BRANCH MANAGER, LIFE INSURANCE CORPORATION OF INDIA vs NIRMALA DEVI

THIS is an appeal against the judgment and order dated 1.9.1999 passed by District Consumer Forum, Ghazipur in Complaint Case No. 77/1998.

THE facts of the case stated in brief are that the complainant''s husband was insured for a sum of Rs. 50,000/- alongwith bonus etc. All the premiums were paid in time. THE policy had commenced on 28th July, 1994. According to the complainant, late Gorakhnath Singh was admitted to District Hospital, Ghazipur on 25.9.1996 at about 5.00 a.m. and died on the same day at 5.30 p.m. THE death certificate was obtained and thereafter the complainant who was the nominee in the policy filed a claim before the Insurance Company which has been repudiated. The opposite party in the written version has alleged that the deceased had suppressed material facts. The deceased was consuming liquor and on account of this his liver was damaged. He died on account of this illness. In the proposal form it was writen that the deceased never took liquor.

The learned District Forum after considering the case of the parties came to the finding that there is deficiency in service and hence it decreed the claim for Rs. 50,000/- alongwith bonus etc. to be paid within a period of one month.

AGGRIEVED against the order of the learned District Forum, Life Insurance Corporation of India has come in appeal and has challenged the correctness of the order passed by the Forum. We have heard the learned Counsel for the appellant. Learned Counsel for the appellant has argued that the deceased was brought to the hospital in a coma stage and the general condition was low. According to the learned Counsel the doctor reported that the patient was a known alcoholic and had died on account of this illness. The note filed by the learned Counsel for the appellant will go to show that the patient was admitted at 5.10 a.m. and he died at 5.30 p.m. In the notes which was prepared at the time of admission, it was not mentioned anywhere that the deceased was smelling of alcohol or anybody told the doctor concerned that the patient used to take alcohol. In the death certificate also it is mentioned that when the patient was admitted he was in coma with low general condition. In the hospital treatment certificate, this fact has also been mentioned. Learned Counsel for the appellant has placed reliance on the report of doctor dated 27.2.1998 which has been given on the basis of bed head ticket. This bed head ticket has not been produced before the learned District Forum in order to show as to who disclosed that the deceased was consuming alcohol and his condition had become so on account of that fact. When the bed head ticket has not been produced, a certificate based on that ticket carries no weight. The wording is as under : "In this case it seems that the life assured was taking alcohol for a long period, i.e. years together and that has damage his liver and this liver damage has caused coma with internal bleeding and death."

THAT the opening words are "it seems". Therefore, the doctor who has written this report is not certain whether the deceased was regularly taking alcohol. Besides this report, there is no other document on record to prove this fact. No blood test of the deceased was got done to show presence of alcohol in his blood. No post-mortem examination of the deceased was done to show that the liver of the deceased had stopped functioning and was severely damaged on account of consumption of liquor. No affidavit has been filed by the doctor who had written on the bed head ticket that the deceased was consuming liquor. Therefore, in the absence of any evidence it cannot be said that the deceased was consuming liquor and he died on account of damage to the liver. The Life Insurance Corporation has repudiated the claim without any basis and without investigating the facts of the case. Therefore, the judgment and order of the learned District Forum are perfectly right and needs no interference. The appeal is, therefore, liable to be dismissed. ORDER The appeal is dismissed and the judgment and order of the learned District Forum are confirmed. Let compliance of this order be made within a period of two months from the date of this order. Let copy as per rules be made available to the party. Appeal dismissed.