ORIENTAL INSURANCE CO. LTD vs VARINDER SINGH & 2 ORS

Respondents no. 1 & 2 are minor son and daughter of late Sh. Amarjeet Singh. They filed a consumer complaint in the District Forum Amritsar alleging that their father was an employee of respondent no.3 Dharam Parchar Committee. The employer Singh had taken a group insurance policy under which Amarjeet Singh was provided accident insurance cover for a sum of Rs.7.5

lacs. According to the complainants Amarjeet Singh died on 22.10.2007 due to accidental fall from the stairs. Insurance claim in this regard was submitted but the petitioner insurance company repudiated the claim on the ground that death of late Amarjeet Singh was heart attack and not accidental fall.

District Forum Amritsar on consideration of the pleadings and the evidence came to the conclusion that Amarjeet Singh as a consequence of accidental fall from the stairs, allowed the complaint. The petitioner was thus directed to pay a sum of Rs.7.5 lacs with 6% thereon from the date of complaint till the realisation of amount to the respondents complainants besides Rs.10,000/- was awarded as compensation on account of harassment, mental agony and litigation expenses.

Being aggrieved of the order of the District Forum, the petitioner insurance company preferred an appeal. The State Commission Punjab vide impugned order dated 11.05.2012 reaffirmed the order of the District Forum and dismissed the appeal. This had led to the filing of the revision petition.

Learned Shri Mohan Babu Agarwal, Advocate has contended that the impugned order of the foras below are based upon incorrect appreciation of facts and law. It is contended that foras below have failed to appreciate that on the receipt of insurance claim, due investigation was conducted and as per the report of the investigator, cause of death of late Amarjeet Singh was heart attack and not the injury due to falling from the stairs. It is further contended by the petitioner that the foras below have failed to appreciate that as per the terms and conditions of the insurance policy, the claimants were required to intimate the death of the insured to the insurance company before the cremation unless there is a reasonable cause. It is contended that in violation of said condition, immediate intimation of death before cremation was not given, even the matter was not reported to the police and nor Post mortem was got conducted to establish the death. Thus, the petitioner company was justified in repudiating the claim in view of the adverse investigation report.

Learned Ms. Saman Khan, Advocate for the respondent complainant has contended that the group insurance policy was obtained from Dharam Parchar Committee. Immediate intimation of death of Amarjeet Singh was given to the Committee, therefore, it cannot be said that respondent complainants have violated the terms and conditions. It is further contended that since the death of Amarjeet Singh was not due to commission of any crime, there was no occasion to intimate the police. Merely because post mortem on the body has not been conducted, it cannot be said that cause of death of Amarjeet Singh was the injury because of accidental fall.

We have considered the rival contentions. It is not disputed that late Amarjeet Singh was covered under the Group insurance policy obtained by respondent no.3. It is also not disputed that Amarjeet Singh died on 22.10.2007. The only dispute between the parties is regarding the cause of death. Thus, the question which needs to be answered is whether Amarjeet Singh died because of accidental fall from the stairs or he died because of heart attack?

On perusal of record, we find that learned State Commission has answered the above noted question in para 17 of the impugned order, which is reproduced as under: "The appellant insurance company mainly relied upon the report of the investigator in repudiating the claim of the minors, but the appellant insurance company has

read the report of the investigator Ex.R-3 in piecemeal manner. The evidence which was in favour of the appellant insurance company was relied, but the evidence which was against the appellant insurance company was discarded. As per the report Ex.R-3, the investigator recorded the statements of Sh.Manjit Singh, Kirpal Singh, Jaimal Singh, Gurmeet Singh, Kuldip Singh and Amrik Singh. Out of these six witnesses, only two witnesses stated before the investigator that the deceased Amarjit Singh died of heart attack at night, whereas the other four witnesses stated that he fell from the stairs of his house and died. Thus, the report of the surveyor is not impartial and has been rightly discarded by the District Forum. Although, the deceased was not taken to any hospital, nor there is any postmortem examination report, yet the evidence of the respondents which is supported by the evidence of Kuldip Singh, Nambardar and Jaimal Singh, who submitted their affidavits Ex.C-10 and Ex.C-11 and the report of the investigator Rx.R-3 if read together, go to prove that deceased Amarjit Singh fell from the staircases on 21.10.2007 and died in the morning of 22.10.2007. The repudiation of the claim of the minors by the appellant insurance company was not justified and the District Forum has passed a detailed and speaking order and there is no ground to interfere with the same."

On reading of the above, it is clear that the State Commission was influenced by the affidavit evidence of Kuldeep Singh and Jaimal Singh and the State Commission rejected the report of the investigator M/s Royal Associates on the ground that he has given undue weightage to the statement of two witnesses examined by him ignoring the fact that four other persons examined during investigation have supported the theory of death of Amarjeet Singh due to the injuries as a consequent upon accidental fall from the stairs. On careful scrutiny of the report of investigator and the affidavits Ex. C-10 & C-11 of Kuldip Singh, Nambardar and Jaimal Singh, we are of the view that the State Commission has not appreciated the evidence in correct perspective. As per the report of the investigator, Kuldip Singh and Jaimal Singh in their respective statements before the investigator stated that on 22.10.2007 insured Amarjeet Singh fell down from the stairs and died due to injuries. However, in their affidavit evidence, neither of the above said witnesses have stated about any injury suffered by deceased Amarjeet Singh due to fall from the stairs. From this, it is evident that Kuldip singh and Jaimal Singh are not stating the truth and their testimonies cannot be relied upon. Further, on perusal of the report of the investigator M/s Royal Associates, we find that during investigation investigator recorded the statement of Manjeet Singh, who is brother of the deceased. The aforesaid statement is reproduced as under: " We contacted Mr. Manjit Singh s/o Raghbir Singh r/o Village Varpal Dist. Amritsar. He stated that he is employed in Punjab Police. His brother Amarjeet Singh s/o Raghubir Singh was driver in SGPC His brother fell from the stairs at 6.00 a.m. on 22.10.07 from his house. He had serious head injuries due to this. He died on the spot. He was about 50 years of age. The wife of Amarjeet Singh died some time back. He left behind his son Harvinder Singh aged 17 years and a dauther Harmit Kaur aged 13 years. He is looking after these children. They are staying with him. His brother was getting a pay of Rs.7-8 thousand per month. He reported to police post at Chowky Varpal. Post mortem was also not carried out. As they requested SDM Amritsar not to conduct post mortem Funeral was carried on 22.10.07."

On reading of the above, it is clear that death of the insured was reported to the police at Chowki Varpal and on the request of the family members of the deceased Amarjeet Singh, SDM waived conducting of post mortem on the dead body. In order to succeed in the insurance claim, the complainants were required to prove that Amarjeet Singh had died as a consequence of accidental fall from the stairs. The claimants have failed to lead cogent evidence to discharge the aforesaid onus of proof. Instead, they have not even cared to summon and prove the report lodged at Police Post Varpal, which obviously would have contained first hand information about cause of death of Amarjeet Singh. Even the family of the deceased requested the SDM to waive the post mortem on the body of the deceased which could have established the cause of death. From this it is evident that claimants have failed to produce the best evidence i.e. report made at the Police Post Varpal and also the claimants by getting the waiver of post mortem have ensured that exact cause of death of Amarjeet Singh is not scientifically established. As the complainants have failed to produce the best evidence and by their own effort ensured that post mortem on the dead body of the insured is not conducted, we are inclined to draw an adverse presumption against them. Thus, it can be safely inferred that the story of death of Amarjeet Singh due to accidental fall is false and there is truth in the statement of witnesses Kirpal Singh and Amrik Singh made to the investigator that Amarjeet Singh died because of heart attack.

In view of the discussion above, we are of the view that foras below have failed to appreciate the evidence in correct perspective. The impugned orders, therefore, suffers from material irregularity and cannot be sustained. Accordingly, we allow the revision petition, set aside the impugned order and dismiss the complaint.