RAMSAKHI Vs. ORIENTAL INSURANCE COMPANY LIMITED

JUDGEMENT

(1.) This complaint under Sec.12 read with 17 is filed on behalf of the parents of the deceased insured Ram Dayal Singh claiming the amount under the Janta Personal Accident Insurance Policy (hereinafter called the 'janta Policy' for short) issued by the opposite parties.

(2.) It was averred in the complaint that the deceased insured R. D. Singh son of the complainant had obtained Janta Policy No.152501/47/99/00176, as a member of the Steel Workers Union (INTUC), Bhilai. The said policy covered the risk from 9.1.1999 to 8.1.2011. The assured amount under the said policy was Rs.5 lacs which was payable in case of accidental death of the insured. The premium of the policy was duly paid by the insured. According to averments in the complaint Ramdayal Singh while travelling by train, met with an accident near Allahabad, as he slipped down from the train and was over run by it. The accident as above proved fatal. The claim was submitted by the complainant No.1 to the opposite party on 5.10.2000. However, the claim has still not been settled despite notice served on the respondents.

(3.) The opposite parties insurer resisted the complaint. It was averred that documents viz. , FIR, post-mortem etc. submitted by the complainant did not bear the name of the victim, therefore, the investigation on the claim was necessitated. According to the opposite party they appointed investigator Anurag Mishra to investigate the matter. It was denied by the opposite parties/insurers that the deceased Ramdayal Singh died in train accident as averred by the complainant. It was further averred that the claim could not be settled earlier, due to delay in investigation by the Surveyor. It was further averred by the opposite parties by way of amedment that though the complainant had specifically stated and declared that the insured Ramdayal Singh did not take any group personal accident insurance policy, from any other company but during investigation it was revealed that the said declaration of the complainant was wrong and that the deceased had taken another group insurance policy from United India Insurance Company ensuring for the period from 7.5.1998 to 5.5.2003. It was, therefore, averred that the deceased obtained the insurance policy by suppressing aforesaid material facts.