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1 A/1341/2019
Date of filing :29.07.2019
Date of order :24.02.2021
MAHARASHTRA STATE CONSUMER DISPUTE
REDRESSAL COMMISSION,MUMBAI, BENCH AT
AURANGABAD.
FIRST APPEAL NO. : 1341 OF 2019
IN COMPLAINT CASE NO.: 304 OF 2018
DISTRICT CONSUMER FORUM : AURANGABAD.
The New India Assurance Company Ltd,.
Jeevan Suman, LIC Building, N-5, Plot No.3,
CIDCO, Jalgaon raod, Aurangabad.
The New India Assurance Company Ltd,.
Through its Authorized signatory,
Mahesh Compound, Adalat road,
Aurangabad.
APPELLANT
VERSUS
M/s Navjeevan Hatcheries Pvt. Ltd,.
Through Mr.Anil Kashinath Bharadkar,
Sidharth Complex, Railway Station road,
Aurangabad.
RESPONDENT
CORAM :
Smt.S.T.Barne, Hon`ble Presiding Judicial
Member.
Mr.K.M.Lawande, Hon’ble Member.
Present :
Adv.M.R.Deshmukh for appellant,
Adv.A.B.Katkar for respondent.
J U D G M E N T
(Delivered on 24/02/2021)
Per Smt.S.T.Barne, Hon’ble Presiding Judicial Member.
2 A/1341/2019
1. This appeal is arising out of judgment and order in C.C.No.
304/2018 decided by District Consumer Forum, Aurangabad on
28.6.2019. the appellant New India Assurance Company Ltd,. is the
opponent and respondent M/s Navjeevan Hatchery Pvt. Ltd,. is the
complainant in the original complaint before District Consumer
Forum. They are hereinafter, referred as per their status in the
complaint before District Consumer Forum. The complainant is
having his business office at Sidharth Complex, Railway Station road,
Aurangabad. The complainant secured insurance policy for its
workers/employee bearing policy number 1604003616100000455
with effect from 31.3.2017 till 30.3.2018.
2. It is case of complainant that one Bhimrao Banduji Sasane was
working as a watchman at the head office of complainant. On
26.11.2017 he met with an accident while he was on duty. He
sustained grievous head injury and bodily injury. He was immediately
shifted to the hospital and he died on 29.11.2017 due to Acute
Myocardial Infarction. There was fracture to his skull on right and
left side and there was internal bleeding. Thus, he sustained brain
injury and died out of it’s complication. It was immediately informed
to opponent Insurance Company on his death by e-mail dated
29.12.2017. The opponent sought documents by letter dated
22.2.2018 for settlement of claim. However, on 19.6.2018 the
opponent repudiated the claim of complainant without perusing the
entire medical record and thereby caused deficiency in service.
Hence, the complainant filed consumer complaint before District
Consumer Forum.
3 A/1341/2019
3. The respondent Insurance company has filed it’s reply. The
copy of same is at page No. 54 to 61. The opponent has not disputed
that the complainant has secured insurance policy under Worksman
Compensation Act. It is the contention of complainant that deceased
Bhimrao Sasane died on 29.11.2017, due to Acute Myocardial
Infarction i.e. due to heart attack which is not covered under the
policy. There is no relation between employment and cause of death.
The complainant failed to intimate the accident to labour officer or
Worksman
compensation
Commissioner
within
jurisdiction.
Therefore, it can be inferred that the accident is not occurred during
the course of employment of complainant. The District Consumer
Forum has no jurisdiction to decide or adjudicate the claim of
employer and employee relationship in the present complaint. The
opponent has rightly repudiated the claim on the basis of post
mortem report, wherein the cause of death is mentioned as “Acute
Myocardial Infarction Associated With I
