BEFORE THE DISTRICT FORUM: KURNOOL
Present: Sri. T.Sundara Ramaiah , B.Com B.L., President
And
Sri. M.Krishna Reddy , M.Sc., M.Phil., Male Member
Tuesday the 21st day of September, 2010
C.C.No 110/09
Between:
G.Rajesh Kumar, S/o. Late G.Lakshman Rao,
H.No.12/123, Pinjari Street, Kurnool-518002.
…..Complainant
-Vs-
1) Branch Incharge, GTFS Multiservices Ltd.,
3rd Floor, Ucon Plaza, Kurnool-518001.
2) Assistant Manager Claims, Bajaj Allianz General Insurance Company Ltd.,
10 B, O.C. Ganguli Sarani, Kolkatta-700020.
…Opposite PartieS
This complaint is coming on this day for orders in the presence of Sri. P. Siva Sudharshan, Advocate, for complainant, and Sri. M. Azmathulla, Advocate for opposite party No.1 and opposite party No.2 is called absent set ex-parte and upon perusing the material papers on record, the Forum made the following.
ORDER
(As per Sri. T.Sundara Ramaiah, President)
C.C. No. 110/09
1. This complaint is filed under section 11 & 12 of C. P. Act, 1986 praying to direct the Ops
(a) to pay the policy amount of Rs.1,00,000/- to the
complainant with interest at 24% p.a from the date of death
of the deceased i.,e 14-07-2006 till the date of realization.
(b) to grant a sum of Rs.20,000/- towards mental agony
( c) to grant a sum of Rs.5,000/- towards cost of the complaint.
(e) to grant any other relief as the Hon’ble Forum may deem fit and proper in the in the circumstances of the case.
2. The case of the complainant in brief is as follows:- The complainant’s father G.Lakshman Rao is a member of the OP.No.1. G.Lakshman Rao obtained insurance policy from OP.No.2 through OP.No.1. The period of the policy is from 15-09-2005 to 14-09-2010. As per the terms and conditions of the policy the nominee is entitled for insured amount of Rs.1,00,000/- in the case of accidental death of the insured. G.Lakshman Rao accidentally fell down on road on 13-07-2006 near Y junction on Kurnool , Sunkesula Road and he died on 14-07-2006 while undergoing treatment in Government General Hospital , Kurnool. Kurnool Taluq police registered a case in Cr.No.245/2006 U/S 174 Cr.P.C. The complainant submitted the claim to OP.No.2 through OP.No.1. OP.No.2 issued a reply notice for the legal notice got issued by the complainant stating that the insured had history of falling down due to giddiness earlier. OP.No.2 also asked the complainant to produce final order of Mandal Executive Magistrate and final report of police. Even after submitting the said documents OP.No.2 did not settle the claim. Hence the complaint.
3. OP.No.2 remained set ex-parte. OP.No.1 filed written version stating that the complaint is not maintainable. OP.No.1 is having its registered office at Kolkata. OP.No.2 issued a policy certificate as per the memorandum of understanding with OP.No.1. The claim form submitted by the complainant was forwarded to OP.No.2. OP.No.2 is not liable to pay any amount to the complainant. There is no deficiency of service on the part of the OP.No.1. The complaint is liable to be dismissed against OP.No.1.
4. On behalf of the complainant Ex.A1 to A8 are marked and the sworn affidavit of the complainant is filed. On behalf of the OP.No.1 Ex.B1 to B4 are marked and the sworn affidavit of OP.No.1 is filed.
5. Both parties filed written arguments.
6. The points that arise for consideration are
(i) whether there is deficiency of service on the part of the Ops ?
(ii) whether the complainant is entitled to the relief as prayed for?
(iii) To what relief?
7. Points No.1 & 2 :- Admittedly G.Lakshman Rao father of the complainant obtained a policy bearing No. 0G-05-2401-9960-00000041 from OP.No.2 through OP.No.1. Ex.A7 is the copy of the said policy. It is the case of the complainant who is the nominee under Ex.A7 policy that his father died on 14-07-2006 due to the injuries received by him by accidental fall on 13-07-2006 . To prove the same the complainant relied on Ex.A1 and A2. Ex.A1 is the copy of the FIR in Cr.No.245/2006 of Kurnool police station. It is mentioned in Ex.A1 that somebody informed the complainant that the deceased fell on the road on 13-07-2006. It is also mentioned in Ex.A1 that on 14-07-2006 the father of the complainant died while undergoing treatment in Government General Hospital, Kurnool. Ex.A2 is the post mortem certificate of the deceased where in it is mentioned that the deceased died due to bleeding from head injury. As seen from the contents of Ex.A1 and A2 it is very clear that the deceased received injuries due to accidental fall on 13-07-2006 and died on 14-07-2006 due to the bleeding from the said injury.
8. It is the contention of the complainant that inspite of repeated demands OP.No.2 did not settle the claim. Admittedly the complainant gave a legal notice Ex.A4 to OP.No.2 and OP.No.2 gave a reply Ex.A5. In Ex.A5 reply notice issued by OP.No.2 it is mentioned that the son of the insured gave information that the insured had a history of falling down due to giddiness. The OP.No.2 did not choose to contest the matter. No evidence is placed by OP.No.2 that the deceased obtained the policy by suppressing the material facts regarding to his health. It is OP.No.2 who has to pay the assured amount to the complainant who is a nominee under the policy. OP.No.1 can not be held liable as he is not a party to the policy. There is deficiency of service on the part of OP.No.2. The complainant is entitled to the assured amount of Rs.1,00,000/- and other benefits.
10. Point No.3: In the result the complaint is partly allowed directing the OP.No.2 to pay assured sum of Rs.1,00,000/- with other benefits if any to the complainant with interest at 9% p.a from the date of the complaint i.e 10-06-2009 till the date of payment along with costs of Rs.500/-. The complaint against OP.No.1 is dismissed.
Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 21st day of September, 2010.
Sd/- Sd/-
MALE MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant : Nil For the opposite parties : Nil
List of exhibits marked for the complainant:-
Ex.A1. Photo copy First Information Report dt. 15-7-2006.
Ex.A2. Photo copy of Postmortem report dt. 15-7-2006.
Ex.A3. Photo copy of Final report of Taluq Police, Kurnool
dt.30-12-2006.
Ex.A4 Office copy of legal notice dt. 28-5-2007.
Ex.A5. Reply of OP2 dt. 11-6-2007.
Ex.A6. Photo copy of Letter of complainant to OP2 dt.17-7-2007.
Ex.A7. Photo copy of policy copy NO.OG-05-2401-9960-00000041, for Rs.1,00,000/-
Ex.A8. Photo copy of receipt of OP1 dt.24-8-2005.
List of exhibits marked for the opposite parties:
Ex.B1. Photo copy of Terms and conditions of the policy,
dt.24-10-2005.
Ex.B2. Photo copy of claim form dt.28-07-2006.
Ex.B3. Photo copy of Letter dt.07-08-2008 issued by the OP2.
Ex.B4. Photo copy of Letter dt.20-02-2009 addressed to the complainant
Sd/- Sd/-
MALE MEMBER PRESIDENT
// Certified free copy communicated under Rule 4 (10) of the
A.P.S.C.D.R.C. Rules, 1987//
Copy to:-
Complainant and Opposite parties
Copy was made ready on :
Copy was dispatched on :
