Page 115 - Suri’s - NCDRC ON LIFE INSURANCE 2017 V1.3

Suri’s - NCDRC ON LIFE INSURANCE 2017 115

mission by way of an appeal. The said appeal having been dismissed, the insurer
is before this Commission by way of this revision petition.
3. The whole case of the petitioner company is that the insured was an alco-
holic and was diagnosed with alcohol lever disease and its complications. The afore-
said plea of the insurer is based upon certain photocopies of the record purporting to
be a Government Medical College & Hospital, Chandigarh in respect of the de-
ceased. It is an admitted position that no doctor who may have treated or examined
the insured in Government Medical College & Hospital, Chandigarh was produced
before the District Forum to prove that the deceased was an alcoholic and was diag-
nosed with alcohol lever disease and its complications. Admittedly, no official from
the aforesaid hospital was produced to prove that the photocopies filed by the insurer
were supplied by the said hospital and were true and correct copies of the record of
treatment of the deceased insured. In fact, as noticed by the State Commission, the
photocopies produced by the petitioner company were not even authenticated or certi-
fied by any official of the hospital. It was also noticed by the State Commission in
this regard that even the affidavit of the person who allegedly collected these photo-
copies from the hospital was not filed. In my view, since the complainant had denied
the alleged alcoholism and ailment of the insured, it was obligatory for the insurer to
either produce the doctor who had allegedly treated him in the hospital or to file his
affidavit. Alternatively, it could have examined an official of the hospital to prove
the authenticity of the photocopies which the petitioner company filed before the Dis-
trict Forum in support of its case. In the absence of any such evidence, mere produc-
tion of some unattested, unverified and unauthenticated photocopies, could not have
been the basis of holding that the deceased was an alcoholic and was diagnosed with
alcohol lever disease and its complications. No application for producing additional
evidence was filed by the petitioner before the State Commission, despite losing be-
fore the District Forum. No such application is filed with this Revision Petition. The
concurrent findings of the fora below therefore, do not call for any interference by
this Commission in exercise of its revisional jurisdiction.
4. During the course of arguments, it was pointed out by the learned counsel
for the petitioner company that the sum assured was only Rs.13,75,000/- but the Dis-
trict Forum has directed payment of Rs.15,10,250/- with interest on that amount. The
contention of the learned counsel for the complainant in this regard is that not only
the sum assured but some bonuses etc. were also payable in terms of the insurance
policy. It is made clear that if as per the terms of the insurance policy, a sum of
Rs.13,75,000/- was payable in the event of death of the insured, the petitioner com-
pany will pay only the said amount @ 9% per annum from the date of filing of the
complaint and the cost of litigation quantified by the District Forum and upheld by
the State Commission. If however, a higher amount was payable in the event of the
death of the insured, that amount shall be paid alongwith interest on that amount at
the same rate of interest alongwith compensation and cost of litigation. The payment
in terms of the order shall be made within four weeks from today. The revision peti-
tion stands disposed of.

......................J, V.K. JAIN, PRESIDING MEMBER

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