(1.) THIS appeal under Section 15 of the Consumer Protection Act, 1986, is directed against the order dated 5.11.2004 in Complaint No. 31/2004 by the District Consumer Disputes Redressal Forum, Durg (hereinafter called the 'District Forum' for short) directing the appellant/insurer to pay to the complainant/respondent Rs. 5 lacs with interest @ 9% per annum as also Rs. 500 as cost of the complaint.
(2.) THE deceased insured Pawan Kumar Dhankar was the employee of the Bhilai Steel Plant and member of Indian National Trade Union Congress (hereinafter called the 'INTUC' for short). The appellant/Oriental Insurance Co. Ltd., issued Janta Personal Accident Policy (hereinafter called the 'Janta Policy' for short) to the members of the INTUC. Under the said policy, it was stipulated that, in case of death of the member covered under the policy, in an accident the assured amount of Rs. 5 lacs would be paid by the appellant/insurer. The risk was covered from 9.1.1999 to 8.1.2011. It is also not in dispute that certificate of insurance No. 27809 marked Annexure A -6, filed in this appeal, was issued by the appellant, in favour of the said Pawan Kumar Dhankar. It is further not in dispute that the deceased Pawan Kumar Dhankar died on 14.11.2003, allegedly, while crossing the railway line. The complainant, therefore, lodged a claim with the appellant/insurer, by letter dated 13.1.2004 (Annexure A -28). Her claim was, however, repudiated by the appellant/insurer by their letter dated 16.1.2004 (Annexure A -27) on the ground that the said Janta Policy was cancelled by the appellant by their letter dated 26.11.2001 (Annexure A -14). Feeling aggrieved, by the repudiation as above the complainant approached the District Forum.
(3.) THE complaint was resisted by the appellant/insurer mainly on the ground that the policy was cancelled by their letter dated 26.11.2001 addressed to the INTUC. It was further averred that since the deceased has committed suicide, there was breach of terms of policy and, therefore, the appellant/insurer was not liable to pay the assured amount under the policy.