Chamba District Commission Holds Future Generally Insurance India Co. Liable For Wrongful Repudiation Of Accidental Claim Based On Invalid Blood Report

Brief Facts:

Late Mr Anil Kumar held an insurance policy with Future Generally Insurance India Insurance Company (“Insurance Company”) for personal coverage amounting to Rs. 1,00,000/-. One day, while driving, a stray animal appeared suddenly in front of his motorcycle. In an attempt to avoid a collision, he lost control and fell into a narrow valley. The accident led to his demise.

The Complainants, being the legal heirs, filed a claim with the Insurance Company. However, the Insurance Company rejected the claim. Feeling aggrieved, the Complainants filed a consumer complaint in the District Consumer Disputes Redressal Commission, Chamba, Himachal Pradesh (“District Commission”).

In response, the Insurance Company argued that according to the FIR filed at the local police station, Mr Kumar's death resulted from rash and negligent driving, causing intentional self-inflicted injury. Additionally, it argued that the Regional Forensic Science Laboratory (RFSL), Dharamshala, reported the presence of 222.76mg% Ethyl Alcohol in Mr. Kumar's blood. Based on this evidence, the Insurance Company argued that the claim made by the Complainants was rightfully repudiated.

Observations by the District Commission:

The District Commission referred to the RFSL report, which stated that there was the presence of ethyl alcohol in the blood of the deceased. However, during the cross-examination, the District Commission noted that there were discrepancies regarding the handling and testing of the blood sample. The Assistant Director from the Chemistry and Toxicology Division of the Himachal Pradesh State Forensic Laboratory admitted that the sample remained in their custody for a considerable period without specifying the exact date of testing. Furthermore, the District Commission noted that alcohol concentration could increase over time due to in vitro synthesis caused by bacterial action which raised doubts about the accuracy of the report.

Given these discrepancies and the reliance solely on the RFSL report by the Insurance Company, the District Commission held that the repudiation of the claim was unjustified. Therefore, the District Commission held the Insurance Company liable for deficiency in services. Consequently, the District Commission directed the Insurance Company to pay a sum of Rs. 1,00,000/- to the Complainants along with interest @ 9% per annum. It was also directed to pay a compensation of Rs. 10,000/- along with Rs. 10,000/- for the litigation costs to the Complainants.

Case Title: Asha Devi and Others vs Future Generally India Insurance Company Ltd.