PURIBEN RAMJIBHAI PATEL vs NEW INDIA ASSURANCE CO. LTD.

THE , widow of insured Ramjibhai who was covered under miscellaneous accident insurance policy, has claimed Rs. 2 lakhs for the accidental death of Ramjibhai on 2.10.89. Ramjibhai was an agriculturist and while operating the electric motor for the bore met with an accident by electric current on 20.4.89 and got burns on the hand and was thrown off. He was admitted in the hospital but discharged by the Doctor within three days after the accident. According to the complainant Ramjibhai was not completely cured and was subsequently affected by gangrene and died because of septisimia. THE was requested to pay the insurance amount but repudiated and did not pay the insurance amount. THE complainant has accordingly claimed Rs. 2 lakhs under the insurance policy.

THE Opposite Party by written statement admitted that Ramjibhai was caused electric burns on the fingers of the hands but contended that they were minor injuries and he was treated by Dr. K.J. Parikh in the Valay Surgical Hospital from 20.4.89 to 22.4.89 and had subsequently examined and certified that all the burns were healed and no Neckirigidity was found. Dr. Parikh had found that Ramjibhai had deep burns of 10 mm diameter over pulps of 2, 3, 4, 5th fingers and over diagram of 1st and deep semel burns involving lid finger of right hand-fiesor aspect. No fracture was found. According to the Opposite Party, Ramjibhai was completely cured of the electric burn injuries and had not died of the accident. As the abovesaid injuries were caused, the Opposite Party offered Rs. 3750/- to the complainant but she refused to accept. THE Opposite Party is still prepared to pay that amount. The main dispute between the parties is the cause of death of Ramjibhai. According to the complainant the cause of death was the accidental burns which ultimately resulted into septisimia but according to the Opposite Party the burns were minor and Ramjibhai was completely cured and no septisimia was caused of any burns. It is also contended that post mortem was not got done and, therefore, cause of death could not also be ascertained.

Dr. Tribhuvanbhai N. Patel in his certificate dated 6.11.89 (Ex. 52) certified that Ramjibhai Motibhai Patel was admitted with electrical burns on both hands on 20.4.89 and at that time he was in shock but recovered from the burns caused to the fingers and was discharged on 22.4.89. with the treatment for backache and muscle pain on lower limbs. Ramjibhai was taking some treatment for server neurits. He had neuritic pain. He advised Ramjibhai to take rest upto December 1989. It is submitted that Ramjibhai was discharged from the hospital within two days and, therefore, the injuries must not be severe and he must have been cured.

THE complainant relied on the certificates and evidence of Dr. C.A. Shah (Exh. 20). Dr. C.A. Shah has stated that he new Ramjibhai and was called for the treatment in 1989. As stated by him in his certificate he had examined Ramjibhai Motibhai on 15.10.89 and at that time Ramjibhai had severe neurits, gangrene of fingers and he was in septicimic shock. Subsequently he had examined him lastly on 19.10.89 and at that time he was in terminal stage due to septisimia and was in shock too. When he visited Ramjibhai on 15.10.89 he had told him that he had electric burns and previously had taken treatment of Dr. Tribhuvanbhai N. Patel. In the opinion of Dr. Shah because of the electric burns, the finger tissues had dried and that part had become black. In his opinion Ramjibhai was affected by gangrene and because of the pain he was in shock. He stated that if the circulation of blood is disturbed because of any reason that may result in the gangrene. He also opined that because of electric shocks there was possibility of such gangrene. But he could not say that gangrene must have been the result of electric shock. In his opinion gangrene may result, if the wound is caused because of electric shock and complications arise out of that. He also opined that because of electric shock sometimes complications may occur subsequently. In cross examination by Shri R.R. Panchal, learned Advocate for the Opposite Party, Dr. C.A. Shah stated that he is M.B.B.S. and he is general practitioner at Dehgam. he did not know that Ramjibhai was treated by any other Doctor after the injury but he knew that he was treated by Dr. Tribhuvanbhai N. Patel. He was also shown the case papers by Dr. T.N. Patel. In his cross examination he was shown the report dated 4.5.89 and admitted that there was no reference of gangrene in the said report. He had no contact with Dr. T.N. Patel. In the cross examination he expressed the opinion that there was possibility of gangrene because of the electric shock and there was less possibility of such gangrene because of any other reason. Dr. Shah clearly admitted that he could not say that Ramjibhai had died because of gangrene as he had not seen the dead body. He, however, stated that even without carrying out the post mortem the reason of death could be known but in case the post mortem is done, the reason may be more certain. He had not taken the blood for pathology report and had not seen any such pathology report but only stated by visual examination that Ramjibhai was affected by septisimia and, therefore, he had advised to be taken to hospital. It was his opinion that Ramjibhai was affected by septisimia. THEre was no possibility of laboratory test in village. Septisimia may be because of some other reasons but whatever opinion he has given was because of his clinical knowledge and if at all post mortem would have been carried out, the exact cause of death could have been ascertained. As Dr. Shah relies on some observations at page 245 in the book of ''Modi''s Textbook of Medical Jurisprudence and Toxicology'' he was asked that whether death by septisimia could be ascertained only by post mortem, he stated that inference can be drawn even without post mortem. Dr. Shah has clearly admitted that he could not say as to whether Ramjibhai had died because of gangrene as he had not seen the dead body after Ramjibhai expired. Apart from that, the opinion of Dr. Shah is too general to come to the conclusion that Ramjibhai had expired because of septisimia and that the septisimia was the result of electric burns. It is true that the cause of the death may be ascertained even without the post mortem but for that the other evidence except the post mortem should be clear and cogent to come to the conclusion that the death was only because of the particular accident contended by the party. If no cogent and convincing evidence is forthcoming to ascertain the cause of the death, then the post mortem can be the reliable evidence for the cause of the death. If at all the complainant wanted to claim the insurance amount on the ground that the cause of death was the ultimate result of the accident, she should have got the post mortem of the deadbody of Ramjibhai carried out. We, therefore, hold that the complainant has failed to establish that the death of Ramjibhai was due to septisimia and that septisimia, if at all was caused, was because of the electric burns.

DR. Shah has relied on certain observations by DR. Modi in the above referred book. At page 245 DR. Modi has observed that "sometimes death may follow later due to complications of electrical injury like infection, burns, blunt force injury etc." That possibility cannot be ruled out. But DR. Modi in the same book under the caption "Medico-legal Questions" has also observed that "as a rule, electrocution death case should be sent for complete medicolegal postmortem and the blood sample/viscera should be analysed in order to answer the question as to whether the victim was impaired at the time of accident". As discussed above, the complainant should have got the post mortem carried out to establish the cause of the accidental injury. Dr. V.N. Shah is examined by tht Opposite Party, he is M.B.B.S., M.D. (Medicines) and having private consultation clinic and he is in the panel of the doctors of the Insurance Company. He had seen the treatment papers for the treatment of Ramjibhai. He considered the treatment given by Dr. T.N. Patel. In the opinion of Dr. V.N. Shah late complication of the electric burns, gangrene and septismia will never occur. Considering the reports of other Doctors also, it is stated that Ramjibhai was completely cured of the burns. He also stated that Ramjibhai expired after six months but his death is not because of the burn injuries and the burn injuries had no connection with the death. In the cross-examination Dr. V.N. Shah admitted that he is a Physician. He also admitted that even if burn injuries are cured and septisimia is caused in the internal part, the medical expert would come to know as septisimia would cause fever and the patient would feel local pain. He could not say the reason for the death of Ramjibhai. If more puss is collected in the finger then septisimia may be caused by that. He also could not say the exact reason of the death of Ramjibhai. He has expressed the opinion because of his experience as Doctor and on the basis of the authority referred by him. The expert opinion of Dr. V.N. Shah clearly establishes that the death was not due to septisimia or such septisimia would not be caused such a long period. For the purpose of claim for the accidental death it is obligatory on the claimant to establish the death by accident. The complainant has failed to establish it and, therefore, the complainant is not entitled to claim Rs. 2 lakhs. The Opposite Party Insurance Company has already admitted that it is prepared to pay Rs. 3750/- for the treatment. The complainant, if so desires may accept it. The complaint therefore deserves to be dismissed. ORDER The Complaint is dismissed. Parties to bear their own cost. Complaint dismissed.