Before the District Forum: Kurnool
Present: Sri K.V.H. Prasad, B.A., LL.B., President
And
Smt C.Preethi, M.A., LL.B., Member
Sri R.Ramachandra Reddy, B.Com., LL.B., Member
Wednesday the 9th day of March, 2005
C.D.No. 69/2004
Smt Hussainamma,
W/o. Dudekula Peddakasim,
R/o. 3/194,
Kotha Peta,
Bethamcherla (V),
Kurnool Dist. . . . Complainant represented by his
counsel Sri C. Satyanarayana,Advocate
-Vs-
1. Branch Manager,
Andhra Bank,
Betchamcherla (V),
Kurnool Dist. ... Opposite party No.1 represented by his
Counsel Sri A.Ramasubba Reddy,Advocate
2. Divisional Manager,
National Insurance Co Ltd,
Division -1, Post Box No.236,
Jhaveri Mansion, Bank Street,
Koti, Hyderabad. .. . Opposite party No.2 represented by his
Counsel Sri P. Ramanjaneyulu,Advocate
O R D E R
(As per Smt C.Preethi, Hon’ble Lady Member)
1. This CD complaint of the complainant is filed under section 12 of C.P. Act, 1986, seeking a relief against the opposite parties to pay policy amount of Rs.1,00,000/- with 12% interest per annum from the date of accident, Rs.10,000/- as compensation for suffered mental agony, Rs.2,000/- as costs of this case and any such other relief or reliefs which the complainant is entitled in the circumstances of the case.
2. The brief facts of the complainant’s case is that the complainant’s Son, Dudakula Shaik Shavali has opened an Abhaya Gold Savings Bank bearing A/c No. 10899 with opposite party No.1, which covers accidental benefits to the account holder as per the scheme in agreement with opposite party No.2. The complainant’s Son on 25.5.2003 died due to Snake bite and the claim is submitted through the District Collector to the opposite parties for settlement. But to the dismay of the complainant the opposite party No.2 through its communication dt 12.12.2003 repudiated the claim as there is no Post Mortem. Report and viscere test. But the complainant submits that the Doctor certificate and village secretary certificate establish that the complainant’s sons death is due to snake bite. Therefore, the non payment of policy amount to the complainant is amounting to deficiency of service.
3. The complainant in support of her case filed the following documents Viz (1) Xerox copy of repudiation letter of opposite party No.2 dt 12.12.2002 addressed to opposite party No.1 (2) Pass bok of deceased D.Shaikshavali bearing No. 10899 (3) Death Certificate issued by Dr G.V. Naidu dt 26.5.2003 (4) certificate issued by Sub. Inspector of Police, Bethamcherla Police Station and (5) Death Certificate issued by Village Secretary dt 27.5.2003, besides to the sworn affidavit of the complaint in reiteration of her complaint averments and the above documents are marked as Ex A.1 to A.5 for its appreciation in this case and caused interrogatories to the opposite parties.
4. In pursuance to the notice of this Forum as to this case of the complainant the opposite parties appeared through their standing counsel and contested the case by filing separate written versions as their defence.
5. The written version of opposite party No.1 questions the maintainability of the complainants case and admits the complainant’s son deceased D.Shaik Shavali opened an Abhaya Gold Saving Bank A/c No. 10899 and terms and conditions of the said scheme is printed on the last pages of the said book. On the intimation of death of account holder, the claim form was forwarded on 20.8.2003 by opposite party No.1 to opposite party No.2. But the opposite party No.2 through their letter dt 12.9.2003 expressed their inability to settle the claim on the ground that post mortem certificate and police reports are essential for settling the claim. Thereafter on 22.11.2003 the opposite party No.1 has written a letter to reconsider but opposite party No.2 did not accept for payment of assured amount. As per the scheme the opposite party No.1 has done every thing and it is for opposite party No.2 to settle the claim and therefore seeks for the dismissal of complaint against opposite party No.1.
6. In substantiation of its case the opposite party No.1 filed the following documents Viz (1) Proforma Pass book containing terms and conditions (2) letter dt 30.7.2003 of opposite party No.1 to opposite party No.2 (3) letter dt 20.8.2003 of opposite party No.1 to opposite party No.2 (4) letter dt 22.11.2003 of opposite party No.1 to opposite party No.2 and (5) repudiation letter dt 12.12.2003 of opposite party No.2 to opposite party No.1, besides to the sworn affidavit in reiteration of its written version and the above documents are marked as Ex B.1 to B.5 for its appreciation in this case and caused interrogatories to opposite party No.2 and suitablely replied to the interrogatories filed by the complainant.
7. The written version of opposite party No.2 questions the maintainability of the complainants case either in law or on facts and denies all the material allegations made in the complaint avernments. It admits as it expressed its inability to settle the claim without Post Mortem Report and Viscera Test vide letter dt 12.12.2003 to opposite party No.1 and the requirements made in the above letter are mandatory and not directory. It further submits that the opposite party No.2 is only binding on the contract in between opposite party No.2 and opposite party No.1’s Head office at Saifabad Hyderabad and not with opposite party No.1. The accidental claims any aroused during the policy period the opposite party No.2 will pay the same only when the policy holder satisfies the terms and conditions of the policy. As the complainant failed to satisfy the said conditions the opposite party No.2 was constrained to repudiate the claim of the complainant. And lastly it submits as per the claim No.12 of MOU between opposite party No.1and opposite party No.2 the Court at Hyderabad exclusively shall have jurisdiction to try any disputes raised by the insured persons/ the banker to any claims arising out of agreement. Hence, there is no deficiency of service on part of opposite party No.2 and seeks for the dismissal of complaint with exemplary costs.
8. In substantiation of its case the opposite party No.2 filed the following documents Viz (1) policy bond of Group Personal Accident along with terms and conditions and (2) agreement between M/s National Insurance Company Ltd and Andhra Bank, Head Office at Saifabad Hyderabad, besides to the sworn affidavit of opposite party No.2 in reiteration of its written version avernemnts and the above documents are marked as Ex B.6&B.7 for its appreciation in this case.
9. Hence, the point for consideration is whether the complainant has made out her case alleging deficiency of service and deficient conduct on part of opposite parties.
10. It may be stated at the out set that the dispute involves in this case centers round the claim of the complainant for Rs.1,00,000/- policy amount, and the dispute of the same is raised by the opposite parties by simply putting the complainant to strictly prove the material allegations of the complaint. The material facts that emerge from complaint averments are that complainant’s son by name one D.Shaik Shavali, who obtained Abhaya Gold Saving Account with opposite party No.1 vide Ex A.1. The Ex A.1 envisages, pass book bearing A/c No. 10899 was opened by the deceased by depositing Rs.4,000/- on 31.12.2001. Out of the said amount Rs.50/- was debited from his account towards insurance charges. The said Abhaya Gold Scheme was launched by opposite party No.1 in collaboration with opposite party No.2. Under the said scheme if any account holder’s death is due to accidental one an amount of Rs.1,00,000/- will be paid as accidental benefit to the beneficiaries of the account holder and in case of partial disability Rs.50,000/- will be paid. While such is so the son of the complainant died on 25.5.2003 due to Snake Bite and the said fact was intimated to opposite party No.1. It is also seen that the opposite party No.1 addressed a letter dt 30.7.2003 to the opposite party No.2 to send claim form and inturn claim form was sent to complainant. Accordingly the complainant submitted claim form with all relevant document to the opposite party No.1 who inturn forwarded the same to opposite party No.2 but the opposite party No.2 repudiated the said claim through their letter dt 12.12.2003. The main plank of attack made by opposite party No.1 is that it did its part of the job in complying with all the material furnished by the complainant to it and they have submitted it to opposite party No.2. They have also issued remainder letters dt 20.8.2003 and 22.11.2003 to opposite party No.2 to settle the claim of the complainant. As such the opposite party No.1 says that it is not liable to pay any amount to the complainant. While the opposite party No.2 pleaded that it was only due to the fault or failure of the complainant in not furnishing required information and the material insisted by opposite party No.2 as per the terms and conditions of the scheme, the claim could not be settled. As such, it is seen from the pleadings each opposite parties blaming on others intersay. It is the submission of the learned counsel for complainant that the complainant’s son is an account holder of Abhaya Gold Scheme and his a/c No is 10899 opened with opposite party No.1 by paying Rs.4,000/- on 31.12.2001 and maintained the account till his death on 25.5.2003 due to Snake bite as can be seen from the Doctor Certificate in Ex A.3 and certificate issued by sub inspector of police in Ex B.4 filed by the complainant. The Ex A.3 envisages that D.Shaik Shavali was taken to the Doctor G.V Naidu on 25.5.2003 at 10.30 P.M and that he was found dead by the said Doctor already due to Snake bite. The Ex A.4 envisages that D.Shaik Shavali’s death was due to Snake bite, the complainant made absolutely clear that the death of Shaik Shavali is on account of Snake bite and the same was informed to opposite party No.1 by the complainant and inturn opposite party No.1 forwarded to opposite party No.2, who did not settle the claim, but insisted for production of Post Mortem Report and Viscera Test. When the death is not due to Criminal Act their is no question of FIR and further the insisted documents as per opposite party No.1, are as per their terms and conditions, but there is no whisper in Abhaya Gold Scheme Pass book as to the filling of Viscera report or of any agreement that is in between opposite party No.1& 2 which binds the account holder. This stand of opposite party No.2 sticking on and insisting for the production of said documents unless produced the claim could not be settled is rightly repelled by learned counsel for complainant by placing reliance of the Hon’ble A.P.State Commission report in 2000 ALD (Cons) 96, wherein it was held that unless a death is of suspicious nature in question registering FIR, conducting postmortem or inquest does not arise. In that case also the facts were similar. As such the stand of Insurance Company insisting on the production of such documents is held to be illegal and not valid and untenable. The learned complainant counsel stressed re-iterating that since the death was resulted due to snake bite and that there was no suspicious no question of registering the F.I.R and of getting to autopsy conducted or inquest conducted does not arise. As such the plea of the opposite party No.2 is not tenable and the claim of the complainant is sustainable. The opposite party No.2 in their written version contended in bid to justify the stand of the opposite party No.2 insisting on production of the said documents cannot be countenanced in the light of the binding and direct ruling of the Hon”ble A.P.State Commission referred to above. It is further seen on careful scrutiny of the totality of the facts and circumstances having due regard to the nature of the claim and the written version and relative contentions that cannot be persuaded ourselves to accept the plea of the opposite party No.2 throw the blame on the opposite party No.1 to exonerate its liability. As such the opposite party No.1 done its job forwarding the material or the documents to the opposite party No.2 and also by reminding the same to settle the claim of the complainant. The claim of the complainant rather support that the complainant is beneficiary entitles the policy amount under the account. As regard to the evidence there is no independent material placed on record by the complainant to sustain her claim for compensation of Rs.10,000/- for the mental agony and other costs as claimed. But due to non settlement of the claim of the complainant by the opposite party No.2 though the considerable length of time taken the opposite party No.2 is liable to pay the amount with nominal costs of Rs.1,000/- besides the Insurance benefit amount of Rs.1.00 lakh. Thus, the point is found accordingly in favour of the complainant and against the opposite parties 1&2. The opposite party alleges that as per caused No.12 of MOU between opposite party No.1 & opposite party No.2, the Court at Hyderabad, exclusively shall have jurisdiction, but the deceased policy holder opened account bearing No. 10899 within the jurisdiction of this Forum. Hence, the complaint of the complainant has jurisdiction to be entertainably this Forum.
11. In the result, this complaint is allowed directing the opposite parties 1& 2 jointly and severally to pay a sum of Rs.1.00 lakh to the complainant together with interest @ 12% per annum from the date of the death of the deceased i.e 25.5.2003 till the date of payment together with costs of Rs.1,000/- within a month from the date of receipt of this order.
Dictated to the Stenographer, Typed to the dictation corrected by, us pronounced in the Open Court this the 9th day of March, 2005
Sd/-
Sd/- PRESIDENT sd/-
MEMBER MEMBER
