ORIENTAL INSURANCE CO LTD vs Gangu Bai

MRS. Vineeta Rai, Member-The present revision petition has been filed by the Oriental Insurance Company Ltd. (hereinafter referred to as the ''petitioner'') against the order of the State Consumer Disputes Redressal Commission, Andhra Pradesh (hereinafter referred to as the ''State Commission'') which accepted the appeal of one Smt. Gangu Bai (hereinafter referred to as the ''respondent'') who was the original complainant before the District Forum.

THE facts of the case are that one Ram Singh, husband of the respondent was a Member of PACCS Ltd. (hereinafter referred to as the ''Society'') and had opened an account therein. Under a scheme available with that society, the said Ram Singh had taken a Group Insurance Policy for Rs. 1,25,000 under which the society deducted the required premium from his account and remitted it to the petitioner/Insurance Company According to the respondent, on 20.2.2001, her husband on his way to the agricultural field accidentally fell into a well and drowned. An FIR was lodged with the police and a post-mortem was conducted which indicated the cause of death asphyxia because of drowning. The police investigated the case and concluded that it was a clear case of accidental death due to drowning. Respondent, therefore, filed a claim with the petitioner Insurance Company through the society which repudiated the claim as being fraudulent. According to the petitioner/Insurance Company, during the investigations conducted by an investigator appointed by it, on-the-spot inquiries revealed that it was a case of suicide because the deceased was depressed, having been suspended from duty and also a case of fighting with a colleague was registered against him which was pending in the Court of a Judicial Magistrate. Since the insurance policy taken by the deceased covered only death in case of injury or accident caused by violent and visible means, the claim was according to the petitioner, rightly repudiated.

AGGRIEVED by this, respondent filed a complaint before the District Forum which dismissed the complaint by concluding that in all probability the deceased intentionally threw himself in the well to commit suicide. Aggrieved by this order, respondent filed an appeal before the State Commission which was allowed. The relevant part of the order of the State Commission reads as follows: "We have gone through the material on record. The contention of opposite party No. 2 that the deceased was suspended from duty four years prior to his death and therefore was depressed is unsustainable. The investigation report Ex.A. 3 filed by the opposite parties is not supported by any affidavit or substantial documentary evidence. Even the FIR states that the deceased person fell down in the well and that it is an accidental death. The post-mortem examination states that the death was caused due to asphyxia as a result of drowning and even the police final report dated 28.2.2001 states that it is a clear case of accidental death due to drowning. The final report of the police clearly states that there is no foul play suspected by anybody and that it is an accidental death due to drowning. Taking into consideration the FIR, the final report of the police and the Post-Mortem Report, we are of the considered opinion that the District Forum has erred in dismissing the complaint on the ground that the death was on account of suicide."

THE State Commission directed the petitioner to pay the respondent, the claim amount of Rs. 1,25,000 with interest @ 9% per annum from the date of repudiation i.e. 15.10.2001 till date of realization together with costs of Rs. 3,000 within six weeks failing which interest would be levied @ 12% per annum. Hence, the present appeal filed by the petitioner/Insurance Company.

LEARNED Counsel for both parties made oral submissions. Learned Counsel for petitioner stated that there was adequate evidence which had been appreciated by the District Forum which clearly indicated that the respondent''s husband had committed suicide. The well in which he drowned was contaminated with dirt and algae and the water was unfit for both drinking purposes or irrigation. Therefore, the statement of the deceased''s father in the FIR that late Ram Singh fell into the well while drinking water is incorrect. It is not in dispute that the deceased had been placed under suspension while working as a Constable at Asifabad Police Station and that there was also a case pending against him which could well be obvious reasons for depression leading to his suicide. Apart from this, the Chappals of the deceased had been left on the Bund of the well which also indicated that he knowingly jumped into it. In view of these facts, based on the report of the investigator the insurance claim of the respondents which did not cover suicide, was rightly repudiated.

COUNSEL for respondent contended that on the basis of the Inquest Report as well as the detailed investigation of the police, it was concluded that the deceased Ram Singh while passing the path of the Bund of the backwall of the well accidentally fell into it and died. The State Commission gave due credence to the independent investigation of the police and in a speaking order concluded that the cause of death of respondent''s husband was on account of the accident.

WE have heard learned Counsel for both parties and have gone through the evidence on record. The petitioner/Insurance Company has relied entirely on the report of the investigator appointed by it to conclude that the respondent''s husband committed suicide. However, it is significant to note that he has not filed any affidavit before the Fora below in respect of these findings. Further, the conclusion of the investigator that the husband of respondent committed suicide because he was in a depressed state of mind following his suspension, cannot be conclusive proof of the fact that he had committed suicide in the absence of supporting evidence and specially since the deceased had been suspended four years prior to the incident and, therefore, there was a little likelihood that this was an immediate provocation and reason for his depression and suicide. On the other hand, the report as well as the detailed investigation conducted by the police has clearly concluded that the husband of the respondent died as a result of accidental drowning by falling into the well. In view of these facts, we see no reason to interfere with the order of the State Commission which is upheld in toto.

THE petitioners are directed to pay the respondent the sum of Rs. 1,25,000 along with interest @ 9% per annum from the date of repudiation i.e. 15.10.2001 till date of realization together with costs of Rs. 3,000 within six weeks failing which interest would be levied @ 12% per annum. The revision petition is, therefore, dismissed. Revision Petition dismissed.