur for investigation and report whether the deceased has consumed liquor or poison etc. Shri R.R.Kulkarni, Assistant Chemical Analyzer, Regional Forensic Science Laboratory, State of Maharashtra, Nagpur-12 has given the report of Analysis as :-

 

Police Department’s Sub-Divisional Police Officer has send his final report to S.D.M. Deori about deceased Yadorao Gopalrao Patle, Aged about 60 years, R/o. Karutola, P.S.Salekasa died due to fell down in the well accidentally at his field. And S.D.M. Deori has ordered u/s 174 Cri.P.C. to close the investigation. Thus, O.P. failed to prove their allegation that the deceased Yadorao Patle died due to falling in well under influence of liquor. Hence it is clear that deceased Yadorao died in accidental death and is entitled for D.A.B. Claim with interest from the date of repudiation of claim i.e. from 7-1-2008 and the cost of complaint case with physical and mental harassment charges. Hence we proceed to pass the following order :-.

 

 

 

1.                  Complaint is allowed.

2.                  O.P.is directed to pay Rs.50,000/- (Rs.Fifty Thousand) as Double Accident Benefit and which carry interest @ 12% per annum from 7-1-2008 to till realization of amount.

3.                  O.P.is also directed to pay Rs. 3000/- as the mental and physical harassment compensation with cost of the complaint case Rs.1000/-.