Haryana

StateCommission

A/921/2015

MANJEET KAUR - Complainant(s)

Versus

LIFE INSURANCE CORP. - Opp.Party(s)

T.S.NALVI

12 Apr 2016

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION, HARYANA,PANCHKULA

                                                 

First Appeal No.921 of 2015

Date of Institution: 21.10.2015

Date of Decision: 12.04.2016

 

Manjeet Kaur, aged 35 years, wife of Late Sh.Chhabeg Singh, r/o village Madudan, Tehsil Shahabad, Distt. Kuruksehtra.

     …..Appellant

                                                Versus

 

1. The Senior Divisional Manager, L.I.C. of India, 439, Model   Town, Karnal.

2.      The Senior Manager, LIC of India, Kurukshetra.

         …..Respondents

 

CORAM:   Mr. R.K.Bishnoi, Judicial Member.
                   Mrs.Urvashi Agnihotri, Member.

 

Present:-    Mr.T.S.Nalvi, Advocate for the appellant.

Mr.R.S. Kataria proxy counsel for Mr.Satyawan Ahlwat, Advocate counsel for the  respondents.

 

                                      O R D E R

 

URVASHI AGNIHOTRI, MEMBER:

 

1. Manjeet Kaur – complainant is in appeal against the Order dated 15.09.2015 passed by the learned District Consumer Disputes Redressal Forum (for short District Forum), Kurukshetra, for the enhancement of the compensation granted to her, while partly allowing her complaint.
2. In brief, the husband of the complainant Sh. Chhabeg Singh S/o Sh. Bachan Singh purchased two accidental insurance policies No.173833612 and 175152444 for Rs.1,26,000/- and Rs.2,00,000/- on 28.12.2003 and 23.10.2006 respectively. The deceased Chhabeg Singh was an agriculturist and on 07.06.2011 while he was working in his fields, he was bitten by a snake and died there and then. The complainant being a nominee of the insured applied for the insurance claim followed by a legal notice to the OPs on 21.08.2014.  However, the Ops allowed the claim against the insurance policy No.173833612, but rejected the claim against the other policy No.175152444 of the complainant. Aggrieved against this the complainant approached the District Forum claiming accidental insured amount of Rs.3,26,000/- alongwith interest @18% p.a. from the date of death and the damages for harassment and mental agony etc.   
3. In reply, OP-1 pleaded that the complainant had concocted a false story of snake bite just to take the accident benefit under the policies by defrauding the Corporation. They further pleaded that in fact on the basis of the claim papers, the payment of Rs.3,26,000/- i.e. Rs.2,00,000/- plus Rs.1,26,000/- in both the policies had already been made vide cheque No.443526 and 443527 on 10.09.2011. Therefore, the accident benefit has been denied as per the rules of the Corporation. Thereupon, the learned District Forum partly allowed the complaint by grating the following relief:-

“11. As already mentioned, the complainant is entitled to amount of Rs.1,26,000/-. So, we partly allow the present complaint and direct the OPs to make payment of rs.1,26,000/- along with simple interest @9% per annum from the date of filing of present complaint i.e. 24.09.2014 till its realization. This order should be complied within a period of two months, failing which penal action under Section 27 of the Consumer Protection Act, 1986 would be initiated against the OPs. File be consigned to record after due compliance”.

 

4. Against this impugned order dated 15.09.2015, the complainant has come up in appeal before us and has vehemently reiterated the contentions raised before the District Forum. In nutshell the appellant contends that the learned District Forum had wrongly held that the complainant was not entitled to the accidental benefits in policy No.175152444 amounting to Rs.2,00,000/- on the basis of thereof.
5. We have heard the learned counsel for the parties and have also gone through the record. From the written statement filed by the OP and the documentary proof referred to therein it is evident that the OP had already made the payment of basic claim of Rs.3,26,000/- i.e. Rs.2,00,000/- plus Rs.1,26,000/- in both the polices vide cheque No.443526 and 443527 dated 10.09.2011. However, they have not made the payment of Rs.2,00,000/- against policy No.175152444 because according to the OP the complainant had not lodged the FIR regarding the death by snake bite, nor got any M.L.R. or postmortem conducted by the authorities concerned. Further, the death by snake bite was not covered under the “Accident Clause” terms and conditions of the policy.
6. On the other side, it is evidence from record that the death Sh.Chhabeg Singh did take place due to snake bite, which fact is duly corroborated by Dr.Gurdeep Singh, BAMS, and the Gram Panchayat as also the register of the village Chowkidar and the Anganwari register.  Moreover, it is settled by the Hon’ble National Commission in Dharmisetty Srinivas Rao Vs New India Assurance Company –I(2006) (CPJ) 11 (NC) that death occurred by snake bite is duly covered within the definition of “Accident” and no postmortem etc. is necessary in such a case. Therefore, in view of the overwhelming evidence available in the present case, the question of lodging FIR did not arise.
7. Consequently, we find merit in the appeal filed by the complainant and the stand taken by the OP wholly untenable in law. Accordingly, the appeal is allowed and the impugned order of the learned District forum is modified and the Ops are directed to pay to the complainant the total amount claimed by him i.e. Rs.2,00,000/- against policy No.155152444 alongwith interest @ 9% p.a. from the date of filing the complaint i.e. 24.09.2014 till its realization.

 

 

April 12th, 2016                      Urvashi Agnihotri                                R.K.Bishnoi,                                                   Member                                               Judicial Member                                              Addl. Bench                                        Addl.Bench                

S.K.