Gitaben vs NATIONAL INSURANCE CO. LTD.

PETITIONER herein, who was the complainant before the District Consumer Disputes Redressal Forum, Ahmedabad (Rural) District, Ahmedabad, Gujarat (hereinafter referred to as the District Forum'' for short), being aggrieved by the Order dated 7.10.2005 passed by the State Consumer Disputes Redressal Commission, Ahmedabad, Gujarat (hereinafter referred to as the State Commission'' for short) in Appeal No. 1298 of 2004, has filed the present Revision Petition. By the impugned Order, the State Commission has reversed the Order passed by the District Forum and held that the petitioner is not entitled to the insured amount as the husband of the petitioner did not die because of an accident.

BRIEFLY stated, the facts of the case are: Deceased Dharmendrasinh Jitubhai Chudasama, husband of the petitioner/ complainant had taken a Janta Group Policy No. 01931/003/149/98 -99 from the respondent -Insurance Company in the sum of Rs. 5,00,000. The facts set out in the complaint are that the husband of the petitioner had gone to take bath in the Patadiya (Kund) situated at Dholera. While bathing, he slipped and, on account of the same, he sustained serious injuries on his head and was taken to a local Doctor, who after examining him, referred him for treatment to Rana Surgical Hospital at Bhavnagar where his CT Scan was done. Doctors at Bhavnagar advised the attendants of the patient to take him to Ahmedabad. On his way to Ahmedabad, he succumbed to his injuries on 11.11.1999. He was brought back to the village and cremated without getting the post -mortem done. F.I.R. was lodged on 15.11.1999. Petitioner filed an insurance claim with the respondent -Insurance Company, which was repudiated on the ground that the petitioner has failed to prove that her husband had died due to any accident. That no post -mortem was got done and the F.I.R. was also registered later after 4 days of death. Being aggrieved, petitioner filed a complaint before the District Forum.

DISTRICT Forum, relying upon the history recorded by Dr. Rana at Bhavnagar, held that the death was accidental and, accordingly, allowed the complaint. Petitioner was directed to pay a sum of Rs. 5,00,000, i.e., the insured amount along with interest @ 9% p.a. from the date of filing of the complaint till realisation. Rs. 10,000 were awarded towards mental harassment and Rs. 5,000 were awarded as costs which were to be paid within one month. Aggrieved by the Order passed by the District Forum, respondent -Insurance Company filed an Appeal before the State Commission, which has been allowed by the impugned Order.

STATE Commission has set aside the Order passed by the District Forum and dismissed the complaint. It has been held that petitioner''s husband did not die due to an accident. That the post -mortem was not got done and the Affidavit of the Doctor, who had examined the deceased at Bhavnagar, had not been filed. That documents produced were required to be proved by filing the Affidavit of the Doctor who had examined the petitioner''s husband. That the death of petitioner''s husband was due to "cerebral" haemorrhage from which it could not be concluded that the death occurred due to an accident.

LEARNED Counsel for the parties have been heard at length.

ONUS to prove that the deceased had died due to the injury suffered by him was on the petitioner. Petitioner/complainant was not present at the time of the alleged accident. Any person who may have been present at the time of the alleged accident has also not been produced as witness. Local Doctor who had examined the deceased in the village has not been produced. Dr. Rana, to whose Clinic the deceased was taken, has also not been produced. Post -mortem was also not got done. Counsel for the petitioner relies upon three documents -(i) The Certificate issued on 16.11.1999 by Dr. Rana; (ii) CT Scan Report; and (iii) Discharge Summary -to contend that the deceased had suffered injuries, which resulted in "cerebral haemorrhage". These documents have been placed as Annexures B'', C'' and D''. Production of documents is one thing whereas proof of documents is another. State Commission, in its Order, has recorded that the petitioner has not proved these documents. No witness, who could identify the handwriting of Dr. Rana, has been produced. We agree with the view taken by the State Commission that the petitioner has failed to prove the above -mentioned documents.

BE that it may, we have examined all the three documents. In the certificate issued by Dr. Rana, it has been mentioned that the deceased had suffered "cerebral haemorrhage". He does not state in the certificate that the deceased had suffered an injury because of which he suffered the "cerebral haemorrhage". CT Scan Report also shows that the deceased had suffered from "subarachioid (sic) haemorrhage". In the Discharge Summary, Dr. Rana does not mention about any injury. The only thing mentioned by him is that deceased had allegedly fallen in Patadiya (Kund). He does not mention about any injury or the region in which the injury was suffered. These documents do not prove that the husband of the petitioner had suffered "cerebral haemorrhage" because of the sudden fall in Patadiya (Kund).

THE Insurance Company had appointed an Investigating Agency to hold inquiry. It had also taken the opinion of Dr. Mayank Patel as to the cause of the death. Both, the Investigating Agency and Dr. Mayank Patel, opined that the death was not due to an accident. The Report of the Investigating Agency as well as the opinion of Dr. Mayank Patel cannot be taken into consideration as the Insurance Company has also failed to prove these documents by producing the Investigator and Dr. Mayank Patel. No reliance can be placed on the Report of the Investigating Agency or Dr. Mayank Patel as neither the Investigator nor Dr. Mayank Patel were produced.

WE agree with the view taken by the State Commission that the petitioner has failed to prove that the deceased had suffered "cerebral haemorrhage" because of the injury suffered by him while bathing. There is no infirmity in the Order passed by the State Commission.

FOR the reasons stated above, we do not find any merit in this Revision Petition and dismiss the same leaving the parties to bear their own costs.