RASHMI JALOTA Vs. NEW INDIA ASSURANCE CO LTD

JUDGEMENT

(1.) The true import and scope of a Group Personal Accident Policy issued by the nationalized Insurance Companies is the larger significant question in this complaint. More pointedly at issue is the controversy whether the death of the widowed complainant's husband was caused by an accident or other wise?

(2.) Learned Counsel for the parties are unreservedly agreed that herein there is no dispute whatsoever on facts. These may, therefore, be noticed with relative brevity. The Late Shri Yogesh C. Jalota, the husband of the complainant was an employee of the Yamuna Syndicate Limited (Opposite Party No.3 ). The said concern through M/s. Escorts Dealers Development Association Ltd. (Opposite Party No.2) had taken out a Group Personal Accident Insurance Policy for its employees with the New India Assurance Company Limited (Opposite Party No.1 ). It is common ground that Shri Jalota was fully covered by the said policy.

(3.) Shri Y. C. Jalota (hereafter called the deceased) alongwith another co-employee Shri Sudhir Mohan had accompanied Shri Ramesh Malhar, the Managing Director of the Yamuna Syndicate Limited on an official visit to Bangalore in August 1990. Shri Sudhir Mohan and the deceased were staying in one room in a hotel in Bangalore and on the morning of the 12th of August, 1990 both of them left the hotel in the course of their official duties. While they were walking along a cinema hall called 'pallavi at about 11.30 a. m. , the right knee of the deceased forcibly dashed against the panel of a cycle resulting in the dislocation of the patela and causing acute pain and agony to him. His companion Sudhir Mohan managed to put him in a motor vehicle (the deceased was unable to stand) and immediately took him to the well known St. Martha Hospital in Bangalore. Because the deceased complained of acute chest pain apart from the injury on the knee, the hospital staff carried out certain investigations including an E. C. G. of the heart of the deceased. Owing to the broken tissues of the knee and patela, the doctor thought it necessary to put the whole of his right leg and thigh in plaster. During this process the deceased complained about acute chest pain, but apparently because the E. C. G did not disclose any serious heart injury, he was given a sedative and after a bed rest of about two hours at the St. Martha Hospital was discharged there from around 2.30 p. m. The deceased on a stretcher was put in an ambulance and taken to his hotel, but before he could reach his room he started feeling very uneasy and started breathing hard and ultimately fainted. Noticing his serious condition Sudhir Mohan immediately rushed him back to the same hospital in the same ambulance van, where the deceased was attended to in the emergency ward. However, despite all medical aid the deceased could not survive and died of cardiac arrest around 3.30 P. M on that very day.