Punjab-Haryana High Court
Harpal Singh @ Haripal Singh And Anr vs Tata Aig General Insurance Company Ltd on 21 March, 2024
Author: Alka Sarin
Bench: Alka Sarin
RSA No.1077 of 2021 1 2024:PHHC:041583
IN THE HIGH COURT OF PUNJAB AND HARYANA AT CHANDIGARH
117 RSA No.1077 of 2021
Date of Decision : 21.03.2024
Harpal Singh @ Haripal Singh and Another ....Appellants
VERSUS
Tata AIG General Insurance Company Ltd. ....Respondent
CORAM : HON'BLE MRS. JUSTICE ALKA SARIN
Present : Mr. Arun Sharma, Advocate for the appellants.
ALKA SARIN, J. (Oral)
1. The present appeal has been preferred by the appellants
aggrieved by the judgment and decree dated 12.01.2021 passed by the First
Appellate Court reversing the judgment and decree dated 04.12.2018 passed
by the Trial Court.
2. The brief facts relevant to the present case are that the plaintiff-
appellants approached the civil court on the ground that they were entitled to
receive the claim amount on account of death of Jaswant Kaur as the
insurance policy was taken by her husband i.e. plaintiff-appellant No.1
herein from the defendant-respondent. It was further averred in the plaint
that the plaintiff-appellant No.1 - Harpal Singh @ Haripal Singh - and his
wife Jaswant Kaur (since deceased) took the insurance policy
No.0200371489 from the defendant-respondent on 05.03.2014 for a sum of
Rs.25,00,000/-. Plaintiff-appellant No.1 stood as nominee for Jaswant Kaur
in the said insurance policy and was covered for 100% of the sum insured by
Jaswant Kaur and Jaswant Kaur was covered for 50% of the sum insured and
their son, namely, Harjot Singh (plaintiff-appellant No.2 herein) was
integrity of this order/judgment
RSA No.1077 of 2021 2 2024:PHHC:041583
covered for 25% of the sum insured being the legal heir of Jaswant Kaur. It
was further the case that on 26.06.2014, when plaintiff-appellant No.1 came
to his house, he was shocked to see that Jaswant Kaur had fallen down on
the floor and was injured. Plaintiff-appellant No.1 called his son who further
called Dr. Dharampal Sharma who checked Jaswant Kaur and declared her
dead. The doctor declared that it was an accidental death due to the injuries
suffered by Jaswant Kaur. The plaintiff-appellants lodged a claim in July
2014 for the death claim of Jaswant Kaur. It was further the case that the
investigator appointed by the defendant-respondent demanded some amount
illegally to get the claim settled. It was further the case that despite three
letters the defendant-respondent did not accede to their claim. A legal notice
in this regard was also sent on 08.07.2015. It was further stated in the plaint
that earlier a petition was filed under Sections 11 to 14 of the Consumer
Protection Act, 1986 before the District Consumer Disputes Redressal
Forum, Patiala, however, he was advised to approach the civil court. It is
pertinent to note that the outcome of the said petition before the District
Consumer Disputes Redressal Forum has not been stated. Learned counsel
for the plaintiff-appellants is also not in a position to apprise the Court as to
what was the order passed by the Consumer Court. Thereafter, it was
averred that the plaintiff-appellants approached the Permanent Lok Adalat,
Patiala to settle the claim and since the other side did not appear to settle the
claim, they withdrew their application. Hence, the present suit. Notice was
issued to the defendant-respondent which admitted to having issued the
accidental claim policy, however, it was stated that the policy was subject to
certain terms and conditions. It was further averred that the plaintiff-
appellants had registered a claim vide claim No.748891 dated 09.08.2014 for
the death of Jaswant Kaur on 26.06.2014. At the time of registration of the
integrity of this order/judgment
RSA No.1077 of 2021 3 2024:PHHC:041583
claim it was informed that Jaswant Kaur had died due to fever. While
processing the claim of the plaintiff-appellants the defendant-respondent
informed that the claim was not admissible as the death was due to fever and
was not covered under the terms and conditions of the policy being a
sickness related condition. The claim was denied vide letter dated
18.12.2014. Meanwhile, one more claim was registered with the defendant-
respondent on 18.09.2014 vide claim No.760941. It transpires that the
plaintiff-appellant No.1 changed his statement and as an afterthought
mentioned that Jaswant Kaur had died due to accidental injuries. Finally,
letter dated 31.12.2014 with respect to earlier claim No.748891 was sent
stating that the death due to sickness was not covered under the policy.
While processing claim No.760941 the plaintiff-appellants failed to prove
that Jaswant Kaur had died due to accidental injuries and despite repeated
requests and reminders dated 05.11.2014 and 27.02.2015, plaintiff-
appellants failed to submit any medical certificate or documents showing the
condition at the time of death and certifying that the death was a result of
accidental injuries. No FIR or postmortem report was produced. In view of
the fact that there was no response to the reminders it was inferred by the
defendant-respondent that Jaswant Kaur did not die of any accidental
injuries and hence claim of the plaintiff-appellants was repudiated vide letter
dated 07.04.2015. The plaintiff-appellants filed a replication reiterating the
averments made in the plaint and denying those in the written statement.
3. On the basis of pleadings of the parties, the following issues
were framed :
1. Whether the plaintiff is entitled for declaration that
plaintiffs are entitled to receive the claim of late Jaswant
integrity of this order/judgment
RSA No.1077 of 2021 4 2024:PHHC:041583
Kaur for Insurance Policy taken by her from defendant?
OPP
2. Whether the claim of insurance is not admissible as
per insurance policy? OPD
3. Whether the present suit is not maintainable? OPD
4. Relief .
4. The Trial Court vide judgment and decree dated 04.12.2018
decreed the suit. Aggrieved by the judgment and decree of the Trial Court an
appeal was preferred by the defendant-respondent which appeal was allowed
by the First Appellate Court vide judgment and decree dated 12.01.2021.
Hence, the present regular second appeal.
5. Learned counsel for the plaintiff-appellants would contend that
PW-3 Dr. Dharampal Sharma had stepped into the witness-box, who was a
registered medical practitioner and had a certificate issued certifying him as
a RMP by the Haryana Government and hence there was no requirement of a
FIR or a postmortem report in the present case.
6. Heard.
7. In the present case, admittedly, there is no FIR which was
registered regarding the injuries suffered by Jaswant Kaur. There is also no
medical record of the deceased having been taken to the hospital. There is no
postmortem report showing the cause of death. PW-1 Harpal Singh i.e. the
plaintiff-appellant No.1 herein, admitted in his cross-examination that there
was no injury mark on the body of Jaswant Kaur. He further admitted that he
did not come to know that the death of Jaswant Kaur was accidental. When
he reached home he found his wife lying on the floor and he sent his son to
bring Dr. Dharampal Sharma. Similar is the statement of PW-2 Harjot Singh
who stated that when he came home he saw his mother lying on the floor.
integrity of this order/judgment
RSA No.1077 of 2021 5 2024:PHHC:041583
However, her body was not sent for postmortem examination. PW-3 Dr.
Dharampal Sharma stated in his cross-examination that he has a RMP
certificate issued to him by the Haryana Government. He also admitted that
there was no injury mark on the body of Jaswant Kaur. The First Appellate
Court also noticed that the qualification of Dr. Dharampal Sharma was that
he was only a Matric pass. Even he, who is stated to have declared Jaswant
Kaur dead, stated that there was no injury mark on her body. There is no
death certificate which was issued by any doctor or even by Dr. Dharampal
Sharma. Interestingly, earlier a claim was lodged wherein it was stated that
Jaswant Kaur had died due to fever. Before the said claim was repudiated a
second claim was filed stating that Jaswant Kaur had died due to accidental
injuries. There is no reason forthcoming as to why in the first claim it was
stated that Jaswant Kaur had died due to fever and subsequently the story
was changed. It may have been understandable if there was any medical
record to support the change in the stand taken in the claim petition,
however, in the present case there is none.
8. In view of the above and in view of the fact that there is total
absence of evidence on the record to even remotely suggest that the death of
Jaswant Kaur was due to accidental injuries, this Court does not find any
merit in the present appeal. No question of law muchless substantial
question of law arises in the present appeal. The appeal is accordingly
dismissed. Pending applications, if any, also stand disposed off.
( ALKA SARIN )
21.03.2024 JUDGE
jk
NOTE: Whether speaking/non-speaking: Speaking
Whether reportable: YES/NO
integrity of this order/judgment
