Date of filing:28-02-2013
Date of Disposal: 21-03-2014
DISTRICT CONSUMER DISPUTES REDRESSAL FORUM: ANANTHAPURAMU
PRESENT:- Sri S.Niranjan Babu, B.A.,B.L., President (FAC).
Smt.M.Sreelatha, B.A., B.L., Lady Member
Friday, the 21st day of February, 2014
C.C.NO.19/2013
Between:
H.K.Nagaraju @ M.Nagaraju
S/o Vannurappa
Junjurampalli Village,
Rayadurg Mandal,
Ananthapuramu District. … Complainant
Vs.
- The Divisional Manager,
United India Insurance Co. Ltd.,
11-170-B, 1st floor,
Meda Mansion, Subash Road
Ananthapuramu.
- The Branch Manager,
Andhra Pragathi Grameena Bank,
Bhoopa Samudram, Rayadurg Mandal,
Ananthapuramu District.…Opposite Parties
This case coming on this day for final hearing before us in the presence of Sri M.C.Ram Kumar, Advocate for the complainant and Sri V.Krishna Sharma, Advocate for the 1st opposite party and Sri G.Ramgopal, Advocate for the 2nd opposite party and after perusing the material papers on record and after hearing the arguments on both sides, the Forum delivered the following:
O R D E R
Sri S.Niranjan Babu, President (FAC):- This complaint has been filed by the complainant under section 12 of the Consumer Protection Act, 1986 against the opposite parties 1 & 2 claiming a sum of Rs.50,000/- towards sum assured under KCC Policy with interest @ 9% p.a. from the date of death till the date of realization and Rs.25,000/- towards mental agony and costs of the complaint.
2. The brief facts of the complaint are that :- The complainant’s wife has taken a Group Insurance Policy from the 1st opposite party through 2nd opposite party under KCC Policy. The complainant is the husband and nominee of the deceased H.K.Yellakka @ Mallakka, resident of Junjurampalli Village, Rayadurg Mandal, Ananthapuramu District. The wife of the complainant while working in the fields of Kamma Durgamma W/o Kamma Thippanna on 21-08-2010 at about 4.00 P.M. she was bite by snake. After the said incident, she was shifted to Rayadurg Government Hospital and on their advice she was shifted to VIMS Hospital, Bellary. While she was undergoing treatment, she succumbed at about 9.30 P.M. on 24-08-2010. The same was reported by her husband to the Police of Rayadurg and a case was registered in Rayadurg Police Station and they investigated the case. After the death of the complainant’s wife, a postmortem was conducted by the Professor Head of Forensic Medicines, Govt. Medical College, Bellary and opined that the deceased died due to snake bite.
3. During the life time of the complainant’s wife, she has taken a Group Insurance Policy (KCC) No.051000/47/10/43/00000129 from the opposite party No.1 through opposite party No.2. Subsequently a claim was made bearing No.051000/47/10/43/90000620 alongwith other required documents. Later the said claim was repudiated by the 1st opposite party on untenable grounds. After repudiation as there was no other go to the complainant, the complainant filed this complaint claiming the sum assured under KCC policy alongwith interest from the date of death till the date of realization and also a sum of Rs.25,000/- towards mental agony.
4. The 1st opposite party filed a counter stating that the allegation in the complaint that the deceased was bite by snake on 21-08-2010 while she was attending to the agricultural work and she was taken to Bellary Hospital on 24-08-2010 and while undergoing treatment in the said hospital, she died at 9.30 P.M. on 24-08-2010 due to snake bite only is not admitted by this opposite party. The further allegation that the medical reports and the police records also reveal that the cause of death of the deceased was due to snake bite and there was no foul play and there was no suspicion about the cause of death of the deceased is not true.
5. The opposite party further submits that the alleged occurrence of snake bite as alleged in the complaint is to be proved by the complainant and even the records clearly reveal that the snake bite was caused on 21-08-2010 and the deceased died on 24-08-2010, but the deceased did not inform to anybody about the snake bite and there is no complaint at all. In fact, the alleged complaint is given by the complainant only after the death of the deceased in order to get wrongful gain from the opposite party. Further the complainant has also to explain discrepancy in the name of the deceased in various records. Further the opposite party submits that the allegation that the medical record clearly reveals that the cause of death is due to snake bite is absolutely false. In fact, immediately after the postmortem examination on 25-08-2010 the duty doctor, who conducted postmortem examination clearly mentioned in his opinion that “reserved pending for the want of chemical analysis report and Histopathology opinion. “ As seen from the RFSL Report dt.06-01-2011 clearly reveals that after analysis “ it was found that there was no chemical poison substance found “, which clearly shows that the deceased did not die due to snake bite. Inspite of the above report, the complainant managed to get opinion in favour of him to suit his claim, which is not binding on the opposite parties.
6. The 1st opposite party further submits that as per the policy conditions the alleged incident should have been informed to the concerned officials immediately or within 30 days from the date of occurrence, but as seen from the records there is abnormal delay in informing the same to the officials i.e. beyond 30 days. Hence, the complainant has violated the condition No.1 of the policy. The further allegation of the complainant that he approached the opposite parties number of times and he finally got issued a legal notice on 25-07-2012 is not true. In fact, the 2nd opposite party repudiated the claim under valid grounds. The 1st opposite party further submits that after thorough investigation, the claim of the complainant was repudiated and there is no deficiency of service on the part of the opposite party and hence the opposite party has rightly repudiated the claim and not liable to pay as prayed by the complainant.
7. The 2nd opposite party filed counter stating that the 2nd opposite party is only collecting the premiums from its customers and forward the same to the 1st opposite party in order to cover them under KCC Policy. The 2nd opposite party further submits that there is no lapse on the part of the 2nd opposite party as they have collected the premium from the complainant and the same was forwarded to the 1st opposite party and thereby they discharged their duties and there is no deficiency of service on their part. Further 2nd the opposite party submits that 2nd opposite party is not a necessary party to the above proceedings and there is no allegation as such against the 2nd opposite party and hence they are not liable to pay any compensation.
8. Basing on the above pleadings, the points that arise for consideration are:-
1. Whether there is deficiency of service on the part of the opposite parties
1 & 2 ?
2. To what relief?
9. In order to prove the case of the complainant, the complaint has filed evidence on affidavit on his behalf and marked Ex.A1 to A11 documents. The 1st opposite party has filed evidence on affidavit on its behalf and marked Ex.B1 to B4 documents. The 2nd opposite party did not file any evidence on affidavit and not marked any documents on its behalf.
10. Heard on both sides.
11. POINT NO.1: - The counsel for the complainant submitted that the complainant’s wife by name H.K.Yellakka @ Mallakka during her life time has enrolled as Member of Group Insurance Policy with the 1st opposite party through the 2nd opposite party. Group Insurance Policy bearing No. 051000/47/10/43/00000129 issued by the 1st opposite party under which the deceased was a member. Subsequently, the wife of the complainant while working in the fields of Kamma Durgamma on 21-08-2010 at about 4.00 P.M. she was bite by a snake. After the snake bite, she was shifted to Rayadurg Government Hospital and on their advice she was shifted to VIMS Hospital, Bellary. While she was undergoing treatment, she succumbed at about 9.30 P.M. on 24-08-2010. Further the counsel for the complainant submits that the same was reported by her husband to the Police of Rayadurg and a case was registered and investigated by the Rayadurg Police and after investigation the Police filed a final report to the Mandal Executive Magistrate, Rayadurg requesting to drop further action in the said case as it was not a case of suspicious death.
12. The counsel for the complainant submits that the postmortem was conducted by the Head of the Forensic Medicine, Bellary and they have opined that the deceased died due to snake bite. Basing on the FSL Report, the counsel for the complainant submitted that the complainant made a claim bearing No.051000/47/10/43/90000620 alongwith necessary documents to the 2nd opposite party. The counsel for the complainant argued that to the surprise of the complainant a repudiation letter was sent by the 2nd opposite party dt.17-05-2012 which is marked as Ex.A10 stating that the claim was repudiated as the said Yellakka did not die due to snake bite and even as per Forensic Lab Report, Tirupati there was no chemical poisonous substance found in the viscera contents analysis. Since the KCC Policy-holder Smt.Yellakka did not die due to snake bite and the said claim was repudiated as per the policy conditions. Further the counsel for the complainant argued that after receiving the repudiation letter with untenable grounds, the complainant has no other go except to file this complaint claiming sum assured Rs.50,000/- under the said KCC Policy and also a sum of Rs.25,000/- towards mental agony and award costs.
13. The counsel for the 1st opposite party argued that there is no dispute with regard to issuance of the policy but the cause of death as alleged by the complainant is not established by the complainant. The counsel for the 1st opposite party argued that the alleged snake bite was on 21-08-2010 while she was working in the fields but the deceased died on 24-08-2010 at VIMS Hospital, Bellary. The counsel for the 1st opposite party argued that though the deceased was bite by a snake on 21-08-2010, the same was not informed by the deceased to any of her family members and it is only on 24-08-2010 she was taken to Rayadurg Hospital and on their advice only the complainant took the deceased to VIMS Hospital, Bellary and on the same day the complainant’s wife died at about 9.30 P.M. on 24-08-2010. The counsel for the 1st opposite party argued that as per the conditions of KCC Policy the death occurred information should be given to the authorities immediately or under unavoidable circumstances, the same should have been informed within 30 days from the date of occurrence, but in the instant case intimation was made after lapse of 50 days, which is against to the policy conditions.
14. Further the counsel for the 1st opposite party argued that after thorough verification of F.I.R., Postmortem Certificate and Forensic Lab Report issued by the concerned authorities. The fact that there is no chemical poisonous substance found in viscera contents analysis and it clearly shows that the deceased did not die due to snake bite. The counsel for the 1st opposite party argued that as the cause of death was not existing, the death claim of the complainant was rightly repudiated by the 1st opposite party and they are not liable to pay any compensation to the complainant and they have not caused any deficiency of service. Hence they are not liable to pay any compensation towards mental agony or costs.
15. The counsel for the 2nd opposite party argued that they are only the premium collecting party and the premium collected so was forwarded to the 1st opposite party and there is no liability on the part of the 2nd opposite party and there is no deficiency of service on the part of the 2nd opposite party as the premium collected by them was forwarded to the 1st opposite party and thereby they discharged their duties. Hence, there is no deficiency of service on their part and they are not liable to pay any compensation whatsoever to the complainant.
16. After hearing arguments of both sides and perusing the documents submitted, there is no dispute with regard to issuing of policy by 1st opposite party. The main contention of 1st opposite party is that there is a delay of more than 50 days in giving intimation to the 1st opposite party which is one of the prime condition of the policy. Further the contention of the 1st opposite party is that the deceased Yellakka was bite by snake on 21-08-2010 and the same was not informed to any one as per the complaint itself and when the said Yellakka was taken to Rayadurg Hospital on 24-08-2010 i.e. after a lapse of 3 days and on the advice of the Rayadurg Hospital authorities, she was shifted to VIMS Hospital, Bellary on the same day and she succumbed on the same day at about 9.30 P.M. And another contention of the 1st opposite party is that the complainant filed a complaint at Rayadurg Police Station only on 25-08-2010 i.e. subsequent to the date of death.
17. The contention of the counsel for the complainant is that though the deceased did not inform that she was bite by snake to any of her family members and it was only on the advice of the Rayadurg Hospital Authorities she was shifted to VIMS Hospital, Bellary, where she died on the same day at about 9.30 P.M. does not mean that she died due to some other reason. The arguments of the complainant is that the Postmortem Report and FSL Report clearly establish that the deceased died due to snake bite and the police investigation also reveal the same and the case was dropped as unnatural death.
18. After considering both sides contentions and the Postmortem Report, which is marked as Ex.A3 wherein Doctor opined in his final opinion that the death was caused due to respiratory failure as a result of poisonous snake bite and the Police investigation report also shows that the deceased died due to snake bite only. Further FSL report, which is marked as Ex.B3 wherein in their opinion that there was no chemical poisonous substance found in them means that there is no created or prepared chemical poisonous substance found in the body parts, but whereas the snake poison is a natural poison. Hence the contention of the counsel for the 1st opposite party cannot be taken into consideration that as there is no chemical poisonous substance found in them as per Ex.B3 and the deceased did not die due to snake bite because his opinion is that there is no chemical poisonous substance found in the parts sent for F.S.L. but the word chemical poisonous is different from snake poison and the FSL report did not rule out that there is no poison found in them and even the police investigation and the final opinion of the Postmortem Report clearly establish that the cause of death was due to snake bite.
19. In the above circumstances, we are of the view that the complainant’s wife died due to snake bite as contended by the counsel for the complainant and the 1st opposite party is liable to pay the insurance sum assured under KCC Policy.
20. POINT NO.2 – In the result, the complaint is allowed by the directing the 1st opposite party to pay a sum of Rs.50,000/- with interest @ 9% p.a. from the date of complaint till the date of realization to the complainant and also to pay a sum of Rs.1,000/- towards costs of the complaint within one month from the date of this order. The complaint against the 2nd opposite party is dismissed without costs.
Dictated to Steno, transcribed by him, corrected and pronounced by us in open Forum this the 21st day of Mach, 2014.
Sd/- Sd/-
LADY MEMBER, PRESIDENT(FAC),
DISTRICT CONSUMER FORUM, DISTRICT CONSUMER FORUM,
ANANTHAPURAMU ANANTHAPURAM
APPENDIX OF EVIDENCE
WITNESSES EXAMINED
ON BEHALF OF THE COMPLAINANT: ON BEHALF OF THE OPPOSITE PARTY
EXHIBITS MARKED ON BEHALF OF THE COMPLAINANT
Ex.A1 - Photo copy of FIR in Cr.No.106/2010 of Rayadurg P.S.
Ex.A2 - Photo copy of Inquest report relating to deceased K.Yellakka.
Ex.A3 - Photo copy of Postmortem Report relating to deceased K.Yellakka.
Ex.A4 - Photo copy of Final Report submitted by the Sub Inspector of Police,Rayadurg.
Ex.A5 - Office copy of legal notice dt.16-07-2012 got issued by the complainant to the
1st opposite party.
Ex.A6- Postal acknowledgment signed by the 1st opposite party.
Ex.A7 - Attested copy of Family Members Certificate relating to the complainant.
Ex.A8 - Death Certificate relating to deceased Yellakka issued by the Panchayat
Secretary, Gramasachivalayam, Mallapuram Village, Rayadurg Mandal,
Ananthapuramu District.
Ex.A9- Statement of Account relating to deceased Yellakka @ Mallakka issued by
2nd opposite party dt.10-07-2012.
Ex.A10 – Repudiation letter dt.17-05-2012 issued by the 1st opposite party to the 2nd
Opposite party by marking a copy to the complainant.
Ex.A11 – Reply notice dt.10-08-2012 got issued by the 1st opposite party to the counsel for the
complainant.
EXHIBITS MARKED ON BEHALF OF THE OPPOSITE PARTY NO.1
Ex.B1 – Kishan Credit Card Scheme Policy bearing No.050900/47/10/43/00000026 issued by
the 1st opposite party .
Ex.B2 - Photo copy of Postmortem Report relating to deceased K.Yellakka.
Ex.B3 – Attested copy of FSL Report dt.06-01-2011 issued by A.P.Forensic Science
Laboratories, Hyderabad.
Ex.B4 - Attested copy of Histopathology Report relating to deceased K.Yellakka issued by
Vijayanagar Institute of Medical Sciences, Bellary dt.14-09-2010.
Sd/- Sd/-
LADY MEMBER, PRESIDENT(FAC),
DISTRICT CONSUMER FORUM, DISTRICT CONSUMER FORUM,
ANANTHAPURAMU ANANTHAPURAM
