Justice (Retd.) Surjit Singh, President (Oral):
1. This appeal, under Section 15 of the Consumer Protection Act, 1986, is directed against the order dated 15.03.2013, of learned District Consumer Disputes Redressal Forum, Hamirpur, whereby a complaint, under Section 12 of the Consumer Protection Act, 1986, filed by respondent Karam Chand, a brother of the deceased-Milkhi Ram, has been allowed and a direction given to the appellant to pay the sum assured, with interest at the rate of 9% per annum, from the date of the complaint, i.e. 04.09.2008, to the date of its payment and also to pay Rs.5,000/-, on account of litigation expenses.
2. Deceased-Milkhi Ram, was employed as a Beldar with Public Works Department, represented by respondents No.2 and 3. The Public Works Department had purchased a policy from the appellant, covering the risk of accidental death of its employees. The policy covered deceased-Milkhi Ram also. On 10.01.2006, when Milkhi Ram was engaged in the work of road construction/road repair and was carrying a bucket of hot coaltar, he stumbled and fell as a result of which hot coaltar fell on one of his face wrists and other parts of the body. He sustained burn injuries and was taken to a nearby Primary Health Centre immediately. From the Health Centre, he was shifted to Regional Hospital, Hamirpur, where he remained admitted upto 18.01.2006. He was treated conservatively for burn injury, as per medical record available on the record of the learned District Forum. On 18.01.2006, he was discharged and was advised rest upto 08.02.2006. He was again rushed to the Regional Hospital, Hamirpur, on 08.02.2006, with the problem of intestinal obstruction. He was operated upon on the same day. Next following day, he died.
3. Claim was lodged with the appellant, through respondents No.2 and 3, for payment of insurance money. Appellant repudiated the claim on the ground that the death had not taken place due to any accident, but because of intestinal obstruction. Respondent No.1, then filed a complaint, under Section 12 of the Consumer Protection Act, 1986, seeking a direction to the appellant to pay a sum of Rs.2.00 lacs, on account of insurance money, and also to pay compensation and litigation expenses.
4. Appellant contested the complaint and took the plea that cause of death of Milkhi Ram was intestinal obstruction and that the alleged accident, resulting in burn injuries, had no nexus with the death of insured.
5. Learned District Forum, vide impugned order, has concluded that the intestinal obstruction was the result of burn injuries caused by hot coaltar and with this finding, impugned order has been passed.
6. We have heard learned counsel for the parties and gone through the record.
7. Respondent-complainant examined a doctor of Regional Hospital, Hamirpur, who operated the deceased for intestinal obstruction and also testified about treatment of the deceased for burn injuries on the basis of record, consisting of treatment history, Annexure CW1/B and sisters chart, Annexure CW1/C. As per testimony of this doctor (whose name is Dr. R.K. Abrol, and was examined as CW1) deceased sustained burn injuries on his right hand, forearm, right thigh and face and was admitted to the Regional Hospital, Hamirpur, on 11.01.2006. The witness testified that he was again admitted on 08.02.2006, with the history of sudden onset of distension and pain abdomen and not passing stool and urine for the last one day. According to this witness, deceased had suffered chemical burns with sepsis and deformity of the wrist and complained of pain abdomen and distension of abdomen for the last three days. He was dehydrated and abdomen was distended and then surgery was conducted. The patient died on the next following day. As per this doctor, the burns suffered by the deceased and subsequent stress ulcer leakage and adhesions formation could have been the cause of intestinal obstruction.
8. To rebut the evidence of the above named doctor, appellant adduced additional evidence before this Commission. It tendered in evidence affidavit of a medical practitioner, namely Dr. D.J. Dass Gupta, who is on the panel of the appellant. As per affidavit of this doctor, he has given his opinion, Annexure A1, on the basis of the medical treatment record of Milkhi Ram. His opinion is to the effect that death was due to natural disease process and not due to accident, i.e. burn injury. The witness was cross-examined by respondent No.1s counsel. In the cross-examination, he admitted that intestinal obstruction could have been secondary to internal feeding, but qualified the opinion that in the case of deceased, burn injuries were not serious and also the obstruction had occurred long after the patient was discharged after treatment for the burn injury. Testimony of the witness that burn injuries were not serious, does not seem to be correct. Doctor from the hospital, where the patient was treated, namely CW1 Dr. R.K. Abrol, testified that deceased had suffered sepsis and deformity of the wrist, which fact by itself is enough to hold that the burn injuries sustained by the patient were of serious nature. Though the patient had been discharged on 18.01.2006, yet Annexure R2/A, issued by Medical Officer of Regional Hospital, Hamirpur, is to the effect that he was treated conservatively and was advised rest from 19.01.2006 to 08.02.2006. The fact that he was advised rest for so long a period, even after discharge, again suggests that the burn injuries were not minor, but of serious nature.
9. Dr. D.J. Dass Gupta, admitted in the cross examination that the doctor, who actually treated the patient, was in a better position to give opinion as to the exact cause of intestinal obstruction. The doctor, who treated the deceased, namely R.K. Abrol, CW1, stated that though the exact cause could have been ascertained only if the postmortem was conducted, yet in his opinion, the burn injuries caused stress ulcer leakage and adhesion formation, which caused intestinal obstruction, resulting in the death.
10. As a result of the above stated position, we are of the considered view that there was a nexus between the accident and the death of the patient and, therefore, the appeal is dismissed.
11. A copy of this order be sent to each of the parties, free of cost, as per Rules.