Complainant Smt.Joginder Kaur has filed the present complaint against the opposite parties U/S 35 of the Consumer Protection Act (for short, C.P.Act.) seeking necessary directions to the opposite parties to produce whole record relating to policy and also directed to pay the remaining amount of Rs.1,00,000/- as per terms and conditions of the policy of opposite parties alongwith future interest and other benefits etc as the deceased died due to sudden railway accident. Opposite parties be further directed to pay Rs.50,000/- as unnecessary physical and mental harassment alongwith Rs.10,000/- as litigation expenses, in the interest of justice.

2.        The case of the complainant in brief is that her deceased son namely Sh.Sandeep Kumar was having policy no.473046010, under QLY, Premium of Rs.1225/- sum assured Rs.1,00,000/- DOC 21.9.2010 with the opposite parties and she is the nominee under the said policy being his mother. She had surrendered original policy, documents, showing her as nominee, to the opposite parties, which are lying in the office of the opposite parties.  She has next pleaded that his son was making the payments of its premiums regularly to the opposite parties without any delay, as per terms and conditions of the said policy.  Unfortunately, on 21.4.2019, the deceased son was going to some urgent work and he was trying to cross railway lines, then a railway train was coming very fast without any signal and blowing horn and suddenly struck him as a result of which, he fell down and train crushed him and he died on the spot due to railway accident. He was a young person of about 33 years of age. There is no previous medical record/treatment in respect of mental illness of his deceased  son and Gurdaspur Railway police registered DDR no.12 dated 22.04.2019, u/s 174, and recorded the statement of relatives, family members and other persons of locality, as per policy report, deceased Sandeep Kumar died due to sudden railway accident. She has next pleaded that dead body of deceased was brought to dead house Gurdaspur, for post mortem and concerned doctor wrongly mentioned in its post mortem report that this was the case of mental illness, without any documentary evidence, and police record, and the opposite parties paid only Rs.1,00,000/-to her as per the technical point of mental illness, whereas this was the case of sudden accident and as per the terms and conditions of the policy, if the policy holder dies due to accident, then his nominees are entitled for doubled amount i.e. Rs.2,00,000/-. The deceased died leaving behind his wife, children, old aged mother i.e. complainant and father, and a brother who were totally dependent upon the earning of the deceased, namely Sandeep Kumar. She approached to the office of the opposite parties and requested them to pay remaining amount of Rs.1,00,000/- but the opposite parties deliberately failed to consider the police report and flatly refused to pay her any amount.  Thus, there is deficiency in service on the part of the opposite parties. Hence this complaint.

 3.         Notice of the complaint was issued to the opposite parties who appeared through their counsel and filed their written reply submitting therein that death claim payment under the policy in question has been paid and a sum of Rs.1,16,270/- has been credited in the Account No.8460010039919 (PNB) being maintained by the claimant. The complainant is not entitled for DAB claim under the policy in question. It was next submitted that no doubt train may be running very fast, but it was denied that train driver has not blowing horn reaching so near the Railway Station. As regards to putting down a signal, which is regular and compulsory process. A special man of railway department on duty operates and put the signal down as and when train comes. Hence it is not a sudden death and due to negligence of railway department. The death is due to mental illness of the deceased. As regards to DDR under Section 174 Cr. P.C. is a mandatory to register in such cases. Obtaining statements from the family members and other relatives without any cause do not matter.  There are not competent to confirm cause of death of the deceased. The doctor is the competent authority who can confirm cause of death after conducting post-mortem. It was denied that the concerned doctor has wrongly stated the cause of death in his postmortem report that it was the case of mental illness whereas, it was known case of EPILEPSY as per Hospital record. As per opinion of the doctor in the postmortem report cause of death was 'edh' (Epidural Hematoma) which is sufficient to cause of death in an ordinary cause of nature. The policy also confirmed the death of deceased due to Psychatric illness history in postmortem report. Panchyat Nama dated 21.4.2019 obtained during the course of enquiry by G.R.P.Gurdaspur which itself is explanatory that Sandeep Kumar died due to mental illness in train accident. All other averments made in the complaint has been vehemently denied and lastly prayed that the complaint may be dismissed with costs.

4.        Ld.counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW-1/A alongwith copies of documents Ex.C-1 to Ex.C-4.

5.     Alongwith the written statement the opposite party has filed affidavit of Sh.Mohinder Pal, Assistant Administrative Officer Ex.OPW1 alongwith copies of documents Ex.OP-1 to Ex.OP-4.

6.        Written arguments filed by the parties.

7.      We have carefully gone through the pleadings of counsel for the parties; oral arguments advanced by their respective counsels and have also appreciated the evidence produced on record with the valuable assistance of the learned counsels for the parties for the purposes of adjudication of the present complaint.

8.      In the said case Sandeep Kumar was holder of LIC Policy No.473046010.  Sandeep Kumar met with an accident with train on 21.4.2019 and D.D.R./FIR was lodged for the same by GRP placed at Ex.C-3. In the DDR/FIR report of deceased Sandeep Kumar Column 20 the cause of death has been mentioned as Railway Accident. In column 21 while answering the question whether there was any circumstances/rumor which point towards suicide? The same has been answered by GRP as  -/Nil thereby rules out any apprehension of suicide.

9.     A postmortem report conducted at Civil Hospital Gurdaspur by the Medical Officer Dr.Puneet Gill on 22.4.2019 has elaborated on the injuries to the body of the deceased. In the report doctor has mentioned about undigested food in the stomach and some gelatinous articles in the small intestine which have otherwise been not chemically examined regarding its contents. In the opinion of the Doctor the cause of death has been mentioned as "EDH which is sufficient to cause of death in ordinary cause of nature." A Panchyat Nama has also been placed in the file signed by some villagers Piara Singh, Jagdish Raj, Ramesh Kumar, Kulwant Singh and Satnam Singh wherein the cause of death of Sandeep Kumar as Railway Accident and have drawn apprehension regarding deceased being mentally upset but have failed to produce anything on record regarding his being mentally upset. As regards Ex.OP-2,1/3 placed on record by opposite party regarding treatment of Sh.Sandeep Kumar deceased was availing of treatment from a Private Hospital duly run by a qualified Doctor for EPILEPSY. The same can be construed as evidence that Sh.Sandeep Kumar was well aware regarding his ailment and as a responsible person had sought treatment from qualified doctor for the same.

10.    From the facts placed above, we are of the considered opinion that Sh.Sandeep Kumar met with a train accident on 21.4.2019 which in no way points to his committing suicide. Opposite party on its part have arbitrarily denied the double accident benefit to the nominee of Sh.Sandeep Kumar. The complaint is partly allowed and opposite party have on its part has paid the sum assured to the nominee of the deceased Sandeep Kumar against Policy No. no.473046010. Opposite party is directed to release the double accident benefit to Smt.Joginder Kaur nominee of Sh.Sandeep Kumar deceased within a period of 45 days from the receipt of copy of this order alongwith 6% interest from the date of occurrence of accident/death of the complainant till its realization. Opposite party is further directed to pay Rs.20,000/- as harassment and Rs.10,000/- as litigation expenses to the complainant Smt.Joginder Kaur.

11.     The complaint could not be decided within the stipulated period due to heavy pendency of Court Cases, vacancies in the office and due to pandemic of Covid-19.

12.     Copy of the order be communicated to the parties free of charges. After compliance, file be consigned.                                                                                                                                                                                                     (NaveenPuri)                                                                                                                     President   

Announced:                                              (Raghbir Singh Sukhija)

December 22, 2022                                                        Member

*MK*