LAWS(NCD)-2004-3-324

MOHIT BATRA Vs. ORIENTAL INSURANCE COMPANY LIMITED

Decided On March 09, 2004
MOHIT BATRA Appellant
V/S
ORIENTAL INSURANCE COMPANY LIMITED Respondents

JUDGEMENT

(1.) This complaint has been filed by Shri Mohit Batra seeking issuance of direction to the Oriental Insurance Company Limited (for short hereinafter referred to as the Insurance Company) both through Regional Manager, Divisional Office-II, SCO No.48-49, Sector 17-A, Chandigarh and its Branch Manager, SCO No.40, Sector 7, Panchkula to pay a sum assured under the Janta Personal Accident Policy (for short hereinafter referred to as the Policy) bearing No.47/1999/23-CH-76114 with interest @ 18% per annum together with a sum of Rs.50,000/- as compensation for mental agony and harassment etc.

(2.) The aforesaid policy was taken on 4.5.1998, which covered the risk of the life of the complainant who paid a sum of Rs.855/- as the premium. The risk of the life of the complainant was secured for five years w. e. f.4.5.1998 to 3.5.2003 vide copy Annexure C-1. The complainant is a qualified Civil Engineer and was posted in Gujarat. He came to Panchkula in February 2001 from Ahmedabad to attend marriage of his sister-in-law. It has been alleged that on 27.2.2001, he had gone to take certain photographs of the houses constructed in Panchkula, which could be suitable for earthquake prone area in Gujarat and while doing so he slipped from the Bajri and fell inside the railway track and his both legs were crushed by the train coming from the side of Amabala. Due to this accident, he became 100% disable vide Certificate Annexure C-2. A claim was filed by the complainant for payment of sum assured under the policy of insurance with the Insurance Company/o. Ps. who repudiated his claim on the ground that the condition of the policy was not fulfilled inasmuch as he tried to commit suicide and was not involved in any accident. This led to the filing of the complaint.

(3.) The O. Ps.-Insurance Company filed joint written statement. In the preliminary objection, it was contended that the complainant had not approached the Commission with clean hands inasmuch as, as per the terms and conditions of the policy, the claim is payable only in case of death or disablement is the result of an accident caused by external violation and visible means i. e. , fire, drowning, road fall accident, electrocution, etc. etc.