ORIENTAL INSURANCE CO LTD Vs. GANGU BAI

JUDGEMENT

(1.) The present revision petition has been filed by the Oriental Insurance Company Ltd. (hereinafter referred to as the 'Petitioner') against the order of the State Consumer Disputes Redressal Commission, Andhra Pradesh (hereinafter referred to as the 'State Commission') which accepted the appeal of one Smt. Gangu Bai (hereinafter referred to as the 'Respondent') who was the original complainant before the District Forum.

(2.) The facts of the case are that one Ram Singh, husband of the Respondent was a Member of PACCS Ltd. (hereinafter referred to as the 'Society') and had opened an account therein. Under a scheme available with that society, the said Ram Singh had taken a Group Insurance Policy for Rs. 1,25,000 under which the society deducted the required premium from his account and remitted it to the Petitioner/ Insurance Company According to the Respondent, on 20.2.2001, her husband on his way to the agricultural field accidentally fell into a well and drowned. An FIR was lodged with the police and a post-mortem was conducted which indicated the cause of death asphyxia because of drowning. The police investigated the case and concluded that it was a clear case of accidental death due to drowning. Respondent, therefore, filed a claim with the Petitioner Insurance Company through the society which repudiated the claim as being fraudulent. According to the Petitioner/ Insurance Company, during the investigations conducted by an investigator appointed by it, on-the-spot inquiries revealed that it was a case of suicide because the deceased was depressed, having been suspended from duty and also a case of fighting with a colleague was registered against him which was pending in the Court of a Judicial Magistrate. Since the insurance policy taken by the deceased covered only death in case of injury or accident caused by violent and visible means, the claim was according to the Petitioner, rightly repudiated.

(3.) Aggrieved by this, Respondent filed a complaint before the District Forum which dismissed the complaint by concluding that in all probability the deceased intentionally threw himself in the well to commit suicide. Aggrieved by this order, Respondent filed an appeal before the State Commission which was allowed. The relevant part of the order of the State Commission reads as follows: