PADMABATI BEHERA Vs. ORIENTAL INSURANCE CO LTD

JUDGEMENT

(1.) BOTH the cases have been filed under Section 12 of the Consumer Protection Act, 1986 in short C.P. Act, by two different complainants for deficiency in service of the Oriental Insurance Company Ltd. represented through its Sr. Divisional Manager, and Branch Manager, Oriental Insurance Co. Ltd., Mochisahi Square, Puri, hereinafter be called as opposite party Nos. 1 and 2 respectively, in settling the death claim of late Biranchi Narayan Behera.

(2.) A common judgment is passed in both the cases for convenience, as the cases are heard analogously in one day.

(3.) THE specific case of Padmabati Behera and opposite party No. 3 is that the Group Personal Accident Insurance Scheme in short G.P.A.I.S. assures the family members of the insured to give 3 lakh rupees on event of death of an insured. Said Biranchi met with an accidental death due to electric shock on 19.12.2000 at 11 a.m., when he was discharging his duty in repairing the electric line under the Budhapal Electrical Section of Deogarh Electrical Sub -Division, Deogarh. After this matter was reported at Kundaigola Police Station, U.D. Case No. 3 of 2000 was registered and post mortem on the dead body was conducted through a doctor and evidence of witnesses was recorded by the police. Ultimately, the police submitted final form with information that accidental death occurred to Biranchi due to electric shock while connecting fuse in the Palrama Feeder and there is no suspicion of foul play. The opposite party No. 3 submitted claim on behalf of said Padmabati before opposite party Nos. 1 and 2 on 9.2.2001 which is expected to be settled within seven days from the receipt of the claim. But, opposite party No. 1 vide its letter dated 11.10.2001 (Annexure -3) requested opposite party No. 3 to provide the viscera report of Biranchi for finalizing the claim as the Final Form submitted by police discloses that Biranchi was in drunken state and died on sheer negligence. Though the Medical Officer in short M.O.H.C. Chhedeipada, C.H.C., Dist. Angul vide his letter (Annexure 4) dated 22.11.2001 and A.S.I., Kundaipali out post vide his letter (Annexure 5) dated 12.11.2001 in reply to the further inquiry by opposite party No. 3 about the cause of the death of Biranchi, reported that the cause of death of Biranchi is not due to his own negligence but due to electric shock for which the viscera was not sent for examination yet, opposite party Nos. 1 and 2 knowing about the same sat over the matter for long time. Ultimately, opposite party No. 2 rejected the claim vide letter dated 25.2.2002 (Annexure 7) on the ground that Biranchi died due to his drunkenness for which the claim cannot be settled in view of the exclusion clause of the scheme. But there was no cogent and satisfactory evidence before opposite party No. 2 to form such opinion. Therefore, each of the complainant of both these C.D. cases claimed the insured amount of 3 lakh, interest @ 24% per annum on the insured amount from 19.12.2000, Rs. 1,08,000 towards mental agony and harassment of family members of Biranchi, expenses towards journey and correspondence and cost of litigation in total Rs. 6,38,000 and Rs. 6,33,000 respectively, to which complainant Padmabati Behera is entitled.