Complaint is filed on 14-07-2009
Compliant disposed on 4-6-2010
BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM ::AT:: KARIMNAGAR
PRESENT: HON’BLE SRI K. DEVI PRASAD, B.Sc., LL.B., PRESIDENT
SRI. K. CHANDRA MOHAN RAO, B.Com ., LL.B., MEMBER
FRIDAY, THE FOURTH DAY OF JUNE, TWO THOUSAND TEN
CONSUMER COMPLAINT NO. 110 OF 2009
Between:
Elpula Ramavva @ Ramakka, W/o. Late Erraiah, Age 47 years, Occ: House wife, R/o. Dongathurthy, V/o. Dharmaram mandal of Karimnagar district.
… Complainant
AND
- The Branch Manager, Andhra Bank, Ratnapoor (v), Ramagundam mandal, Karimnagar district.
- The Divisional Manager, United India Insurance Co. Ltd., Divisional Office No.4, II Floor Posnett Bhavan, Ram Koti- Hyderabad.
…Opposite Parties
This complaint is coming up before us for final hearing on 11-5-2010, in the presence of Sri M. Anil Kumar and D. Sridhar, Advocates for complainant and Sri Ch.Shiva Kumar Raju, Advocate for opposite party no.1. The opposite party no.2 remained exparte, and on perusing the material papers on record, and having stood over for consideration this day, the Forum passed the following:
:: ORDER::
1. This complaint was filed on 14.7.2009 under Section 12 of C.P.Act 1986. The brief facts of the complaint are as detailed below.
2. The complainant is the resident of Rathnapur village and the wife of the deceased Elpula Erraiah who had account under Abhaya Gold Scheme with opposite party no.1’s Bank of Rathnapur Village under A/c.No.90621 opened on 22.5.2001. A Pass Book was issued to the deceased with assurance of insurance coverage to the extent of Rs.1,00,000/- in the event of accidental death of the account holder payable by opposite party no.2 under contract of insurance between the insured and insurer.
3. The deceased died on 11.1.2006 at Edulapur on account of accidental fall into SRSP Canal. A case was registered with Police Station Srirampur who carried out investigation under Cr.No.02/2006 and reported that the death was due to mechanical Asphyxia due to drowning based on PME Report Dt: 14.4.2006.
4. After the receipt of report from Police the complainant approached opposite party no.1 with request for payment of Rs.1,00,000/- entitled under the terms of Abhaya Gold Scheme in respect of the account held by the deceased. But surprisingly opposite party no.2 the insurer repudiated her claim on 31.7.2007 on the plea that the deceased had fallen into the Canal on account of consumption of Alcohol and died as was found in enquiry and scrutiny of papers. Based on this conclusion opposite party no.1 issued a letter to the complainant informing of the said repudiation.
5. The complainant submits that the rejection of her claim by opposite party no.1 & 2 is not proper and unjustified pleading that her husband had died on account of accidental fall into Canal, but not under the influence intoxicant as alleged by opposite party no.2. The rejection of her claim is illegal and intentional without any valid material. The complainant alleges that this repudiation is against the spirit of Insurance Law because opposite party no.1 is legally bound to protect the interest of the account holders. The ground stated by opposite party no.2 for repudiation of her claim is without any material but only to evade payment of the assured amount, which constitutes that opposite party no.1 & 2 are deficient of service. The complainant asserts that she is a consumer within the meaning of C.P.Act 1986.
6. In order to substantiate her claim the complainant refers to another account held by the deceased with opposite party no.1 under A/c.No.4245 covering risk of accidental death by opposite party no.2, in which opposite party no.2 accepted her claim and paid Rs.25,000/- as liable under insurance terms to the complainant without raising any objection. Subsequently the complainant approached opposite party no.1 to settle her claim but to no success. Alternatively complainant got issued Legal Notice on 8.6.2009 to opposite party no.1 & 2 under registered post no.5524 Dt: 8.6.2009. Opposite party no.1 replied on 9.6.2009 stating that he was only a facilitator and so the responsibility of settling her claim lay with opposite party no.2 the insurer. But opposite party no.2 has not yet given any reply to her legal notice. No acknowledgment has been received from opposite party no.2 though Legal Notice is send to correct address. As such the Legal Notice is deemed to have been served on opposite party no.2 under the provisions of Sec 27 of General Clause Act.
7. As such the complainant filed this complaint in this Forum on 14.7.2009 praying for direction to opposite parties to pay a sum of Rs.1,00,000/- assured under the said Abhaya Gold Policy under A/c.no.90621, Rs.10,000/- towards mental and physical agony and Rs.5,000/- as costs totaling to Rs.1,15,000/- jointly or severally.
8. Opposite party no.1 filed counter on 25.9.2009 denying all the allegations made in the complaint, terming them as false, fabricated, baseless and misconceived. Opposite party no.1 submits that this complaint is not maintainable on the ground that the there is no defect or deficiency of service on the part of opposite party no.1. Opposite party no.1 avers that there was no delay on its part. Opposite party no.1 further contends that the complainant is not a consumer within the meaning of Sec 2 (1) (d) of C.P.Act 1986. Opposite party no.1 pleads that there was no privity of contract between the complainant and opposite party no.1’s Bank and as such the complaint is liable to be dismissed. Opposite party no.1 submits that soon after the receipt of claim papers from the complainant they were forwarded to opposite party no.2 the insurer for settling her claim. As such opposite party no.1 cannot be held deficient of service.
9. Since opposite party no.1 is only forwarding agency, the liability of settling the claim of the complainant is shifted to opposite party no.2 the insurer. As such opposite party no.1 has nothing to do with regard to repudiation of her claim. Opposite party no.1 submits that it reserves the right to file additional counter as and when necessary at later stages. Opposite party no.1 contends that the claim of Rs.1,15,000/- under different heads is exorbitant, un-just, arbitrary and without any legal basis and finally prays for dismissal against opposite party no.1.
10. Opposite party no.2 did not file any counter or documents and was set exparte on 7.9.2009.
11. The complainant and opposite party no.1 have filed their Proof Affidavits reiterating the allegations and denials in the mentioned in complaint and counter. Opposite party no.1 did not choose to file any document. The complainant filed documents marked under Ex.A1 to A16. Ex.A1 is the original Pass Book of A/c No.90621 issued by opposite party no.1. Ex.A2 is another original Pass Book of A/c No.4245 issued by opposite party no.1. Ex.A3 is the copy of letter of settlement of claim pertaining to the A/c No.4245 by opposite party no.1. Dt: 12.2.2008. Ex.A4 is the letter of repudiation Dt: 31.7.2007. Ex.A5 is the copy of Final Opinion as to the case of death Dt: 14.6.2006. Ex.A6 is the PME Report Dt: 12.1.2006. Ex.A7 is the copy of death Certificate Dt: 2.6.2006. Ex.A8 is the copy of Family Members certificate Dt: 4.3.2006. Ex.A9 is the Xerox copy of F.I.R. Dt: 12.1.2006. Ex.A10 is the attested copy of Report/Opinion issued by A.P. Forensic Science Laboratories Dt: 25.2.2006. Ex.A11 is the Xerox copy of Final Report issued by the Hon’ble Executive Magistrate and MRO at Srirampur Dt: 29.4.2006. Ex.A12 is the copy of Inquest Report in Cr.No.02/2006 Dt: 12.01.2006. Ex.A13 is the copy of Legal Notice Dt: 8.6.2009 issued by counsel for complainant addressed to opposite parties. Ex.A14 is the postal receipt. Ex.A15 is the Acknowledgment Card. Ex.A16 is the reply from opposite party no.1 Dt: 9.6.2009 addressed to counsel for complainant.
12. Point for consideration is whether the opposite parties are deficient in service and if so what relief can be awarded to the complainant?
13. A perusal of the records and documents reveal that the deceased died of accidental fall in the SRSP Canal. The PME Report marked under Ex.A5 states the cause of death as mechanical Asphyxia due to drowning which strengthen the claim of the complainant that the death of the deceased is accidental.
14. The allegation that the deceased had fallen into Canal on account of consumption of intoxicant and died as attributed by opposite party no.2 vide Ex.A4 letter Dt: 31.7.2007 for repudiating the claim of the complaint as mentioned in the complaint, though diagnosed as opposite party no.2 failed to file its counter or any evidence through documents. Opposite party no.2 was set exparte on 7.9.2009.
15. Besides opposite party no.2 accepted the similar claim by the complainant in respect of another account no.4245 under Ex.A2 held by the deceased covering risk of accidental death and sanctioned Rs.25,000/- as assured under the said account, vide its letter Ex.A3 without raising any objection. As such repudiation of claim of complaint by opposite party no.2 in respect of account no.90621 held by the deceased, husband of complaint is unjust and untenable and amounts to deficiency of service on the part of opposite party no.2.
16. A look at the Pass Book Ex.A1 of the deceased in respect of account no.90621 reveals the absence of any mention with regard to plea of opposite party no.1 that its role is only as a facilitator and forwarding agency for settlement of claim arising of accidental deaths, which amounts to deficiency of service on the part of opposite party no.1 towards the complainant.
17. The plea of opposite party no.1 that the complainant is not a consumer is ill-founded and untenable in the light of provision under Sec 2(1) (d) II of C.P. Act 1986.
18. In the result the complaint is allowed and the opposite parties are directed to pay jointly and severally to the complainant a sum of Rs.1,00,000/- as assured under Abhaya Gold Scheme with interest @ 9% per annum from the date of filing the complaint i.e. 14.7.2009 till the date of realization and Rs.1,000/- as costs within one month from the date of receipt of this order.
Dictated to Stenographer and transcribed by her, after correction the orders pronounced by us in the open court this the 4th day of June, 2010.
Sd/- Sd/-
MEMBER PRESIDENT
NO ORAL EVIDENCE HAS BEEN ADDUCED ON EITHER SIDE
FOR COMPLAINANT:
Ex.A1 is the original Pass Book of A/c No.90621 issued by opposite party no.1.
Ex.A2 is another original Pass Book of A/c No.4245 issued by opposite party no.1.
Ex.A3 is the copy of letter of settlement of claim pertaining to the A/c No.4245 by opposite party no.1. Dt: 12.2.2008.
Ex.A4 is the letter of repudiation Dt: 31.7.2007.
Ex.A5 is the copy of Final Opinion as to the case of death Dt: 14.6.2006.
Ex.A6 is the PME Report Dt: 12.1.2006.
Ex.A7 is the copy of death Certificate Dt: 2.6.2006.
Ex.A8 is the copy of Family Members certificate Dt: 4.3.2006.
Ex.A9 is the Xerox copy of F.I.R. Dt: 12.1.2006.
Ex.A10 is the attested copy of Report/Opinion issued by A.P. Forensic Science Laboratories Dt: 25.2.2006.
Ex.A11 is the Xerox copy of Final Report issued by the Hon’ble Executive Magistrate and MRO at Srirampur Dt: 29.4.2006.
Ex.A12 is the copy of Inquest Report in Cr.No.02/2006 Dt: 12.01.2006.
Ex.A13 is the copy of Legal Notice Dt: 8.6.2009 issued by counsel for complainant addressed to opposite parties.
Ex.A14 is the postal receipt.
Ex.A15 is the Acknowledgment Card.
Ex.A16 is the reply from opposite party no.1 Dt: 9.6.2009 addressed to counsel for complainant.
FOR OPPOSITE PARTIES: -NIL-
Sd/- Sd/-
MEMBER PRESIDENT
