Anju Goel vs Oriental Insurance Co. Ltd

Dr. S.M. Kantikar, Presiding Member

This Revision Petition has been filed under section 21 of the Consumer Protection Act, 1986 by Anju Goel (hereinafter referred to as the “Complainant”) against the Impugned Order dated 28.12.2010  passed by State Consumer Dispute Redressal Commission, Haryana at Panchkula, (for short “the State Commission”) in First Appeal No. 2570 of 2003, wherein the Appeal filed by the Appellant (Respondent herein) was allowed and the Order dated 01.10.2003 passed by District Consumer Dispute Redressal Forum, Kurukshetra (for short ‘District Forum’) in CC No. 373/2002 was set aside.

The issue relates to repudiation of death insurance claim due to accident. Briefly, Bushan Lal Goel (since deceased) got himself insured with Oriental Insurance Co. (OP) against the accidental death due to subsistence of the policy, he died on 04.12.2001 due to fall from his motorcycle. His wife Anju Goel submitted the claim with the Insurance Co., but it was repudiated and additionally, the OP cancelled the Long Term JPA policy No. 47/99/00021 vide letter dated 21.2.2002 and sent a cheque for Rs. 764/- as a refund of the premium for the unexpired period. Being aggrieved by the repudiation of the claim, the Complainant filed a Consumer Complaint before the District Forum and claimed compensation of Rs. 5,00,000/- as insured amount with interest and Rs. 10,000/- towards litigation cost.

The Insurance Co., in its written version, denied any deficiency and stated that the Complainant filed the complaint with unclean hands. Her husband did not die in the accident. She has not filed FIR or Post-Mortem report to prove that it was an accidental death.

The District Forum allowed the Consumer Complaint and awarded sum of Rs. 5 lakh to the Complainant along with interest @ 10% per annum from the date of filing the complaint i.e. 5.7.2002 till realisation

Being aggrieved by the Order of the District Forum, the OP filed the First Appeal No. 2570 of 2013 before the State Commission, same was allowed and the Order of the District Forum was set aside with the following observation:-

“We find force in the contention raised on behalf of the appellant-opposite parties. From the evidence produced on record on behalf of the opposite parties, it is a case of no evidence. The complainant was asked to submit some relevant documents i.e. proof of accident, police report, medico-legal" report or post mortem report and death certificate of the Life Assured but the complainant failed to produce the relevant documents. There is no evidence to prove that the Life Assured had died in an accident. No DDR, PMR, ITR or death certificate has been produced to substantiate the version of the complainant. Thus, in the absence of any documentary evidence the complainant cannot be allowed to pay any insurable benefits with respect to the policy obtained by the Life Assured.

Thus, under the facts and circumstances of the case we are of the view that the District Forum has committed great error while passing the Order dated 1.10.2003 and as such the impugned order is not sustainable in the eyes of law”.

Being aggrieved, the Complainant filed the instant Revision Petition before this Commission.

Heard the learned counsel for the parties. Perused the material on record including the Original Record requisitioned from the District Forum.

Evidently, the Complainant failed to prove that the death of her husband was accidental, because there was no FIR, no Post-Mortem report, no statutory compliances made by the Complainant, therefore, in my view, the Order of the State Commission cannot be faulted.

Based on the foregoing discussion, the repudiation by the Insurance Co. is justified. The Order of the State Commission, being well reasoned, is confirmed.

The instant Revision Petition stands dismissed. The Parties to bear their own costs.