BHARTIBEN DAHYABHAI PATEL vs Life Insurance Corporation of India

THIS appeal arises from order dated 3.2.1998 rendered by the learned Consumer Disputes Redressal Forum, Ahmedabad City, Ahmedabad dismissing Complaint bearing No. 670 of 1995 on the ground that the opponent Life Insurance Corporation of India (LIC) had made payment as per the discharge voucher issued by the complainant in full and final settlement of the claim.

IT would appear that one Dahyabhai Patel was insured for Rs. 50,000/- with the opponent LIC of India and the policy of insurance was coupled with accident benefit. He died on 26.2.1993 resulting into the complainant widow of the deceased insured preferring claim under the policy of insurance in question. Admittedly, the opponent LIC of India issued discharge voucher in June, 1993 which was signed and transmitted by the complainant on or around 7.6.1993. On the strength of the discharge voucher, the opponent LIC issued payment of Rs. 50,000/- on or around 10.7.1993. The complainant approached the learned Forum in 1995 by way of the aforesaid complaint alleging that she was illiterate and, therefore, on account of ignorance she signed the discharge voucher and received payment as aforesaid. According to her stand it was accidental death of her husband - the insured and, therefore, she was entitled to accident benefit in the sum of Rs. 50,000/- over and above interest and cost. The opponent resisted the complaint canvassing the unqualified discharge voucher issued by the complainant as also unqualified payment received by the complainant. Opponent LIC also resisted the complaint on the ground that the death of the insured was natural death and the complainant did not set out the particulars about the alleged accidental death in the claim form. The complainant did not set out the particulars of the illness and/or the accidental fall in the claim form. Considering the material placed on record, and after hearing the parties, the learned Forum came to the conclusion that on perusal of the claim form death of the insured was stated to be brain haemorrhage. The complainant did not state in the claim form that the insured died on account of a fall while coming out of the bath room. The complainant also did not set out the fact that the insured sustained injuries on occipital region of his head. The learned Forum, therefore, came to the conclusion that there was no deficiency in service on the part of opponent LIC of India. We have heard the learned Advocates appearing for the parties. We have gone through the certificate of Dr. Ranjit V. Acharya. We propose to consider the certificate even though there was no affidavit filed before the learned Forum as also before us. The certificate would indicate that the person was admitted to Karnavati Hospital under the treatment of said doctor who is MD [Med.], FICA [USA] and the doctor has certified the cause of death to be ''sub-arachloid haemorrhage''. Such type of haemorrhage could have occurred also on account of hypertension/diabetes. To that extent there is no evidence worth the name so as to indicate the cause of death to be accidental. Dr. M.K. Joshi, Member-At this stage I would propose to make a note that ''sub-arachloid haemorrhage'' is internal haemorrhage and can hardly occur by head injury. If at all there was any fall, it might be due to such haemorrhage.

To continue with this order, it would further appear that the complainant had accepted the amount after issuing the discharge voucher and sat silent for considerably long period as can be seen from the aforesaid dates. The case is not one of fraud or coercion or undue influence. The case is also not of mutual mistake of fact on the part of both the parties. Opponent LIC of India is not shown to be under any mistake of fact either with regard to the nature of the policy or with regard to the nature of death. Even the complainant has presented herself with a half-hearted submission of fact saying that the insured died accidental death but her stand is not supported by either medical evidence or by any evidence which would have indicated facts. Even the case papers are not before the learned Forum or before this Commission so as to indicate that any history with regard to accidental death was given to concerned doctor under whose care the injured was admitted in Karnavati Hospital. There is no statement of fact regarding any mark of external injury, not even haematoma. Be that it may, having assessed the whole factual aspect of the matter, we are of the opinion that the learned Forum has not committed any mistake in reaching to the conclusion that opponent LIC of India was not deficient in service.

IN the result, this appeal is dismissed, with no order as to costs. Appeal dismissed.