Before the District consumers 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
Monday the 11th day of August, 2003
C.D.No.86/2002
Y.Sarada Devi,
Wife of Late Y.Mallaiah,
House No.1-14-D, Raithunagaram (V),Nandyal (M),
Kurnool District. . . . Complainant represented by her counsel
Sri J.P.Basava Raj, Advocate.
-Vs-
- The Branch Manager,
Represtented by its Branch Manager,
Life Insurance Corporation of India,
Kurnool.
- The Divisional Office,
Life Insurance Corporation of India,
Represented by its Divisional Manager,
P.B.No.10, College Road,
Cuddapah-516 004 . . . Opposite parties represented by his counsel Sri.I.Anantha Rama Sasiry, Advocate
O R D E R
This CD complaint of the complainant is filed under section 12 and 13 of C.P. Act, 1986, is for direction on the opposite party to pay her the Accidental Benefits due for RS.1, 85, 000/- with 18% interest per annum till payment, RS.50, 000/- as compensation for mental agony and any other relief or reliefs which the complainant may be entitled in the exigencies of the case.
The brief facts of the complainant’s case as per the complaint is that the complainant is the wife and nominee of one Y.Mallaiah who holds 6 LIC policies No.s 650024141, 651318713, 651586169, 651598191, 651588055 and 651588989. The said Mallaya died on 1.6.1998 and all the policies were in force at the time of his death. The complainant informed about the death of the assured to the opposite parties and submitted claim forms. Inspite of various representations through letters dt 12.4.2000, 20.5.2000, 27.5.2000 and 6.10.2000 the opposite parties paid only the assured amount but repudiated the accident benefits under the said policies through their letters dt 21.5.2000, 12.7.2000, 29.5.2000 and 6.1.2001. The complainant further submits the opposite parties repudiated the claim of the complainant as the assured involved himself in an immoral activity and having committed breach of Law and was murdered, as the cause for assures death was murder the accidental claim was repudiated. A case in S.C.No.381/1999 in the Court of Principal Sessions Judge, Kurnool, was filed and the case was abated as the accused was also murdered. As the said repudiation for accident benefits was improper without proper assessment of relevant record and the said conduct of opposite parties in repudiating the claim is amounting to deficiency of service, the complainant resorted to this Forum for redressal of her grievances.
The complainant encloses to the complaint the following documents Viz, Postmortem Certificate, FIR copy in crime No.107/1998 of Nandyal Taluq P.S, inquest report of the deceased Yeddala Golla Mallaiah, FIR copy in crime No.123/1999 of Nandyal Taluq P.S, remand report to the Addl. Judicial First Class Magistrate, letter of complainant to opposite party No.1 dt 12.4.2000 along with copy of Judgement of Sessions case No. 381/99, Fax receipt No.40419, confirm report of Fax dt 20.5.2000, office copy of letters of complainant to opposite parties dt 20.5.2000, 27.5.2000, 6.10.2000, another letter of the complainant dt Nil to the opposite parties along with courier receipt No.s 69227335 and 69227337, opposite party No.2 letters dt 21.5.2000, 12.7.2000, 29.5.2000 and speaking orders of the opposite parties dt 6.1.2001.
In pursuance of the receipt of the notice as to this case while the opposite party No.2 filed its written version in support and in defence to the complaint averments to contest the case and opposite party No.1 filed a memo adopting the written version of the opposite party No.2
The written version of the opposite parties besides questioning the justness and the maintainability of the complainants case denies the demise of Y.Mallaiah complainant’s husband as alleged in the complaint and alleges the suppression of the facts by the complainant as to the real cause of the demise of the said Y.Mallaiah. As the relevant case records FIR and inquest report disclose that the assured was murdered due to illicit contacts with the wife of the accursed, so the murder of the assured was not treated as accident even though the case is abated with the demise of the accused will not obliterate the factual position. As there is fraudulent mis-representation and suppression of material facts in the demise of the assured as it was not accidental, it justifies the repudiation of the accidental claim under 10 (b) (i) and (iv) of the terms and conditions of the insurance policy and already paying assured amounts of the 6 policies to the complainant.
The said repudiation of the accidental claims of the 6 policies was made through the speaking order dt 6.1.2001 advising the complainant if aggrieved to prefer an appeal before the Zonal Manager, LIC, Hyderabad, as the complainant did not prefer any appeal to the Zonal Manager it is not justifiable to raise her dis- satisfaction through Consumer Forum and denies of any deficiency of service on its part and so seeks the dismissal of complaint with costs.
The opposite parties encloses to its written version the following documents Viz speaking order dt 6.1.2001, Charge Sheet in Crime No.107/98 of Nandyal Taluq P.S. FIR copy in crime No.107/98 and policy conditions.
Hence the point for consideration is whether the complainant has made out any deficiency of service and the deficient conduct in repudiating of the accident claim of her deceased husband policies and there by any of her entitleness to the reliefs sought:-
The complainant encloses 19 documents mentioned in the list and the opposite party filed 4 documents, neither the complainant nor the opposite parties filed their sworn affidavit in re-iteration its versions in support of their documents so the documents are not marked as exhibits as mere filing of documents doesn’t dispence with its proof.
The opposite parties in its written version is not denying the status of the policy holder to the deceased husband of the complainant under the 6 LIC policies and the status of the complainant as nominee of the said policy holder. More over the opposite parties paid the contractual amounts under the above 6 policies in favour of the complainant on 12.12.1998 itself. The only dispute alleged by the opposite parties is that the assured death (murder) is not accidental as he invited death by having illicit relation with the wife of the accused. It is well settled that when an insurer repudiates the claim the burden to prove the allegation lies on the insurer in this case the opposite parties placed any material on record where from it can be inferred that there was any material facts as alleged by the opposite parties, on the other hand the opposite parties refering to charge sheet in crime No. 107/98 and FIR 107/98 which at the most envisages the allegations as to the death of the assured. On the death of the assured a case was registered under section 302 IPC, from the report it is evident that it was not a case of death caused by any immoral activity and having committed breach of law. More over the complainants husband case was abated in S.C.No.381/ 1999 as the accused was also murdered so no credence can be given to those documents.
Hence the opposite parties failed in substantiating the allegations made in their written version and the documents filed in its support does not appear to be worthy of any credit as the assured amount of the 6 policies have already been settled and paid to the complainant on the death of the assured and the said allegations of the opposite parties are not proved by placing any cogent relevant documents on record, hence no evidence remains placed to prove that said assured Mallaya involved in any immoral activity and having committed branch of Law.
In the said circumstances repudiating the accidental claim of the complainant, the conduct of opposite parties is certainly amounting to deficiency of service and thus entitling the complainant to the policy amount. A careful perusal of the documents placed will go to show that the repudiation of the accidental claim by opposite parties under the said 6 policies was not made after due consideration of the fact as the assured amount on the said 6 policies was settled by opposite parties itself and the said amount was paid to the complainant without entertaining any doubt and the said repudiation of accidental claim was made by the opposite parties on 6.1.2001 i.e lapse of 21/2 years after the demise of the assured.
In the result the complaint is allowed directing the opposite parties to pay the accidental claim of RS.1, 85/-000/- to the complainant with 9% per annum from the date of demise i.e 1.6.1998 till realization and as the opposite parties has driven the complainant to seek redressal in the Forum RS.10, 000/- and RS.2, 000/- as compensation and costs and the opposite parties are granted one month time from the date of receipt of this order for compliance. In default the opposite parties to pay the supra awarded amount with 12% interest per annum from the date of default of compliance of this order till realization.
Dictated to the Stenographer, Typed to the Dictation corrected by us, Pronounced in the Open court this the 11th day of August , 2003.
Sd/- Sd/- Sd/-
MEMBER PRESIDENT MEMBER
APENDIX OF EVIDENCE
Witnesses Examined
For the complainant:Nill For the opposite parties:Nill
List of Exhibits marked for the complainant:- Nil
List of Exhibits marked for the opposite parties:- Nil
Sd/- Sd/- Sd/-
MEMBER PRESIDENT MEMBER
//Certified free copy communicated under Rule 4 (10)
of the A.P.S.C.D.R.C. Rules, 1987//
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Complainant and Opposite parties :
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