Heard learned counsel for the appellants and learned counsel for respondent No. 2. None appears for respondent No. 1.

2.      This appeal is filed u/s 15 of the Consumer Protection Act (hereinafter called the ‘Act’ in short). Parties hereinafter were arrayed as the complainants and OPs as per their nomenclature before the learned District Forum.

3.      The case of the complainant in nutshell is that the complainant and her husband jointly purchased Group Janata Personal Accident Insurance policy through OP No. 3 covering the period from 23.2.2004 to 22.2.2019. The policy was issued on 23.2.2004 for sum assured of Rs.4,00,000/- for the life of the policy holders. It is alleged inter alia that the policy holder died on 6.3.2006 at M.K.C.G.Medical College and Hospital,Berhampur due to accident. Thereafter, claim was made but it was not settled. After legal notice issued to  OP Nos. 1 and 2,  they repudiated the claim on 29.6.2010 denying the allegations. However, the complainant filed the complaint due to non-settlement of claim.

4.      OP Nos. 1 and 2 filed written version stating that they have sold the policy to the complainant and his wife. They have already got the information and sent the surveyor, who found that complainant had already died on 5.3.2006. Since documents have not filed, they have repudiated the claim  rightly. So, there is no deficiency in service on their part.

5.      OP No. 3 filed written version admitting the case of the complainant.

6.      After hearing both the parties, the learned District Forum passed the following order:-

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In the result we direct the opposite party No. 2 to pay sum insured of Rs.4,00,000/- (four lakh) only together with cost of Rs.1000/- to the complainant within one month of receipt of this order.”

7.      Learned counsel for the appellants submitted that the learned District Forum has committed error in law by not applying the judicial mind to the facts of the case. According to him the complainant has not filed the documents to settle the claim. Therefore, he submitted that since the complainant failed to produce the documents, they have rightly repudiated the claim. The learned District Forum ought to have considered all these facts and law. Therefore, he submitted to set aside the impugned order by allowing the appeal.

8.      Learned counsel for respondent No. 2 supports the impugned order.

9.      Considered the submission of learned counsel for the respective parties and perused the impugned order including the DFR.

10.    It is admitted fact that the complainant and her husband purchased the insurance policy from OP Nos. 1 and 2 through OP No. 3. It is not in dispute that the complainant’s husband died while fell down. It is also not in dispute that the sum assured of Rs.4,00,000/- is payable by OP Nos. 1 and 2 in case of accidental death. The only question arises in this case whether the husband of the complainant died due to accident. There are catena of decisions settled to opine that falling of the  policy holder suddenly can be taken as accident. Since the death occurred due to accident, it is an accidental death. Moreover,  it is very clear from  the postmortem report that  the complainant died due to accident. Since the accidental death has occurred, we are of theview that there is nothing to interfere with the impugned order. As such, the impugned order is confirmed and the appeal stands dismissed. No cost.

        DFR be sent back forthwith.

        Supply free copy of this order to the respective parties or the copy of this order be downloaded from Confonet or Website of this Commission to treat same as copy supplied from this Commission.