GEETA JEEVNANI Vs. ORIENTAL INSURANCE COMPANY LIMITED

JUDGEMENT

(1.) Smt. Geeta Jeevnani has filed this complaint under Sec.17 (a) (i) of the Consumer Protection Act, 1986 (for short the "act") attributing deficiency in service to and claiming Rs.5,60,000/- with interest from, respondent-the Oriental Insurance Company Ltd.

(2.) Complainant is widow of late Dilip Kumar who was insured with the respondent for a sum of Rs.5,00,000/- against accidental death under a policy titled as Janta Personal Accident Insurance Policy taken out by late Dilip Kumar from the respondent on 14.11.1996. The period of insurance was from 14.11.1996 to 13.11.2007. It is also no more in dispute that late Dilip Kumar on 29.3.1997 around 4:00 p. m. died an accidental death due to drowning in Kerwan Dam 35 kms. away from Bhopal. A report of the incident was lodged with the police, the same evening at 4.30 p. m. It appears that the body of the deceased was taken out from the water the same evening. The police after conducting inquest under Sec.174, Cr. P. C. on 30.3.1997 at 10.00 a. m. handed over the body of the deceased to the Department of Forensic Medicine and Toxicology, Gandhi Medical College, Bhopal for post-mortem examination. The autopsy was performed the same morning at 10.15 a. m. and it was reported that the death was due to asphyxia as a result of drowning. The blood and viscera of the deceased were also preserved and later, on 31.3.1997 analysed chemically. As per the Chemical Examination Report it was found that there was alcohol in concentration of 100 mg% in stomach, 130 mg% in viscera and 130 mg% in blood.

(3.) Complainant, the widow of the deceased and who was also nominee under the insurance policy, presented claim before the respondent-Insurance Company for the assured sum. However, the respondent - Insurance Company after certain investigations repudiated the entire claim vide letter dated 17th February, 1998 on the ground that the deceased at the time of the drowning was under the influence of liquor and the claim was, therefore, hit by proviso 4 of the terms and conditions of the policy. Feeling aggrieved by the action of the respondent - Insurance Company the complainant has come up before this Commission claiming Rs.5 lacs as the amount assured, Rs.50,000/- as compensation and Rs.10,000/- towards miscellaneous expenses.