Haryana

StateCommission

A/72/2016

ORIENTAL INSURANCE CO. - Complainant(s)

Versus

REENA RANI - Opp.Party(s)

D.C.KUMAR

01 Aug 2016

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

                                                         First Appeal No.72 of 2016

Date of Institution: 25.01.2016

Date of Decision: 01.08.2016

 

1.      Oriental Insurance Company Ltd., Branch Office Opposite Girls Hindu College near Bus Stand Jagadhri Distt. Yamuna Nagar.

2.      Oriental Insurance Company Ltd., Divisional Office No.14 Plot No.80 F.I.E. Industrial Area Patparganj Delhi.

3.      Oriental Insurance Company Ltd.,  Oriental House, A-25/27 Asaf Ali road, New Delhi

          All through Shri S.P. Singh, Regional Manager, The Oriental Insurance Company Ltd.,  Regional Office, LIC Building, II Floor, Jagadhri Road, Ambala Cantt.   

…..Appellants

 

Versus

 

Reena Rani aged 36 years wife of late Gopal, R/o Village Khajuri PO Nagal Tehsil Jagadhri Distt. Yamuna Nagar.

…..Respondent

CORAM:             Mr. R.K.Bishnoi, Judicial Member.

                             Mrs. Urvashi Agnihotri, Member.                                                                                                                                        

Present:               Shri D.C.Kumar, Advocate counsel for appellants.

Shri Bahadur Singh, Advocate counsel for respondent.

 

                                                   O R D E R

R.K.BISHNOI, JUDICIAL MEMBER:-

          A widow filed complaint for payment of insurance amount payable under Nagrik Suraksha policies.  It was alleged that her husband obtained following policies from the opposite parties (O.Ps.):-

“Policies No.	Date of issuance	Sum assured	Cover note No.
271700/48/2009/1450	28.11.2008	Rs.2,50,000/-	270000381482
271700/48/2009/1451	28.11.2008	Rs.3,00,000/-	270000381483”

 Due to Snake bite he died on 04.07.2009.  Thereafter she submitted claim for compensation, but, the same was repudiated without any reasonable ground.  Hence the complaint.

2.      O.Ps. filed reply admitting the insurance policies but alleged  that the complainant miserably failed to show that her husband died due to snake bite.  It was mentioned in post mortem report (PMR) that cause of death could be given after receipt of Histopathological report from PGI-MS Rohtak and report of chemical examiner of Forensic Science Lab (FSL), Karnal, which were never produced.  When reports were not submitted, her file was closed as ‘no claim’.  As she failed to prove the case of death she was not entitled for any compensation.  Objections about accruing cause of action, non-joinder of parties, concealment of material facts were also raised and requested to dismiss the complaint.

3.      After hearing both the parties, learned District Consumer Disputes Redressal Forum, Yamunanagar at Jagadhari allowed the complaint vide impugned order dated 14.12.2015 and directed as under:-

“Resultantly, we partly allow the complaint of complainant and direct the OPs insurance company to pay Rs.2,00,000/- only under personal accident section i.e. 80% of total sum insured of Rs.2,50,000/- vide policy bearing No.271700/48/2009/1450 and Rs.3,00,000/- on account of GPA policy bearing No.271700/48/2009/1451 i.e. to pay total sum of Rs.5,00,000/- (Rs.2,00,000/- +3,00,000/-=5,00,000/-) to the complainant being nominee of the deceased alongwith interest at the rate of 7% per annum from the date of filing of complaint till  its realization and also to pay a sum of Rs.5,000/- as compensation for mental agony, harassment as well as litigation expenses of Rs.2000/-.”

4.      Feeling aggrieved therefrom, O.Ps.-appellants have preferred this appeal.

5.      Arguments heard. File perused.

6.      Learned counsel for the appellants vehemently argued that as per insurance policy Ex.R-12 insured was entitled for compensation in case of death due to accident.  In this case death did not occur due to any accident. So, he was not entitled for compensation. It was also argued that complainant miserably failed to show that her husband died due to snake bite.  As per report of FSL Annexure-11 no poison was detected.  Had he died due to snake bite, poison must have been detected. So, her version cannot be believed and learned District Forum wrongly granted the compensation.

7.      This argument is of no avail.  As per conditions mentioned in Ex.R-12 it cannot be presumed that a person should have external injury as in Motor Vehicular Accident etc.  As per these conditions if a person has received, injury in any manner he is entitled for compensation.  For ready reference condition No.1 of Ex.R-12 is as under:-

“Sustain any bodily injury resulting solely and directly from accident caused by external, violent and visible means, the sum hereinafter set forth in respect of any of the insured persons specified in the schedule.”

          From the perusal of this condition,  it is clear that if a person has died due to any type of external violation then he is entitled for compensation.  It does not mean that the violent act should be with the human being or any machinery.  If a person has died due to snake bite even then it is covered by the accident. Word 'accidental death’ means any unnatural death except suicide. Company cannot escape from his liability only on this ground.  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 due to snake bite is duly covered by the definition of “Accident” and no postmortem etc. is necessary in such a case.

9.      Now the question comes about the cause of death.  It is alleged by the complainant that when her husband went to bring wheat husk snake gave bite which proved fatal.  In column No.5 of PMR Ex.C-9 it is clearly mentioned by doctor that there were two pin point marks near left elbow as it was snake bite.  This fact corroborates version of the complainant.  If in Annexure-11 it is mentioned that no common poison was detected,  it does not mean that there was no snake bite. This report was given about the following parcels:-

          “Exbt-1a: Stomach, part of small and large intestine.

          Exbt-1b:   portion of lung, liver, spleen and kidneys.

          Exbt-1c:   Portion of brain.

          Exbt-Id:   Blood from heart approx 7 ml.

          Exbt-Ie:   Saline preservative approx, 80 ml.”

This report does not disprove the version of complainant or fact mentioned in PMR.  It pertains to general poison as also discussed by District Forum.

10.    Poison of snake acts in different manner.  In cobra-bite effect will be neurotoxin that inhibits the function of neurons, cells in the nervous system.  In bite by viper or other poison stake the effect is called hemotoxin.  It destroys red blood cells, causes hemolysis, disrupts blood clouting and also attack other type of cells and tissue and often cause organ failure.  If a person is administered normal poison then it could be detected from aforesaid samples, but, not in snake-bite case. 

11.    More so, O.Ps. have not produced the report of PGI-MS Rohtak When PGI was asked to give report, O.Ps. could have easily approach the said authorities.  It cannot be expected from a widow lady to run from pillar to post.  In the present case the complainant is resident of District Yamuna Nagar and is to look after two children.  It must be difficult to carry children with her or to leave them at the house.  Particularly, when her husband has died due to snake-bite it might be lurking in her mind that such like an other incident may not occur O.Ps. are having proper paraphernalia and were able to collect the report easily.  As per these arguments right of the complainant cannot be jeopardised.  Learned District Forum has taken into consideration each and every aspect from every angle and there is no reason to disturb the impugned order.  Resultantly the appeal fails and the same is hereby dismissed. 

12.    The statutory amount of Rs.25000/-  deposited at the time of filing the appeal be refunded to the appellants against proper receipt and identification in accordance with rules.

 

August 1st, 2016

Mrs.Urvashi Agnihotri, Member, Addl.Bench

R.K.Bishnoi, Judicial Member Addl.Bench

S.K.