This revision petition is directed against the order dated 14.07.2011 of the Andhra Pradesh State Consumer Disputes Redressal Commission, Hyderabad (in short, he State Commission in appeal no. 1301 of 2009. By this order, the State Commission allowed the appeal of the respondent/complainant and held that repudiation of the insurance claim of the respondent/complainant on account of death of his father (insured) was not sustainable. The State Commission, therefore, directed the petitioner Insurance Company to pay the insured amount of Rs. 5 lakh to the respondent/complainant with cost of Rs.2000/- within two weeks of the date of its order. 2. I have heard Mr. K. L. Nandwani, learned counsel for the petitioner and perused the records carefully. 3 (i) The ground on which the insurance claim of the respondent/complainant was repudiated and also urged by Mr. Nandwani was that the death of the insured was intimated after four months as against the stipulated period of one month. (ii) Dealing with this contention of the insurance company, the State Commission has observed as under: . There is no dispute of the fact that the appellant father obtained personal accident insurance policy bearing no. 1802373313200004 from the respondent insurance company for the period frm 23.01.2007 to 22.01.2008 for the sum assured of Rs. 5 lakh. The appellant has stated that his father sustained dog bitten injuries at his scrotum and upon thighs. The prescription issued by Sattibabu Multi Speciality Clinics and Diagnostics supports the version of the appellant father sustaining injuries due to a dog bite. It is recorded on 05.12.2007 by Dr. Balasubramanyam of the hospital as atient attacked by dog on the Road Parawada. Injuries. Dog bitten injuries at Scrotum. Exposed testicles and ruptured. Pt. GC is poor, SEMICONSCIOUS He was referred to surgical specialist with the advice that he required blood transfusion immediately. 8. Dr. Balasubramanyam has deposed that he treated the father of the appellant on 05.12.2007 for the injuries he had sustained on account of two dogs while he was proceeding on his bicycle and the injuries at his testicular part were grievous and delacreated with severe bleeding with explosive deep blood vessels. According to the doctor the appellant father sustained the injuries when he fell from the bicycle due to attack and chase by the dogs as also the dogs had bitten him at testicular region and the upper thighs. He had opined that such injuries would cause the death of the patient. The doctor evidence establish the case of the appellant that his father had sustained injuries when he fell down from the bicycle and bitten by the dogs at the testicular region and the upper thighs. 9. Except denying the version of the appellant, the respondent insurance company had not appointed any investigator to rebut the evidence adduced by the appellant. We do not see any reasons not to give credence to the evidence of the doctor particularly in the absence of any evidence rebutting thereto on the side of the respondent insurance company. It is settled law that the respondent insurance company has the obligation to prove that the grounds of repudiation had been based on legally sustainable evidence. Insofar as the intimation of the accident beyond the period of 30 days is concerned, the appellant has stated that he was not aware of policy obtained by his father and when he came to know about the policy, immediately he had given intimation to the respondent insurance company. 10. For all the foregoing reasons, we are of the considered opinion that the appellant father died due to the injuries sustained in the wild chase as also bite of the dogs and the repudiation of the claim as such is not sustainable 4. Even a cursory perusal of the detailed discussion in the State Commission order would be sufficient to demonstrate that all conditions for acceptance of the insurance claim except the point of reporting the osswithin one month of its occurrence had been substantially fulfilled. In this case, the delayed intimation of the death of the insured due to the injuries he suffered on account of the ccident(namely, falling off his bicycle and thereafter vicious dog bites on his inner thighs and scortum) cannot be held to be ruinous to the insurance claim because the facts and circumstances of the death were clearly established on the basis of medical records as well as deposition of the doctor who attended on the deceased insured. Therefore, unlike in cases of theft of movable insured property, the delay in intimation was not prejudicial to the insurance company in that it was not prevented, because of the delay, from carrying out any investigation into the facts and circumstances leading to the insurance claim to satisfy itself if the ccidentand consequent ossfell within the (other) substantive conditions of the insurance policy. It is difficult to imagine that the complainant could have cooked up the story that his father died of dog bites in the manner stated and that too in active collaboration and collusion with a doctor at a hospital. 5. In view of the foregoing, I am not inclined to interfere with the impugned order of the State Commission in exercise of the revisionary powers under section 21 (b) of the Consumer Protection Act, 1986. 6. The revision petition is accordingly dismissed, with no order as to cost. |