ORDER Mr. Justice K.D. Shahi, President—This is an appeal against the order dated 17.10.2003 passed by the District Forum, Nainital whereby the complaint of the complainant was dismissed for recovery of the insured amount of the insured under Janta Personal Accident Insurance Policy. 2. The brief facts of the case are that the father of the complainant Sh. Jagat Singh was insured for a sum of Rs. 5,00,000/- on 12.9.1996. The age of the insured was given as 68 years in the policy and there is no dispute regarding payment of premiums etc. According to the complainant on 11.1.2000, the insured Sh. Jagat Singh fell in the bathroom, received severe head injury and as a result of haemorrhage from the said injury, he died. The complainant completed all the formalities but on 17.10.2000 the Insurance Company repudiated the claim of the complainant treating the death of the insured as a natural death. Therefore, the complainant filed the complaint. 3. After taking the evidence of the parties and hearing them the learned Forum rejected the complaint, against which order the present appeal has been filed. 4. We have heard the learned Counsel for the parties and gone through the records. The only dispute is whether the insured has suffered any head injury or not? Whether he died out of haemorrhage from the said injury or whether he died a natural death? The brief facts are that Sh. Jagat Singh shown to be aged 85 years in the records of the hospital was admitted in Susheela Tiwari Memorial Forest Hospital, Haldwani on 7.1.2000. He was discharged on 10.1.2000. The papers of the hospital show that he was discharged from the hospital. The papers of the said hospital also show that the insured had a tendency to fall down. The insured died on 11.1.2000 as alleged due to fall in the bathroom and as a result of head injury due to this fall. The information of the death of the insured was given to the Insurance Company on 24.1.2000 after 15 days of the death. The Insurance Company files objections before the learned Forum that there was no FIR, no post-mortem. Had immediate information been given to it, it could have enquired into the cause of death and could have secured post-mortem but it was not done. The Insurance Company files objections before the learned Forum that there was no FIR, no post-mortem. Had immediate information been given to it, it could have enquired into the cause of death and could have secured post-mortem but it was not done. However, an inquiry was made by the Insurance Company and the Investigator/Surveyor gave his report dated 30.3.2000. 5. According to the complainant he has called Dr. R.C. Agarwal to examine the insured after the accident. Dr. R.C. Agarwal has given the following certificate on 12.1.2000, “Certified that late Sardar Jagat Singh s/o late Sardar Sujan Singh aged about 72 years, R/o Gali No. 9, Rampur Road, Haldwani was attended by me and I found him expired of haemorrhage following accidental head injury on 11.1.2000 at about 5.30 p.m.” The word “was attended by me” is clear. This doctor is not an illiterate one. He is M.B.B.S., D.T.C.D. (Lucknow), M.C.C.P. (U.S.A.) and he must be presumed to know ordinary English at least meaning of “attended by me”. Then he wrote `I found him expired’ I mean not any other person. This certificate specifically shows that the insured has died out of accidental head injury and after attending the patient and personally finding him dead, the doctor gave this certificate. 6. After this the Surveyor/Investigator started to investigate the matter. He has called for the report from Susheela Tiwari Memorial Forest Hospital and the repoort of Dr. R.C. Agarwal. We will first take the report of Dr. R.C. Agrawal. He wrote, “I wish to inform you that I was called to attend on late Shri Jagat Singh on 11.1.2000 at about 5.30 p.m., who had fallen in bathroom and having bleeding due to head injury and had become unconscious as told to me by his son. I found him expired on reaching to attend him. Cause of death could have been bleeding and head injury by fall in bathroom as told. It looked to be an accidental death, although I did not witness the same”. It is true that the doctor has not witnessed the accident but he also did not write that he did not witness the injured. He has gone to attend him. It cannot be believed nor any sane person will take a doctor to the injured or patient and even if he was dead, the doctor will not see him. It is true that the doctor has not witnessed the accident but he also did not write that he did not witness the injured. He has gone to attend him. It cannot be believed nor any sane person will take a doctor to the injured or patient and even if he was dead, the doctor will not see him. If the doctor has gone there even after death, it is he who will examine him and declare him dead, not the family members. Everybody tries even after the death, if the doctor has gone there to examine the patient, to do if he can do anything. This Dr. R.C. Agrawal is a liar of the first grade. These are the doctors who are degrading and insulting the doctor’s profession. When the party called him, he gave one certificate. When he was approached by the Insurance Company, he gave another certificate. It is surprising from this report that the son of the injured has told the doctor that the injured has become unconsious. What for he as a doctor if he will not see that the patient is conscious or unconscious. He has by this certificate tried to please both the parties by saying that what the complainant says may be correct but he has not seen the patient. He reported “it looked to be an accidental death”. Who looked it if did not he? If he was called after accident, still he says that I have written that I did not witness the accident. I did not write that this was not accidental death. Such type of doctors cannot be appreciated and it is apparent from this certificate itself that this certificate has been procured by the Insurance Company to digest the insured amount. 7. Now coming to the report of Susheela Tiwari Memorial Forest Hospital. Certain queries were made to them. This report says that the patient was ill but this report does not prove that he did not die out of any accident and died a natural death. Even if a person is at the verge of death, still if he suffers death from an accident, it is an accidental death and not a natural death. You cannot say that he was already about to die, he fell down and became dead, therefore, it should be treated as a natural death. Even if a person is at the verge of death, still if he suffers death from an accident, it is an accidental death and not a natural death. You cannot say that he was already about to die, he fell down and became dead, therefore, it should be treated as a natural death. The letter of Susheela Tiwari Memorial Forest Hospital dated 1.3.2000 has been filed, which is a confindential report to the Insurance Company. It shows that the insured was ill but the hospital did not give any report regarding the cause of death. It is specifically written in item (v) of this letter no comment is possible to ascertain his cause of death and item (vii) not possible to comment over cause of death is written. From where the age of the insured became 85 is not clear, when admittedly according to the Insurance Company the age of the patient was 68 years on the date of insurance i.e., 12.9.1996 and according to Dr. R.C. Agrawal about 72 years on the date of death. However, Susheela Tiwari Memorial Forest Hospital has also written that the back ground illness of insured can lead to fatal stroke (a type of nervous failure). Even if the pateint fell because of fatal stroke or nervous failure and he sufferd injuries and died out of those injuries, this is nothing else but an accidental death. 8. The learned Counsel for the Insurance Company advanced 2 to 3 arguments to show that the death of the victim may not be accident, it may be natural death but to get the money, the complainant has made it an accidental death. This is why the report of the death was made to the Insurance Company on 24.10.2000 so that post-mortem, etc. may not be done. The second argument was if it was an accidental death, there should have been FIR or post-mortem. All these facts lead to suspicion. The simple reply to all these queries is the statement of the complainant and his wife. These statements have been recorded by the Surveyor himself and have been filed by the Insurance Company. The Insurance Company cannot dispute these statements.The wife of the complainant has stated that on 11.1.2000 at about 5,00 p.m. she was in the kitchen. She heard a noise from the bathroom. She rushed to bathroom. These statements have been recorded by the Surveyor himself and have been filed by the Insurance Company. The Insurance Company cannot dispute these statements.The wife of the complainant has stated that on 11.1.2000 at about 5,00 p.m. she was in the kitchen. She heard a noise from the bathroom. She rushed to bathroom. She saw her father-in-law who spoke to call Narendra his son. She saw that the Balti was at the head of the victim and blood was coming out from the head. After this the victim became unconscious. She informed this fact to her husband who came along with Dr. R.C. Agrawal. The doctor cleaned the head, checked the head and the nerves and he said that the nerves are running slow and again he declared the victim dead. If the doctor after this statement says that he did not examine the victim, he is a liar. 9. Regarding the post-mortem or FIR, every person does not know law, although he is presumed to know law but if there is no crime and no action is to be taken against anybody, ordinary people avoid lodging FIR. So is the case with the post-mortem. The complainant could have lodged the FIR or could have got the post-mortem done, had he known that his father was insured. He did not call Dr. R.C. Agrawal to create evidence of death but he had called Dr. R.C. Agrawal to save the victim if he could. He did not lodge the FIR or did not get the postmortem because no action was to be taken of this accidental death and this is all celar from the statement of the complainant. Sh. Narendera stated that he got a telephone from his wife that his father is unconscious. He had a fall in the bathroom and he was bleeding. He immediately rushed to the house of Dr. R.C. Agrawal. Dr. R.C. Agrawal came with him and found that the victim was dead. The complainant immediately rushed to Dr. Saxena of Susheela Tiwari Memorial Forest Hospital to try to save the victim if he is alive but the doctor was not available. He came to the house. Still if Dr. R.C. Agrawal says that he did not examine the patient, how can we believe him because according to the complainant even on telling of Dr. Saxena of Susheela Tiwari Memorial Forest Hospital to try to save the victim if he is alive but the doctor was not available. He came to the house. Still if Dr. R.C. Agrawal says that he did not examine the patient, how can we believe him because according to the complainant even on telling of Dr. R.C. Agrawal that the pateint is dead, he was still not assured of his death and he rushed to get another doctor. However, the complainant further stated that he came to the house, cremated the father on 12.1.2000. He stated that he is solemnly speaking that he did not know that his father was insured. Sh. Khanduja who is the agent also did not inform him about the insurance. On 14.1.2000 some well wisher enquired whether his father was insured or not, then on 15.1.2000 he searched out the policy. He immediately ran to the house of Sh. Khanduja agent. He asked from Sh. Khanduja when you were present on 11.1.2000 at his resident in the condolence, then why did he not inform about the policy of his father? Certain other queries from the complainant were made in the presence of witness Sh. Balwant Singh Mair. The complainant stated that his father could move after having been discharged from the hospital. He has also checked him in the bathroom. To be fair enough the Surveyor could have examined Sh. Khanduja and should have put queries to Dr. R.C. Agrawal as well regarding the statement of the complainant and his wife. Sh. Khanduja could have very well explained whether the complainant did know about the policy earlier or not and if Sh. Khanduja would have stated that he was present on 11.1.2000 at the condolence meeting and had informed the complainant regarding the policy etc. or had a talk regarding the policy etc., then a presumption could have been raised but when it is specific that the complainant did not know about the policy till 14/15.1.2000 and he did not take it as a criminal case, then the mere non-lodging of FIR or not conducting the post-mortem is not fatal for his case. or had a talk regarding the policy etc., then a presumption could have been raised but when it is specific that the complainant did not know about the policy till 14/15.1.2000 and he did not take it as a criminal case, then the mere non-lodging of FIR or not conducting the post-mortem is not fatal for his case. If there is delay in informing the Insurance Company, that is not with any deliberate intention but merely because the complainant did not know about the insurance and after performing the last rites etc., after getting the policy and instructions from agent Sh. Khanduja, he has informed the Insurance Company, he cannot be blamed for delay in informing the Insurance Company. 10. We have already said that FIR and post-mortem report are necessary only to prove accident. It is not mandatory that there should be necessarily FIR or post-mortem and if accidental death is proved otherwise, then in the absence of FIR or otherwise the claim should not be rejected. At page 7 of his report, the Surveyor has written that the attending doctor alone has the right to declare the patient as dead but to ascertain the circumstances under which the patient has died or the cause of his death is not within his jurisdiction. It is only a judicial body or the authorized medical institution that has the legal right to declare a death as accidental or natural. From where this observation came, we are unable to appreciate. Any doctor can see the injury, any doctor can see the haemorrhage, any doctor can see that there was excessive bleeding and the death is possible by that accident. If there is heart failure or nervous shock by this accident, then also this shall be accidential death. In every accident or gun shot injury in the post-mortem report, the doctor always writes death due to haemorrhage and nervous shock but by that it cannot be said that the death is natural one. 11. There is no other reason to create suspicion in the accidental death of the insured. We have gone through the judgment pronounced by the learned Forum. The learned Forum has rejected the complaint merely on the survey report and the report of Dr. R.C. Agrawal whose first version is without any tenting but the second version appears to have been obtained by the Insurance Company. We have gone through the judgment pronounced by the learned Forum. The learned Forum has rejected the complaint merely on the survey report and the report of Dr. R.C. Agrawal whose first version is without any tenting but the second version appears to have been obtained by the Insurance Company. The death of the insured was only due to the accident. His risk was fully covered under the policy and, therefore, the claim of the complainant should have been allowed by the learned Forum. We do not agree with the finding recorded by the learned Forum and that is to be set aside. ORDER The appeal is hereby allowed. The order dated 17.10.2003 is hereby set aside. The complaint is also allowed. The Insurance Company is hereby directed to pay the insured amount of Rs. 5,00,000/- (Rupees five lacs) to the complainant along with interest @ 9% from 17.10.2000, on the date on which the claim was repudiated till the actual date of payment. Cost of this appeal shall be easy. Appeal allowed. ––