BEFORE THE DISTRICT CONSUMER’S 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 23rd day of October, 2012
C.C.No.143/2011
Between:
M.Saraswathi, W/o. Late M.Venkateswarlu,
D.No.3/112A, Govindapalli Village, Sirivel Mandal - 518 563,Kurnool District.
…Complainant
-Vs-
Golden Multi Services Club Limited,By its Manager,
38-5, 2nd Floor, U-Con Plaza, Park Road,Kurnool District - 518 001.
2. M/s. Reliance General Insurance Company Limited,By its Manager,
38-4, 2nd Floor,Alankar Plaza, Park Road, KURNOOL - 518 001.
3. M/s. Reliancae General Insurance Company Limited,By its Manager, Himalaya House,
5th Floor D.No. 38-B, Jawarlal Nehru Road, Calcutta-700 071.
...Opposite ParTIES
This complaint is coming on this day for orders in the presence of Sri.S.Siva Rama Krishna Prasad, Advocate for complainant and Sri.M.Azmathulla, Advocate for opposite party No.1 and Sri.P.Ramanjaneyulu, Advocate for opposite party No.2 and opposite party No.3 called absent and upon perusing the material papers on record, the Forum made the following.
ORDER
(As per Sri. M.Krishna Reddy, Male Member) C.C. No.143/2011
1. This complaint is filed under section 12 of C.P. Act, 1986 praying:-
To direct the opposite parties to pay assured amount of Rs.3,00,000/- with interest @ 24% per annum;
To award the sum of Rs.1,00,000/- towards compensation for causing mental agony to the complainant by the opposite party No.2;
To award costs of the complainant;
To grant such other relief or reliefs as the Honourable Court deems fit and proper in the circumstance of the case.
2. The case of the complainant in brief is as under:- The complainant is the wife of Late.M.Venkateswarlu. On 24-02-2011 while Late.M.Venkateswarlu was repairing the electrical transformer, he received the electric shock and fell down. Late.M.Venkateswarlu died on 01-03-2011 while undergoing treatment in Image Hospital at Hyderabad due to injuries received due to electric shock. Immediately the complainant lodged a complaint. The police registered a case under section 174 Cr.P.C. The deceased was the member in opposite party No.1 service club. Opposite party No.3 provided group insurance facilities to the members of opposite party No.1. The life of the deceased M.Venkateswarlu was insured for a sum of Rs.3,00,000/- under the policy. M.Venkateswarlu died due to electric shock while the policy was in force from 19-08-2010 to 18-08-2011. The complainant is the nominee under the policy. The complainant informed about the death of her husband due to electric shock to opposite party No.1. Opposite party No.1 forwarded the claim of the complainant to opposite party No.3. Opposite party No.3 repudiated the claim on 23-08-2011 on the ground that the intimation regarding the death of M.Venkateswarlu was received 55 days after his death. Opposite party No.2 and opposite party No.3 adopted unfair trade practice in settling the claim. Hence the complaint.
3. Opposite party No.3 set exparte.
Opposite party No.1 filed written version stating that opposite party No.2 and opposite party No.3 agreed to extend the insurance coverage to the members of opposite party No.1. Opposite party No.3 issued the policy after collecting the premium. Opposite party No.1 has no role in settlement of the claim. On 13-04-2010 opposite party No.1 submitted all the documents to opposite party No.3. Opposite parties 2 and 3 are responsible in settlement of claim.
Opposite party No.2 filed written version stating that the complaint is not maintainable. Deceased M.Venkateswarlu was a member in opposite party No.1 service club. Opposite party No.1 obtained Group Personal Accidental Policy for the assured amount of Rs.3,00,000/- from opposite party No.3. The complainant submitted claim form before opposite party No.1 on 09-04-2011 and the same was forwarded to opposite party No.3 along with letter dated 13-04-2011 and it was received by opposite party No.3 on 19-04-2011. Opposite party No.3 repudiated the claim on 23-08-2011 as there was delay of 55 days in giving intimation about the death of the insured. The claim intimation and form should reach the opposite party No.3 within stipulated period of 20 days from the date of incident of the death. The claim of the complainant was repudiated as it was not in time. The complainant filed present complaint with an ulterior motive to gain wrongfully. The death of M.Venkateswarlu might have been caused due to his self-negligence. He might have touched electric wire for committing suicide. There is no deficiency of service on the part opposite parties. The complainant is not entitled for the reliefs as prayed for. The complaint is liable to be dismissed.
4. On behalf of the complainant Ex.A1 to A6 are marked and sworn affidavit of the complainant is filed. On behalf of the opposite parties Ex.B1 to B3 are marked and sworn affidavits of opposite parties 1 and 2 are filed.
5. Both sides filed written arguments.
6. Now the points that arise for consideration are:
Whether there is deficiency of service on the part of Opposite Parties?
Whether the complainant is entitled for the reliefs as prayed for?
To what relief?
7. POINTS I and ii:- Admittedly M.Venkateswarlu was a member in the opposite party No.1 service club. Opposite party No.1 obtained Ex.B1 Group Personal Accidental Policy for its members from opposite party No.3. The sum assured under the policy is Rs.3,00,000/- for each member. Ex.B1 policy was in force from 19-08-2010 to 18-08-2011.
8. It is the case of the complainant that her husband M.Venkateswarlu met with an electric shock on 24-02-2011 and died on 01-03-2011 while undergoing treatment in Image Hospital at Hyderabad. Ex.A3 is the copy of the F.I.R., in Crime No.23/2011 Ex.A4 is the copy of the Inquest Report. In Ex.A3 and A4 it is clearly stated that the deceased M.Venkateswarlu met with an electric shock on 24-02-2011 while repairing the transformer and received injuries. In Ex.A5 Post Mortem Report it is clearly mentioned that the deceased M.Venkateswarlu received injury. It is the contention of the opposite party No.2 that the deceased M.Venkateswarlu might have died by committing suicide. There is no medical evidence on record to show that M.Venkateswarlu died by committing suicide. The complainant in her sworn affidavit clearly stated that her husband met with an electric shock on 24-02-2011 and died on 01-03-2011 while undergoing treatment in Image Hospital at Hyderabad. No evidence is let in by opposite party No.2 to establish that M.Venkateswarlu met with an electric shock due to his negligence only.
9. Admittedly the complainant is the nominee under the policy. She submitted the claim form before opposite party No.1 on 09-04-2011. It was forwarded to opposite party No.3 along with a letter dated 13-04-2011. Opposite party No.3 received it on 19-04-2011. Opposite party No.3 by its letter Ex.B2 dated 23-08-2011 repudiated the claim of the complainant stating that there was delay of 55 days in giving intimation about the death of M.Venkateswarlu. It is submitted by the learned counsel appearing for the opposite party No.2 that the death of the insured should be intimated to be opposite party No.3 within 20 days from the date of the death. Admittedly there is no documentary evidence on record to show that the complainant intimated about the death of her husband to opposite party No.3 within 20 days from the date of the death of her husband. In Ex.B1 policy it is mentioned that upon the happening of any event which may give rise to a claim the claimant/beneficiary shall give notice thereof to the company within 20 days from the date of occurrence. According to the complainant her husband died on 01-03-2011 due to electric shock. She did not give intimation about the death of her husband to opposite party No.3 within 20 days. It is submitted by the learned counsel appearing for the complainant that mere delay in giving intimation about the death to opposite party No.3 is not much fatal and delay in giving intimation was not prejudicial to the insurance company. There is ample evidence on record to establish that M.Venkateswarlu died on 01-03-2011 due to the accidental injuries received while repairing the transformer on 24-02-2011. The complainant could able to establish that her husband died accidentally. The learned counsel appearing for the complainant relied on a decision reported in Revision Petition No.3572/2011 of National Consumer Disputes Redressal Commission, New Delhi dated 29-11-2011. In the said decision it is held that the delayed intimation of death of the insured cannot be held to be ruinous to the insurance claim because the facts and the circumstances of the death were clearly established. In the present case also it is a clear establish that the insured met with an electric shock on 24-02-2011 and received injuries. He died on 01-03-2011 while undergoing treatment in Image Hospital at Hyderabad. No prejudice was caused to the insurance company because of delay in giving death intimation of the insured M.Venkateswarlu by the complainant. Admittedly in case of accidentally death of the insured the opposite party No.3 is liable to pay assured amount of Rs.3,00,000/- to the nominee. M.Venkateswarlu husband of the complainant died accidentally while the policy Ex.B1 was in force. The opposite party No.3 was not just and reasonable in repudiating claim of the complainant on the sole ground that there was delay in giving intimation about death. There is deficiency of service on the part of the opposite parties 2 and 3.
10. In the result, the complaint is partly allowed directing the opposite parties 2 and 3 jointly and severally to pay assured amount of Rs.3,00,000/- to the complainant with interest at 9% per annum from the date of repudiation of the claim i.e., 23-08-2011 till the date of payment along with costs of Rs.500/-. The complaint against opposite party No.1 is dismissed.
Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 23rd day of October, 2012.
Sd/- Sd/-
MALE MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant : Nill For the opposite parties : Nill
List of exhibits marked for the complainant:-
Ex.A1 Photo copy of Letter addressed by the opposite party No.1
to opposite party No.3 dated 13-04-2011 along with
claim Form.
Ex.A2 Photo copy of Repudiation Letter dated 23-08-2011.
Ex.A3 Photo copy of F.I.R. in Crime No.23/2011 Sirivella P.S.,
Kurnool District, dated 02-03-2011.
Ex.A4 Photo copy of Inquest Report dated 02-03-2011.
Ex.A5 Photo copy of Report of Post Mortem Examination
dated 02-03-2011.
Ex.A6 Photo copy of Policy bearing o.01400886670309007943241.
List of exhibits marked for the opposite parties:-
Ex.B1 Photo copy of Policy bearing No.1503302914000007 along
with terms and conditions
Ex.B2 Photo copy of Repudiation Letter dated 23-08-2011.
Ex.B3 Photo copy of Letter addressed by the opposite party No.1 to
opposite party No.3 dated 13-04-2011 along with
claim Form.
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 :
