BEFORE THE DISTRICT CONSUMER FORUM : MEDAK AT SANGAREDDY
PRESENT: Sri Patil Vithal Rao, B.Sc., LL.B.,President
Smt. Meena Ramanathan, B.Com., Lady Member
Sri G.Sreenivas Rao, M.Sc., B.Ed.,LL.B.,PGADR (NALSAR),Member
Monday, the 15th day of April, 2013
CC. No. 25 of 2012
Between:
Smt. Shasikala W/o Satyanarayana,
Age: 25 years, Occ: house hold,
R/o Sirgapoor (V) Mandal Kalher,
Medak District. ……Complainant
And
- The General Manager,
M/s Oriental Insurance Co. Ltd.,
Rep by it Divisional Manager, OIco.Ltd.,
Ambara Plaza, 2nd Floor,
Ahmed Nagar-M.H. 414001
(Policy No. 16305/48/2010/639 valid up to
18.09.2009 to 17.09.2011)
- The Regional Manager,
Oriental Insurance Co.Ltd., T.P. Hub,
Post. Box No. 45, Snehalatha building,
Begumpet, Hyderabad.
……Opposite parties
This case came up for final hearing before us on 01.04.2013 in the presence of Sri C. Vittal Reddy, Advocate for complainant, opposite party No. 1 set experte and Sri P. Bal Reddy, Advocate for opposite party No. 2 and heard the arguments of both sides, on perusing the record and having stood over for consideration till this day, this Forum delivered the following:
O R D E R
(Per Se Smt. Meena Ramanathan, Lady Member)
The complainant, who is the w/o of one deceased Satyanarayana, approached this Forum by way of the present complaint under Section 12 of the Consumer Protection Act, 1986, claiming Rs. 1,00,000/- the policy amount with costs and interest @ 18% and Rs. 50,000/- towards compensation. Her contention, in brief, is that her husband Satyanarayana subscribed a newly introduced policy called Nagarik Suraksha and that the opposite parties assigned him the policy No.163305/48/2010/639 on 18.09.2009. The policy was valid till 17.09.2011. On 21.10.2010 at 9:30 p.m. her husband – a home guard working at Shankarampet (V) Police Station while going on his scooter to the Police Station, met with an accident and sustained severe head injury and died. A case was registered for the same against an unknown vehicle and the opposite parties were also informed. She filed a claim for the policy amount but the opposite parties have failed to respond. Hence she has filed this present complaint.
2. Opposite party No. 1 set exparte.
3. Opposite party No. 2 filed their counter resisting the claim on the grounds that the deceased died because of rash and negligent driving on his part and also deny that he was the policy holder and that the complainant is the nominee. They further submit that the policy was valid for one year and as such the complainant cannot claim compensation. They further state that the complainant failed to file the death certificate and legal heir certificate. Moreover the deceased died owing to a motor vehicle accident and as such the owner and insurance company of that vehicle are necessary parties but have not been impleaded. They also submit that the complainant did not inform them about the death of the policy holder. The Nagarik Suraksha policy is not covered for the present case and under the policy’s terms and conditions this claim is not valid. Hence seek to dismiss this present complaint.
4. Complainant filed evidence affidavit and marked Ex. A1 to A7 to substantiate her claim. Opposite party No. 2 filed evidence affidavit of RW. 1. Heard the oral submissions and perused written arguments of the complainant’s counsel and the documents submitted.
5. Now the point for consideration is that whether there is any deficiency of service on the part of the opposite parties in not granting the reliefs in favour of the complainant as prayed for?
Point:
6. It is not in dispute that the deceased Satyanarayana took a Nagarik Suraksha Policy for himself on 18.09.2009. The problem is regarding the coverage of the policy and that the status of the complainant as nominee of the (policy) insured. Ex. A2 is the policy issued by oriental insurance company. This policy is a Nagarik Suraksha Policy. The policy No. 163305/48/2010/639 and name Satyanarayana Bheemaiaham is clearly mentioned and the nominee is written as –Shasikala Satyanarayana and relationship – wife is also noted. The period of coverage is 18.09.2009 to 17.09.2011. It is pertinent to mention here that the insured met with an accidental death on 21.12.2010. Therefore it is very much within the coverage of the policy.
7. Ex.A2 is the FIR issued on 22.12.2010 i.e. the next day after the accident basing on the report of the complainant. It is also mentioned in it that the accident was caused by a driver of an unknown vehicle. The case is registered against an unknown vehicle and the police report does not say that the deceased drove his vehicle rashly and negligently. In the present case the complainant is not claiming any relief under the Motor Vehicle Act to make the driver of the unknown vehicle and it’s insurance company as parties to this complaint.
8. In the evidence of RW. 1, (executive legal of opposite party No. 2) objection have been raised regarding the complainant not being the legal heir. How is that correct? When she is the nominee as per the policy, filing the legal heir certificate is not necessary and there definitely exists a contract between the complainant (as the nominee) and both respondent No. 1 & respondent No. 2. If RW.1 works (as he claims) in the legal department of opposite party No. 2, he should be aware of the terms and conditions of the Nagarik Suraksha Policy and the period of coverage. But unfortunately he disputed it.
9. Ex.A2 is the Nagarik Suraksha Policy – (the terms and conditions were filed subsequently) – On reading the conditions mentioned on the rear of the policy, it is clearly evident in Hindi – that for death by accident there is 100% coverage.
10. Ex.A3 is the post mortem report where in cause of death is shock due to cerebral haemorrhage due to head injury. Ex. A4 is the inquest report (Panchanama). Ex. A5 is the legal notice and Ex. A6 is the courier receipts (3 in number). Ex. A7 is the death certificate and here again cause of death is due to accident on 21.12.2010. Thus it is clear that the complainant has filed all material documents to substantiate her claim. Therefore there is no force is the allegation of opposite parties that necessary documents were not brought on record by the complainant.
11. When the complainant approached opposite party No. 1 by issuing a legal notice, Ex. A5, seeking to settle her claim covered by the policy, there was no response which resulted in initiation of the present proceedings. Thus there is a cause of action to file the present case.
12. In view of the aforesaid discussion we hold that the complainant, being the nominee of the insured, is entitled to the policy amount of Rs. 1,00,000/- with reasonable interest @ 9% p.a. Further she is also entitled for a reasonable compensation of Rs. 25,000/-. The point is answered accordingly.
13. In the result, the complaint is allowed directing the opposite parties to pay the policy amount of Rs. 1,00,000/- with interest @ 9% p.a. from the date of death of the insured till realization. Further, they shall also pay Rs. 25,000/- as compensation. Time for compliance: One month.
Dictated to Stenographer, after transcription and correction the order is pronounced by us in the open court today on this the 9th day of April, 2013.
Sd/- Sd/- Sd/-
MALE MEMBER LADY MEMBER PRESIDENT
APPENDIX OF EVIDENCE
WITNESS EXAMINED
For the complainant: For the opposite parties:-
PW. 1 – Shashikala | RW. 1 – P.R. Kumar (Executive Legal) |
DOCUMENTS MARKED
For the complainant: For the opposite parties:-
Ex.A1/dt. 22.12.2010 – Copy of FIR. | -Nil- |
Ex.A2/dt. 22.12.2010 – Copy of Policy. | |
Ex.A3/dt. 22.12.2010 – Copy of Post Mortem Examination Report. | |
Ex.A4/dt. 22.12.2010 – Copy of inquest report. | |
Ex.A5/dt. 22.12.2010 – Copy of legal notice. | |
Ex.A6/dt. 28.07.2011 – Courier receipts (Three). | |
Ex.A7/dt. 03.01.2011 – Attested copy of death certificate. | |
Sd/- Sd/- Sd/-
MALE MEMBER LADY MEMBER PRESIDENT
Copy to:
- The Complainant
- The opp.Parties
- Spare copy
