SHAKUNTLA Vs. NEW INDIA ASSURANCE COMPANY LTD

JUDGEMENT

(1.) KAPIL Dev aged 58 years possessed a Hospitalisation and Domiciliary Hospitalisation Benefit Policy for the period 24.6.1992 to 23.6.93 in the sum of Rs. 1,50,000/ - and in this regard he had deposited a premium of Rs. 1,500/ -. Kapil Dev allegedly fell from a staircase on 3.9.1992. He died on 30.10.1992. The District Forum -II, Union Territory, Chandigarh ordered on 23.8.1999 for payment of Rs. 6,875/ - together with interest @ 12% p.a. from 1.2.1993 till realization. Aggrieved against this judgment Mrs. Shakuntla, the complainant widow has attempted the present appeal.

(2.) KAPIL Dev aged 58 described in employment was admittedly insured from 24.6.1992 to 23.6.1993. It was a kind of MEDI+CLAIM Insurance Policy. The Scheme -A under which the policy was issued is described as under : "1. Scheme -A Category Category Category Category Category I II III IV V Hospitalisation and Rs. Rs. Rs. Rs. Rs. Domiciliary Hospitalisation Insurance AND Personal Accident 1,500 950 700 Insurance' The relevant part of the statement of Dr. Harinderpal Dewan, aged 42 years, resident of House No. 3067, Sector 26D, Chandigarh, recorded in the Forum is reproduced as under : "The deceased came to me for the first time on 3.9.1992. He disclosed that he had fallen from staircase and received injuries which on examination I detected slip lumber disc. Such a patient can be given treatment at home also. I admitted the patient for doing investigation. Later on he was discharged and given treatment at his residence. During investigation the patient was subjected to complete haemogram, X -ray spine & AP Aleatoral." Besides this other relevant part of the statement is as under : "I do maintain record with regard to patients to whom I give treatment. The record of the present case is no longer preserved by me since after three years I destroy the record." The relevant part of the statement of Kanti Prasad examined in the District Forum is as under : "I am running a tea stall. Deceased used to visit my stall and as such I knew him. I had gone to the house of the deceased at about 1.30 or 2.00 p.m. on 3.9.1992. After fall Sh. Kapil Dev was removed to the clinic of Dr. Dewan. He was transported in a fiat car. I cannot tell the exact cause of the death. It may be due to fall from the staircase. As far as I remember Sh. Kapil Dev remained admitted in the clinic of Dr. Dewan for 5 - 7 days. After the mishap I have visited the house of the deceased on one or two occasions to inquire about his health. As and when I visited the deceased I found him lying on the bed." The oral evidence of the aforesaid two witnesses goes to show that Kapil Dev did have a fall on 3.9.1992 and he was carried to a nearby private clinic of Dr. Harinderpal Dewan. However after a few days he was shifted to his own residence where he died at the end of next month on 30.10.1992. A certificate Annexure C -2 dated 30.10.1992 issued by Dr. Harinderpal Dewan is reproduced as under : "DEWAN CLINIC AND X -RAY. Dr. H.P. Dewan Phone : 42667 Resi. MBBS Ex. PCMS/I, Clinic Regd. No. 21383 Shop No. 1 -2, Gurudwara. Ex. Resident Doctor, Gen. Market, Bapu Dham Sector 26 Hospital Section 16, Chd. CHANDIGARH. Ex. Medical Officer/(Ph), TIMINGS. Authorised Medical Attendent, Morning: Central Govt. Employees. 9.00 a.m. to 12.00 p.m. L.I.C. Evening. Central Warehousing Corp. 4.30 ap.m. to 7.00 p.m. Facility. ForGaynaecoIogy, Dated 30.10.1992 PTS(Patient) Dr. MRS.J.I.SAGGU, m:d. (pgi). X -Ray : Certified that Kapil Dev Garg aged 60 years appx. Expired on 30.10.1992 at 12.20 a.m. due to cardiac arrest due to slip. I was present at that time. E.C.G. Clinical Laboratory Accination Sd/ - Physiotherapy (Dr. Harinder Pal Clinic Res : 3067, Dewan) Sector 27 D, Chd. MBBS Ex. PCMS -I" A perusal of the oral evidence and certificate referred to above shows that the patient did have a fall on 3.9.1992 but obviously the cardiac arrest on 30.10.1992 could not be the immediate result of the fall which Kapil Dev experienced on 3.9.1992.