UTTRAKHAND STATE CONSUMER DISPUTES REDRESSAL COMMISSION
C.C. Pant and Kusum Lata Sharma, Members
NEW INDIA ASSURANCE COMPANY LIMITED - Appellant
Versus
JAI BHAGWAN SHARMA AND ANR. - Respondents
First Appeal No. 209 of 2010
Decided on : 25-02-2011
Mr. Suresh Gautam, Advocate, for the Appellant; Mr. Gopal Narsan, Advocate, for the Respondent
Headnote:
Insurance - Accidental Death Insurance Cover - Court finds ample evidence regarding the accidental death of the insured and criticizes the insurance company's inhumane approach in considering the claim. The appeal is dismissed.
Fact of the Case:
The complainant's son had an accidental death covered by an insurance policy. The insurance company repudiated the claim citing lack of documentation regarding the cause of death.
Finding of the Court:
The court found ample evidence of the accidental death and criticized the insurance company's inhumane approach in considering the claim. The appeal was dismissed.
Issues: Dispute over the validity of the insurance claim due to lack of documentation regarding the cause of death.
Ratio Decidendi: The court emphasized the need for empathy and understanding in considering insurance claims, especially in cases of accidental deaths, and found the insurance company's approach to be inhumane.
Final Decision: The appeal was dismissed, and the insurance company was directed to pay the insured amount and damages to the complainant.
ORDER
C.C. Pant, Member - This is Insurance company's appeal against the order dated 3.6.2010 passed by the District Forum, Haridwar, allowing consumer complaint No. 342 of 2008 and directing the insurance company to pay to the complainant the insured amount and Rs. 5,000 towards damages within a period of one month from the date of the order. The District Forum also directed that on receipt of the insured amount, the same be deposited with a nationalized bank or a Post Office under a scheme having higher rate of interest, either in the name of the widow of the deceased if he was married or in the name of the complainant if the deceased was not married.
2. The facts of the case which led the complainant to file a consumer complaint before the District Forum are that the son of the complainant Sh. Jai Bhagwan Sharma had taken a debit card of the HDFC Bank Ltd.-opposite party No. 1 which also carried an insurance cover against accident for a maximum sum of Rs. 5,00,000. Regarding the insurance cover, the opposite party No. 1 had made arrangements with The New India Assurance Company Limited-opposite party No. 2. The son of the complainant died in an accident on 30.3.2008. The complainant intimated the opposite parties, but no action was taken by them. A notice was also given, but to no avail. On filing a consumer complaint before the District Forum, Haridwar, the District Forum allowed the same in the above manner vide order dated 3.6.2010. Aggrieved by the said order, the opposite party No. 2 Insurance Company has filed this appeal.
3. None appeared on behalf of respondent No. 2. We have heard the learned Counsel for the appellant and respondent No. 1-complainant and perused the material placed on record.
4. There is no dispute in respect of the debit card, insurance cover under a mutual arrangement between the opposite parties and its validity, death of the son of the complainant, etc. The main contention of the appellant is that the insured did not meet an accidental death because no document regarding post-mortem or medical report indicating the cause of death was submitted. For this reason, the appellant has not made any deficiency in service by repudiating the insurance claim of the complainant. In support of the contention, the learned Counsel for the appellant pressed into service a decision dated 22.10.2009 of this Commission rendered in First Appeal No. 206 of 2007, Ranjeet Singh v. Iffco-Tokio General Insurance Company Limited and Another.
5. The learned Counsel for the respondent No. 1-complainant reiterated the facts narrated in the consumer complaint, written statements and as averred in the affidavits filed in support thereto.
6. We considered the respective submissions. The case of "Ranjeet Singh", as cited by the learned Counsel for the appellant, had facts different from the instant case. That was a case of snake biting and no one was an eye-witness to that incident. Even the doctor, who certified the death, had merely stated in his report that the person (deceased) died on the way when he was being brought to his clinic. The doctor did not state even a single word whether it was a case of snake biting or not and whether any symptoms of snake biting were found. In the present case, we are of the view that there is ample evidence regarding the accidental death of the insured. The appellant's approach in considering the claim appears to be quite inhumane. The appellant should have considered the circumstances that a young man of 30 years of age had died in an accident, casting a shadow of grief and sorrow in his family. How the family members and relatives can think of lodging an FIR immediately and to get the post-mortem done. What was required to be done in such a situation, was to take the person immediately to a hospital and try to save the life. In such a hurry, no one can think of the formalities like FIR, post-mortem, etc. Unfortunately, the life could not be saved. In an atmosphere heavily laden with grief and