Before the District CONSUMERS Forum Kurnool
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 February, 2005
C.D.No.151/2003
P.Gomathi,
W/o Narayana Reddy,
H.No.2/466-C,
Munnangi Rami Reddy Apartments,
Srinivasa Nagar,
Nandyal Post,
Kurnool District. . ..Complainant represented by his counsel
Sri.A.Rama Subba Reddy, Advocate.
-Vs-
- The Divisional Manager,
Oriental Insurance Company Limited,
Kurnool. . ..Opposite party No.1 represented by his counsel
Sri.D.Srinivasulu, Advocate.
- The Branch Manager,
Oriental Insurance Company Limited,
Nellore. . ..Opposite party No.2 represented by his counsel
Sri.V.V.Krishnama Raju, Advocate.
O R D E R
(As per Sri K.V.H. Prasad, President)
1. This consumer dispute case of the complainant is filed under section 12 of the C.P. Act seeking a direction on the opposite parties to pay Rs.2,00,000/- towards the risk coverage amount of the policy, Rs.10,000/- as compensation and costs of this case alleging deficiency of service of the opposite parties as the opposite parties not settled the claim preferred by the complainant on the pretext of the non-submission of the driving license of the deceased policy holder who insured with the opposite party No.2 under Janatha Accident Personal Insurance Scheme for the period 15-02-1999 to 14-02-2009 for a sum of Rs.2,00,000/- paying premium of Rs.500/- and died on 28-08-2001 at 12.41 noon near petrol bunk Atmakur Village of Nellore District while going on moped being hit by a Van.
2. As per the facts averred in the complainant the claim is made by the complainant consequent to the demise of Narayana Reddy the said policy holder in accident, seeking the risk covered amount of Rs.2,00,000/- as nominee and wife of the said policy holder. But the said claim preferred by the complainant was not settled on the pretext of the Driving License of the deceased policy holder was not submitted. In the absence of any stipulation in the terms and conditions of the said policy warranting the policy holder to hold a driving license to cover the risk of the accidental death the said non-settlement of the claim by the opposite parties is not justifiable and the said conduct of the opposite parties in non-settling the claim on the said pretext of non-production of the driving license of the said policy holder is a clear deficiency of service and making out the liabilities of the opposite parties for the claim of the complainant.
3. In pursuance of the receipt of the notice of this Forum as to the case of the complainant the opposite parties 1 and 2 made their appearance into the case and filed their written version statements in denial of the complainant’s case and any of their liability to the claim of the complainant.
4. The written version of the opposite parties 1 and 2 besides denying the truth of the complainant’s averments and requiring their strict proof and the dismissal of the complainant’s case with costs firstly questions the territorial jurisdiction of this Forum as the accident occurred at Atmakur Village of Nellore District which is beyond the territorial jurisdiction of the Kurnool Forum, secondly denying the alleged fact of loss of the Driving License of the deceased in the said accident, submit of its requirement for the settlement of the claim, thirdly of the defaultive conduct of the complainant in complying the requirements asked for the settlement of the claim and latter’s hasty approach to the Forum without waiting for the decision of the Insurance Company and lastly alleging the claim of compensation claimed as abnormal.
5. The written version of the opposite party No.2 besides denying any deficiency of service on its part allege the case of the complainant firstly barred by limitation against it, secondly alleging the opposite party No.1 as not authorized to represent and conduct in the complainant’s case for it as the cause of action has arisen within the jurisdiction of Nellore District Forum and thereby want of territorial jurisdiction of the Forum and thirdly the case of the complainant as premature as filed without providing required material to the opposite parties for the settlement and not awaiting the decision of the Company on the said claim and so seeks the dismissal of the complainant’s case with costs.
6. In substantiation of the complainant’s contention and its case while the complainant side has relied upon the documentary evidence Ex.A1 to Ex.A6, sworn affidavit of the complainant in reiteration of the case and the reply of it to the interrogatories served on it and that of the reply of the opposite parties to its interrogatories, the opposite parties side merely made their reliance on their sworn affidavit which are in reiteration of its defense and of the reply of the complainant’s side to its interrogatories.
7. Hence, the point for consideration is whether the complainant has made out the alleged deficiency of the service of the opposite parties in order to have the claim from the opposite parties?
8. The reply of the opposite party No.1 to the interrogatories of the complainant being not in a form of the sworn affidavit as contemplated under Order XI Rule 8 and 9 C.P.C. and Appendix-C Form No.3 they are not remaining worthy of consideration.
9. The Ex.A1 is the letter dated 02-01-2003 addressed by the opposite party No.2 to the complainant requiring the compliance of the complainant and providing it a copy of the driving license of the Narayana Reddy (Policy holder) within 7 days of the receipt of the said letter in default of which the claim will be closed. The complaint being preferred in this Forum on 18-07-2003 i.e., about 6 months after to Ex.A1 there appears no hasty conduct on the part of the complainant in approaching the Forum for redressal as from the Ex.A1 the non-compliance of the direction by the complainant within a week of the receipt of the said letter attracts closer of claim at their end and in the follow up of the said contingency or closer of claim the complainant approached the Forum for redressal of his grievance on the opposite parties arbitrary closer of the claim requiring the production of an irrelevant material for settling the claim not amounts to any premature or a hasty one.
10. The Ex.A4 is an attested Xerox copy of the receipt evidencing the payment of premium of Rs.500/- by the deceased policy holder on 15-02-1999 for the commencement of Janatha Personal Accidental Insurance in his favour from that day on wards for a period of 10 years covering the risk of the accidental death for an assured amount of Rs.2,00,000/- mentioned in the policy schedule in Ex.A3.
11. The Ex.A5 the terms and conditions covering the said scheme of the Janatha Personal Accident Insurance Policy for the age group of 5 to 70 years excludes from its scope the accidental deaths on account of intentional self injury, suicide or attempted suicide or that occurred violence under the influence of intoxicating liquors or drugs or that occurred directly or indirectly on account of insanity or on account of insured’s acts of committing any breach of the Law with criminal intends or an account of war, invasion act of foreign enemy, hostility of declared or un declared war, Civil war, rebellion, revolution, insurrection, mutiny, military or suspended power or on account of seizer, capture, arrest, restrains and detainments of all thieves, princes and the people of what nations, conditions or quality sover. This no condition of Ex.A5 contract governing the said policy scheme or exclusions which applies to the said policy takes any mention that the accidental death occurred of the insured whilest traveling on a vehicle, due to the other vehicles collision with it even, must possess a valid driving license for considering the said death claim. Hence, the opposite parties conduct of requiring the complainant to produce before it the copy of the driving license of the deceased policy holder is un warranted for settling the said claim of the accidental death of the said deceased policy holder. Hence, the demand of the opposite party by production of the driving license of the deceased as referred in Ex.A1 letter and the previous referred correspondence therein being requiring the complainant the production of that which is not required for the consideration and the settlement of the accidental death claim of the policy holder and further threatening to close the claim if the said was not complied by the complainant within a week receipt of the said communication remains without any doubt as an arbitrary one the consequential inaction on the said pretext amounts to deficiency of service.
12. The Ex.A6 letter dated 11-04-2002 of the Regional Office Oriental Insurance Company Limited, Hyderabad addressed to the complainant acknowledging the receipt of her letter dated 25-05-2002 and the Registration of her complaint as No.285 and revert to the complainant on hearing from its Divisional Office, Kurnool as to the position, also does not appear to be providing any material to feel any hastiness of the complainant in approaching the Forum for redressal as from the date of presentation of the complaint she appears to have waited for the response of the opposite parties for more than one year three months, thereafter to the Ex.A6. Further there being no material from the opposite parties side as to the settlement of the said claim either way so far even exhibits the high quality of indifference of the opposite parties and thereby making out deficiency of service of superlative quality.
13. The acts of every pendent light as to the additions to the pleadings or impleading of the parties dates back to the date of institution of the said complaint when once they were permitted and hence there appears no merits in the plea of the bar of the limitation to the complainant against the opposite party No.2, especially when it has corresponded with the complainant vide Ex.A1 and its earlier references mentioned therein and thereby acquised of the matters and further when it is not disputing the demise of the said insured due to accidental death on account of the road accident with a van and when it is not divulging in the replies to the interrogatories the source and the basis on which it could insist for driving license of the deceased policy holder who met accidental death.
14. Further the conditions of the said policy says if the company shall dis-claim the liability to the insured for any claim, such claim shall not within 12 calendar months from the date of such dis-claim, have been made the subject of the Suit in a Court of Law, then the claim shall for all purpose be deemed to have been abandoned and shall not thereafter be recoverable there under. By the above wording the claims on dis-claim shall be barred for being entertained Legal Redressal Agencies if they are not preferred within 12 calendar months of the said dis-claim. As there is no dis-claim at all of the claim of the complainant by the opposite parties by any specific repudiation, the said limitation does not operate against the complainant in his approach to this Forum for redressal of the grievances as to the conduct of the opposite parties in not settling her claim.
15. In the above circumstances as the opposite party No.2 more so appears to have not settle the claim requiring the production of such documents which is not obligated of its consideration under the terms and conditions of the policy for settling a claim of the accidental death, there appears a clear deficiency of service of the said opposite party towards the complainant, especially when it is not disputing or questioning the accidental demise of the policy holder for want of any other material in proof of the same.
16. As there is no dispute a to the assured amount of Rs.2,00,000/- in case the death of the policy holder under the said policy and as the Ex.A3 also envisages the assured amount as Rs.2,00,000/- and the demise of the policy holder Narayana Reddy husband of the complainant being on account of an accident occurred on road on account of the collision of a Van was not disputed by the opposite parties and the said accidental death of the policy holder as occurred during the subsistence of the said policy and the said policy being not vitiated otherwise the opposite party No.2 cannot escape of its liability to the claim of the complainant preferred under the said policy as nominee and his wife.
17. The jurisdiction of this Forum for entertaining this matter is not Ousted as the opposite party No.1 is a Branch transacting the business of the Oriental Insurance Company Limited to which the opposite party No.2 was also a Branch and the Section 11 Consumer Protection Act provides jurisdiction on the place of Branch also.
18. Therefore, in the result of the above discussion the compliant is allowed finding the deficiency of the service of the opposite party No.2 in settling the claim of the complainant and hence the opposite party No.2 is directed to pay to the complainant the assured amount of Rs.2,00,000/- of the policy holder under the said policy as the later met accidental death the contingency of which entitles the said amounts to his nominee wife, the opposite party No.2 is also directed to pay an interest of 12% on the assured amount from the date of the demise till realization as it delayed the settlement of the claim by its deficient conduct. The opposite party No.2 further directed to pay Rs.2,000/- as costs to the complainant to defray her legal expenses. Time for compliance of the supra order is one month to the opposite party No.2 from the date of the receipt of this order.
19. In the circumstances stated above the case of the complainant against the opposite party No.1 is dismissed.
Dictated to the Stenographer, Typed to the Dictation corrected by us, and pronounced in the Open Court this the 9th day of February, 2005.
MEMBER PRESIDENT MEMBER
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant :- Nil For the opposite parties :- Nil
List of Exhibits Marked for the complainant:-
Ex.A1 Letter dated 02-01-2003 addressed by opposite party No.2 to the complainant.
Ex.A2 Attested Xerox copy of claim Form.
Ex.A3 Attested Xerox copy of policy.
Ex.A4 Attested Xerox copy of payment receipt No.10/0849178.
Ex.A5 Printed broucher of terms and conditions of the policy.
Ex.A6 Letter dated 11-04-2002 from Regional Office to the complainant.
List of Exhibits Marked for the opposite parties:- Nil
MEMBER PRESIDENT MEMBER
