Court-2 APPEAL NO. 514 OF 2016 Shardaben Bhikhabhai Patel (Widow of late Shri. Bhikhabhai Davabhai Patel)

Sardarpura, Post: Falasan Ta: Idar, Dist: Sabarkantha. …. Appellant Vs.

United India Insurance Co. Ltd.

4/Division Office, First Floor, United India Bhavan, In-come tax Circle, Ashram Road, Ahmedabad-380014. ...Respondent Appearance: Ld. Advocate Mr. P.V.Patel For the appellant, Ld. Advocate Mr. Darshil Parikh on behalf of Mr. V.P.Nanavaty for Respondent.

Coram: Shri M. J. Mehta, Judicial Member Order by Shri M.J. Mehta, Judicial Member

1. Being aggrieved and dissatisfied with the judgment and order dated 18.04.2016 passed by the DCDRC, Ahmedabad (addl) in Consumer Complaint No. 251 of 2015, the appellant has preferred instant appeal on the grounds that the impugned order is arbitrary, perverse and bad in law.

2. The parties will be referred as per their original nomenclature for the sake of the convenience.

3. Brief facts of the present case are as under:

complainant has obtained personal accidental policy for the period of 30.03.2010 to 29.02.2015 for sum insured of Rs. 5,00,000/-. On 20.03.2014 dog come across on the road and due to that complainant fall-down from the bike, and 108 was called and he was taken to the government hospital, but as complainant’s heath was not improving therefore, he was shifted to the Life Line Hopital Idar and then in the Apollo Hospital for the period of 20.03.2014 to 31.03.2014 and incurred expenses of Rs. 6,00,000/- Further without any permission complainant shifted to his house where he died on 13.05.2014. However, FIR, Inquest Panchnama was not carried out, there was no evidence on record that can establish the cause of death was due to accident.

4. On 04.10.2014 complainant’s wife placed the claim before the insurance company and as the FIR, Police Panchnama, Post Morterm Report was not carried out on that ground on 15.12.2014 the complainant repudiated the claim of the opponent.

5. Being aggrieved with the same the insurance company has filed the consumer complaint for amount of Rs. 5,00,000/- with 12% interest, Rs. 25,000/-for the mental agony and Rs. 15,000/-

for the cost of the complaint.

6. District Commission has observed that here in the case there is nothing on record to establish the factual aspect that the accident has taken place. Even there is no any kind of receipt or note from the 108 ambulance or nursing staff etc. are not brought by complainant. So District commission has not accepted the reason advance by complainant side and ultimately complaint was dismissed.

7. Today we have heard Ld. Advocates for both the sides, we gone through the judgment of the District Commission and also evidence advance by both the sides, here in the case Ld. Advocate Mr. P.V.Patel for the complainant has drawn my attention at page no. 23, history was noted that “A/H/O fell down from bike on 19.03.2014 near vadali. Patient was taken to life line hospital by 108. Patient shifted to Apollo hospital on 20.03.2014 00.30 am by Ambulance from life line hospital to Apollo Hospital Ahmedabad”.

This fact is not accepted by the District Commission and that’s why the appeal shall have to be allowed and order of the District Commission is to be quashed and set aside and compensation shall have to be awarded in favor of the complainant.

8. Ld. Advocate Mr. Darshil Parikh has submitted that the page no. 23 is not a sufficient proof to establish the accident had taken place, in absence of Post Mortem report, medical history papers from whom the history was brought on record, name of informant, entry in the government hospital where the patient was brought immediately. Thereafter ultimately patient was shifted to the Apollo hospital where he was treated. Than complainant was taken home without any permission of the doctor where he passed away.

9. F