Sri.Siddegowda, President 1. This complaint is filed under section 12 of the Consumer Protection Act 1986, for settlement of accidental benefit under the policy issued by the Opposite parties. 2. The case of the complainant is that her son H.M.Prabhu Swamy had obtained insurance policy for Rs.1,00,000/- commencing from 02.03.2006 nominating the complainant. Unfortunately the son of the complainant died due to snake bite on 22.12.2006 when he was going to his land to feed water to the crops through the borewell. The same was found in the early morning of 23.12.2006 at about 5.30 a.m. Hence, the death of insured is an accidental death due to snake bite. Thereafter, the complainant filed claim form before the Opposite party for payment of the sum assured Rs.1,00,000/- and also Rs.1,00,000/- for accidental death of her son due to snake bite. The Opposite party paid sum of Rs.1,00,000/- towards the sum assured, but Opposite party has not settled Rs.1,00,000/- legally payable to the complainant for the accidental death. Therefore, the Opposite parties have committed deficiency in service. The Opposite parties have adopted the unfair trade practice to defeat the legal claim of the complainant. Therefore, the present complaint is filed for payment of the accidental benefit with interest of Rs.12.5% p.a. from the date of death. 3. The Opposite party has filed version, admitting the life insurance obtained by H.M.Prabhu Swamy for Rs.1,00,000/- and complainant is the nominee. Admitting the death of insured on 23.12.2006 on the basis of death certificate, it has denied that complainant is entitled for accidental benefit also. On humanitarian grounds, the basic sum assured was settled for Rs.1,00,000/- on 31.10.2007. The complainant vide her death intimation letter dated 02.03.2007 has stated that the cause of death may be due to snake bite, but in support of her claim she has not submitted any corroborative reports like F.I.R., Post Mortem report etc., to prove that the death is due to snake bite. Mere statement of presumption of death is not sufficient to consider the accident benefit. As per condition no.10 of the policy, the death by accident is to be proved to the satisfaction of the Corporation. In this case, the complainant has failed to submit reports to prove that the death is due to snake bite. The Opposite party has settled the claim and the complainant has given her discharge in full and final satisfaction of all claims and demands in respect of the disputed policy. The complainant had signed the discharge form without any undue influence, fraud or coercion. The claiming of accident benefit is an after thought. The complaint is a frivolous one and the Opposite party has not committed any deficiency in service and therefore, the complaint is liable to be dismissed with costs. 4. During trial, the complainant and one witness is examined to prove her case. The Opposite party examined one witness and produced the documents Ex.R.1 to R.5. 5. We have heard both sides. 6. Now the points that arise for our considerations are:- 1. Whether the Opposite party has committed deficiency in service by not settling the accidental benefit? 2. Whether the complainant is entitled to the accidental benefit of Rs.1,00,000/- with interest? 7. Our findings and reasons are as here under:- 8. POINT NO.1:- The undisputed facts are that H.M.Prabhu Swamy, the son of the complainant had obtained Life Insurance Policy as per Ex.R.1 for Rs.1,00,000/- commencing from 02.03.2006 and the complainant is the nominee and the policy was in force. Apart from, sum assured accidental benefit for Rs.1,00,000/- is also provided in this policy. It is also undisputed that on 23.12.2006 the insured Prabhu Swamy died and death certificate is produced as per Ex.R.3. It is also undisputed that the complainant intimated the death of her son and claim the policy amount as per letter Ex.R.2 dated 02.03.2007. She has also filed claim form and thereafter the Opposite party has paid Rs.1,00,000/- being the sum assured on 30.10.2007 obtaining discharge form. 9. Now the grievance of the complainant is that though the complainant preferred the claim, claiming the insurance amount and also accidental benefit as death of her son was snake bite, the Opposite party only paid only basic sum assured and has failed to pay the accidental benefit of Rs.1,00,000/-, though it is specifically stated that the death was due to snake bite. 10. The contention of the Opposite party is that as per Ex.R.2 the complainant suspected and presumed the death of her son was by snake bite and the complainant did not produce any report to prove that the death was due to snake bite to consider as accidental death and further, the complainant has executed discharge towards in full and final satisfaction of all claims and demands under the above policy as per Ex.R.4 and further out of the insurance amount received, she obtained another policy for another son by giving letter Ex.R.5. Therefore, the Opposite party has not committed any deficiency in service. 11. To prove the case, apart from the complainant, the complainant has examined one witness who is the native of the same village. Both complainant and the witness have specifically admitted that they have not seen the biting by the snake and they were not present at the time. According to the evidence of the complainant that her son went to land to feed water to the crops in the night time and in the early morning her husband went to see her son and villagers also went there and found the insured was lying in their land and they told that he died due to snake bite. The complainant has examined a witness. Her has deposed that in the morning when he was going towards his land, the husband of the complainant was crying loudly and when he went to see, he found on verification of the body, the body has turned it to blue colour and there was foam out of the mouth and there was sign of snake bite on the leg and on that basis he opined that death was due to snake bite. But in the cross-examination he deposed that when he saw, the foam was coming from the mouth of the Prabhu Swamy (assured) and on that basis he came to the opinion that the snake has bitten. So, the evidence of the witness is contradictory. At one breath he deposed that the foam had come from the mouth of the deceased, but another breath is deposed that when he went to see, foam was coming from the mouth. After death of a person, there was no question of coming of foam from the mouth. Even in case of consuming poison, the body would turn it blue colour and there is no direct evidence to prove the snake bite and even admittedly they have not got examined by a doctor and produced the doctor certificate to prove that the death was due to snake bite. Admittedly, there was no report to the police and there is no post mortem to prove the death by snake bite. Specifically in Ex.R.2 dated 02.03.2007 which is the first death intimation letter claiming the policy amount, it is specifically stated ÌÑÀÐÕ Ðà¤Ð½ÌÐÔÙÐÔ ¹Ð½ÄÑÙ. So, it is only a suspicion and presumption of snake bite, on the ground that the face of the assured turned to blue colour and there was bruise wound on the ankle of the leg. 12. It is well established law that the nominee shall prove that the death of the deceased was accidental by producing sufficient evidence. Mere suspicion or presumption of snake bite cannot be accepted by the Corporation without medical certificate. Even though in rural areas, the villagers will not report the death by snake bite or drowning the water or fall from tree, to the police and do not get post mortem of dead body, but there must be cogent evidence to prove that death was due to snake bite and not suspicion or presumption. 13. Further, though in the claim form, the reason of death is shown as snake bite and the Opposite party has settled the claim for the sum assured, the complainant did not protest at the time at all and in fact she has obtained another policy from the Opposite party for another son by giving letter Ex.R.5 and she has executed discharge form in full and final satisfaction of all claims under the above policy as per Ex.R.4. The complainant has admitted the signature in Ex.R.4 and R.5. But she has deposed that she does not know that Ex.R.4 is the discharge form and Ex.R.5 is for issuing a policy for another son out of the amount settled. The contention of the learned counsel for the complainant is that the complainant is a illiterate lady and Ex.R.4 is in English version and it was not explained to her and the Opposite party has exercised unfair trade practice to defeat the legal claim and the Opposite party has failed to produce the investigation report as to the cause of death. RW.1 has deposed that after the intimation of death, the corporation would get enquiry of the matter. It is denied by the witness that the investigation has not been produced, since it was against the Corporation. The witness has not specifically admitted that there is investigation report in this case. So as observed above it is the primary duty of the nominee to prove by means of cogent evidence that the death was due to snake bite. Merely because, in the claim form it is stated that the death was due to snake bite, the Opposite party is not bound to pay the accidental benefit without proof of death by snake bite. When admittedly there is execution of discharge form Ex.R.4 as full and final satisfaction of the claim under the policy, it is not the case that the Opposite party has obtained the signature of the complainant to the discharge form by exercising undue influence, fraud or coercion or misrepresentation. The complainant has not at all pleaded in the complaint that by exercising undue influence, fraud or coercion or misrepresentation by stating they would immediately pay the amount if she put the signature to the discharge form. Though Ex.R.4 discharge form is in English version there is clear declaration by the Development Officer that he has explained the contents of the discharge form to the claimant in Kannada language and the claimant has affixed her signature to this form after fully understanding the contents thereof. It is admitted by the complainant that at the time of putting the signature to his discharge form, her son and LIC Agent were also present. It is not the case that she being an illiterate, her son protested for this obtaining signature to the form without explaining the contents and the Opposite party officials exercised fraud. In the decision reported in I (2009) CPJ 49 in the case of Parvathi Devi Vs- LIC of India, Rajasthan State Commission has clearly stated that when the discharge voucher has been executed in the presence of witness towards the full and final settlement of the claim of insurance and the amount was accepted in full and final discharge of claim and there was no protest lodged after receiving the amount when there is no proof that discharge voucher obtained by fraud, misrepresentation or undue influence, the complaint is liable to be dismissed. This finding of the Rajasthan State Commission is also found in decision of West Bengal State Commission in the case of LIC Vs- Jamuna Chanda reported in III (2004) CPJ 181. 14. So, in the present case also when the complainant has accepted the basic sum assured by executing discharge voucher towards full and final satisfaction of the claim and when she has not protested by issuing any letter to the Opposite party complaining the fraud or undue influence or misrepresentation and when the complainant has not at all pleaded in the complaint that the Opposite party settled the claim of basic sum of the policy and obtained her signature to the voucher by misrepresentation, fraud or undue influence, the complaint against the Opposite party for accidental benefit is not maintainable and hence, it cannot be said that the Opposite party has committed deficiency in service at all. Therefore, we answer the point in the negative. 15. POINT NO.2:- Since, the complainant has failed to prove the death was due to snake bite and the complainant has executed the discharge voucher and when exercising of fraud, misrepresentation, undue influence or coercion is not pleaded and proved, the complainant is not entitled to the accidental benefit claim. 16. In the result, we proceed to pass the following order; ORDER The complaint is dismissed. However, there is no order as to costs. (Dictated to the Stenographer, transcribed, corrected and then pronounced in the open Forum this the 27th day of January 2009). (PRESIDENT) (MEMBER) (MEMBER)
