Nisha Nath Ojha
- In the instant case the Complainant has sought for following reliefs against the Opposite party:-
- To direct the opposite parties to pay the insured amount along with 12% interest.
- To direct the opposite parties to pay Rs. 50,000/- ( Rs. Fifty Thousand only ) as Compensation as well as litigation costs.
- The facts of this case lies in a narrow compass which is as follows:-
The complainant has asserted that she is the nominee of her insured husband namely Late Prabhat Kumar whose dead body was found in the railway boggy of Capital Express on 17/18.05.2007 and thereafter FIR was lodged in Danapur railway Junction by railway manager on 18.05.2007. Her husband was insured under Janta Personal Accidental Insurance Policy vide annexure – 1 which was effective from 13.02.1997 to 12.02.2009 i.e. for 12 years with opposite parties. The dead body was sent for post mortem on 19.05.2007 by railway police and after that post mortem report was prepared on 19.05.2007 whereby and where under the doctor have advised to get the viscera report checked as will appear from annexure – 4. It appears from post mortem report that viscera was reserved for chemical analysis. After receiving the knowledge of death of her husband her family claimed the dead body which was handed over to the brother of the deceased namely Aditya Kumar as will appear from annexure – 5.
It is surprising that without getting the viscera of the deceased examined by forensic laboratory as per advise of the doctor the police submitted final report stating therein that the death of the insured was natural as will appear from annexure – 6.
The complainant thereafter filed an application to opposite party no. 2 on 11.09.2007 vide annexure – 7 requesting him to pay the benefit under the Janta Personal Accidental Insurance Policy vide annexure – 1 stating all the reason for filing the aforesaid petition after delay. Thereafter opposite party no. 2 issued a letter to opposite party no. 1 for appointment of investigator for ascertaining the claim as will appear from annexure – 8.
The grievance of the complainant is that uptill now his claim has not been considered.
On behalf of opposite parties a written statement has been filed admitting the genuinity of annexure – 1, in Para – 7 of written statement the following facts have been asserted, “that the insurance company on the basis of the perusal of document as such the FIR, Post Mortem report, Final Form in U.D. case no. 13/07 (Danapur railway Police) and the investigation report of Sri Navneet Ranjan found that the death of insured was natural and not accidental as such the risk prime facie was not covered under the JPA Insurance Policy, and therefore vide letter dated 03.12.2008 issued to the complainant repudiated the claim of the complainant.”
From bare perusal of annexure – B it appears that the claim of the complainant has been repudiated vide letter dated 03.12.2008. Annexure – A is nothing but investigating report of the investigator namely Navneet Ranjan. In Para – 5 of the investigating report the following facts have been stated, “the police authority had filed the report before the SDM Danapur, Stating therein the normal death of the deceased, without analysis of clinic examination of viscera of the deceased. Which was accepted by the SDM Danapur on 04.08.2008. Initially the doctor who conduct the post mortem examination was opined “NO CAUSE COULD BE ASCERTAINED.”
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We have narrated the brief facts of the respective parties in the aforementioned paragraph.
The genuinity of annexure – A stands admitted by opposite parties. It goes without saying that the claimant is entitled to receive benefit of annexure – A i.e. Janta Personal Accidental Insurance Policy if the death of insured occurred due to any accident.
From bare perusal of the police report i.e. annexure – 7 it is crystal clear that investigating officer has submitted final report on the ground that the death of the insured namely Prabhat Kumar appears to be natural.
From bare of annexure – A which is nothing but investigating report of Navneet Ranjan it is crystal clear that the learned SDM, Danapur had accepted the final report of investigating officer on 04.08.2008 and directed IO for close of investigating without viscera report. Thus it is crystal clear that the husband of the complainant died of natural death and as the learned SDM has accepted the police report we find no any cogent evidence to take another view in this regard.
From the fact discussed above it is crystal clear that the complainant’s husband died of natural death and as such the opposite parties had rightly repudiated the claim of the complainant.
For the discussion made above, the complaint has no merit and as such this complaint stands dismissed but without costs.
Member President
