HYDERABAD

F.A.  293/2008  against C.D. 213/2007,  Dist. Forum-I, Visakapatnam  

Between:

Ms. Singanapalli Soujanya

D/o. Late S. Ramachandra Rao

Age: 22 years, R/o. MIG-1

Plot No. 238,  Rajivnagar Colony

Kurmannapalem

Visakapatnam.                                           ***                           Appellant/

            Complainant       

                                                                   And

1)  M/s. United India Insurance Company Ltd.

Divisional Office : IX, 206, 207

Saptagiri  Towers, Begumpet

Hyderabad

2)   The Regional Manager

M/s. United India Insurance Company Ltd.

Daba Gardens, Near Pen School

Visakapatnam.

3)  The Branch Manager

M/s. A.P.S.T.C. Ltd.,

D.No. 52-14-77

Resapuvanipalem

Visakapatnam.                                            .***                        Respondents/

Opposite Parties

Counsel for the Appellant:                          M/s.  A.S.C. Bose  

Counsel for the Respondent:                       M/s.  V. Sambasiva Rao  (R2)

CORAM:

HON’BLE SRI JUSTICE D.APPA RAO, PRESIDENT.

    &

                                SMT. M. SHREESHA, MEMBER.

TUESDAY, THIS THE THIRTEENTH DAY OF  JULY TWO THOUSAND TEN

ORAL ORDER:  (Per Hon’ble Sri Justice D. Appa Rao, President)

***

1)                 Appellant is unsuccessful complainant.

2)                 The case of the complainant in brief is that the respondent insurance company issued insurance policy under personal accident scheme for engineering students and parents for the period from 29.8.2003 to 28.8.2007 covering the risk for Rs.  3 lakhs in case of their death due to accident.    When  the complainant’s father was working at HPCL quarters  he fell down on 14.7.2006 from a height, received head injuries and was admitted in KGH hospital, Visakapatnam and succumbed to injuries on 17.7.2006.    When she made claim it was repudiated on the ground that it was not accidental.   Therefore, she filed the complainant claiming   Rs. 3 lakhs under the policy, Rs. 50,000/- towards tuition fee and boarding charges together with interest, compensation and costs. 

3)                The insurance company resisted the case.   However, while admitting issuance of policy,  it denied that the complainant’s father died due to accidental fall.    On receipt of information, it appointed an investigator who in turn by his report dt.  30.10.2006 informed that the death was due to heart attack (Intra cerebral) haemorrhage,   CVA with right hemiarsis and haemorrhage stroke,   a natural death.     There was no visible external injury.    It gave a correct reply to the notice issued by the complainant and repudiated the claim.    Therefore, it prayed for dismissal of the complaint with exemplary costs. 

4)                The complainant in proof of her case filed her affidavit evidence and got Exs. A1 to A8 while the respondent insurance company filed the affidavit evidence of its Deputy Manager and got Exs. B1 to B5 marked. 

5)                The Dist. Forum after considering the evidence placed on record opined that the death was not accidental.   It was due to cardiac arrest vide case sheet Ex. A3 enclosed with the investigation report Ex. B3.

6)                Aggrieved by the said decision, the complainant preferred this appeal contending that the Dist. Forum did not appreciate either facts or law in correct perspective.     It ought to have seen that the death was accidental and he suffered haemorrhage and therefore she prayed that the amount covered under the policy be paid. 

7)                The point that arises for consideration is whether the order of the Dist. Forum is vitiated by mis-appreciation of fact or law?

8)                There is no dispute as to the issuance of policy and entitlement of the money covered under the policy in case of accidental death of either the assured or her parents vide policy Ex. A1.  It is also not in dispute that the complainant’s father S. Ramachander Rao died on 17.7.2006 while undergoing treatment at KGH Hospital, Visakapatnam.   Ex. A3   death summary shows that cause of death as ‘Cardio respiratory arrest’ and underlying cause of death as “Haemorrhage stroke”.  This she intends to attribute to a fall from a height at  the work place.   According to her he  sustained   head injury and consequently haemorrhage stroke.    Despite repudiation that the said injury was not due to fall or that it was not accidental, the complainant for reasons best known did not file any certificate from the medical officer who examined him and gave Ex. A3.    The investigator in his report Ex. B3 after perusing the hospital records mentioned that there was ‘no history of head injury’, CT scan medical test reports show  hemorrhagic stroke with mid line shaft.    Dr. K. V. Ramana Rao opined that the death was due to   cardio respiratory arrest due to haemorrhage stroke.    At the cost of repetition, we may state that there was no external violent and visible injury or any injury corresponding injury noted in the brain.    A perusal of Photostat copy of case sheet in no way advance the plea raised by the complainant that the death was due to accidental fall.    It must have been  a natural death, and therefore the complainant was not entitled to any amount covered under the policy.    We do not see any mis- appreciation of fact or law by the Dist. Forum in this regard.  There are no merits in the appeal.

9)                 In the result the appeal is dismissed.   No costs. 

1)       _______________________________

PRESIDENT                 

2)      ________________________________

 MEMBER          

   Dt. 13. 07.  2010.

*pnr

“UP LOAD – O.K.”