Haryana

Karnal

124/2013

Reena Devi W/o Satpal - Complainant(s)

Versus

Life Insurance Corporation Of India - Opp.Party(s)

Vinod Sharma

09 Mar 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.  

                                                          Complaint No.124 of 2013

                                                               Date of instt.: 6.03.2013

                                                          Date of decision: 9.03.2016

 

 

Smt.Reena Devi wife of late Shri Satpal son of Shri Raghbir Singh resident of village Anjanthali tehsil Nilokheri district Karnal.

.                                                                               ……..Complainant.

                                      Vs.

 Life Insurance Corporation of India, Karnal-2, 5 Sant Nagar, Hansi Road, Karnal through its Divisional Manager.

 

 

                                                                           ……… Opposite Party.

                     Complaint u/s 12  of the Consumer

                     Protection Act.

Before           Sh.K.C.Sharma……….President.                

                   Sh.Anil Sharma…….Member.

Present:-        Sh.Vinod Sharma Advocate for the complainant.

                   Sh.C.J.Wadhwa Advocate for the Opposite Party.

 

ORDER:                  

 

                   This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986, on the averments that her husband namely Satpal had purchased two insurance policies bearing nos. 177478624 and 177478625 from the Opposite Party and she was the nominee  in both the policies. One policy was for Rs.five lakh  according to which  in the event of death of insured  in an accident, the Opposite Party was to pay a sum of Rs.two lakh under the general clause and Rs.three lakh under accidental clause to the nominee.  On 29.9.2011, while her husband was repairing cable wire he received electric shock, and died due to electrocution . No treatment could be provided to him as he died before reaching the hospital. She and other family members were under great mental shock and trauma due to unfortunate death and being illiterate they neither got conducted the post mortem nor lodged the Daily Dairy Report regarding the incident. However, the news of death due to electrocution  while repairing the cable wire, was published in news Paper “Karnal Bhaskar”. After recovering from shock, she lodged her claim under the said policies with the Opposite Party and completed all the formalities, but the Opposite Party paid an amount of Rs.two lakh under the general clause and the matter regarding claim of Rs.three lakh under accidental clause repudiated vide letter dated 31.7.2012 on the ground that she failed to submit the First Information Report and Post mortem report. The repudiation of the claim by the Opposite Party was illegal and amounted to deficiency in services, which caused her mental agony and pain apart from financial loss.

 

2.                 Notice of the complaint was given to the Opposite Party, who appeared and filed written statement disputing the claim of the complainant. Objections have been raised that the complaint is not maintainable in the present form; that the complainant has no loucs standi and  cause of action to file the present complaint; that the complaint is false, frivolous  and vexacious to the knowledge of the complainant and has been filed with malafide intention to claim amount from the Opposite Party.

 

                   On merits, it has been submitted that two policies were issued to Satpal for a sum of Rs.one lakh each commencing from 24.1.2011 and premium installment of Rs.2426/- was payable half yearly in respect of the said policies. The policy carried double accident benefit. As per rule of the Life  Insurance Corporation of India if the policy is issued with double accident benefits and it is proved that life assured died due to accident, double the sum insured is payable. However, the complainant failed to prove on record that life assured died due to any accident, because neither any First Information Report nor  Post Mortem report was submitted to prove the said fact. The death  was established  and the Opposite Party  paid the basic claim in both the policies on 16.2.2012 and accidental claim was regretted, vide order dated 31.7.2012. Merely publishing in the news paper that some one died due to electrocution while repairing cable, does not prove the death by accident. It has been asserted that there was no deficiency in services on the part of the Opposite Party.

 

3.                 In evidence of the complainant, her affidavit Ex.CW1/A, documents Ex.C1 to Ex.C4 and Ex.C7 and copies of affidavits of complainant and her mother in law Smt.Sunheri Ex.C5 and Ex.C6  respectively have been tendered.

 

4.                 On the other hand, in evidence of the Opposite Party, affidavit of  Balihar Singh Ex.OP1 and documents Ex.OP2 to Ex.OP4 have been tendered.

 

5.                 We have appraised the evidence on record,  the material circumstances of the case and the arguments advanced by the learned Counsel for the parties.

 

6.                 It is admitted fact that Satpal deceased life assured had obtained two insurance policies from the Opposite Party, which were to commence from 24.1.2011. He died on 29.9.2011. As per the case of the complainant, the policies were for Rs.five lakh each,  but the Opposite Party  submitted that each policy was for Rs.one lakh. Copies of the Insurance policies are Ex.OP2 and Ex.OP34, which lend support to the version of the Opposite Party that each policy was for Rs.one lakh. There is no dispute that each policy had condition no.11 regarding double accidental benefits.  After the death of the deceased life assured, the Opposite Party had paid basic claim in both the policies, but repudiated the claim of the complainant regarding payment of accidental benefits.

 

7.                 It is the case of the complainant that life assured had died due to electrocution while repairing the cable wire. On the other hand the Opposite Party has submitted that the complainant had neither produced the copy of the First Information Report nor Post Mortem Report nor any conclusive evidence to establish that life assured died due to electrocution. Thus, the material question which falls for consideration in the present case is whether life assured died due to electrocution i.e. accidental death.

 

8.                 The Learned counsel for the Opposite Party  laid emphasis on the contention that neither any Post Mortem report on the dead body of the life assured was got conducted nor any Daily Diary Report or  First Information Report was lodged in the Police Station regarding cause of death  due to  the electrocution. Even, there is no medical evidence of any doctor, who declared the life assured as dead to establish that he died due to electrocution. The news paper report is not sufficient to prove that life assured died due to electrocution. Therefore, accidental claim benefit was rightly declined by the Opposite Party . In support of his contention, reliance has been placed upon Manju Sharma @ Mamta Bhardwaj and Ors Vs. Life Insurance Corporation of India 2013(1)CPC 61 and decision of Hon’ble National Commission in revision petition No.3869 of 2008 titled as Life Insurance Corporation of India Vs.N.Shankjar Reddy decided on 10.10.2013.

 

9.                 To wriggle out of the aforesaid contention, the learned counsel for the complainant vehemently argued that complainant and other family members were under shock due to untimely  and unfortunate death of life assured Satpal and they  all are illiterate, therefore, they neither got post mortem conducted on the dead body of the life assured nor lodged any report with the police that life assured had died due to electrocution.  No treatment could be provided to the life assured as he died before reaching the hospital, therefore, there was no opportunity to examine the life assured by any doctor.

 

10.               In Manu Sharma’s case (Supra),  insurance claim  was filed with the allegations that insured had died due to electrocution but no post mortem examination was conducted on the dead body of the life assured. Under those circumstances, it was held by the Hon’ble National Commission that deceased died due to electrocution was a mere allegation which was not supported by any cogent, convincing and conclusion evidence. It is difficult to fathom as to why did the kith and kin of the deceased thought it better not to get the autopsy  conducted on the dead body of the deceased.  The evidence adduced by the complainant did not go to scotch the doubts about the case. Therefore, revision filed by the complainant was dismissed. In N.Shanker Reddy’s case (Supra), death of life assured Ajay was allegedly due to accidental  fall.  The Life Insurance Corporation of India settled the amount only for policy  amount  which had accidental benefits. There was no  police report, no  death certificate, no post mortem report and no certify ate by any doctor certifying  the cause of death. The only proof of accidental death was the statements of villagers and local Panchayat authority. The claimant had not given an affidavit of any person who was present at the time of accident or death. Under those circumstances, the Hon’ble National Commission held that death by accident was not proved.

 

11.               In the instant case,  no post mortem on the dead body of the life assured was got  conducted, which  could establish that  the cause of death was electrocution.  Even no intimation was given to the police that life assured had died due to electrocution.  If the high voltage current was passing through the cable, which could cause death, then at least the complaint could be made against the Electricity Department or against the operator of the cable, who was operating the system at the relevant time. Neither it has been alleged nor there is any evidence that the complainant was having licence to run cable network in the area or he was working as operator under licnece holder as regular or temporary employee. When the complainant knew that life assured had obtained two policies from the Opposite Party, she must  have take necessary steps for getting post mortem conducted or reporting the matter to the police or electricity department or cable network licence holder, but her explanation that she and other family membrs being illiterate and under shock could not take such steps cannot be considered as reasonable  explanation. Mere news item in news paper  Karnal Bhakar, on the next day that Satpal  cable  operator died due to electrouction while reparing cable is not sufficient to prove that life assured had died due to electrocution. There is no evidence as to who had given such report to the Editor and on what basis.  Under such facts and circumstances, we have no hesitation  in concluding that  the complainant has failed to prove that the  life assured had died due to electrocution, therefore, repudiation of the claim for accidental benefits by the Opposite Party cannot be termed as ilelgal or unjustified in any manner.

 

13.               As a sequel to the foregoing discusison, we do not find any merit in th epresent compalint , therefore, the same is hereby dismissed. The parties concerned be communcated of the order accordingly and the file be consigned to the record room after due compliance.

 

Announced
dated:9.03.2016

                                                                    (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

            (Anil Sharma ) 

               Member.

 

 

 

 

 

Present:-        Sh.Vinod Sharma Advocate for the complainant.

                   Sh.C.J.Wadhwa Advocate for the Opposite Party.

 

                   Arguments heard. Vide our separate order of the even date, the present complaint has been dismissed. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

 

Announced
dated:9.03.2016

                                                                    (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

            (Anil Sharma ) 

               Member.