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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
Ashok Bhan, President and B.K. Taimni, Member
PREM LATA MOHIL - Appellant
Versus
LIFE INSURANCE CORPORATION OF INDIA - Respondent
Revision Petition No. 2093 of 2005 arising from Order dated 28.4.2005 of Himachal Pradesh State Commission in Appeal No. 308 of 2003
Decided on : 21-05-2009
Mr. Ashok Kashyap, Advocate, for the Appellant; None., for the Respondent
Insurance claims can be dismissed if the cause of death is determined to be outside the coverage of the policy, such as excessive alcohol consumption leading to cardiac respiratory failure.
Headnote:
Insurance Claim - Excessive Alcohol Consumption - The court upheld the decision of the State Commission to dismiss the insurance claim, as the deceased's death was attributed to excessive alcohol consumption, which resulted in cardiac respiratory failure, and was not covered under the policy.
Fact of the Case:
The deceased husband of the complainant had taken an insurance policy but died within 3 months of taking the policy due to excessive alcohol consumption. The insurance claim was repudiated by the company, leading to the complaint before the District Consumer Dispute Redressal Forum.
Finding of the Court:
The State Commission endorsed the view that the death of the deceased was due to excessive alcohol consumption, resulting in cardiac respiratory failure, and was not covered under the policy. The court upheld this finding, stating that it was based on evidence and could not be interfered with in revisional jurisdiction.
Issues: Dispute over insurance claim due to the cause of the deceased's death and whether it was covered under the policy.
Ratio Decidendi: The court's decision was based on the finding that the deceased's death was due to excessive alcohol consumption, resulting in cardiac respiratory failure, and was not covered under the insurance policy.
Final Decision: The court dismissed the appeal and upheld the decision of the State Commission, leaving the parties to bear their own costs.
ORDER
Ashok Bhan, President - Complainant petitioner herein has filed the present Revision Petition.
2. Briefly stated, the facts of the case are the deceased husband of the complainant, Shri Om Prakash Mohil, during his life-time, had taken an insurance policy bearing No. 150602026 dated 28.7.1998 for a sum of Rs. 1,00,000. He died on 1.1 1.1998, i.e., within a period of 3 months of the taking of the policy. Petitioner being the nominee, submitted an insurance claim to the Life Insurance Corporation of India for settlement but the same was repudiated by the Insurance Company on the ground that the death of the deceased had taken place due to excessive consumption of alcohol. Aggrieved by this, the respondent filed the complaint before the District Consumer Dispute Redressal Forum, Solan, Himachal Pradesh (hereinafter referred to as the District Forum for short).
3. District Forum dismissed the complaint aggrieved against which the petitioner filed an appeal before the State Consumer Disputes Redressal Commission, Shimla, Himachal Pradesh (hereinafter referred to as the State Commission for short). The State Commission endorsed the view taken by the District Forum. It was held that from the Chemical Analysis Report-Annexure P-5; it was clear that the deceased died due to excessive consumption of alcohol. The alcohol content in the blood of the deceased was to the extent of 434.7 mg. That the Post Mortem Report as well as the Chemical Analysis Report indicates the fact that the death of the deceased, in the instant case, was on account of excessive intake of alcohol which resulted into cardiac respiratory failure. The State Commission recorded the following findings:
"The vice Counsel appearing for the appellant has vehemently argued that in the post mortem report, it has clearly been stated that deceased Shri Om Parkash died due to cardio respiratory failure. On a perusal of the post mortem report available on the record of the case, we find that the death of the deceased has been attributed to cardio respiratory failure and over-dose of alcohol. The net result of the report of the Medical Officer in Part-VI thereof, i.e., opinion of the Medical Officer, records that the "Patient died of alcohol poisoning". However, this opinion of the doctor in the report over post mortem was subject to final outcome of chemical analysis report. The chemical analysis report, Annexure R-5 on the record, amongst other observations, clearly states that the alcohol content in the blood of the deceased was to the extent of 434.7 mg. fully corroborating the version/observation of the doctor in the post mortem report that the patient died of alcohol poisoning. Both these documents, post-mortem report as well as the chemical analysis report are indicative of the fact that the death of the deceased in the instant case has occurred on account of excessive intake of alcohol by the deceased and resultant cardio respiratory failure and the risk of death in these circumstances is not covered under the Policy. Therefore, we do not find any ground, whatsoever, to differ with the findings of the learned District Forum with which we are in complete agreement.
In the light of what is discussed above, the appeal is dismissed, leaving the parties to bear their own costs."
(Emphasis supplied)
4. We have seen the Post Mortem Report as well as the Chemical Analysis Report. The opinion recorded by the Doctor as to the cause of death in the Post Mortem Report is that the deceased died because of excessive intake of alcohol. To the similar effect is the Chemical Analysis Report.
5. We agree with the view taken by the State Commission and find no infirmity in the same. Finding recorded by the State Commission is a finding of fact based on evidence. Such finding cannot be interfered in exercise of revisional jurisdiction. No error in exercise of revisional jurisdiction has been pointed out. Dismissed. No costs.
