By Smt. C.S. Sulekha Beevi, President,<br /> <br /> 1. Complainants are the legal heirs and dependents of deceased Mohamed Ali who was a subscriber of Mathrubhoomi daily. Every subscriber is insured with 1st opposite party as per an agreement entered into between 1st and 2nd opposite parties. Sri. Mohammed Ali died on 20-4-2006 due to lightening. The claim preferred before opposite parties for benefits under the insurance policy was repudiated for the reason that postmortem report was not produced. Complainants had also preferred application before District collector for relief under Natural Calamity Distress Fund. An amount of Rs.50,000/- was paid to 1st complainant after proper enquiry. Complainants alleged that opposite party has denied the claim on flimsy grounds and prays for Rs.50,000/- as compensation along with the benefits under the policy.<br /> 2. Both opposites filed separate version. Insurance Coverage as subscriber of Mathrubhoomi was admitted by 1st opposite party. It is submitted that the policy is only for accidental deaths and complainants did not produce postmortem report to prove the cause of death. An investigation was arranged by the Company revealed that no evidence or trace of damage caused due to lightening was available on the spot. The claim was repudiated for these reasons and there is no deficiency in service. Second opposite party filed a formal version. No relief is claimed against second opposite party.<br /> 3. Evidence consists of affidavits filed by both sides. Exts.A1 to A8 marked on the side of complainant. Exts.B1 to B3 marked on behalf of opposite party No.1.<br /> 4. The complainants' say is that Mohammed Ali who wast he subscriber of Mathrubhoomi died on 20-4-06 due to lightening. The claim for benefits under the policy was repudiated by opposite parties for the reason of non production of postmortem report. Admittedly no postmortem was conducted. The vital question for consideration is whether opposite party No.1 was justified in repudiating the claim for the reason of non production of postmortem report. Counsel for complainants placed strong reliance on Ext.A3 which is the photocopy of the First Information Report registered by Areacode Police on receiving the information of death of Mohammed Ali.The First Information Report is registered under Sec.174 Cr.P.C. The cause of death narrated by first informant in Ext.A3 is lightening. Under Section 174(1) Cr.P.C. The police has to conduct an investigation into the cause of death and submit the report to District Magistrate or Sub Divisional Magistrate. Sec.174(3) provides the instances for which police has to forward the body for examination by Civil Surgeon. If police or complainants have no doubt regarding the cause of death it is not incumbent to conduct an autopsy. Thus in cases which do not fall under Sec.174(3) postmortem examination need not necessarily be conducted. It can be inferred that on investigation police had concluded the cause of death to be lightening. Ext.A3 therefore sufficiently proves the case of complainant that death occurred due to lightening. Even though the cause of death is disputed by 1st opposite party there is no iota of evidence tendered by opposite party to controvert the case put forward by complainant. It appears that complainants had also preferred an application for monetary relief from the Natural Calamity Distress Fund of Government. An enquiry was conducted on this application by Revenue Authorities. Ext.A5 is the report submitted by Village Officer who conducted the enquiry. In Ext.A5 the cause of death is shown as lightening. Ext.A6 is the Certificate issued by Tahsildar that an amount of Rs.50,000/- was paid to 1st complainant as relief from the Natural Calamity Distress Fund. All these documents invariably establishes and proves that death was due to lightening. The intention of producing Postmortem report is to prove the cause of death. When there is no doubt regarding the cause of death and when the cause is established by sufficient records opposite party was not justified in denying the claim on this ground. It was further contended by opposite party No.1 that death was due to Natural Calamity and would not fall within the meaning of the word 'accident'. This position is already settled by Hon'ble National commission by the dictum laid in 2008 CTJ 22(CP) NCDRC Rita Devi @ Rita Gupta Vs. National Insurance Co. Ltd. and others where it is held,<br /> “Death not occurring in the usual course or natural course of events or due to events/causes not reasonably anticipated is an accidental one – That being so, held death due to cold wave is not natural but is accidental because all the persons may not feel the same effect and it is by natural external violent force.”<br /> 5. From the above discussions we hold the act of opposite party No.1 in repudiating the claim amounts to deficiency in service. While settling claims insurance companies should take a human approach rather than be highly technical. We consider that the benefit of Rs.one lakh as under the policy along with interest @12% per annum would serve justice to complainants. No relief is claimed against Opposite party No.2 and hence exonerated from any liability.<br /> 6. In the result, we allow the complaint and order opposite party No.1 to pay a sum of Rs.1,00,000/- (Rupees One lakh only) to the complainants together with interest @ 12% per annum from the date of complaint till realisation along with costs of Rs.1,000/-(Rupees one thousand only) within two months from the date of this order.<br /> <br /> Dated this 28th day of April, 2008.<br /> <br /> <br /> <br /> C.S. SULEKHA BEEVI, PRESIDENT<br /> <br /> <br /> <br /> <br /> E. AYISHAKUTTY, MEMBER<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> APPENDIX<br /> <br /> <br /> Witness examined on the side of the complainant : Nil <br /> Documents marked on the side of the complainant : Ext.A1 to A8<br /> <br /> Ext.A1 : Photo copy of the letter dated, 17-7-06 sent by K.P.Vilasini,<br /> Mathrubhoomi Agent to 2nd opposite party.<br /> Ext.A2 : Photo copy of the letter dated, 13-7-06 sent by 2nd opposite party<br /> to Mathrubhoomi Agent.<br /> Ext.A3 : Photo copy of the First Information Report dated, 20-4-06 by <br /> A.S.I., Areacode Police Station.<br /> Ext.A4 : Photo copy of the Death Certificate dated, 02-5-06 of deceased<br /> Muhamed Ali.<br /> Ext.A5 : Photo copy of the enquiry report of application submitted by<br /> 1st complainant.<br /> Ext.A6 : Copy of the letter No.E5-1656/2007 dated, 28-3-07 by Tahsildar,<br /> Ernad to complainants.<br /> Ext.A7 : Photo copy of the repudiation letter dated, 02-3-07 by first <br /> opposite party to first complainant.<br /> Ext.A8 : Photo copy of the letter dated, 17-3-07 by 2nd opposite party<br /> to first complainant.<br /> <br /> Witness examined on the side of the opposite parties : Nil<br /> Documents marked on the side of the opposite parties : Ext.B1 to B3<br /> Ext.B1 : Photo copy of the agreement entered into between 2nd opposite<br /> party and 1st opposite party dated, 14-7-2004.<br /> Ext.B2 : Photo copy of the investigation report dated, 15-02-07 by <br /> T.V. Sasidharan<br /> Ext.B3 : Photo copy of the repudiation letter dated, 02-3-07 by first <br /> opposite party to first complainant.<br /> <br /> <br /> <br /> <br /> <br /> C.S. SULEKHA BEEVI, PRESIDENT<br /> <br /> <br /> <br /> <br /> <br /> E. AYISHAKUTTY, MEMBER<br />