STATE CONSUMER DISPUTE REDRESSAL COMMISSION

BIHAR, PATNA

Appeal No. 219 of 2019

1. The Divisional Manager, L.I.C. of India, District- Begusarai

2. The Branch Manager, LIC of India, Branch- Samastipur, Sakin- Taj Road, Samastipur, PO, PS & District-

                                                                                                                                                         … Appellants

Versus

Rajesh Jha @ Rajesh Ranjan, S/o Late Ganesh Jha, Advocate, Sakin- Kahsipur (Lalit Nagar), Ward No. 7, Samastipur, PO, PS- Samastipur   

                                                                                                                                                       …. Respondent

Counsel for the Appellant: Adv. Ajay Kumar

Counsel for the Respondent: Adv. Satendra Kumar Dubey

Before,

Hon’ble Mr. Justice Sanjay Kumar, President

Mr. Ram Prawesh Das, Member

Dated 22.06.2023

As per Sanjay Kumar, President.

O r d e r

1. Present appeal has been filed on behalf of appellant /opposite party /LIC of India for setting aside the judgment order dated 15.05.2019 passed by the Ld. District Consumer Forum, Samastipur in Complaint Case no. 47 of 2017 whereby and whereunder the Ld. Forum has allowed the complaint case and directed appellant to pay Rs. 6,00,000/- for both the insurance policies and further directed to pay Rs. 20,000/- for mental harassment and Rs. 20,000/- for physical and economic harassment and Rs. 10,000/- as cost of litigation within a period of 45 days failing which interest @ 10% p.a shall become payable.
2. Briefly stated the facts of the case is that wife of complainant Pooja Jha had purchased two life insurance policies from LIC of India for sum assured amount of Rs. 5,00,000/- and Rs. 1,00,000/- for which premium of Rs. 15,486/- & Rs. 3,773/-was payable half yearly.
3. It was further stated that the life assured suffered accidental burn injuries in the house due to leakage of cooking gas from gas cylinder while cooking and thereafter, she was immediately rushed to the Ford Hospital, Patna. Statement of deceased was recorded by the police, however subsequently she succumbed to her burn injuries on 15.09.2015.
4. Complainant claimed double sum assured amount as insured had died in an accident, however, life insurance company paid the sum assured amount of Rs. 5,00,000/- and Rs. 1,00,000/- but refused to pay double sum assured amount against which complainant gave legal notice for payment of accidental death benefit but insurance company neither replied nor paid the accidental death benefit amount as such complainant filed a consumer complaint case before the District Consumer Forum, Samastipur in which opposite party/LIC appeared and filed its written statement.
5. Opposite party in its written statement stated that the insurance company had asked complainant to submit documents as FIR, Police Report as well as post mortem report which is mandatory for settlement of accidental death benefit claim and as complainant did not submit said documents double sum assured amount was not paid.
6. The District Consumer Forum, Samastipur after hearing both the parties and considering the evidences placed on record held that complainant has produced copy of FIR which bears signature of brother of deceased in which statement of insured was recorded by the police in which she has stated that due to leakage cooking gas from the gas cylinder fire broke out as a result of which her sari caught fire and when she raised alarm family members reached and extinguished the fire. Her brother also arrived No one is responsible for this incident. A petition was filed by brother of deceased addressed to officer in-charge of police station in which it was stated that family members do not want postmortem of the dead body to be conducted.
7. The District Consumer Forum has relied upon judgment and order rendered by State Consumer Forums placed before the forum that in absence of post mortem report the accidental death benefit can not be denied. The District Consumer Forum has further relied on the judgment and order of High Court in which it was held that if death from accident is established then there is no requirement of post mortem report and allowed the complaint case of the complainant, aggrieved by which present appeal has been filed on behalf of LIC of India.
8. It is submitted on behalf of counsel for the appellant that in order to settle accidental benefit claim certified copy of the FIR, PFR and PMR are mandatory to ascertain the nature of death whether it is natural or accidental but complainant failed to provide those documents in absence of which accidental benefit claim is not payable. The counsel for appellant has relied upon the judgment of Life Insurance Corporation of India & Anr. Vs. N. Shanker Reddy in (2014) CJ 181 (N.C)
9. Counsel for the respondent has supported the judgment and order passed by District Consumer Forum and submits that there is no error or infirmity in the impugned order.
10. Heard the parties
11. It is an admitted position that deceased life assured had purchased two life insurance policies in which complainant being husband of the insured was made nominee and insured received severe burn injuries on account of accidental fire which broke out due to leakage of cooking gas from gas cylinder and fire caught sari of the insured while she was cooking and on her raising alarm family members came and extinguished the fire and took her to the Ford Hospital where her statement was also recorded by the police upon which FIR was drawn in which she stated that it was an accidental fire for which no one is to be blamed. However, subsequently she succumbed to her burn injuries.
12. The facts of this case  establishes without any doubt that death of insured was on account of accidental fire and it was not a natural or normal death as such complainant was entitled for accidental death benefit. The judgment cited by counsel for the appellant is not applicable in facts and circumstances of present case as in the cited case there was neither any FIR nor any report of Hospital whereas, in present case FIR as well as hospital report was available which conclusively establishes a case of accidental death.
13. There is no merit in this appeal is accordingly dismissed.

(Ram Prawesh Das)                                                                                                       (Sanjay Kumar,J)

       Member                                                                                                                        President

Md. Fariduzzama