Oriental Insurance Co. Ltd., the petitioner herein, was the opp.party before the District Forum.

        Complainant/respondent’s husband was an employee of SAIL and insured with the petitioner under Group Personal Accident Policy for Rs.2,50,000/-.  On 31.12.2005, respondent’s husband fell down in the night and suffered injuries on his head.  He was taken to the hospital where he was declared dead.  Respondent lodged claim which was repudiated by the petitioner on the ground that the insured had died due to illness and high blood pressure.  It was also stated by the petitioner that death was natural and not accidental.  Being aggrieved, respondent filed complaint before the District Forum.

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        District Forum dismissed the complaint, aggrieved against which, respondent filed appeal before the State Commission.  State Commission set aside the order of the District Forum and directed the petitioner to pay Rs.2,50,000/- to the respondent within 90 days with interest @ 6% p.a. from the date of filing of the complaint till realization.  Relevant finding of the State Commission reads as under :

“The death of late Barister Bhagat look place after his fall in bathroom. The injury caused on his head has been described and as usual the Cardio Respiratory failure was held the cause of death. This has not been disputed that Cardio Respiratory failure may occur with such injury on head. Therefore we find that root cause of death was fall in bathroom which in all circumstances in accident.

Smt. Thakur on behalf of the OPPOSITE PARTY/respondent strenuously argued that the deceased suffered with B.P and the fall look place because of high B.P. It was also stated that the incident took place in the house and the cover was for work place only. We have not been able to the policy which mentions for which place the coverance was available.

Furthermore Accident need not be taking, place in any identified area. It is always in unexpected manner/pattern and cannot be predicted. The deceased

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fell down for whatever reason to suffer head injury and declared dead in Bokaro General Hospital. We have no hesitation to hold that the fall was accidental and death due to such accidental fall. We further fined that his was covered in Group Accident Policy in force on 31.12.05.”

        We agree with the view taken by the State Commission.  In the postmortem report it has been stated that “the injury was antemortem caused by hard blunt substance possibly due to fall on hard blunt substance.”  This clearly shows that the insured died due to accidental fall resulting in head injury which was fatal.  Dismissed.