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Judgment
THESE two Revision Petitions have been filed by both the parties against the single order passed by the State Commission allowing the appeal.
BRIEF facts, necessary to understand the case, are that the complainant''s deceased husband Sukhwinder Singh had availed Accident Claim Policy. Late Mr. Sukhwinder met with an accident on 18.10.1993 sustained injuries and after remaining in different hospitals died on 19.6.1995. The deceased had lodged a claim immediately after accident on which a Surveyor was appointed who confirmed the factum of accident and supported the claim. Not being satisfied, a second Surveyor, Dr. Goyal was appointed by the respondent who also confirmed the factum of accident and reported that the case was genuine. Not being satisfied with these reports matter was further examined by the Insurance Company and finally the claim was repudiated on 26.3.1996 on the ground that the deceased, while taking the policy, had concealed material facts relating to the health that he had or was suffering from jaundice. Alleging negligence, the complainant moved the District Forum seeking various reliefs. District Forum after hearing both the parties dismissed the complaint. On an appeal being filed by the complainant before the State Commission, it allowed the appeal, set aside the order of the District Forum and directed payment of Rs. 1 lakh, the insurance amount along with interest @ 12% effective from 13.3.1994 and costs of Rs. 2,000/-.
Two separate Revision Petitions have been filed against this order. Revision Petition No. 1514/1999 :
THIS Revision Petition is filed by the Insurance Company praying for setting aside the order of the State Commission. Revision Petition No. 1861/2000 : This Revision Petition has been filed by the complainant on 27.5.2000 against the order of the State Commission dated 7.5.1999 and the final order passed in review on 30.11.1999 praying for enhancement of compensation. Order under challenge is dated 7.5.1999. Even though there is no time limit for filing Revision Petitions, yet one year''s delay has not been justified. In any case, it appears to be a counter-blast to the petition filed by the Insurance Company.
IT was argued by the learned Counsel for the Insurance Company, Mr. S.M. Suri, that there is enough material on record to show that the deceased was suffering from jaundice, he was an alcoholic and had severe liver problem. He died on account of this ailment and not on account of accident. The deceased was alcoholic and it was after such a bout that he was hit on the road. All material on record supports the fact that the deceased had jaundice for a long time and he concealed this fact at the time of taking the policy. State Commission erred in not appreciating the material on record in this regard making its order bad in law hence needs to be set aside. On the other fand, it was argued by the complainant that it is clear from the record that both the Surveyors who visited the deceased at his residence saw him in plaster-bed ridden, as a result of accident. He did not conceal any information at the time of taking the policy. The company is unnecessarily trying to harass a widow. The order of State Commission is correct and needs to be maintained. We have seen the material on record and heard the arguments. There is no material on record to show that the deceased had a jaundice at the time of taking the policy and secondly that this fact was within his knowledge. In order to lean on the fact of concealment, the Insurance Company has to prove its knowledge, which is not proved by any material on record. In any case it was not a life policy but Accident Claim Policy. Factum of accident and injuries have been clearly brought out by the two separate Surveyors (Doctors at that) who visited the deceased at his residence. Whole of the record is replete with details of injuries/fracture. The Insurance Company is harping on the point that cause of death was jaundice and not the accident, but where is the proof ? There is no death certificate giving the cause of death on record for us to examine the point. It is not disputed that accident occurred on 18.10.1993, claim was preferred immediately, the insured died on 19.6.1995. The Insurance Company takes more than two years, from the date of preferring a claim, and nine months from the date of death, to repudiate the claim only in March, 1996. This itself is a clear case of deficiency in service. Well-reasoned order of the State Commission does not call for any interference. 8. We find no merit in the Revision Petitions filed by both the parties, hence dismissed. No orders on costs. Revision Petitions dismissed.