BEFORE THE DISTRICT FORUM:KURNOOL

Present: P.V.Nageswara Rao , M.A., LL.M., President(FAC)

And

Smt. C.Preethi,  M.A.LL.B., Lady Member

And

Sri. M.Krishna Reddy, M.Sc.,M.Phil., Male Member

Thursday  the 1^st day of October , 2009

C.C. 194/08

Between:

Smt. K. Rama Thulasamma  alias Thulasamma,  w/o. Late Korrapati Subba Reddy,

D.No.5/20, Cherla Kottur Village ,  Banaganapalli Mandal,  Kurnool District 518124.                            

  …      Complainant                                                     

                                 Versus

1. The Manager,  Andhra Bank,

DNo.23/6 Astanam Road, Banaganapalli- 518124.

1. The Branch Manager, LIC of India ,

D.No.40/2, R.S.Road, Nandyal - 518501.

3. The Divisional Manager, Pension and Group Scheme Divisional Office,

Jeevan Prakash Buildings ,  D.No.40-50-60-1, Hyderabad - 500063.              

                  ….Opposite parties

                            This complaint is coming on this day for orders in the presence of Sri. S.V.Krishna Reddy , Advocate,  for  the  complainant , and Sri. G.S.Vijaya Bhaskar Reddy ,    Advocate for  opposite  party No. 1 and  Sri. G.Md. Habeebur Rahiman ,  Advocate for opposite parties 2 and 3 and upon perusing the material papers on record, the Forum made the following.

ORDER

(As per Sri.M.Krishna Reddy, Male Member)

C.C.No. 194/08

1. Alleging deficiency of service , the complainant was filed U/S 12 & 13 of C.P.Act , 1986 seeking direction on the opposite parties to pay accidental death benefit of Rs.1,00,000/- with future interest covered under “AB Jeevan Abhaya” policy , Rs.20,000/- for causing mental agony and cost of the case.

1. The complainant  K. Rama Tulasamma is the widow  of Korrapati Subba Reddy  who died due to snake bite. The circumstances  that led to  file this complaint by Rama Tulasamma are that the husband of the complainant  opened ‘ AB Jeevan Abhaya “ bearing No. ABJ 1437 saving account in Andhra Bank , Banaganipalli. The benefit of the  ABJ SB A/c is that member  is entitled for an assurance of Rs.1,00,000/-  in case of normal death and Rs.2,00,000/-  in case of accidental death. While attending  to his field work on 05-07-2006, the husband of the complainant  died due to snake bike  . There upon the complainant requested  the opposite parties  to pay her , the amount with accident benefit  submitting all necessary documents  and forms. The opposite parties  failed to consider the death as accidental  and paid basic sum assured Rs.1 lakh treating the  death as normal. Inspite of her request  for the payment  of additional sum  of Rs.1 lakh  under accident  benefit , opposite parties did not  respond, therefore the  complainant is forced to file a complaint in this forum.

1.    The complainant in proof of his case filed her affidavit  and got Ex.A1 to Ex.A8 marked.

1. Per contra, the complaint was contested by opposite parties who filed written version  . Briefly stated, it is their case  that Andhra Bank , the Master  policy holder is opposite party No. 1 will act on behalf of the members  in all  matters relating to the scheme.  Andhra Bank  will only act as a facilitator  and settlement  of claims is done by insurance company at  their  sole discretion . Opposite party No. 1  admitted that the  husband  of the complainant  had AB  “ Abhaya Jeevan”  SB A/c No.1437 with him which was in force on 05-07-2006. On the receipt  of information  about the death of complainant’s husband , he passed on information to opposite parties 2 and 3  and requested  them to send claim forms to the complainant.  Accordingly  the claim forms  were sent to the complainant  and after receiving  the filled in forms  enclosed with necessary  documents from complainant , the opposite party  No. 1 forwarded  them to opposite party  No. 2 for the settlement. opposite party  No. 1  was only a facilitator  forwarding  the claim to opposite parties 2 and 3 , had no role  take a decision and has done  its job properly .Therefore there is  no deficiency  on the part of opposite party  No. 1 and hence it is prayed to dismiss the case against  him.

1. Opposite parties 2 and 3 are Branch Manager  , LIC of India  , Nandyal  and Divisional Manager  , P & Gs Unit, Division  office , Hyderabad  respectively. opposite party  No. 2 and opposite party  No. 3 filed  their joint written version  and according to their view ,the husband of the complainant  had SB A/c bearing No. ABJ 1437  with opposite party  No. 1 who is a master  policy holder . The account holder and husband  of complainant died  due to snake bite  on 05-07-2006 at 3.00 PM  while working in the fields  of cherla Kothur  Village  of Banaganipalli  Mandal was stated as fake, beliving that the death was normal , the assured sum of Rs.1 lakh as per MOU between LIC and AB was paid to the complainant  by Demand Draft bearing No. 323680 dated 28-10-2006 through  opposite party  No. 1 . Further the scheme is  envisaged  to provide  an amount of Rs.1 lakh  in the event of unfortunate death , if the death is due to accident an additional benefit equal to the sum assured  under the assurance  shall be payable to the ABJ A/c  holder. But as per  rule 16 of MOU , snake bite is excluded  from accident benefit. Therefore  the opposite party No. 2 and 3 discharged their liabilities  as per MOU and there is deficiency of service on their part. Hence the  complaint is not maintainable  and deserves for dismissal.  

6.     The documents  marked Ex.B1 and Ex.B2 are filed  by opposite parties to substantiate  their version.

7.     The points that arise for consideration are

1) Whether the death of the husband of complainant  due to snake  bite is entitled  to the accident benefit.

2) Whether the complainant has proved  deficiency in service on the part of the opposite parties ?

3) Whether the claim under accident benefit was unjustly repudiated?

8.       Admitted facts by both parties  are that the complainants husband had ABJ SB a/c 1437 in opposite party No. 1 bank. The benefit  of account holder was assurance  of Rs.1 lakh  in the event of unfortunate  death and Rs.2 lakhs in case of death  due to accident  .The complainants husband died due to snake bite  while he was working in his field at Chela Kothur Village of Banaganapalli Mandyal .   The opposite party No. 1 being  a facilitator forwarded  the claim forms and necessary documents , to opposite parties 2 and 3 i.e, insurance company . Ex.A3 insurance company paid an amount of Rs.1 lakh  vide D.D.No.323680 dated 28-10-2006 in favour of the nominee. K. Tulasamma  through  opposite party No. 1 treating  the death as unfortunate .  Ex.A4 is proceedings of MRO , Ex.A5 is copy of FIR , Ex.A6 is PM certificate . Ex.A7 is inquest report  envisages that the death of complainants husband was due to snake bite , Ex.A8 is a letter  from sub inspector  of police to the MRO. Banaganipalli establishing  that the death of the complainants husband  is unnatural  and ref. as Cr.No. 97/06  under Section 174 Cr.P.C. Accidental death  due to snake bite . But opposite party No. 2 and 3 disputed  that as per rule 16 of Ex.B2 snake bite  is excluded from accidental benefit.

9.     In view of the facts and circumstances contained in the above  paragraph if is felt that the  death of complainants husband is accidental and  that the insurance company  should think in such way that it would serve the purpose  and object of getting  insurance covering . Hence the Forum held that the widow of the insured is entitled to the accidental benefit.

10.    In the result , the complaint is allowed directing the opposite parties 2 and 3 jointly to pay Rs.2 lakhs  minus the amount already paid treating  the death as an accident  with interest @ 9% p.a from the date of claim  and Rs.1500/- towards the cost of the case within 45 days from the date of receipt of this order. The claim on opposite party No. 1 is dismissed.

Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 1^st day of October ,  2009.

        Sd/-                          Sd/-                          Sd/-

LADY MEMBER              PRESIDENT FAC)     MALE MEMBER

                                  APPENDIX OF EVIDENCE

Witnesses Examined

For the complainant :     Nil            For the opposite parties :Nil

List of exhibits marked for the complainant:-

             Sd/-                              Sd/-                                        Sd/-

LADY MEMBER                 PRESIDENT (FAC)                  MALE 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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