1. The Complainant has filed this Complaint under section 12 of the Consumer Protection Act, 1986 against the opponent United Insurance Co., Ltd., contending that his father one Chikkanne Gowda took a policy on his life, which is a Personal Life Insurance through the opponent for a sum of Rs.25,000/- on 22.09.2004. <br /> 2. It is further alleged that his father on 30.08.2005 was hit by a Bull and later on died on the same day. That insurance policy taken by the deceased was in force as on date of his death, and then he as a dependent of the deceased made a claim with the opponent by producing his death certificate, but the opponent did not honour the claim and stated that a legal notice was also issued in this regard on 26.05.2006. That he has undergone mental agony and therefore prayed for directing the opponent to pay the insured amount of Rs.25,000/- with interest from 30.08.2005 and also damages of Rs.20,000/-. Contending that cause of action for the Complaint arose on the date of death of his father and thus has prayed for relief as prayed for.<br /> 3. The opponent has filed it’s version admitting the personal insurance policy taken by the opponent from it for a sum of Rs.25,000/- but denied the other allegations and contended that on the claim of the Complainant they had requested the Complainant to furnish certain particulars and documents in order to consider his claim, but the Complainant did not furnish those documents, that the Complainant has not proved the cause of death of his father and further denying that there is deficiency in the service on their side have prayed for dismissal of the Complaint.<br /> 4. During enquiry, the Complainant and an Official of the opponent filed their affidavit evidence in support of their respective allegations and the objections raised by them, by reiterating the stand they have taken in their Complaint and version. Both the parties have produced certain documents.<br /> 5. We have heard the counsel for both the parties and perused the records.<br /> 6. On the above contentions, following points for determination arise.<br /> 1. Whether the Complainant proves that the Opponent has caused deficiency of service in not honouring the claim made by the Complainant?<br /> 2. Whether the Complainant is entitled for relief prayed for?<br /> 3. What order?<br /> 7. Our findings are as under:-<br /> Point no.1 : In the Affirmative.<br /> Point no.2 : See the final order.<br /> Point no.3 : As under:<br /> <br /> REASONS<br /> <br /> 8. Points no. 1 & 2:- The fact that the Complainant is one of the legal heirs of deceased Chikkanne Gowda and the deceased Chikkanne Gowda took a Personal Line Insurance for Rs.25,000/- with effect from 22.09.2004 from the Opponent are not in dispute between the parties. The opponent has also not denied it’s liability to pay the insured amount to the heirs of the deceased insured, but sought certain particulars and documents from the Complainant in order to consider the claim of the Complainant. But, the Complainant has contended that his father, the deceased died due to Bull hit, therefore no Complaint was given to the police, no post mortem was also done, therefore some of those important documents sought for by the opponent could not be furnished and therefore, he has contended the opponent is not right in insisting upon for production of those documents filing of the Complaint to the police would not have served any purpose, as they could not proceed against the Bull for causing the death of his father. Therefore, the body of the deceased was not subjected to post mortem examination and no police Complaint was filed, as such furnishing copy of FIR and post mortem report do not arise. Under these circumstances the question that crop up is whether in the absence of cause of death of the insured the complainant is not entitle to claim the relief. <br /> 9. The Complainant in his affidavit evidence has categorically sworn to that his father died due to Bull hit, therefore the question of giving police Complaint did not arise and dead body was also not subjected to post mortem examination. It is on the claim of the Complainant the opponent found to had directed it’s investigation Officer to enquire into cause of death of the deceased and to submit a report. It is on this assignment of the opponent the investigation Officer of the opponent after taking up investigation in the village of the deceased regarding the cause of death and other auxiliary issues submitted his report dated 02.08.2006 to the opponent and the opponent itself has produced copy of that report with a policy copy with a memo. The Complainant has also produced the certificate issued by the Secretary of the concerned Grama Panchayath, which reveals that the villagers stated before the Secretary, Grama Panchayath that the deceased Chikkanne Gowda died due to Bull hit. The report of the investigation Officer of the opponent also discloses that his investigation done locally revealed that the deceased died due to Bull hit and on the basis of information he collected, he has also opined that death of the deceased was due to necking down by a Bull. The opponent has neither questioned nor controverted the certificate of cause of death issued by the Secretary, Grama Panchayath and also not disputed the cause of death of the deceased as reported by it’s own investigation Officer. The Complainant has stated in his affidavit evidence that he felt no need to give police Complaint regarding the death of his father, because his father died due to Bull hit, and giving police Complaint would not have served any purpose, because the police could not have prosecuted the Bull, sounds to the reason and the belief he entertained. Therefore, under these circumstances when the cause of death of the insured is not disputed by the other side, whether the opponent is justified in denying the payment of the insured amount on the ground the heirs of the deceased did not produce the police records and P.M. examination report. The answer is the opponent cannot. The conditions of the policy taken by the deceased also provide that on production satisfactory materials for proving the cause of death the claim of the insured or the claim of the heirs of the insured has to be honoured. Therefore when the cause of death is either known are not disputed, non-production of the F.I.R. copy, Complaint copy and post mortem examination report to the company would not deprive the beneficiary is to claim the relief under the policy, we in support of our view, rely upon the decisions rendered by the Hon’ble National Commission reported in (2006) CTJ page – 146 (CP), 1(2006) CPJ 11 (NC) and another decision of Gujarat State Commission reported in 1994 (3) CPJ page – 296. In these decisions, the Hon’ble National Commission and Gujarat State Commission have held “when the cause of death is established, there is no need for any autopsy of the deceased or on the ground that autopsy report not submitted the insurance company cannot repudiate the claim”. Relying upon these decisions, we hold that the opponent has not contradicted the opinion of its own investigation officer and report of Secretary of Grama Panchayath which disclose the cause of death and the same having not been deputed the opponent cannot be justified in having denied to settle the claim, which in our view amounts to deficiency in their service. However, the opponent found to have sought survivalship certificate from the Complainant but he has not produced any such certificates. Therefore, there is laps on his part also. Having regard to this requirement, we cannot impose any other compensation to the opponent other than what they are entitled under the policy.<br /> 10. The investigation report of the investigator of the opponent reveals that deceased had two wives and the claimant is the son of the second wife Smt.Lakshmamma. The Complainant has not disputed this report of the investigator of the opponent. Therefore, it emerges that deceased has left behind many other heirs, other than this Complainant. But, the Complainant has suppressed that fact and come up with this Complaint on his own. Therefore, he alone cannot claim the benefit under the policy. Under these circumstances, we have no hesitation to direct the opponent to honour the payment of insured amount to the heirs of the deceased under the terms, we are going to impose below. With this, we answer point no.1 in the affirmative and pass the following order on point no.2 & 3.<br /> ORDER<br /> <br /> 1. The Complaint is allowed in part.<br /> 2. The opponent Insurance Company Ltd., is directed to pay insurance amount of Rs.25,000/- due to the insured Chikkanne Gowda to his heirs on production of succession certificate.<br /> 3. Give a copy of this order to each party according to Rules.<br />