SUSHILA CHAUHAN Vs. NATIONAL INSURANCE CO LTD

JUDGEMENT

(1.) Late B.S.Chauhan, husband of the Revision Petitioner was an employee of Cimmco Birla India Ltd. and as such, covered under a Group Personal Insurance Policy taken by the Company. As seen from the record, on 17.9.1997 during night hours, Shri Chauhan fell down the stairs and suffered head injuries. At about 10:55 PM he was shifted to Government Hospital Bharatpur and expired there, soon after at 11:50 PM. Respondent/National Insurance Company Ltd. repudiated the claim on 28.3.1998, on the ground that as per the post-mortem report, the deceased was under alcoholic intoxication.

(2.) District Forum, Bharatpur, allowed the Consumer Complaint filed against repudiation of the claim and the insurance company was directed to pay the claim amount of Rs.2,28,816/- with 9% interest from the date of repudiation. The Complaint, to the extent it related to the employer, was dismissed.

(3.) While allowing the complaint, the District Forum has noted that as per the report of the surveyor/investigator appointed by the Insurance Company, Shri Chauhan had died of head injury sustained in the fall. It was therefore incumbent upon the Insurance Company to obtain the viscera examination report and to take it into consideration. This was not done. The Complaint was rejected on the ground of post-mortem report only which had noted smell of alcohol. The District Forum held that it cannot be the basis for rejecting the claim under the policy.