D.O.F. 13.09.2010
D.O.O.05.01.2012
IN THE CONSUMER DISPUTES REDRESSAL FORUM KANNUR
Present: Sri. K.Gopalan : President
Smt. K.P.Preethakumari : Member
Smt. M.D.Jessy : Member
Dated this the 5th day of January 2012.
C.C.No.229/2010
1. Gouri.A.C,
2. Mini.A.C,
‘Arukandathil’ ,
P.O.Cherukunnu, Kannur 670 301 Complainant
(Rep. by Adv.T.V.Haridasan)
1. TATA CONSULTANCY SERVICE LTD.
Gateway Park Business, Fort Road, No.13 MIDC
Andheri East Mumbai 400093.
2. The New India Assurance Company Ltd.,
MRO III Claims Hub Cell,
New India Centre Building 17-A
Cooperage Road, Mumbai 400039. Opposite Parties
O R D E R
Sri.K.Gopalan, President
This is a complaint filed under Section 12 of Consumer Protection Act for an order directing the opposite parties to pay an amount of `20 lakhs after settling the claim.
The fact of the case of the complainant is that AC Manu, the insured was the only son of complainant No.1, who was B.Tech Degree holder in Electronics & Communication. He was employed through campus selection by 1st opposite party and working as Analyst. He was on deputation to Tokyo, Japan to complete the project work of 1st opposite party. Mr.A.C Manu was insured under personal accident Insurance with 2nd opposite party. The premium amount was deducted from the salary of deceased Manu. Mr.Manu was on short leave from Tokyo. He reached Mumbai on 10.8.2007. On 12.8.2007 he traveled in Train No.2124 U.P.Decan Queen from Pune to Lonewala. When the train reached Talegaon Railway station at about 0825 hours he fell down from the train and happened to be under the running express train and died on the spot. Pune Railway line police station registered FIR and after post mortum body was handed over to the relatives. Police recorded the death as accidental and close the file. 1st opposite party processed the claim with 2nd opposite party but the claim was repudiated stating that deceased Manu knowingly put his life in damages. Repudiation of claim intent to deprive the legally entitled claim as per policy.
Pursuant to the notice 2nd opposite party entered appearance and filed version denying the main allegations of complainant as follows: The sum insured in the event of the death is `15, 00,000. But complainants are not entitled for the sum insured since the death covered under the policy was not arising out of an accident. The death was predetermined suicide by jumping before the running train. Hence 2nd opposite party is not li9able to indemnify. The incident of death was reported to 2nd opposite party on 26.9.2007. But while going through the FIR it is seen that the PS1 Railway police Talegaon received a written notice from the Station Master, Talegaon Railway station stating that an unknown person was known person was knocked down by Train NO.2124 Decan Queen and the engine driver of the said train reported the station Master accordingly. The victim was taken to primary centre Talegaon where he was declare dead .The Panchanamas says that the person died around 8.25 hours on 12.8.07 as he came under the running express train which was going towards Mumbai. The spot of death is in the middle of the Telagon Railway station. Hence if a person is traveling from Mumbai to PUne he would be traveling by a down train and if the train is stopping at Talegaon, then the train would come on the extreme left track and halt at the station. If the train is not stopping at Telegaon station, then it would be passing through the main line. Manu was not a passenger in the Decan Queen, whereas he was in the railway station earlier and that he had jumped before the running train with the predetermined intention of committing suicide. This opposite party availed the service of General Insurance Investigation and appointed the investigators M/s.Yogesh Associates to investigate into the matter. In their report investigator has specifically mentioned that the deceased Manu was not a passenger in the Decan Queen since the train has no halting at Talegaon Railway station. On an enquiry made by him to some of the people who saw the incident it revealed that when the Decan Queen entered the Talegaon railway station the Deceased Manu ran towards the running train and jumped before the train. The circumstances indicate that the deceased did not fall from the train where as he had jumped before the train to commit suicide. Hence repudiation was made on valid reasons. The total claim `20,00,000 is made without any basis. As per the policy the limit of the liability, if the claim is allowable, is only up to a maximum limit of `15,00,000.
1st Opposite party remained absent and subsequently declared exparte. 2nd opposite party Insurance company is the actual contestant
On the above pleadings the following issues have been taken for consideration.
1. Whether there is any deficiency on the part of opposite
Parties?
2. Whether the complainant is entitled for the remedy as
prayed in the complaint?
3. Relief and cost.
The evidence consists of the oral evidence of PW1, PW2, DW1 and Exts.A1 to A7 and Ext.B1 & B2.
Issue Nos.1 to 3
Admittedly the 2nd opposite party is the insurer of the deceased A.C Manu against personal accident. The sum insured in the event of death is `15,00,000. The case of the complainants is that Mr.A.C.Manu was on short leave from Tokyo and reached Mumbai on 10.8.2007. On 12.8.2007 he was traveling in a train NO.2124 up from Pune to Lonavala with valid ticket No.55978357 dated 12.8.2007. When the train reached Talegaon railway station at about 08.25 hours train No.2124 up dashed the deceased and he come under the running express train and died on the spot. FIR was registered. The mater was investigated and police recorded the death as accident and closed the file. 1st opposite party processed the claim with 2nd opposite party with all the documents but the claim was repudiated. Opposite party contended that since the death of the insured was due to the predetermined suicide by jumping before the running train. 2nd opposite party is not liable to indemnify the 1st opposite party and pay any amount as compensation to the complainants.
PW1, the brother of the 1st complainant adduced evidence by way of chief affidavit in tune with the pleadings. He has stated that the deceased Manu was an extra ordinary brilliant student. He was well placed by 1st opposite party and drawing handsome salary. There is no circumstance that leads him to commit suicide. He was traveling from Pune to Lonewala with valid ticket. He fell, ran over the running train and died on the spot. All the official records show the death is accident.
Complainants produced inquest panchanama Ext.A1 which shows that the station Master Talegaon has given written memo to Railway Police station house officer and informed that driver of the train No.2124 UP express had informed that one unknown person came under the said train at Talegaon Railway Main Line R.K.M.No.15715-6 due to dash fall on the track and therefore to do the necessary things. Police went to the spot of incident and made entries to the effect what they had seen and the person was brought to primary heath center Talegaon and the Medical officer after the examination declared him as dead.
According to Panchas and the police the death of the deceased occurred dated 12.8.07 before 8.25 hrs. at Railway station Rail K.M.No.15715-6 and Train No.2124 Up dashed the deceased and he came under the running express train and the body of the deceased is separated in to two parts. Ext.A2 spot panchanama also stated police has taken to safe custody a Railway ticket dated 12.8.07 bearing number NO.55978357 Pune to Lonavala. Ext.A3 is the death certificate and Ext.A6 is the Insurance particulars.
PW1 in his cross examination deposed that it is not correct to say that Manu had committed suicide. He has also stated that Man u was traveling from Pune to Lonewala. PW2 adduced evidence as follows: PW2, Mr.Jayachandran is a relative of Manu, who had been working in Pune. He has adduced evidence that the accident was taken place at 08.25 and he came to know the incident of death at 9’ 0 clock. He reached at Talegaon at 11.30 when he reached at station the body was taken laying in structure at platform. He further deposed that he could understand that the accident took place at the middle track. Two tracks were use for goods train and other two tracks were used for journey train. He saw the dead body and it was recorded in panchnama. Manu was traveling from Pune to Lonawala. Police has taken the ticket under custody. Hew learned that Manu was fallen from the train at Talegaon Railway station. Police recorded it as accidental death. Police has closed the file recording accidental death. At the time of accident Manu was an Engineer in Japan. To his knowledge there was no reason as far as Manu is concerned to commit suicide. In cross examination he has deposed that he was residing at 12 km away from Talegaon station. He made enquiry after receiving call from his cousin brother from Goa. He called me suspecting that it was Manu who happened to die. PW2 identified Manu on seeing the dead body laying in the structure at Platform. Police told him that Manu died falling from the train.
It can be seen that the relative of Manu came on the spot within two hrs of incident and identified the dead body. So PW2 is a person who could witness almost everything what had happened after the death. So his evidence has much relevance in co-ordinating the circumstantial evidences. The information given by the train driver, reporting of the station master and the investigation recording of police, shows all are of opinion that the death of the insured Manu is purely an accidental death. It can very well be seen that before the entry of insurance people on seen there was no suspicion occurred anywhere with respect to the death of Manu as suicide.
Insurance company denied the claim on the ground that the death of the insured was suicide. Opposite party contended that the death of the insured was due to predetermined suicide by jumping before the running train. 2nd opposite party insurance company repudiated the claim based on the investigation report dated 24.7.08 submitted by M/s.Yogesh Associates.
It is an admitted fact that incident was taken place on 12.8.2007. DW1, the Manger of 2nd opposite party deposed that the investigator was deputed for investigating the incident. Opposite party contended that they have availed the service of the General Insurance Investigator and appointed the investigator M/s.Yogesh Associates to investigate into the matter and they submitted report on 24.7.08. The report submitted after one year of the incident. But the said report marked as Ext.B2 with objection has not been proved by the opposite party. None of the investigators were examined before the Forum. On perusal of the said report on the file reveals that they have stated in their conclusion that the circumstrnacial evidence clearly indicates that the causative factor for death of Mr.Manu was his negligent and wrongful act. In the report nowhere they have used the word suicide. The contention of opposite party is that he had jumped before the running train to commit suicide. But the alleged report of the investigation agency dated 24.7.2008 after one year of the incident in their conclusion depending on circumstantial evidence stated that the causative factor for death of Mr.Manu was his negligence and wrongful act. Opposite prty failed to prove tht Manu had been committed suicide.
In the light of the fact that the entire official documents of police and Railway etc. had been recorded the death of Manu as accidental death, the burden lies up on the shoulders of opposite party to prove the death was as a result of predetermined suicide so as to justify the repudiation of claim. Whereas, even the document up on which they repudiated the claim they have entered into conclusion, that too only on circumstantial evidence, that the causative factor for death of Manu was his negligence. If it is negligence how can it be called it is a predetermined suicide. So it is certain, even with the help of that report it is not possible for opposite party to prove that death of Manu was taken place as a result of suicide.
The favorable circumstantial evidence in favour of the complainants also cannot be ignored as far as the case in hand is concerned. It can be seen that the facts brought out by the complainants that Mr. A.C.Manu the insured is a B.Tech. Degree holder, who was employed through campus selection by 1st opposite party and working as system annalist he was on deputation to Tokyo, Japan to complete the project work of 1st opposite party and he was on leave etc. have not been denied by opposite party. It was also not denied that he was drawing handsome salary. Considering these aspects a man of ordinary prudence cannot jump in to a conclusion that such a young man will commit suicide for reason not known to any body else, in the way as is explained by opposite party. It is also pertinent to note that police had not recovered any suicide note from the body of deceased Manu and the police close the file recording the mater as suicide.
Taking into consideration the facts and circumstances of the case together with the available evidence revealed on the official records we are of opinion that the fate of Mr.Manu had been determined due to the accidental death and there is no reason to believe that he was committed suicide. Thus 2nd opposite party is liable to pay the insurance amount to the complainants. It is admitted that as per the insurance policy, the limit of the liability of the insurance company if the claim is allowable, in the event of death of the employee of the insured, is only `15,00,000 . Hence we hold that 2nd opposite party is liable to pay `15,00,000 to complainants with a cost of `1000. Issues 1 to 3 are found in favour of complainant and order passed accordingly.
In the result, the complaint is allowed directing the 2nd opposite party 2 to pay `15,00,000 (Rupees Fifteen Lakh only)as claim amount and an amount of `1000(Rupees One thousand only) as cost of this litigation to the complainants within one from the date of receipt of this order, failing which the complainant is entitled for interest @ 8% from the date of filing of this complaint till realization. The complainant is at liberty to execute the order as per the provisions of consumer protection Act.
Sd/- Sd/- Sd/-
President Member Member
APPENDIX
Exhibits for the Complainant
A1. Copy of the inquest panchnama by police inspector Pune
dt.12.8.07.
A2. Copy of the spot Panchanma by “ “
A3. Copy of death certificate dt.26.9.07.
A4. Copy of the letter dt.13.11.09 issued by OP
A5. Copy of intimation letter issued by 2nd OP
A6. Copy of Policy particulars issued by 2nd OP
A7. Power of Attorney
Exhibits for the opposite parties:
B1. Copy of Health Insurance policy scheme
B2. Copy of the investigation report.
Witness examined for the complainant
PW1. A. C.Rajeev
PW2. T. Jayachandran
Witness examined for the opposite parties
DW1. K.S.Ramkumar
/ forwarded by order/
Senior Superintendent
Consumer Disputes Redressal Forum, Kannur
