BEFORE THE DISTRICT CONSUMER FORUM :: WARANGAL
Present : Sri D. Chiranjeevi Babu,
President.
And
Sri.Patel Praveen Kumar,
Male Member.
Tuesday, the 14th day of June, 2011.
CONSUMER COMPLAINT No.64/2010
Between:
Smt.Pulla Vinodha, W/o.Late P.Raju,
Age:33 years, Occu:Household,
Permanent resident of Uppal Post,
Kamalapur Mandal.
Presently residing at Laxmipuram,
Near Hanamkonda Bus Stand,
Hanamkonda, Warangal District. …Complainant
And
The Branch Manager,
LIC of India, Jeevan Jyothi,
Main Road, Parkal,
Warangal District. …Opposite Party
Counsel for the Complainant :: Sri.P.Nagesh, Advocate.
Counsel for the Opposite Party :: Sri.Md.Valiuddin, Advocate.
This complaint is coming for final hearing before this Forum, the Forum pronounced the following order.
ORDER
Sri D. Chiranjeevi Babu, President.
This complaint is filed by the complainant Smt.Pulla Vinodha against the Opposite Party under section 12 of Consumer Protection Act, 1986 for a direction to pay an amount of Rs.2,00,000/- i.e. Rs.1,00,000/- being the outstanding amount towards double the policy amount and Rs.1,00,000/- towards harassment, mental torture, agony along with interest and with costs.
The brief averments contained in the complaint filed by the complainant are as follows:
The case of the complainant isthat the complainant is the wife of Late Pulla Raju, who died in road accident on 29-09-2008. During his lifetime, the deceased Raju obtained policy bearing No.687659948 for Rs.1,00,000/- commenced from 14-10-2006 from Opposite Party, for which the complainant is the nominee. Due to the death of the deceased, the complainant is entitled to receive double the amount of sum assured. The Opposite Party paid only Rs.89,000/- instead of Rs.1,09,000/- by deducting Rs.20,000/- towards new policy, but the policy has not been released. The complainant made several demands with Opposite Party not to deduct Rs.20,000/- from the policy benefits amount. But the Opposite Party has given deaf ear to her request. The policy sum assured amount of Rs.1,00,000/- and as per rules in the event of death of policy holder the nominee is entitled to receive double the amount of sum assured i.e. Rs.2,00,000/-. The efforts of the complainant with Opposite Party for full payment are in vain. Vexed with the attitude of Opposite Party, the complainant got issued Legal Notice dt:26-08-10 to the Opposite Party for making payment of full benefits of policy amount, for which no reply is received. The acts of Opposite Party amounts to deficiency of service. Hence filed this complaint praying to direct the Opposite Party to pay Rs.2,00,000/- with interest and costs.
The Opposite Party filed the Written Version stating that the Late Sri Pulla Raju had obtained a life insurance policy from Opposite Party Corporation during his lifetime. The Policy Number is 687659948; Date of commencement 14-10-2006; Plan & Term 149-21; Sum Assured 1,00,000/-; Nominee Smt.P.Vinoda, Wife.
The Opposite Party stated that, as per intimation submitted to the Opposite Party Corporation, the said life assured died on 29-09-2008 i.e. within 2 years of commencement of the policy, as such treating the claim under the said policy as Early, as per the rules of the Opposite Party’s Corporation, an investigation has been caused into the bonafides of the said claim, so as to decide its admissibility. During the investigation, it came to light that the deceased life assured had died due to a Road Accident near Ogulapur. As per the conditions and privileges printed on the back of the policy document under the aforesaid policy, under the heading 10(b), the Corporation shall not be liable to pay the Additional Sum referred in (a) or (b) above, if the disability or the death of the Life Assured shall be caused, resulting from the Life Assured Committing any breach of law. The deceased life assured was not possessing any Driving License, which is a violation of the provisions of Motor Vehicles Act. A person driving a vehicle without driving license may endanger his own life and also that of the other travelers on the road.
Further the Opposite Party stated that driving a two wheeler without valid driving license is a breach of law, and as such after careful consideration of all the facts and circumstances of the claim, the standing committee at Divisional Office of the Opposite Party Corporation had decided to admit the claim for basic sum assured only and repudiate the claim for Accident Benefit. Accordingly, the claim was settled for Basic sum assured and Accrued Bonus, since consideration of Accident Benefit is subject to the conditions mentioned under Para 10 of the Conditions and Privileges printed on the back of the Policy bond.
Further the Opposite Party stated that the repudiation of the accident benefit claim under the above said policy was done strictly in accordance with the policy conditions printed on the back of the policy bond under Para 10, and as such all the reliefs prayed for by the complainant at the end of the complaint are fully untenable.
Further the Opposite Party stated that the Hon’ble National Consumer Disputes Redressal Commission, New Delhi have held vide order dated: 26-10-2010 in R.P. No.2922/2006 between LIC of India Vs. D.Veerabhadraiah, basing on the Citation of Hon’ble Supreme Court in Oriental Insurance Co.Ltd., Vs. Sony Cheriyan (1999) SCC 451 held that Since the Insurer undertakes to compensate the loss suffered by the insured on account of risk covered under the policy, the terms of agreement have to be strictly construed to determine the extent of the liability of the insurer and the Opposite Party requested this Forum to dismiss this case.
The complainant in support of her claim, filed her Affidavit in the form of chief examination and also marked Exs.A-1 to A-5. On behalf of Opposite Party V.Bhaskar filed his Affidavit in the form of chief examination and also marked Exs.B-1 to B-6.
Now the point for consideration is:
1) Whether there is any deficiency of service on the part of the Opposite Party?
2) If so, to what Relief?
Point No.1:-
After arguments of both side counsel, our reasons are like this:
The main argument of the Opposite Party is that, as per the conditions and privileges printed on the back of the policy document under the aforesaid policy, under the heading 10 (b) the Corporation shall not be liable to pay the Additional Sum referred in (a) or (b) above, if the disability or the death of the Life Assured shall be caused, resulting from the Life Assured Committing any breach of law. As per the policy bond, it includes that already an accident has to be proved the consideration of the Corporation.
Further the main argument of the Opposite Party is that the deceased life assured has not possessing any Driving License, which is a violation of provisions of the Motor Vehicles Act. A person driving a vehicle without driving license may endanger his own life and also that of the other travelers on the road is one of the violated conditions.
Further, the driving of two wheeler without valid driving license is a breach of law, and as such after careful consideration of all the facts and circumstances of the claim, the standing committee at Divisional Office of the Opposite Party Corporation had decided to admit the claim for basic sum assured only and repudiate the claim for Accident Benefit. Accordingly, the claim was settled for Basic sum assured and Accrued Bonus.
Further the argument of the Opposite Party is that the Hon’ble National Consumer Disputes Redressal Commission, New Delhi have held vide order dated:26-10-2010 in R.P. No.2922/2006 between LIC of India Vs. D.Veerabhadraiah, basing on the citation of Hon’ble Supreme Court in Oriental Insurance Co.Ltd., Vs. Sony Cheriyan (1999) SCC 451 held that Since the Insurer undertakes to compensate the loss suffered by the insured on account of risk covered under the policy, the terms of agreement have to be strictly construed to determine the extent of the liability of the insurer.
So as per this judgment the repudiation of the accident benefit claim under the above said policy was done strictly in accordance with the policy conditions printed on the back of the policy bond under Para 10, and as such all the reliefs prayed for by the complainant at the end of the complaint are fully untenable.
Further in this case, whether the deceased has violated the breach of law, this Forum has to see.
It is true as per Ex.A-1, it is Legal Notice shows that the deceased i.e. husband of the complainant died accidentally. Further it shows that in accident the deceased died. But the complainant has not filed any F.I.R., Charge Sheet or anything with regard to the accident. But the Opposite Party filed some of the documents like Ex.B-2 i.e. F.I.R., Ex.B-3 i.e. Panchanama, Ex.B-4 i.e. Postmortem Report, Ex.B-5 i.e. Final Report, those clearly goes to show that the deceased who was proceeding on Motor Cycle bearing No.AP36 R287 did not notice the parked because of focus of light of a vehicle which was coming in opposite direction, hit the parked lorry from behind. So the deceased died due to only accident. When the deceased died due to accident, certainly the deceased must have driving licence, but in this case there is no driving licence. Further the document i.e. Ex.B-5 clearly goes to show that, at the time of accident the driver was not having any valid driving license and he drove the vehicle & hit the parked lorry from behind with his vehicle. So it clearly goes to show that at the time of accident the deceased was not having any driving license. So the deceased committed breach of law and he violated the insurance conditions.
So whatever the Opposite Party has did is in correct manner because the deceased committed breach of law i.e. violation of provisions of the Motor Vehicles Act. Further the deceased committed breach of law, because at the time of accident, the deceased was not holding any valid driving license, so the deceased committed breach of law. When he committed breach of law under violation of provisions of the Motor Vehicle Act, the complainant is not entitled to get anything from the Opposite Party.Moreover, this is Jeevan Anand (with Accident benefit) Policy, certainly the driving licence is must.
Further shows that as per admission in Legal Notice i.e. Ex.A-1, the deceased died in an accident. When the deceased died in an accident, certainly the complainant has to file the driving license of the deceased. But in this case the deceased’s wife i.e. the complainant has not filed any driving license that shows the deceased committed breach of law. When the deceased committed breach of law, the nominee of the deceased i.e. the complainant is not entitled to get anything from the insurance i.e. Opposite Party.
Further, this Forum has asked the Complainant’s Advocate better file the driving license. He stated that the driving license is not there with the complainant. When he stated like that, certainly it goes to show that at the time of accident the deceased was not having any driving license. When the deceased was not having any driving license, as per Motor Vehicles Act, it is violation of the provisions i.e. breach of law. So that is the reason only, the insurance on careful consideration of all the facts and circumstances of the claim, the standing committee at Divisional Office of the Opposite Party Corporation had decided to admit the claim for basic sum assured only and repudiate the claim for Accident Benefit. Accordingly, the claim was settled for Basic sum assured and Accrued Bonus by the complainant in her complaint.
For the foregoing reasons given by us, we come to the conclusion that we see no grounds to allow this complaint and accordingly this first point is decided in favour of Opposite Party against the complainant.
Point No.2: To what Relief:- The first point is decided in favour of Opposite Party against the complainant this point is also decided in favour of Opposite Party against the complainant.
In the result, this complaint is dismissed without costs.
(Dictated to the Stenographer, transcribed by her, corrected and pronounced by us in the open Forum today, the 14th June, 2011).
President Male Member
District Consumer Forum, Warangal
APPENDIX OF EVIDENCE
WITNESSES EXAMINED
On behalf of Complainant On behalf of Opposite Party
Affidavit of complainant filed. Affidavit of Opposite Party filed.
EXHIBITS MARKED
ON BEHALF OF COMPLAINANT
1. Ex.A-1 is the Legal Notice from the complainant’s counsel issued to the Opposite Party.
2. Ex.A-2 is the Postal Receipt.
3. Ex.A-3 is the letter dt:21-01-2009 to the complainant from the Opposite Party.
4. Ex.A-4 is the Original copy of Death Certificate issued by Warangal Municipal
Corporation.
5. Ex.A-5 is the Award in O.P.No.208 of 2009 on the file of M.A.C.T. (District Judge),
Warangal.
ON BEHALF OF OPPOSITE PARTY
1. Ex.B-1 is the Reply Notice from the Opposite Party to the complainant’s counsel.
2. Ex.B-2 is the Xerox copy of First Information Report.
3. Ex.B-3 is the Xerox copy of Panchanama.
4. Ex.B-4 is the Xerox copy of Report of Postmortem Examination.
5. Ex.B-5 is the Xerox copy of Charge Sheet.
6. Ex.B-6 is the Xerox copy of Final Result.
PRESIDENT
