BEFORE THE DISTRICT FORUM: KURNOOL
Present: Sri K.V.H.Prasad, B.A., LL.B., President
And
Smt.C.Preethi, Hon’ble Lady Member
Friday the 2nd day of February, 2007
C.C. No.123/2006
Smt. Balija Moola Gaja Lakshmi Devi, W/o. B.Subba Reddy,
Resident of Krishnapuram village, Krishnagiri Mandal, Kurnool District.
…Complainant
-Vs-
Divisional Manager,
M/S. New India Assurance Company Ltd., Kurnool.
…Opposite party
This complaint coming on this day for orders in the presence of Sri. S.Siva Rama Krishna Prasad, Advocate, Kurnool for complainant, and Sri. P.Ramanjaneyulu Advocate, Kurnool for opposite Party and stood over for consideration till this day, the Forum made the following:-
ORDER
(As per Smt C. Preethi, Hon’ble Lady Member)
1. This Consumer complaint of the complainant is filed U/S 12 of C.P. Act., seeking a direction on the opposite party to pay Rs.1,00,000/- towards assured amount with 18% interest per annum, Rs.25,000/- towards mental agony, cost of the complaint and any other relief or reliefs which the complainant is entitled in the circumstances of the case.
2. The brief facts of the complainant’s case is that the complainant’s son Late. G.Narayana Reddy has obtained a Group Janatha Personal Accidental Policy bearing No.611500/47/01/00563 with S.No.97 and nominated the complainant as his nominee. The policy holder died in the road accident on 08-11-04, at Sudepalle village bus stop near N.H.7, Veldurthi-Dhone road. A crime also registered U/S 304-A I.P.C. in Cr.No.114/2004 by Veldurthi Police Station. Thereafter, the complainant submitted claim form for settlement of claim but inspite of several requests the opposite parties did not settle the claim nor gave proper answer, being vexed the complainant got issued legal notice dt:09-01-2006. There is no reply to the said notice and the complainant constrained to file this complaint before this forum for redressal.
3. The complainant in substantiation of her case relied on the following documents: viz., (1)certified copy of F.I.R. in a Cr.No.114/2004 of Veldurthi,(P.S) (2)certified copy of inquest report (3)certified copy of postmortem certificate (4)certified copy of Motor vehicles inspector accident report (5)certified copy of charge sheet (6)certified copy of Calendar and Judgment in C.C.No.16/05 of Judicial Magistrate of first class Dhone and (7)office copy of legal notice dt:09-01-2006, besides to the sworn affidavit of the complainant in reiteration of his complaint averments and the above documents are marked as Ex.A1 to A7 for its appreciation in this case. The complainant caused interrogatories to opposite party and suitablely replied to the interrogatories caused by the opposite party.
4. In pursuance to the notice of this forum as to this case of the complainant the opposite party appeared through their standing counsel and filed written version:?
5. The written version of opposite party denies the complaint as not maintainable either in law or on facts but admits the deceased G.Narayana Reddy has taken a Group Janata personal Accident Policy for a period of five years commencing from 12-10-01 to 11-10-06 by paying required premium for assured sum of Rs.1,00,000/- and policy bearing No.611500/47/01/00563 with S.No.97was issued to him and he nominated the complainant as his nominee. But denies that deceased G.Narayana Reddy died in a road accident on 08-11-04 at Sudepalle(v) and the involvement of jeep bearing No.AP 22 U 3484 in the accident and further alleges that the deceased parents along with police colluded with owner of the jeep, jeep driver, doctor and fabricated and invented the documents as to the cause of death of the deceased with a malafide intention to get wrongful gain from opposite party. The complainant of the F.I.R is none another than the brother-in-law of the deceased and he stated in the complaint that the deceased was suffering from illness since one month. The F.I.R, inquest report, P.M certificate, M.V.I report are all fabricated for the purpose of this case and for getting compensation in motor accident claims tribunal.
6. The written version of opposite party further submits that the deceased death is due to committal of suicide as he was suffering from uncurable illness since long period and vexed with life and lost confidence, faith as he was suffering with A.I.D.S. Hence, committed suicide on 08-11-04, the place of death is also created. The M.V.O.P.No.192/2005 on file of principal District Judge Kurnool, was dismissed on the merits on 29-09-06 disbelieving the version of the complainant as false and set up claim. The opposite party further submits that the deceased violated terms and conditions of the policy and committed suicide and he was not covered under the policy and there is no deficiency of service on part of this opposite party and seeks for the dismissal of complainant with costs.
7. In substantiation of his case the opposite party relied on the following documents viz. (1) attested copy of master policy bearing No.611500/ 47/01/61/00563 along with terms and conditions (2)original claim form No.J.N.P/4 (3)certified copy of rough sketch of scene of offence in Cr.No.114/04 and (4)legal heir certificate, besides the sworn affidavit of the opposite party in reiteration of his written version and the above documents are marked as Ex.B1 to B4 for its appreciation in this case. The opposite parties caused interrogatories to the complainant and suitablely replied to the interrogatories caused by the complainant.
8. Hence, the point for consideration is to what relief the complainant is entitled alleging deficiency of service:?
9. It is a case of the complainant that his son late G.Narayana Reddy has insured his life with opposite party under the policy bearing No.61150047/01/61/00563 with S.No.97 for Rs.1,00,000/- and the late G.Narayana Reddy died in a road accident on 08-11-04. On the claim preferred by the nominee the opposite party did neither repudiated the claim nor settled the claim, hence the complainant resorted to the forum for redressal.
10. The main allegation of the opposite party is that the deceased G.Narayana Reddy’s death is not an accidental death but it due to committal of suicide as he was suffering from uncurable illness i.e., A.I.D.S and lost confidence and faith and being vexed with life committed suicide on 08-11-04 and also further alleges that all the documents placed by the complainant before the forum are all false, invented and fabricated having colluded with the deceased parents, police, owner of the jeep, driver of the jeep and doctor. The opposite party in substantiation of the above allegations merely relied on following documents viz.,(1)attested copy of master policy (2)claim form (3)certified copy of rough sheet of scene of offence and (4)legal heir certificate. The sole reliance of the opposite party on the said exhibits without any enquiry there in satisfying of their allegations for reliance by them and arriving at the said conclusion that the policy holder committed suicide is not remaining justifiable, especially when there is no piece of record to substantiative that the policy holder committed suicide as he was suffering from A.I.D.S. There are no documents or any direct evidence showing that the policy holder had taken treatment for A.I.D.S has been put on record by the opposite party, in the absence any evidence produced on record, primary or secondary regarding suffering of A.I.D.S by the policy holder it cannot be said that opposite party has proved on record that the policy holder was suffering from A.I.D.S had committed suicide. Therefore, the opposite parties have failed to proove the case by placing any original documents or by placing on record the certified copies of its original which has not been done. Hence, the allegations of opposite party that the insured committed suicide and all the documents filed are fabricated and concocted is rejected.
11. There is no evidence or affidavit of any doctor on record who has treated the policy holder and unless expert evidence of a doctor is produced it cannot be said that the policy holder was suffering from A.I.D.S, merely relying on Ex.B1 to B4 does’nt suffice, mere assertion or oral testimony inrespect of suffering from A.I.D.S by policy holder cannot be acted upon nor relied upon. Onus is on the opposite party to substantiate their plea that the policy holder committed suicide as he was suffering from A.I.D.S which was not done.
12. Having regard to over all consideration, there is no hesitation to hold that the opposite party have miserablely failed to substantiate that the policy holder committed suicide. Therefore, in these circumstances the non settlement of claim by opposite party is wholly arbitrary, unreasonable and unjust and amounts to deficiency of service on their part.
13. The complainant in substantiating of her case relied on Ex.A1 to A7 i.e., F.I.R. Inquest report, P.M certificate, motor vehicle inspector accident report, charge sheet, Calendar and Judgment in C.C.No.16/05 and legal notice, all the above material in UNI-TONE says that the death of G.Narayana Reddy was due to accident only. Therefore, the complainant is certainly remaining entitled to the assured amount under the above policy. As the opposite party driven the complainant to the forum for redressal the complainant is entitled to costs of Rs.5,000/-also.
14. In the result, the complaint is allowed directing the opposite party to pay to the complainant the assured amount under the policy bearing No. 611500/47/01/00563 with 12% interest per annum from the date of submitting of claim form i.e., 30-08-05 along with costs of Rs.5,000/- within a month of receipt of this order.
Dictated to the Stenographer, transcribed by him, corrected and pronounced in the Open bench on this the 2nd day of February, 2007.
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 certified copy of F.I.R. in Cr.No.114/04 of P.S.Veldurthi.
Ex.A2 certified copy of Inquest report.
Ex.A3 certified copy of post mortem certificate of deceased Balija Gaja
Narayana Reddy.
Ex.A4 certified copy of Motor vehicles Inspector Accident Report.
Ex.A5 certified copy of charge sheet.
Ex.A6 certified copy of Calender & Judgement in C.C.No.16/2005 of Judicial
Magistrate of Ist class, Dhone.
Ex.A7 office copy of legal notice, dated:09-01-2006.
List of exhibits marked for the opposite party:-
Ex.B1 Attested copy of Master policy No.611500/47/01/161/00000563 along
with terms & conditions.
Ex.B2 original claim form No.J.N.P.-4.
Ex.B3 certified copy of Rough sketch of scene of offence of Cr.No.114/04.
Ex.B4 legal-Heir certificate issued by Mandal Revenue officer, Veldurthi.
MEMBER PRESIDENT
Copy to:-
1. Sri. S.Siva Rama Krishna Prasad, Advocate, Kurnool.
2. Sri P.Ramanjaneyulu, Advocate, Kurnool.
Copy was made ready on:
Copy was dispatched on:
Copy was delivered to parties:
