|CPJ 112 (NC): MANU/ CF/0095/2014
|DATE OF JUDGMENT
|23rd March, 2011
|National Consumer Disputes Redressal Commission NCDRC
|Chhattisgarh State Power Holding Company Ltd.
|Bajaj Allianz General Insurance Company Ltd
|HON’BLE MR. JUSTICE K.S.CHAUDHARI, PRESIDING MEMBER HONBLE DR. B.C. GUPTA
The case was heard by the National Consumer Disputes Redressal Commission in New Delhi. The JUSTICE K.S. CHAUDHARI, PRESIDING MEMBER HONBLE DR. B.C. GUPTA, MEMBER .The petitioner was Chhattisgarh State Power Holding Company Ltd. , and the respondent was Bajaj Allianz General Insurance Company Ltd . The case was filed under section 21 (b) of the Consumer Protection Act, 1986 against the impugned order dated 23.03.2011, passed by the Chhattisgarh State Consumer Disputes Redressal Commission (for short the State Commission) in FA No. 649/2010, Bajaj Allianz General Insurance Co. Ltd. Versus Additional Secretary, Chhattisgarh State Power Holding Company Limited, through which consumer complaint number dated 15.09.2010 was passed by the District Consumer Disputes Redressal Forum, Raipur, allowing the appeal no. CC/08/25, allowing the said complaint, was set aside.
FACTS OF THE CASE
The petitioner/complainant Chhattisgarh State Power Holding Company Limited obtained a Group Personal Accident Insurance Policy from the OP for the benefit of its employees for the period 10.09.05 to 09.09.2006, according to which a sum of 4 lakh was payable in case of accidental death of any employee of the petitioner/complainant. The Policy No. OG-06-2303-9902-00000029 was issued by the insurance company on payment of 49,03,900/- as premium. An employee of the complainant, Maniram Sahoo aged 49 years, working as Attendant Class-2 (Line) was doing some construction work for the Chhattisgarh State Electricity Board on 10.07.2006 and he climbed on an electric pole 36 in height for the work. They said Maniram Sahu died after falling from an electric pole. The petitioner/complainant company paid a sum of ` 4 lakh to the legal representatives of the deceased and claimed that amount from the insurance company by sending the claim form along with the required documents on 1.08.2006.
In the written statement filed by the insurance company, it was denied that Maniram Sahu died due to injuries caused by falling from an electric pole. He said that according to the post-mortem report, he died due to cardiac arrest as he was suffering from diabetes and heart disease. The Insurance Company maintained that the claim had been rightly repudiated by them.
- Whether the death occurred due to accident or it is natural death only ?
- Whether the Insurance Company is liable to pay the claim in accordance with the terms and conditions of the Insurance Policy in question ?
The National Consumer Disputes Redressal Commission allowed the revision petition filed by the petitioner and set aside the order passed by the State Commission. The petitioner said that the employee died due to shock but this was not acknowledged earlier. Actually, while working on the pole, the deceased had a heart attack and died there and then fell down. The insured was working on an electric pole and repairing the power supply line. As a result of severe shock due to falling down from the pole, 36 in height, he got a heart-attack, as a result of which, he died.
In the event of death by any means, the cardiac arrest or cardiac failure has to take place and only after that, a person is usually declared as dead. The cause of death stated in the post mortem report, therefore, does not support the version of the respondent that it was a death not due to accident. It has been stated in the post mortem report that no external injury was found on the body of the deceased and as per the above report, the cause of death is cardiorespiratory failure. The cause of cardiac arrest could be the existence of a pre-cardiac disease or even in the absence of such a disease, the cardiac arrest could take place due to shock when he fell from a 36′ in high.
It is made out very clearly from the facts on record, therefore, that this is a case where death has occurred because of an accident, involving fall from an electric pole 36 in height and under the terms and conditions of the Insurance Policy, the respondent is liable to pay compensation to the legal heirs of the deceased employee. The amount of 4 lakh has already been paid to the legal heirs of the deceased employee, the OP has to pay the said amount to the petitioner and also a compensation of 5,000/- for mental agony and 1,000/- as litigation cost as ordered by the District Forum.
In conclusion, the case analysis Chhattisgarh state power holding company ltd. v. Bajaj allianz general insurance company ltd, conclusion, shows that this is a case the cause of death is cardiorespiratory failure. The cause of cardiac arrest could be the existence of a pre-cardiacs disease or ever in the absence of a disease . The cardiac arrest could take place due to shock upon falling from a pole 36’in height. The cause of death stated in the post mortem report, therefore does not support the version of the respondent that it was a death not due to accident .
Under the term and condition of the insurance policy, the respondent is lable to pay compensation to the legal heirs of the deceased employee. The case highlights the importance of having a personal accident insurance policy in place for employees. It also emphasizes the need for insurance companies to honor their commitments and pay out claims in a timely manner.
BY, ADNAN PARWEZ, LLOYD SCHOOL OF LAW, AN INTERN UNDER LEGAL VIDHIYA
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