Nobody appears on behalf of respondent. Though notices were sent to respondent twice by registered post with AD, and AD card of the last notice has also having been received, respondent has not responded to them. The proceeding as such is proceeded ex-parte against him. Heard learned counsel for petitioner – Corporation. Deceased insured had taken LIC policy with Double Accident benefit from petitioner Corporation for assured value of Rs.3,00,000/-. While so, on 12.01.2001, in course of scuffle with thieves in the neighborhood, he allegedly sustained head injuries with a blow of axe. Deceased was admitted to hospital on following day and was discharged on 24.02.2001, and, eventually succumbed to injuries on 28.12.2001. After petitioner – Corporation was moved by widow of deceased insured claiming award of Double Accident Benefit flowing from the Scheme, though Insurance company paid basic sum insured value to respondent, claim for Double Accident Benefit was repudiated on twin grounds. This made respondent file complaint before District Forum which was dismissed, for there being no evidence about insured having died of accidental death. However, State Commission, in appeal filed by aggrieved respondent, having accepted appeal, made petitioner – Corporation answerable to pay benefit of accidental death also. Learned counsel appearing for petitioner has drawn our attention to stipulations made in policy which evidently suggest that benefit claimed by respondent was available only in case of accidental death of insured which was not the feature of the instant case. Our attention ahs also been drawn to the finding of Doctor recorded in Autopsy report which shows cause of death of the insured to be “Septicemia”, attributing death not by head injury. Septicemia, as medical texts suggest, may occur due to so many reasons including infection which may be the result of unhygienic conditions or even due to medical negligence during surgery. Other limb of argument canvassed on behalf of petitioner – Corporation was that if clause 10(B) of the policy was to be taken into consideration, benefit claimed by respondent was available only in the event of death of the insured within 180 days of sustaining bodily injury, solely and directly from the accident caused by outward, violent and visible means. The stipulations made in Clause 10 (B) of policy are in the following terms :- “if life assured sustains any bodily injury resulting solely and directly from the accident caused by outward, violent and visible means, and such injury shall within 180 days of its occurrence, solely, directly and independently of all other causes, result in the death of the life assured”. The implication of this rider clause in the policy is that Double Accident Benefit would be available only when death occurs within 180 days of sustained injury. The insured allegedly sustained head injury on 12.01.2001, following which he was admitted in the hospital on 13.01.2001, from where he was discharged on 24.02.2001. The insured, however, died of septicemia on 28.12.2001. If this be so, claim of respondent for Double Accident Benefit was not covered if this rider clause in the policy was to be given operation. We, accordingly, finding no merit with the finding of State Commission, set it aside and restore that of the District Forum. Revision petition in the circumstances succeeds, but with no order as to cost.
......................JB.N.P. SINGHPRESIDING MEMBER ......................SURESH CHANDRAMEMBER | |