STATE CONSUMER DISPUTES REDRESSAL COMMISSION OF TELANGANA :

                                           At  HYDERABAD

                                                      FA 263 of 2015

                                                   AGAINST

                 CC No. 3 of 2010, DISTRICT FORUM, KHAMMAM

Between :   

Bajaj Allianz Life Insurance Company Ltd

Chennai rep. by its local Branch Manager

Khammam                                ..        Appellant/4^th opp. party

and

      01.         Ogirala Nagamani,

W/o. Late Ravinder, Age:40 Years,

R/o. H.No. 1-231-2, Banjara Colony,

Madhira Village & Mandal,

Khammam District. …  Respondent/Complainant

2. . Authorized Signatory, Road Safety Club Pvt. Ltd.,

 Admin Office, 2A, II Floor, Prakasham Road,

          T. Nagar, Chennai-17.

03..         Authorized Signatory, Reliance General Insurance Co.Ltd.,

               Regd. Office, 3rd Floor, Maker Chambers IV,

222, Nariman Point, Mumbai – 400 021.

04.          SKI Retail Capital Ltd., (Sri Ram Group Co.)

D.No.5-1- 193, 1st Floor, Behind II Town P.S.,

Beside R&B office, Wyra Road,

Khammam. ….      .Respondents/opposite parties 1 to 3

Counsel for the Appellant                  :         Sri Karra Srinivas

Counsel for the Respondents             :         Sri C. Ramachandra Reddy for R-1

                                                                      R2 to R4  served.

Coram                :

                 Honble Sri Justice B. N. Rao Nalla         …      President

                                           And

                          Sri Patil Vithal Rao              …      Member

                          Monday, the Nineteenth Day of February  

                                  Two Thousand Eighteen

Oral order : ( per Hon’ ble Sri Justice B.N.Rao Nalla, Hon’ble President )

                                                            ***

1)       This is an appeal  filed under Section 15 of the Consumer Protection Act by the 4^th  opposite party   praying this Commission  to set aside the  impugned order dated 14.07.2015  made in CC 3 of 2010  on the file of the  DISTRICT FORUM, Khammam.

2)       For the sake of convenience, the parties are described as arrayed in the complaint before the District Forum.

3).      The case of the complainant,   in brief, is that  she is the wife of Ogirala Ravinder, who had enrolled the Membership on 25-03-2007 during his life time with  the opposite party No.1  and it has issued benefits under the certificate insurance vide certificate No.361203 in turn the opposite party No.2 issued a certificate No.AF3/VA000002149 under group personal accident master policy bearing  No.12/29/14/00138/05/dt. 29-03-2007 for a period from 13-04-2007 to 12- 04-2008 and the same was issued by opposite party no.3. Her husband died on 28-03-2008 due to acute renal failure. The claim submitted with all relevant documents in the month of September, 2008 was not settled even after issuance of legal notices on 31.03.2009 and 02.06.2009 which amounts to deficiency in service on the part of the opposite parties. Hence the complaint to direct the opposite parties  to pay Rs.one lakhs, Rs. 20,000/- towards compensation for mental  agony etc and costs.

4).      The first opposite party opposed the above complaint by way  of written version, while admitting  that the husband of the complainant is the member of Road Safety Club with certificate TR No.3190437 for the purpose of Insurance cover and had given a membership card for 36 months, contended  that the opposite party No.1 is coordinating with the insurance company for providing policies to the members, therefore they cannot be made liable and the Insurance policy provided by Bajaj Allianz Life Insurance Company Ltd., for the period in which the deceased died is subject to the terms and conditions of the policy, they are liable to satisfy the claim of the complainant. It is  only to bring awareness among the public with regard to road safety and thereby educate them and make them as members of the club so as to enable them to get insurance cover from an insurance companies. They are confined to the extent of arranging the insurance policy of Insurance company to its members. The claim was  forwarded to Bajaj Allianz Life Insurance Company Ltd  On 09-10- 2008 along with documents which were furnished by the complainant to settle the claim and it is the Bajaj Insurance company to settle the matter. There is no deficiency in service on their part and hence prayed to dismiss the complaint.

5).      The second opposite party Reliance General Insurance contended that the

 insurance policy between the insurer or insured represents a contract between the parties, since the insurer undertakes to compensate the loss suffered by insured on account of risk covered by the insurance policy in terms of the agreement. The opposite party No.1 in its reply notice reported the claim of the complainant was sent  to the Bajaj Allianz Life Insurance Company but not with the opposite party No.2, the same was also informed to the complainant in its reply notice dt. 07-04-2009, inspite of it, the complainant made the opposite party No.2 as party to this complaint unnecessarily, with an ill motive to get wrongful gain from the opposite party No.2. There is no liability on their part. Hence prayed to dismiss the complaint against it.

6).      The complaint against opposite party No.3 is dismissed on 22-10-2010 as the steps against opposite party No.3 has not taken.

7).      The 4^th opposite party Bajaja Allianz Life Insurance company Limited contended that the  complainant has made communication with the opposite party No.1 pertaining to the policy mentioned by her which pertains to Bajaj Allianz General Insurance company and not of this opposite party. The  complainant has misconceived herself with regard to the actual policy wherein, she is supposed to claim the death claim and unnecessarily put this opposite party No.4 into hardship and inconvenience. The averments in the complaint are not within the knowledge of opposite party No.4 and hence unable to admit or deny the same.  The complainant has not established any willful fault, imperfection, shortcoming, inadequacy in the service of the opposite party No.4, There is no deficiency in service on its part and hence prayed to dismiss the complaint against it.

8)       During the course of enquiry before the District Forum, in order to prove her   case, the complainant’s father filed his evidence affidavit and got marked Ex.A1 to A-10 and 1^st opposite party filed his evidence affidavit and  got marked Ex.B1 to B4.  Heard both sides.

9)       The District Forum, after considering the material available on record, held and directed the opposite party No.4 to pay an amount of Rs.50,000/- (Rupees Fifty Thousand only) covered under the group policy bearing No. RCN 0000131, to the complainant with interest @ 9% p.a from the date of filing of the complaint i.e.16-11-2008 till the date of deposit and also directed to pay Rs.2000/- (Rupees two thousand only) towards cost. The complaint against opposite parties No.1 to 3 is dismissed, as they are formal parties.

10)     Aggrieved by the said order, the 4^th opposite party Insurance company preferred this appeal before this Commission.

11).    Appellant filed written arguments. R2 to R4 did not choose to contest the matter.

12)     The points that arise for consideration are,

(i)       Whether the impugned order as passed by the District Forum suffers from any error or irregularity or whether it is liable to be set aside, modified or interfered with, in any manner?

(ii)      To what relief ?

13).   Point No.1 :

There is no dispute that the husband of the first respondent/complainant by name late Ogirala Ravinder had taken an insurance policy from the opposite party No.3 through the opposite party No.1 vide enrollment number 361203, issued a certificate No.AF3/VA000002149 under group personal accident master policy vide No.12/29/14/00138/05/dt. 29-03-2007 valid from 13-04-2007 to 12-04-2008 for Rs.1,00,000/- towards death claim from opposite party No.3 and the complainant is the nominee to the said policy.  There is no dispute that the husband of the first respondent/compliant died on 28.03.2008 and she submitted death claim along with all relevant documents to the second respondent/1^st opposite party. There is no dispute that the claim was not yet settled.

14).    The contention of the 2^nd respondent/1^st opposite party is that the claim submitted by the first respondent/complainant was forwarded to the appellant/4^th opposite party Insurance company and they have no liability since they educate the people and make them as members of the club so as to enable them to get insurance cover from the insurance companies.  On the other hand, the appellant/4^th opposite party insurance company contended that the averments of the complaint are not within their knowledge. We have  observed  the 2^nd respondent/1^st opposite party sent the affidavit given by the nominee  to the appellant/4^th opposite party Insurance company for processing the claim ands taking necessary action vide Ex. B-2  to B4. Hence the contention of the appellant that they have no knowledge with regard to the settlement of the claim cannot be believed as true.

15)     The District Forum observed that the appellant/4^th opposite party even after receipt of intimation letters from the first opposite party no. on 28.04.2008, 07.07.2008 and 09.10.2008 vide Ex. B2, B3 and B4 failed to settle the claim hence it amounts to deficiency in service on its part.

16).    Counsel for the appellant Insurance company argued that the District Forum failed to see that the claim pertains to the “ Bajaj Allianz General insurance company” whereas the complaint was filed against “ Bajaj Allianz Life insurance Company “ as such, the appellant/4^th opposite party is not necessary party and ought to have dismissed the against the 4^th opposite party.  Since the 2^nd respondent/1^st opposite party Road Safety club in its counter at para 5 categorically stated that the Insurance policy provided by Bajaj Allianz Life Insurance Company Ltd for the period in which the deceased died is subject to the terms and conditions of  the policy of M/s. Bajaj Allianz General Life Insurance Co. Ltd, is liable to satisfy the claim. In view of the fact, the above contention need not be taken into account and further the 2^nd respondent/1^st opposite party forwarded the claim to the LIC and it was not rejected that it does not belong to it at the relevant time.

17).    After considering the foregoing facts and circumstances and also having regard to the contentions raised on both sides,   this Commission is of the view that there is no infirmity or irregularity in the impugned order. There are no merits in the appeal and hence it is liable to be dismissed.

18).    Point No. 2 :

In the result, the appeal is dismissed confirming the impugned order dated 14.07.2015 in CC  3/2010 passed by the District Forum, Khammam. There shall be no order as to costs. Time   for compliance four weeks.

                                                            PRESIDENT                     MEMBER                                                                           Dated :  19.02.2018..