(Delivered on  12/12/2019)

PER SHRI. D. R. SHIRSAO, HON’BLE PRESIDING MEMBER.

1.         Being aggrieved by judgment and order passed by  the learned  District Consumer Forum, Bhandara in consumer complaint No. 116/2009  on  07/03/2014, directing the opponent  to pay insurance  claim of Rs. 5,00,000/- to complainant  in respect of  accidental death claim of her husband  along with  interest  on that  amount  along with cost and compensation, the opponent  has preferred this appeal.

2.         Brief facts of the case  are as under. :-

            Respondent /complainant  had filed  consumer complaint  for getting  insurance claim of Rs. 10,00,000/- in respect of  accidental  death  of her husband  against opponent.  She submitted that her husband Urkuda Nagarikar  had taken  accidental  insurance  policy from  opponent for the period  from 04/04/2008 to 03/04/2009.  During subsistence of this insurance policy  on 05/05/2008 her husband  died due to  snake  bite. Hence, she had made insurance claim of Rs. 10,00,000/- in respect of  death of her husband  with opponent.  However,  opponent  had repudiated  her claim on the ground  that  requisite  documents  in respect of  cause of death  of her husband  is not produced before  them. Hence, complainant has filed this consumer complaint  against   the opponent  for getting  insurance claim  of Rs. 10,00,000/- in respect of  death of her husband  from the opponent.

3.         The opponent  contested the complaint  by filing  their  written version on record and  submitted that  the insurance claim  made by  complainant was referred  to Ombudsman. The Ombudsman  has rejected  the claim of the  complainant  on  the ground  that  there is no document  in respect of   cause of  death of  husband of complainant. Hence,  it is there,  contention that  on want of  necessary  documents  they are  not in position  to give  the insurance claim  to complainant  in respect of death of her husband., Hence, they have  not given deficiency in service  to complainant. Hence, consumer complaint  be dismissed.

4.         Considering the rival contentions  of the parties, evidence adduced by them on record  and documents  filed  by them  on record.   The learned District Consumer Forum had come to  conclusion  that  death of  husband of the complainant  has taken place  due to snake bite. However,  by not paying  insurance claim to  complainant in respect of death of her husband, opponent  has given  deficiency  in service  to  complainant.  Hence,  the learned District Consumer Forum directed  opponent to pay insurance  claim of Rs. 5,00,000/- to  complainant  in respect of  death of her husband  along with interest  on that  amount  along with cost  and compensation. Being aggrieved of the same   opponent has preferred this appeal.

5.         Heard, learned advocate appearing for appellant /opponent. He submitted that  in respect of  cause of death  of husband of complainant, complainant  has not produced  any document  on record. Hence, it cannot be  accepted that  death of  husband of complainant  had taken place  by snake  bite.  He further submitted that  the certificate  of Dr. Gajbhiye on which  complainant has placed reliance  had  not treated husband of the  complainant.  He had issued  certificate  in respect of death  of husband  of  complainant  on the basis  of  information  given  by other  persons.  Hence,  said certificate  cannot be considered  in respect of  cause of death  of husband  of the complainant.  He further  submitted that  in respect of death  of husband, complainant  had not given any report  in Police Station . Police  had not  made any enquiry  in respect of death of  husband of complainant.  Dead body of  husband of complainant  was not sent  for  postmortem  examination. Hence, there is no evidence  on record that    husband of the complainant  died by   snake  bite. Hence, he submitted that  the learned District Consumer Forum  by wrongly placing  reliance  on the documents  filed by complainant   had  come to the conclusion  that  the death of  husband of the complainant  had taken place  by snake bite and directed the opponent  to give insurance  claim to  complainant. Hence, he submitted that the order passed by  learned District Consumer Forum   be set aside  by allowing  this appeal.

6.         Although notice of appeal  was served on respondent. No one appeared  for the respondent  and contested appeal on merit. Hence,  we have gone through  record  of case   and  documents filed on record  and   decide  the appeal on merit.

7.         In this case  it is admitted  fact that  the husband  of  complainant Urkuda  Nagarikar had taken  accidental  insurance policy  from opponent  for the period  from 04/04/2008 to 03/04/2009. During  subsistence of  this insurance policy  on 05/05/2008 death of  husband of complainant  had taken place. Hence, complainant had made insurance claim of Rs. 10,00,000/-  in respect of death of  her husband  with opponent. However,  opponent  rejected her claim on the ground that  she failed to produce documents showing cause of death  of her husband. Hence, complainant has filed this complaint.

8.         In this case it is admitted  fact that  in respect  of death  of husband  of complainant,  complainant had not  given  report  in  Police Station. Hence,  in respect of death  of husband  of  complainant  there is no police enquiry  and report  of police in that respect  on record.  In this  case it is admitted fact that  dead body  of husband of complainant  was not sent  for  postmortem  examination. Hence,  there is  no P.M. report  on record to disclose the cause of death  of husband of complainant.  In this case it is the contention of  complainant that as there was snake bite to her husband they were taking    her husband  to Government  Hospital. However,  the health of  husband of the complainant  had become  critical and hence they had taken  him to  Dr. Gajbhiye, a private practitioner. However, when he was on the  way for going  to hospital  he had died. It is  the contention  of the complainant that Dr. Gajbhiye on seeing  the nature of injury   received  by the husband of the  complainant  and symptoms  narrated  by other  persons  to Dr. Gajbhiye , issued  certificate  that  her husband  died by snake bite. In this case  complainant  has also produced  affidavits  of numbers of persons  on record to show the symptoms  of her  husband  after there was  snake  bite to him. All these persons have stated  in their  affidavits  that  after snake bite he was vomited  and froth   was also coming   from his mouth. Husband of the  complainant  had received injury  to his right  toe.  Dr. Gajbhiye  has  verified  that  injury   and had also learnt about  the symptom  after incident  in respect of husband  of the complainant  and opined that  husband of the complainant had died  by snake bite.

9.         The learned advocate appearing for appellant /opponent  has vehemently  argued  that  certificate given  by Dr. Gajbhiye is not in  respect  of  treatment given  by him to  the husband of complainant  and his certificate  is  based   on information  given by the persons  who brought  husband of the  complainant to him. Hence,  the same  cannot  be accepted.  In this case it is  admitted  fact that  when  husband of complainant was brought  to the hospital of Dr. Gajbhiye he had died. Hence,  Dr. Gajbhiye  has verified  the injury  received  by  husband of complainant. He had also asked about the symptoms  which occurred  after the injury  received   by husband of the complainant.  All of them told Dr. Gajbhiye that  husband of the complainant  vomitted  and froth  was also   coming from his mouth. Looking  to all these facts Dr. Gajbhiye opined  that  death  of husband  of the complainant had taken  place due to snake bite.

10.       We are  also of the opinion that  the certificate given  by Dr. Gajbhiye is based  on the information  received  by him and after  verifying  injury  received by  deceased. Hence,  the same can be taken into  consideration. In respect of  symptoms  of husband of the complainant  villagers have  stated by giving  affidavits that   after  incident husband of complainant  was vomiting   and froth  was coming from his  mouth . Under these circumstances there is  reason  to believe that  the death of  husband of the complainant  was due to snake bite. The learned District Consumer Forum has rightly  considered  that  every  time a certificate  of expert  is not required in respect of cause of death  of person. It can be inferred from  the evidence available  on record.  In this case also  although  there is no certificate  of expert  in respect of death  of husband of complainant  there is sufficient evidence on record to show that  the husband of the complainant  had died by snake bite. Hence,  complainant  is entitled  to get  insurance  claim in respect of death of her  husband. The learned District Consumer Forum  has rightly  considered  the same and  directed the opponent  to give  insurance claim to  complainant  in respect of death of her  husband. Admittedly in this  case  complainant could not prove income of her husband as per rules by  producing  income  tax return  on record. Hence,  the learned District Consumer Forum had  rightly  directed opponent  to given insurance claim of Rs. 5,00,000/- to the complainant  along  with interest on that amount along with cost and compensation. In view of the same  we are of the view that  the order passed by the learned District Consumer Forum is legal  and  correct and  hence, the   same is to be confirmed by  dismissing  this appeal. Hence, we proceed to pass the following order.

ORDER

i.          The appeal is hereby dismissed.

ii.          The order passed by the learned    District Consumer Forum, Bhandara  in consumer complaint  No. 116/2009 on 07/03/2014 is hereby confirmed.

iii.         Parties to bear their  own cost.

iv.        Copy of order be furnished to both parties, free of cost.