United India Insurance Co Ltd has been directed by the apex consumer commission to pay Rs 5.1 lakh to the son of a policy holder who had died of a poisonous insect bite while working in the fields.
The National Consumer Disputes Redressal Commission gave the order dismissing the insurance firm's plea against the Rajasthan State Consumer Commission's direction to it to pay the policy holder's son the assured amount of Rs five lakh and Rs 10,000 as litigation cost.
The insurance company had rejected the claim for assured amount saying no post-mortem was conducted to ascertain the actual cause of death and the FIR was not lodged in the case, both of which were required as per its policy conditions.
The NCDRC bench presided by Justice J M Malik, however, rejected the contention saying the medical officer of theGovernment District Hospital had issued a certificate whichshowed insect bite as the cause of death and the matter was also investigated by the sub divisional magistrate (SDM).
"In view of the certificates (of the medical officer and the SDM), non-production of postmortem report pales into insignificance. It is but clear that the deceased was taken to the government hospital wherein he died due to this accident.
"It cannot be said that he died naturally. The question of lodging FIR in this particular case does not possibly arise because enquiry was made by the SDM himself," the bench also comprising NCDRC member Vinay Kumar said.
The state commission's order had come on the plea of the policy holder's son, Giriraj Prasad Meena, challenging the dismissal of his complaint by the district forum.
Meena, resident of Dausa in Rajasthan, had said in his complaint that his father was covered under United India Insurance's public personal accident policy for Rs five lakh for a period of 15 years from January 1999 to 2014.
His father had died in March 2009 after being bitten by a poisonous insect while working in the fields, Meena had said adding that his claim for assured amount was rejected by the insurance company on the ground that medical certificate was issued without following due procedure.