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2001 DIGILAW 3 (CHH)

NATIONAL INSURANCE v. KANTI DEVI

2001-01-03

B.L.KHARE, S.K.DUBEY

body2001
ORDER The following order of the Commission was delivered by S.K. Dubey, J., President. This appeal is directed against order dated 5-3-1998 passed in Case No. 39/96 by the District Consumer Disputes Redressal Forum, Bilaspur (for short the 'District Forum'). 2. Facts giving rise to this appeal are thus: - The deceased Bansidhar Singh husband of respondent no. 1 and father of respondent no. 2 to 5 employed as driver on truck no. M.P. - 26/D-0058 got himself insured by personal accident insurance policy No. 8100046/92 for the sum of Rs.1,00,000/- covering the period from 12-11-1992 to 11-11-1993. However, the personal accident policy was not issued to him. On 14-6-1993 while the deceased was driving the loaded truck from Raipur, on way near village Darpura Police Station-Simga, rear tyre of the truck got burst. The driver sent the helper to take the tyre from Bilaspur while the deceased Bansidhar Singh stayed at the spot for the safety and security of the truck and goods loaded therein. On 17-6-1993 helper came back with the tyre and saw the article and goods of the truck and the papers lying scattered, lock broken and Bansidhar Singh dead. He lodged the report at the Police Station Sigma on which an offence under Section 302 of Indian Penal Code was registered at the Crime No. 95/93. The body was sent for post-mortem. Autopsy Surgeon found cause of death, due to Asphyxia as a result of suspected poisoning but definite opinion depends chemical examination. Visra kept by Autopsy Surgeon was sent by the concerned Police for chemical examination.. On chemical examination of 100 gms visra, 226.0 mgs of Ethyl Alcohol was found, vide report dated 26-7-1994 of the Assistant Chemical Examiner, Forensic Science Laboratory, Sagar. Unidentified accused persons could not be arrested; hence, final report was filed on 31-12-1993. Legal Representatives of Bansidhar Singh made a claim; which was repudiated on the ground that the death was due to intoxicating liquor or drugs. The respondents filed the complaint, which was resisted. The District forum after appreciation of evidence on record held that the possibility of the death may be because of taking ethyl alcohol in excessive quantity, as a result of which the deceased lost control on his body which resulted to Asphyxia. The respondents filed the complaint, which was resisted. The District forum after appreciation of evidence on record held that the possibility of the death may be because of taking ethyl alcohol in excessive quantity, as a result of which the deceased lost control on his body which resulted to Asphyxia. However any such condition of the policy or the exception clause was not brought to the 'notice of the insured, such condition was also not the part of the proposal form, the Insurance Company has also not produced any document or the policy which contains such a condition for repudiating the claim, therefore, ordered the Insurance Company to Pay Rs.1,00,000/- with interest thereon at the rate of 18% p.a. from 1-11-1993 and Rs. 1,000/- as costs of the proceedings to the complainants within a period of 60 days from the receipt of the copy of order. 3. It is not the case of the Insurance Company that the deceased himself consumed ethyl alcohol. The circumstances which emerge out in the case from the FIR and investigation are that the deceased was murdered the blood was found at the spot and on the clothes of the deceased therefore, a case was registered under Section 302 of IPC. Cause of death was Asphyxia. In Stedman's Medical Dictionary, 26th Edition at Page 156 Asphyxia defines as :- Asphyxia Impaired or absent exchange of oxygen and carbon dioxide on a ventilator basis; combined hypercapnia and hypoxia or anoxia. 4. In Parikh's Text book of Medical Jurisprudence, Forensic Medicines and Toxicology, sixth edition reprint 2000 at page 3.35 of section III, the term asphyxia has been dealt thus : The use of the term asphyxia (Greek meaning pulselessness) in the forensic field is restricted to those forms of oxygen lack (anoxia, hypoxia), which result from mechanical interference with the process of respiration, that is, anoxic anoxia. The fact that these conditions are associated with violence provides a sound basis to use this term in such a restricted sense. The term asphyxia is often misused to describe other anoxic states, such as, those due to impaired circulation of blood, deficiency of hemoglobin, or poisoning, e.g. cyanide, when the uptake of oxygen by the tissues is impaired. These types of anoxia as stagnant, anemic, and histotoxic respectively. 5. The term asphyxia is often misused to describe other anoxic states, such as, those due to impaired circulation of blood, deficiency of hemoglobin, or poisoning, e.g. cyanide, when the uptake of oxygen by the tissues is impaired. These types of anoxia as stagnant, anemic, and histotoxic respectively. 5. In the same book at page 3.57 of section III "Suffocation" has been dealt with, which we quote : Suffocdation:- This is a form of asphyxia caused by mechanical obstruction to the passage of air into the respiratory tract by means other than construction of neck or drowning. It includes (1) smothering (obstruction to air passage from outside) (2) choking (obstruction to air passages from inside), and (3) traumatic asphyxia (obstruction to respiratory movements). 6. The deceased was a young man of about 28 years who even might have consumed liquor, but that was not in so much of quantity that is more than 250 m.g. which may cause asphyxia. From the circumstances it is clear that there was scuffle with the miscreants as a result of which blood came out from the mouth causing obstruction in respiratory system. Therefore, merely on the possibility or on the surmises in the absence of legal evidence it cannot be inferred that it was the deceased who himself consumed intoxicating liquor. Even for arguments sake if the deceased consumed intoxicating liquor there is no positive finding or evidence that the cause of death was intake of ethyl alcohol as the quantity of the ethyl alcohol was not so much as to cause death. In Harrison's Principles of Internal Medicines, Volume 2, 14th Edition at page 2503, the death usually occurs with levels between 300-400 mg/dl, which we quote: Behavioral Effects, Tolerance and Dependence:- The behavioral and physiologic effects of any drug depend on the dose, its rate of increase in plasma, the concomitant presence of other drugs or medical problems, and the past experience with the agent. With alcohol, an additional factor is whether blood alcohol levels are arising or falling; the effects of alcohol are more intense during the former period. Even though "legal intoxication" requires a blood concentration of at least 80 to 100 mg/dl, behavioral, psychomotor, and cognitive changes are .seen at levels as low as 20 to 30 mg/dl (i.e., after one to two drinks). Even though "legal intoxication" requires a blood concentration of at least 80 to 100 mg/dl, behavioral, psychomotor, and cognitive changes are .seen at levels as low as 20 to 30 mg/dl (i.e., after one to two drinks). Narcosis or deep sleep is induced in many people at twice the legal i~toxication level, and even in the absence of concomitant medications, death can occur with levels between 300 and 400 mgldl. Ethanol, either alone or in combination with agents such as benzodiazepines, is probably responsible for more toxic over dose deaths than any other agent. 7. In Parikh's Textbook of Medical Jurisprudence and Toxicology, sixth Edition reprint at page 11.16 of section XI Alphabetical Poison Table has been given. At page 11.17 Alcohol (ethyl) has been dealt with which shows that the death occurs above 300 mg%, which we quote : Alcohol 30-50 mg% concentration in blood (ethyl) causes selective impairment of complex skills. 50-100 mg% alcoholic smell, Cerebral dilated pupils, euphoria, loss of restrain Inebraint 100-50 mg% test errors. 150-200 mg% Hepatotoxic clouding of intellect; incoordination of thought, speech, and action; staggers on sudden turning. 200-300 mg% reeling gait with tendency to lurch and fall, vomiting, amnesia. Above 300 mg% stupor, convulsions, coma, hypothermia. Chronic poisoning leads to physical, moral, and mental deterioration. 8. If the medico legal aspect of ethyl alcohol, is considered that would make the thing clear that the deceased even if had consumed intoxicating liquor, but, that was not in the quantity of fatal level. Therefore, repudiation of the claim merely on surmises of the possibility of the death caused by ethylalcohol, in our opinion was not justified, as the possibility of a homicide murder from the circumstances can also not be ruled out for which crime was registered under section 302 of the IPC. The circumstances which emerge in the case gives rise to doubt whether it was the deceased himself who consumed liquor or he was murdered by miscreants after giving him intoxicating liquor. Therefore this benefit of doubt must go in favour of the deceased. 9. Besides, the Insurance Company cannot be permitted to take advantage of exception clause. The printed proforma of personal accident policy filed in appeal contain exception relevant of which we quote :- EXCEPTIONS Provided Always That the Company shall not be liable under this policy for - 1....................... 2..................... .. 3..................... .. 4..................... .. 9. Besides, the Insurance Company cannot be permitted to take advantage of exception clause. The printed proforma of personal accident policy filed in appeal contain exception relevant of which we quote :- EXCEPTIONS Provided Always That the Company shall not be liable under this policy for - 1....................... 2..................... .. 3..................... .. 4..................... .. Payment of compensation in respect of Death Injury or Disablement of the Insured (a) from Intentional self-injury suicide or attempted suicide. (b) Whilst under the intoxicating liquor or drugs (c) whilst engaging in 'aviation or ballooning whilst mounting into, dismounting from or traveling in any ballon or aircraft other than as a passenger (fare paying or otherwise) in the world (d) directly or indirectly caused by venera I diseases or insanity (e) arising or resulting from the Insured committing any breach of the law criminal intent. 6.................. 7.................. 8.................. 10. From the record produced before the Forum it is evident that the conditions or exceptions were not the part of the proposal form nor any such condition was brought to the notice of the deceased. Even the policy was not filed before the District Forum. Therefore the Insurance Company cannot absolve from its liability to pay the sum insured on the well settled principle that contract of insurance is of utmost good faith which must be observed by contracting parties. Good faith forbids either party from non-disclosure of the facts, which the parties know. The insured has a duty to disclose and similarly it is the duty of the Insurance Company and its agents to disclose all material facts in their knowledge since obligation of good faith applies to both equally. See the decisions of the Supreme Court in case of United India Insurance Company Ltd. Vs. MKJ Corporation and M/s Modern Insulators Ltd. Vs. Oriental Insurance Co. Ltd. 11. In view of the above we are of the opinion that the District Forum rightly ordered for payment of insured sum of Rs. 1,00,000/-. 12. However, the award of interest at the rate of 18% p.a. on the amount of Rs. 1,00,000/- from 1-11-1993 in the circumstances of the case is not justified. The deceased died on 14-6-1993 and the claim was repudiated on 15-3-1995, the complaint was filed on 22-3-1996, which ultimately was decided on 5-3-1998, the appeal against which filed on 26--3-98 came up for hearing in the month of November 2000. 1,00,000/- from 1-11-1993 in the circumstances of the case is not justified. The deceased died on 14-6-1993 and the claim was repudiated on 15-3-1995, the complaint was filed on 22-3-1996, which ultimately was decided on 5-3-1998, the appeal against which filed on 26--3-98 came up for hearing in the month of November 2000. The delay in disposal of the case by the District Forum and the appeal cannot be wholly attributed to the appellant. Besides, the order of payment of interest should not be either low or high, therefore, considering overall circumstances, the ends of justice would meet if the interest is awarded at the rate of 12% p.a. on the amount of Rs.1,00,000/- from the date of filing of complaint. Accordingly we direct the appellant to pay the amount of Rs. 1,00,000/- with interest thereon at the rate of 12% p.a. from 22-3-1996 with costs of proceedings Rs. 1,000/- as awarded by the District Forum within a period of two months from the receipt of certified copy of this order, failing which the interest shall be payable at the rate of 15% p.a. 13. Before parting with this appeal, we may observe that this order will not come in the way of the dependents/legal representatives of the deceased who are illiterate and ruralities if they have not been paid the compensation by the employer and/or the Insurance Company for the death as mandated by the provisions of sections 3, 4 and 4A of the Workmen's Compensation Act, 1923 for the death of the deceased workman during the course and arising out of the employment, they shall be at liberty to take appropriate proceedings before the Commissioner for Workmen's Compensation of Competent Jurisdiction in accordance with law: 14. In the result, appeal is partly allowed, the order of the District Forum shall stand substituted as indicated hereinabove. However the appellant shall bear the costs of this appeal, which we fix at Rs.500/-. A copy of this order be conveyed to the parties and a copy be sent to the District Forum alongwith the record of the case. Award of interest modified and appeal partly allowed.