Per Smt. T.SUNEETHA , MEMBER

            The complainant filed this complaint u/s 12 of the Consumer Protection Act seeking directions on the opposite parties to pay a sum of Rs.1,00,000/- towards policy amount along with interest @ 12% p.a. from 25-09-2012 to 06-03-2013, and Rs.20,000/- towards compensation for mental agony and Rs.5,000/- towards legal expenses.

2.   In brief the averments of the complaint are these:

        The complainant’s husband by name Damarla Rama kanth expired on 12-09-2012 due to road accident which occurred on              08-09-12.  The complainant’s husband when he was alive was a member of 1^st opposite party with general member ship No.7035.  He availed crop loan from 1^st opposite party.  The 2^nd opposite party taken up the coverage of insurance facility under personal accident insurance scheme to all the members who availed loan under Kissan Credit Cards (K.C.C.)system.  The insurance coverage was extended to the members of the 1^st opposite party under the K.C.C scheme of the Jenata Personal Accident policy introduced by the 3^rd opposite party under the policy no.62100142120100000012.  The death occurred to the complainant’s husband within the coverage risk period under the said policy of the 3^rd opposite party. The 2^nd opposite party has obtained a blanket coverage policy on behalf of the 1^st opposite party and its members from 3^rd opposite party.  The sum assured for the risk coverage is Rs.1,00,000/-  Therefore, the 3^rd opposite party is under obligation to the extend benefit of the insurance coverage in the event of the accident to the insured covered under personal accident benefit scheme.  The insured died on 12-09-2012 the complainant who is the wife of deceased and nominee for the insurance policy informed to the 3^rd opposite party about the death of her husband and submitted their claim with all requisites like F.I.R, postmortem certificate, death certificate.  3^rd opposite party received all the documents and repudiated the claim through its letter dated 15-04-2013 for want of driving license because the insured met with an accident during driving.  Hence the complaint. 

3.      Version filed by the 1^st opposite party and is adopted by 2^nd opposite party which is in brief as follows: 

            The insured/complainant’s husband Late Damarla Rama kanth S/o.Pullaiah, R/o.Atchampet village & Mandal, Guntur district who was stated to have died on 12-09-2012 due to accident occurred on                08-12-2009, was a member of this opposite party under general membership No.7035 and have availed a loan under No.754 as he was K.C.C. holder of this opposite party. The loan availed by the insured is still subsisting.  The insured was also covered with Jenata Personal benefit scheme under the personal accident insurance (group named) policy issued by the 3^rd opposite party under No.62100142120100000012 covering from 24-04-2012 to 23-04-2013 with risk coverage for Rs.1,00,000/-.  The death occurred within the period of insurance coverage. The death of the deceased was immediately informed and the relevant papers like personal accident insurance claim form, F.I.R., Postmortem inquest were submitted to the 3^rd opposite party who issued accident risk coverage policy by this opposite party.  It is the 3^rd opposite party who has to settle the claim in favour of the complainant. There is no deficiency of service on the part of 1^st & 2^nd opposite parties.  This opposite party or 2^nd opposite party are neither necessary nor proper parties to the complaint.  Hence the Hon’ble Forum may be pleased to dismiss the complaint against the 1^st & 2^nd opposite parties with costs.

 4.     3^rd Opposite party filed its version which is in brief as follows: 

          It is true that the G.D.C.C. Bank, Guntur i.e., 3^rd opposite party obtained Group Jenata Personal Accident Policy from our company for Rs.1,00,000/-  to the Kissan Credit Card members of the 2^nd opposite party valid from 24-04-2012 to 23-04-2013. The complainant has send claim form and other papers to the 1^st opposite party. Through the documents it is observed that at the time of the accident the husband of the complainant Damarla Rama kanth was driving T.V.S. Star City bearing No.AP 07 AX 6788 along with the pillion driver Shaik Bala Saida and also a gas cylinder.  Our company has addressed a Regd. letter dated 27-02-2013 to the 1^st opposite party to submit the attested copy of driving Licence of the deceased within 7 days since the accident occurred while the deceased was riding the two wheeler.    The 1^st opposite party addressed a letter dated 06-03-13 to the complainant requesting her to submit the driving license of the deceased.   But the complainant failed to submit the same.  Having waited for more than one month our company repudiated the claim of the complainant intimated the same to the 1^st opposite party through regd. letter dated 15-04-2013.  The 1^st opposite party intimated the same to the complainant through a letter dated 15-04-2013.  As per the provisions of Sec. 181 of Motor Vehicle Act, driving vehicle without having driving license is punishable offence.  Under these circumstances our company has rightly repudiated the claim of the complainant.  There is no deficiency of service on the part of this opposite party.  Therefore, the Hon’ble Forum may be pleased to dismiss the complaint with costs. 

5.      The complainant and opposite parties filed their respective affidavits. Exs.A-1 to A-9 was marked on behalf of the complainant.  Ex.B-1 to B-4 are marked on behalf of the 3^rd opposite party.

6.   Now the points that arose for consideration in this complaint are:

1. Whether there is any deficiency of service on the part of opposite parties?
2. To what relief?

7.      POINT NO.1:

        The complainant alleged that the death claim of her deceased husband, was repudiated by the 3^rd opposite party for the reason that the deceased died while he was driving the vehicle without the driving license and as per the provisions of Motor Vehicle Act, one should possess an effective driving license to drive the said vehicle U/s.3 of Motor Vehicle Act and punishable U/s.181 of the same Act.

                The 3^rd opposite party’s contention that the necessity of driving license for the insured under the personal accident policy is not supported by any document. Neither the policy filed by the complainant nor the documents filed by the opposite parties contained the terms and conditions of the policy.  The 3^rd opposite party should have filed the terms and conditions of the policy for perusal.        

        In these circumstances, the Forum opines that the insured / deceased was not aware of the terms & conditions when he entered the contract of insurance with the opposite parties. With out such expressed condition is present on the policy the insured would not have chance to know about the conditions.  The 3^rd opposite party committed deficiency of service by not settling the claim of the complainant.  Therefore, the complainant is entitled to claim amount and compensation from the 3^rd opposite party. This point is answered in favour of the complainant.

8.      POINT NO.2:-

        Since, the 3^rd opposite party committed deficiency of service by not settling the claim amount of the insured. The 3^rd opposite party is  liable to compensate the complainant for mental agony.

        The complainant filed affidavit dated 07-03-14 stating:

    “I have no objection to passing on the claim amount claimed by me along with interest and transfer to 1^st opposite party for discharge loan amount of my deceased husband”

        In view of the said memo directing the 3^rd opposite party to give the claim amount (along with 9% interest from the date of claim till date of complaint) to the 1^st opposite party to discharge the loan taken by the complainant’s deceased husband would meet the ends of justice.

9.      In the result, the complaint is allowed in part, in terms as indicated below:

1.  The 3^rd opposite party is directed to pay claim amount of   Rs.1,00,000/- (Rupees one lakh) along with interest @ 9% p.a. from 25-09-2012 (date of claim) till 06-05-13 (date of complaint) to the 1^st & 2^nd opposite parties.

2.     The 3^rd opposite party is further directed to pay a sum of Rs.2,000/- (Rupees two thousand) towards compensation for mental agony to the complainant.

3.     The 3^rd opposite party is further directed to pay a sum of Rs.1,000/- (Rupees one thousand) towards legal expenses to the complainant.

4.     The claim against 1^st & 2^nd opposite parties is dismissed.

The above order shall be complied within a period of six weeks from the date of receipt of this order, failing which the amounts ordered in item No.2 shall carry interest @ 9% p.a. till realisation.

Typed to my dictation by Junior Steno, corrected by me and pronounced in the open Forum dated this the 27^th day of March, 2014.

    Sd/-XXX                                    Sd/-XXX                                   Sd/-XXX

MEMBER                                    MEMBER                              PRESIDENT

APPENDIX OF EVIDENCE

DOCUMENTS MARKED

For Complainant:

For opposite parties:   

                                                                                                        Sd/-XXX

        PRESIDENT

NB:   The parties are required to collect the extra sets within a month after receipt of this order either personally or through their advocate as otherwise the extra sets shall be weeded out.