National Insurance Company Limited, who was the opposite party before the District Forum, has filed the present Revision Petition against the order of State Consumer Disputes Redressal Commission, Haryana, Chandigarh (For short ‘State Commission’) in First Appeal No.1039/2003.  By the impugned order, the State Commission has affirmed the order passed by the District Consumer

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Disputes Redressal Commission, Yamuna Nagar (For short ‘District Forum’).

Shortly stated, the facts are that Kali Ram, husband of respondent Mohini Devi employed with the State Bank of India was insured under Group Janta Personal Accident Insurance Policy bearing No.420301/47/61/98/4389 issued in the name of State Bank of India Staff Association, Chandigarh Circle for a sum of Rs.10 Lacs for the period 31.3.1999 to 30.3.2011.  The said policy provided that if any time during the currency of the policy, the insured suffered any bodily injury resulting solely and directly from accident which is the direct cause of death of the insured, the insured sum will be payable by the company to the nominee under the policy. 

On 04.12.2002 at about 6:30 pm, the insured Kali Ram fell from staircase of his house and suffered accidental injuries.  He was admitted in Gaba Hospital located at Yamuna Nagar on 05.12.2002.  He died there at 4 a.m. on 07.12.2002.  The respondent/complainant informed the petitioner about the death of the insured and claimed the insured sum as per letter dated 19.12.2002.  Necessary documents

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which were asked for from the respondent, were also supplied by her to the insurance company.  The insurance company repudiated the claim on the ground that since no postmortem had been conducted and no report was lodged with the police, the claim filed by her could not be entertained.  Respondent/complainant, thereafter, filed the complaint before the District Forum.

District Forum allowed the complaint and directed the petitioner to pay the insured amount with interest @ 12% p.a. after three months from the date of death and also to pay Rs.50,000/- by way of  compensation on account of mental agony as well as costs of proceedings.

Petitioner being aggrieved filed an appeal before the State Commission.  The State Commission dismissed the appeal except that the rate of interest was reduced from 12% to 9% and the compensation of Rs.50,000/- were waived.

Counsel for the parties have been heard.  It is not disputed before us that the husband of the respondent/complainant was insured with the petitioner insurance company under the Group Janta

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Personal Accident Policy in the sum of Rs.10 Lacs.  It is also not in dispute before us that during the currency of the insured period, the husband of the respondent/complainant died on 07.12.2002 in Gaba Hospital.  The plea taken by the petitioner was that the claim could not be entertained as no postmortem was done or the FIR was lodged; that the death took place due to accident was not proved.  In a case of fall from staircase in his own house, generally speaking, nobody will lodge an FIR.  In the present case, although there is no postmortem report but the Certificate of the Doctor who treated the insured at Gaba Hospital, clearly shows that the insured had sustained injury by falling from the staircase as a result of which he suffered myocardium infraction leading to his death.  The Certificate given by the Doctor reads as under:

“H/o falling down from the stairs leading to______ (sick) & M.I. pulm embolism & death”

We agree with the view taken by the State Commission that the death was due to accidental fall from the staircase which led to the death of the insured.  As per the policy, the petitioner was obliged to

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pay the insured amount which it failed to do.  No ground for interference in the impugned order is made out.  Dismissed.  No costs.