BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I, U.T. CHANDIGARH

========

Mahavir Singh Hooda s/o Sh. Ranbir Singh, r/o H.No.1016, Sector 28, Panchkula.

…..Complainant

                 V E R S U S

The Bajaj Allianz General Insurance Company Limited, SCO No. 139-140, 2^nd Floor, Sector 8-C, Madhya Marg, Chandigarh, through its Manager.

                      ……Opposite Party

CORAM:   SH.P.D.GOEL                      PRESIDENT

          SH.RAJINDER SINGH GILL          MEMBER

          DR.(MRS).MADANJIT KAUR SAHOTA     MEMBER

Argued by: Sh. V.P.S. Namdev, Counsel for Complainant.

Ms.Jaimini Tiwari, Proxy counsel for Sh.Rajneesh Malhotra, Counsel for OP.

PER SH.RAJINDER SINGH GILL , MEMBER

         The complainant has filed the present complaint under Sec.12 of the Consumer Protection Act (as amended upto date) “hereinafter referred to as the Act”. The brother of the Complainant Sh. Hari Om purchased a Policy from OP on 29.10.2005, wherein the Complainant was made a nominee, for a sum assured of Rs.6.00 lacs. Unfortunately, on 7.9.2008, the said Hari Om was found lying dead in the fields due to electric shock suffered by him from the live wires of tubewell. Thereafter, a claim was lodged by the Complainant with the OP. His contention was that despite submitting all the relevant documents and made repeated requests and visits to the OP, it did nothing and rather, sat on his papers. Finally, a legal notice dated 12.2.2010 was served upon the OP, but the same also failed to yield the desired results. Hence, this complaint.   

2.         Notice of the complaint was sent to OP seeking their version of the case.

3.         The OP in their written statement, while admitting the factual matrix of the case, pleaded that the Complainant did not submit any documents in support of his contention that the deceased died due to an accident. As per the terms and conditions of the policy, the Complainant needs to prove his claim with sufficient documentary proof. No PMR, medical and police documents have been submitted by the Complainant to show that the death of the deceased was due to an accident. On receipt of intimation regarding death of the deceased, M/s Surya Claims Bureau Ltd. were appointed as Investigator, who in is report opined that there was no accidental death and, therefore, no claim was payable. As such, his claim was rightly repudiated vide letter dated 10.4.2009. All other material contentions of the complaint were controverted. Pleading that there was no deficiency in service on their part, a prayer has been made for dismissal of the complaint.

4.         Parties led evidence in support of their contentions.

5.         We have heard the learned counsel for the parties and have also perused the record.

6.         It is the case of the complainant that his brother – Hari Om was found lying dead in the fields due to electric shock. He had not reported the matter to the Police and lodged a claim with the OP Insurance Company alleging therein that the death of his brother-Hari Om had occurred due to an accident. 

7.         On the other hand, the OP Insurance Company has contended that the complainant has not lodged any report with the Police, neither any post mortem were conducted on the body of said Hari Om nor any inquest proceedings were done. They had repudiated the claim on the ground that neither F.I.R. was lodged nor Post Mortem was conducted in support of his claim as proof of Accident Death. 

8.         The complainant had also placed on record affidavits of Dr.Ram Kishan Bangru and one Srikisan to support his case. But these affidavits are of no help to complainant in any manner.  Dr.Ram Kishan Bangru, in answer to the questionnaire filed by OP, has specifically stated that no postmortem was conducted by him in any case at any time during his whole life as a medical practitioner.  He further stated that the deceased Hari Om was brought dead before him.

9.         We are of the opinion that the actual cause of death of Hari Om could be ascertained in case the post-mortem of his body was got done by the complainant and in the absence of any such report, it cannot be said that the death of Hari Om, brother of the complainant, was an accidental death.  Moreover, Annexure R-5 placed on record by the OP Insurance Company, establishes that no hospitalization or post mortem was conducted. 

10.       From the above discussion, we came to the conclusion that the complainant has not been able to prove his case.  The repudiation done by the OP was fully justified.  Therefore, we find no merit in this complaint.  The same is accordingly dismissed.  Parties are left to bear their own costs.

11.     Certified copies of this order be sent to the parties free of charge. The file be consigned.