SEEMA Vs. NEW INDIA ASSURANCE CO. LTD.

JUDGEMENT

(1.) This revision petition has been filed under section 21(b) of the Consumer Protection Act, 1986 against the impugned order dated 29.2.2012, passed by the Punjab State Consumer Disputes Redressal Commission (for short 'the State Commission') in First Appeal No. 140 of 2009, "The New India Assurance Co. Ltd. & Anr. vs. Mrs. Seema", vide which, while allowing the appeal, the order dated 11.12.2008, passed by the District Consumer Disputes Redressal Forum, Jalandhar, in complaint no. 10 of 2008, allowing the said complaint, was set aside.

(2.) Brief facts of the case are that Rajesh Mehta, husband of complainant/petitioner had taken individual personal accident insurance policy from the respondent/opposite party/insurance company, covering risk on his life for Rs. 1 lakh, on his wife, Seema for Rs. 2 lakhs and on his two children for Rs. 50,000/- each. The proposal form was filled by Rajesh Mehta on 22.12.2003. It has been stated that the said Rajesh Mehta was found dead under mysterious circumstances near Chaheru bridge on Jalandhar-Phagwara G.T. Road by a police patrolling party, for which FIR No. 32 dated 07.05.2003 was registered at Police Station Sadar, Phagwara and post-mortem examination was also conducted. The inquest report conducted under section 174 Cr.P.C. revealed that cause of death was due to intake of alcohol and wound mark (injury) was found on his dead body, as per the post-mortem report. The report from the Chemical Examiner, Govt. of Punjab, Patiala revealed that aluminium phosphide was detected in the liver, spleen and kidney of the deceased. In the sample of blood, taken from the body of Rajesh Mehta, aluminium phosphide was found. The Insurance company repudiated the claim vide their letter dated 21.05.2004, saying that the claim was not payable under the terms and conditions of the policy as Rajesh Mehta was under influence of intoxicating drugs, at the time of his death. The consumer complaint in question was then filed before the District Forum, claiming payment of Rs. 1 lakh alongwith interest @ 18% per annum and compensation of Rs. 50,000/- and Rs. 10,000/- for cost of litigation. In their reply, before the District Forum, mention was made about exception 5 in the conditions of insurance policy and it was stated that since the death resulted, because of taking poisonous substance aluminium phosphide, the claim was not covered by the insurance policy. However, the District Forum, after taking into account, the evidence of the parties allowed the complaint and directed the respondent/opposite party to pay insurance claim of Rs. 1 lakh alongwith interest @ 9% from the date of final repudiation till realisation and Rs. 4,000/- as compensation, on account of deficiency in service and Rs. 1,000/-, as cost of litigation. An appeal was filed against this order before the State Commission, which was accepted and the order of the District Forum was set aside. It is against this order that the present petition has been made.

(3.) At the time of hearing, the learned counsel has drawn attention to the written reply, filed by the respondent/opposite party before the District Forum, saying that from the said reply, it was clear that as per the post-mortem report, the cause of death was due to intake of alcohol, whereas as per the report of Chemical Examiner, Aluminium Phosphide was detected in various parts of the body of the deceased. The District Forum had come to the right conclusion saying that the Insurance Company had not been able to produce cogent and convincing evidence to establish death by suicide. Since the mystery behind the death of the deceased had not been solved by police investigation or by evidence produced by the Insurance Company, the claim was payable. The learned counsel stated that in the impugned order, the State Commission had not carried out a correct appreciation of the facts and circumstances on record.