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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Ajit Bharihoke, Presiding Member and Suresh Chandra, Member
Bajaj Allianz General Insurance Co. Ltd. —Petitioner
versus
Shri Jayantibhai Nathanbhai Monpara & Ors. —Respondents
Revision Petition No. 2493 of 2012
(From the order dated 10.4.2012 in Appeal No.773/2009 of the Gujarat State Consumer Disputes Redressal Commission, Ahmedabad)
Decided on 24.7.2014
Counsel for the Parties:
For the Petitioners:Mr. K.L. Nandwani, Advocate.
For the Respondent Nos. 1,2,4 & 5: Nemo
For the Respondent No. 3:Mr.Sudhir Bisla, Advocate.
IMPORTANT POINT
In order to repudiate claim lodged by complainants, petitioner company is required to prove its stand by independent evidence.
Headnote:Consumer Protection Act, 1986—Sections 15, 17, 19 and 21—Insurance—Kisan Credit Card Group Personal Accident Policy—Death of person due to fall in well—Repudiation of death claim on ground that it was a case of suicide—Claim allowed by State Commission in appeal—Even though deceased insured was suffering from schizophrenia, there was no evidence to prove that she actually committed suicide by jumping into well—Deceased insured used to carry out agricultural activity regularly on her own and was also a regular member of society and used to avail of finance for agricultural operations from co-operative society—In order to repudiate claim lodged by complainants, petitioner company was required to prove by independent evidence that deceased insured had actually committed suicide which petitioner failed to do—Revision Petition dismissed. (Paras 6 and 7)
Result: Revision Petition dismissed.
Suresh Chandra, Member—This revision petition has been filed by Bajaj Allianz General Insurance Co. Ltd which was opposite party No.1 before the District Forum in the complaint filed by respondent Nos. 1 & 2 who are the legal heirs of the deceased insured Smt. Manishaben Jayantilal Monpara. Respondent Nos. 4 & 5 were opposite party Nos.3 & 4 respectively before the District Forum.
2. Briefly stated, the facts leading to filing of the present revision petition are that the petitioner issued a Group Personal Accident Insurance Policy, namely, Kisan Credit Card Group Personal Accident Policy for a period of one year commencing from 4.8.2002 to 3.8.2003 to respondent No.4, viz., Rajkot District Cooperative Bank Ltd. for the benefit of its members. Each member was insured for a sum of Rs.1 lakh. A similar insurance cover was provided for by respondent No.3 insurance co., namely, New India Assurance Co. Ltd. for a sum of Rs.50,000/-. The deceased Smt. Manishaben Jayantilal Monpara was having farm land in her own name and was a member of respondent No.5 society, namely, Shri Jamvadi Juth Seva Sahakari Mandali Ltd.which in turn was a member of respondent No.4 bank. Thus the deceased Manishaben Jayantilal Monpara was beneficiary of the Group Personal Accident Insurance Policy for two different sums of Rs.1 lakh and Rs.50,000/- under the policy covers provided by the petitioner insurance co./OP-1 and respondent No.3/OP-2 insurance co. respectively. As per the allegation, the deceased Manishaben Jayantilal Monpara fell into the well while working on 24.2.2003. She sustained heard injury and succumbed to the injuries. The incident was reported to the police station and post-mortem was carried out. Respondent Nos. 1 & 2 being the legal heirs of the deceased Manishaben Jayantilal Monpara lodged a claim under the aforesaid group accident personal policy before the petitioner and OP No.2 through respondent No.4 bank. While the petitioner insurance co. repudiated the claim stating that it was a case of suicide, respondent No.3 insurance co./OP-2 repudiated the claim stating that they were not liable to pay. This led the two legal heirs of the deceased insured/respondent Nos.1 & 2 to file the consumer complaint in question bearing No.380 of 2003 before the Rajkot District Consumer Disputes Commission (Additional).
3. Both the insurance companies contested the claim under the complaint by filing their written statements. It was submitted that as per the investigator’s report, the insured beneficiary was mentally retarded and that it was not a case of accidental death but the cause of death was suicide which was covered under the policy Exclusion Clause. The certificate of the psychiatrist and the report of Dr. P.S. Pithadia were also filed in support of the submissions made by the opposite parties. It was also stated that the police had concluded that the deceased had committed suicide due to her mental instability. OP-3 Bank filed its written statement in which regular payment of premium was confirmed but it was stated that the dispute was mainly between the complainants on one hand and the two insurance companies/ OPs-1 & 2 on the other.
4. On consideration of the documents produced and the submissions made by the parties, the District Forum accepted the defence put forth by the OP insurance companies and dismissed the complaint vide its order dated 23.7.2007. Aggrieved of this order of the District Forum, the two complainants filed an appeal No.773 of 2009 against this order before the Consumer Disputes Redressal Forum, Gujarat State, Ahmedabad. The State Commission accepted the appeal of the complainants/respondents-1 & 2 vide its impugned order dated 10.4.2012 which is reproduced thus:-
“1. The Appeal No.773/2009 is partly allowed.
2. The Judgement and Order of the Learned Consumer Disputes Redressal Forum Rajkot is hereby quashed and set aside.
3. The Opponent No.1 & 2 do pay Rs.1,00,000 and Rs.50,000 respectively to the Complainant
