NEW INDIA ASSURANCE CO LTD Vs. KAUSHALYA DEVI

JUDGEMENT

(1.) -In this revision, challenge is to the order dated 14.9.2006 of H.P. State Consumer Disputes Redressal Commission, Shimla, Camp at Mandi allowing appeal against the order dated 20.12.2005 of a District Forum and directing the petitioner to pay amount of Rs. 2,00,000 with interest @ 6% p.a. from the date of filing of complaint to the respondents. The District Forum had relegated the respondents to Civil Court for redressal of their grievances.

(2.) Facts giving rise to this revision lie in narrow compass. Devi Ram, husband of respondent No. 1 and father of respondent Nos. 2 and 3 complainants was working as Beldar in I and PH Department of Himachal Pradesh Government. He was insured under the Group Personal Accident Insurance Scheme for a sum of Rs. 2,00,000 with the petitioner/opposite party Insurance Company. It was alleged that on 11.11.2003 while cleaning Kuhal Devi Ram fell in a deep pit of Kuhal water and died due to asphyxia as a result of drowning. Claim made was repudiated by the petitioner through the letter dated 31.5.2005. Complaint filed thereafter, by the respondent seeking certain reliefs was contested by the petitioner by filing written version. It was alleged that Devi Ram after suffering epileptic fit fell into Kuhal and died and it being not accidental death the case was not covered under the policy and was, thus, rightly repudiated.

(3.) Submission advances by Mrs. Pankaj Bala Verma for petitioner is that Devi Ram had suffered epileptic fit before he fell and died due to asphyxia as a result of drowning on 11.11.2003 and death not being submission, attention was drawn particularly to the certificate issued by Assistant Engineer, I and PH Sub-division, Kanaid, District Mandi (copy at page 26). In this certificate against column No. 3 it is stated that death of Devi Ram was caused due to epileptic fit. Respondents alleged that while cleaning Kuhal, Devi Ram had slipped and fell into a deep pit of Kuhal water and died due to asphyxia as a result of drowning. Burden to prove that Devi Ram before fall had an epileptic fit was on the petitioner Insurance Company. To be noted that the basis for forming the opinion that death of Devi Ram was caused due to epileptic fit has not been disclosed in aforesaid certificate. Insurance Company has not led any evidence in regard to Devi Ram having received any treatment for epilepsy at any time prior to his death. State Commission had, thus, rightly not placed any relevance on the certificate at page 26. There is no illegality or jurisdictional error in the order of State Commission holding the petitioner Insurance Company liable to pay the assured amount the claim being covered under the policy.