DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,<br /> BATHINDA (PUNJAB)<br /> <br /> CC No. 205 of 20.07.2007<br /> Decided on : 07-01-2008 <br /> <br /> Sukhvir Kaur Wd/o Sh. Jang Bahadur, R/o 132 Near Gurudwara Lal Singh, Dhobiana Basti, Bathinda<br /> ... Complainant<br /> Versus<br /> <br /> 1.Reliance General Insurance, Anil Dhirubhai Ambani Group, Regional Office, S.C.O. 212-214, Sector 34-A, Chandigarh.<br /> 2.The Bathinda Central Co-op. Bank Limited, Bathinda, through its Branch Manager. <br /> ... Opposite parties<br /> <br /> Complaint under Section 12 of the Consumer Protection<br /> Act, 1986.<br /> <br /> QUORUM :<br /> Sh. Lakhbir Singh, President<br /> Sh. Hira Lal Kumar, Member<br /> Dr. Phulinder Preet, Member<br /> <br /> For the Complainant : Sh. Harkirat Singh Sidhu, Advocate.<br /> For the Opposite parties : Sh. Sunder Gupta, Advocate, for opposite party No. 1.<br /> Sh. Inderjit Singh, Advocate, for opposite party No. 2.<br /> <br /> O R D E R<br /> <br /> LAKHBIR SINGH, PRESIDENT <br /> 1. Jang Bahadur S/o Sh. Mukhtiar Singh, was the husband of the complainant. He had purchased Insurance Policy No.20-30-11-00010-06 from opposite party No. 1 through opposite party No. 2. Complainant was appointed by him as his nominee. Jang Bahadur was hale and hearty and had no ailment. He was not addicted to any vice and was enjoying good health. He was working as teacher. On 8.11.06, assured was cleaning his .32 Bore 7.65 MM Pistol in the morning. Unluckily its trigger was pressed. Fire shot came out of it and hit the back side of his head. He was immediately referred to civil hospital, Bathinda from where he was taken to Adesh Institute, Barnala Road, Bathinda where he expired on 8.11.06. Daily Diary Report No. 7 dated 9.11.06 was recorded in Police Station Kotwali, Bathinda on the basis of her (complainant's) statement. She had applied insurance claim with the opposite parties vide Claim No.2001C06301100032. Requisite formalities were completed. Opposite parties vide their letter dated 13.3.07 repudiated the claim placing reliance on Condition No. 6(a) of the policy which is given below :<br /> “6. (a) From intentional self-injury, suicide or attempted suicide (b) whilst under the influence of intoxicating. Payment of compensation in respect of death, injury or disablement of the Insured Person liquor or drugs (c) directly or indirectly caused by insanity, (d) arising or resulting from the Insured Person committing any breach of law with criminal intent.”<br /> It is added by her that her claim does not fall under this condition/exclusion. She assails this letter as illegal, null and void, arbitrary and not binding upon her. Her husband did not commit suicide nor had he attempted to commit suicide. It is only an incident due to which he has died otherwise there was no reason for him to commit suicide. Opposite party No. 1 was repeatedly requested to admit her lawful claim, but to no effect. In these circumstances, she alleges deficiency in service on the part of the opposite parties and seeks direction from this Forum to the opposite parties to pay Insurance Claim regarding the death of her husband, Rs. 1.00 Lac on account of mental tension, agony, botheration and loss of reputation besides Rs. 5500/- as cost of the complaint.<br /> 2. Opposite party No. 1 filed reply of the complaint taking legal objections that this Forum has got no jurisdiction to entertain and try the complaint; complaint is bad for non-joinder of necessary party as all the legal heirs of deceased Jang Bahadur have not been impleaded. Complainant has got no locus standi or cause of action to file the complaint; she has concealed material facts from this Forum and complaint is false and frivolous. On merits, there is no specific denial about the purchase of the Insurance Policy No. 20-30-11-00010-06 by Jang Bahadur, husband of the complainant and her appointment in the policy as nominee. It denies for want of knowledge that Jang Bahadur was hale and hearty. Inter-alia its plea is that Jang Bahadur deceased had inflicted self injury/committed suicide and in this way he committed breach of law with criminal intent which is violation of exclusion clause No. '6' of the policy. Complainant has concealed material facts and has lodged false Daily Diary Report No. 7 dated 9.11.06 in Police Station Kotwali in order to get the claim. As per post mortem report, he had received close range/injuries which are not other than self inflicted injuries. She had applied for the claim of insured deceased which has been rightly repudiated vide letter dated 13.3.07 as insured has violated the terms and conditions of the policy. It is not liable to pay any compensation. It denies the remaining averments in the complaint.<br /> 3. Opposite party No. 2 filed separate reply taking legal objections that complaint is not maintainable in the present Form; it is bad for non-joinder and mis-joinder of parties; complainant has not come with clean hands; deceased Jang Bahadur had not purchased any policy from it; he had opened Saving Account with Kal Jharani Branch under Sehkari Bank Bima Yozna and bank had got its customers/saving account holders including Jang Bahadur insured with opposite party No. 1 under the Group Insurance Scheme. In this manner, Jang Bahadur was insured with opposite party No. 1. Liability, if any, to pay any claim to her or other legal heirs of the deceased is of opposite party No. 1. As per record, complainant was/is the nominee of account holder Jang Bahadur regarding account maintained by him. Claim has been repudiated by opposite party No. 1 and not by it. It does not admit the remaining averments in the complaint.<br /> 4. In support of her averments in the complaint, complainant has produced in evidence her affidavit (Ex. C-1), photocopy of letter dated 13.3.07 (Ex. C-2), photocopy of Daily Diary Report (Ex. C-3) and photocopy of Post Mortem Report (Ex. C-4).<br /> 5. In rebuttal, on behalf of opposite party No. 1 affidavit of Dr. Rajesh Shukla (Ex. R-5), affidavit of Sh. Ganesh Jadhav (Ex. R-6), photocopy of Claim Note (Ex. R-7), photocopy of Section 3 Firearm Injuries (Ex. R-8) and on behalf of opposite party No. 2 affidavit of Sh. Gian Chand Gandhi, District Manager (Ex. R-1), photocopy of Janta Personal Accident Policy (Ex. R-2), photocopy of account opening Form (Ex. R-3) and photocopy of ledger (Ex. R-4) have been tendered in evidence.<br /> 6. We have heard learned counsel for the parties. Besides this, we have gone through the record.<br /> 7. Mr. Sidhu, learned counsel for the complainant vehementally argued that Jang Bahadur husband of the complainant was got insured by opposite party No. 2 with opposite party No. 1 as he had opened account, copy of which is Ex. R-3 with opposite party No. 2. Copy of the Janta Personal Accident Policy is Ex. R-2. Deceased Jang Bahadur was cleaning his .32 Bore 7.65 MM Pistol on 8.11.06. Unluckily its trigger was pressed. Fire came out of it and hit the back side of the head of the insured and he succumbed to the injuries. Death of the assured was not a suicide. Rather it was merely an accident. For this, he drew our attention to the affidavit Ex. C-1 of the complainant, copy of the Daily Diary Report No. 7 dated 9.11.06 Ex. C-3 and copy of the post mortem report Ex. C-4 . He further argued that claim has been illegally repudiated by opposite party No. 1 on the basis of Condition/Exclusion No. 6(a) of the policy.<br /> 8. Mr. Gupta, learned counsel for opposite party No. 1 countered the argument of the learned counsel for the complainant by submitting that insurance claim regarding the death of Jang Bahadur has been rightly repudiated vide letter dated 13.3.07, copy of which is Ex. C-2 as there is violation of the terms and condition of the policy.<br /> 9. We have considered the respective arguments. Some exceptions have been given in the policy. Exception/Exclusion Clause No. 6 reproduced above is material.<br /> 10. Sh. Rajan Singla, Advocate was appointed as Investigator by opposite party No. 1. Death claim of Jang Bahadur was investigated by him. Copy of his report is Ex. R-10. He concluded that complainant has failed to prove the death of Jang Bahadur as an accidental one. His affidavit to support his report is Ex. R-9.<br /> 11. Claim has been repudiated by opposite party No. 1 through letter dated 13.3.07 on the basis of Exception/Exclusion No. 6(a) of the policy. Material question for determination is as to whether complainant has satisfactorily proved that death of the assured/her husband was accidental and Exception/Exclusion Clause No. 6(a) is not applicable. In our view she has not succeeded in doing so. This would become evident from the discussion which is made as under :<br /> As per copy of the post mortem report Ex. C-4 deceased had received 1-1/2 cm x 1-1/2 cm stitched wound 6 cm above from upper end of right ear pinna over lying right parietal region and V shaped stitched wound 20 cm extended from upper end of left pinna to left side of forehead 4 cm above left eye brow were present. On disection part of bone under lying the V shaped stitched wound was missing and brain matter, clotted blood had come out from the wound. Bullet injury had caused a tunnel from right side of the forehead to the left side of the forehead. Opposite party No. 1 is relying upon copy of the report Ex. R-7 of Dr. Rajesh Shukla and his affidavit is Ex. R-5. Contention of the learned counsel for the complainant that no weight can be attached to his report and his affidavit as he is not forensic expert or qualified Doctor, cannot be accepted as complainant did not muster courage to cross-examine him. Para No.3,4 & 5 of his affidavit are reproduced as under : <br /> “3. That as per aforesaid Post Mortem Report, the deceased has received piercing wound measuring 1-1/2 centimeter x 1-1/2 centimeter , 6 centimeters above from upper end of the Right Ear Pinna over lying right parietal region and Bullet/cartridge has passed from the right side of the fore-head to the left side of the fore-head. 4 centimeters above left eye brow and the bullet injury has caused a tunnel from right side of the fore-head to the left side of the fore-head.<br /> 4. That as per medical jurisprudence, size of entry of wound – to distance of Bullet from the object i.e. Gun/Pistol was fired 6 centimeters from the head of the deceased.<br /> 5. That such type of injury can only occur in the case of intentional self inflicted injuries and deceased/insured has committed suicide as per aforesaid Post Mortem Report.” <br /> 12. Dr. Shukla is B.H.M.S. & M.H.A. & H.C. He is practising as doctor since 2001. Since he has not been cross examined, report and affidavit have gone unchallenged and unrebutted. According to Ex. R-8 at close range there is usually some burning blackening and tattooing of the skin around the entrance opening, while the hair in the region of the wounds often singed. In this case as well, there was blackening around the wound. Assured/injured was taken to Adesh Institute, Barnala Road, Bathinda where doctor had prepared his case record. In the case summary, he has been shown to have been brought to Emergency with alleged history of self inflicted gun shot injury over head at his house at around 10.30 a.m. Ex. R-12 reveals that assured was also taken to Bharat Brain Hospital. In the case history prepared in that hospital, he has been recorded to have “Allegedly short himself with a pistol”. From the record of Adesh Institute and Bharat Brain Hospital, no other conclusion can be arrived at than the one that some one from the near and dear ones of the assured must have told the concerned Doctors that he had shot himself with a Pistol. We find it difficult to disbelief the observations made by the Doctors of these Hospitals. Plea of the complainant is that the assured was cleaning the Pistol. Generally if one has the intention to clean the loaded fire arm, he would first unload it by keeping the barrel of the weapon to the other side instead of pointing it towards his body. Fact that he kept the barrel of loaded pistol towards his body is a circumstance which supports the report of the Investigator and the letter of repudiation. Part of the body hit by the shot is also indicative of the fact that shot was not unintentional.<br /> 13. From the totality of the facts, circumstances and evidence discussed above, crux of the matter is that the claim has been rightly repudiated by opposite party No. 1 by applying Exception/Exclusion Clause No. 6(a) of the policy as the death of the assured cannot be said to be unintentional incident/or accident. Hence, no deficiency in service on the part of the opposite parties is proved. Complaint being devoid of merits, is dismissed with no order as to costs.<br /> Copy of this order be sent to the parties concerned and filed be consigned.<br /> Pronounced :<br /> 07-01-2008 (Lakhbir Singh )<br /> President<br /> <br /> <br /> (Hira Lal Kumar)<br /> Member<br /> <br /> <br /> (Dr. Phulinder Preet)<br /> Member <br />