DEBENDRANATH NAYAK Vs. NEW INDIA ASSURANCE CO LTD

JUDGEMENT

(1.) Aggrieved by the dismissal of his complaint, C. D. Case No.44/2000, vide order dated 02.05.05 passed by the Orissa State Consumer Disputes Redressal Commission, Cuttack, the original complainant has filed this appeal.

(2.) The case of the complainant is that his wife, Smt. Sabita Sahoo @ Nayak had taken a Janata Personal Accident Insurance Policy No.47550700025 on 3.11.97 in the sum of Rs.5 lakh. It was alleged that during the validity of the said policy, in the intervening night of 12/13.12.98, the insured, Smt. Sabita Sahoo @ Nayak died due to drowning in a well when she had gone to answer the call of nature. Her body was recovered in the morning, inquest proceedings were conducted and body was subjected to post mortem examination. Post mortem examination report gave the cause of death of the deceased as asphyxia due to drowning. Based on the enquiry and the said report, the police submitted the final report. It would appear that originally Mr. Jyoti Parkash Sahoo, father of the deceased insured was declared as the nominee but later, pursuant to a request made by the complainant, he was declared nominee in place of Jyoti Parkash Sahoo. Accordingly, the complainant lodged a claim with the insurance company seeking payment of the payable amount under the policy. After protracted correspondence and despite supply of several documents, as asked for by the insurance company, the insurance company ultimately repudiated the insurance claim vide letter dated 30.09.99 primarily on the ground that Late Sabita Sahoo suffered death due to intentional self injury caused by insanity and, therefore, the claim was not payable as per clause 4 (c) of the Janata Personal Accident Insurance policy.

(3.) The insurance company resisted the complaint by filing written version in which it did not dispute the factum of the issue of Janata Personal Accident Policy in the sum of Rs.5 lakh as also death of the insured, late Savita Sahoo @ Nayak in the intervening night of 12/13.12.98. However, repudiation of the claim was sought to be justified on the ground that at the time of taking the policy the insured had not disclosed certain material facts in regard to her mental state. It was pleaded that the deceased was suffering from a certain disability, viz. , insanity and non-disclosure of such a disability amounted to suppression of material facts which rendered the insurance policy void. The circumstances in which the complainant claimed that the insured, Smt. Sabita Sahoo died were also denied on the ground that version of the complainant was improbable. It was also alleged that the insured might have jumped into the well due to the said mental disability. It was denied that the complainant was entitled to any claim under the said policy, much less any compensation for mental agony and harassment.