BEFORE THE DISTRICT FORUM:KURNOOL
Present: Sri.K.V.H. Prasad, B.A., LL.B President
And
Smt. C.Preethi, M.A.LL.B., Lady Member
And
Sri. M.Krishna Reddy, M.Sc.,M.Phil., Male Member
Tuesday the 26th day of May, 2009
C.C.No. 155/2008
Between:
Smt. Ediga Savitri, W/o Ediga Venkteswarlu Goud Alies Venkatesh,
R/o H.No. 76-116-19-2, Ganesh Nagar, Kallur Mandal-518 003, Kurnool District. … Complainant
Versus
1.In-charge, Sub-Branch, Sanchayani Saving and Investment (I) Limited,
D.No.40-382-5, 3rd Floor, Chintu Complex, Park Road, Kurnool-518 001.
2. In-charge, Sanchayani Saving and Investment (I) Limited,
156-A, Lenin Sarani, Calcutta-13.
3. The Divisional Manager, The New India Assurance Company Limited,
Divisional Office-611 500, No.40-526, H.D.C.T. Complex,1st Floor, RS Road, Kurnool-518 004.
4. The Branch Manager, The New India Assurance Company Limited,
Howraw Branch, Unit No. 512200, Madhsudhan Apartment, P-18, Dobson Lane, 2nd Floor, Howrah, West Bengal-711 101.
5. The General Manager, The New India Assurance Company Limited,
Regd., and H.O. 87, Mahatma Gandhi Road, Fort, Mumbai-400 001. … Opposite parties
This complaint is coming on this day for orders in the presence of Sri.M.Venkoba Rao, Advocate, for the complainant, and opposite parties No.1 and 4, 5 set exparte and OP No.2 dismissed and Sri. Md.Ishaq, Advocate, for the opposite party No.3, upon perusing the material papers on record, the Forum made the following.
ORDER
(As per Sri. K.V.H.Prasad, President)
C.C.No.155/2008
1. This case of the complainant is filed U/s.11 to 13 of C.P.Act seeking an award directing the opposite parties to pay Rs.1 lakh as assured amount of policy with 24% interest, Rs.10,000/- for deficiency of service, and Rs.10,000/- as compensation for mental agony of the costs of the case alleging that in pursuance of agreement between Op’s 1&2 on one side and OP’s 3to5 on the other side, the complainant’s husband – E.Venkateswra Goud was issued Sanchayani Savings and investments policy NO.4751220001513 and group Janatha Personal Accident Insurance Policy No.A113/600199800399 for an assured sum of Rs.1 lakh till 2.12.2013 and the said policy holder died on 26-7-2007 due to Electrocution to the Lorry No.AP.21T 1510 during its drive by the said policy holder and non settlement of the complainant ‘s claim as nominee of said deceased policy holder preferred consequent to demise of said policy holder and the opposite parties not even responding to the legal notice dated.17.1.2008 of the complainant and the said acts of the opposite parties causing mental agony and costs of the case.
2, In pursuance to the receipt of the notice of this Forum as to the case of the complainant , while the opposite party No.1, 4 and 5 remained absent and there by they were set ex parte to the case proceedings, the case against the opposite party No.2 dismissed as not pressed, the opposite party No.3 contested the case causing its appearance through its counsel and filing its written version denying any of its liability to the complainant ‘s claim and seeking dismissal of the complainant ‘s case with costs.
3. The written version of the opposite party No.3 alleges the non response from the complainant to its communication dated.31.12.2007 to submit the claim form with necessary enclosure mentioned there in, which was given in respo0nce to the letter dated.26.10.2007 of the complainant, and so its in ability to take any action for settling the said claim and so there being any deficiency of service on its part deny any of its liability to the complainant ‘s claim.
4. In substantiation of the above contentions while the complainant side has taken reliance on documentary record in Ex.A1 to A5 and the sworn affidavit of the complainant, the opposite party side has taken reliance on documentary record in Ex.B1 and B2 and sworn affidavits of opposite parties No.3.
5. Hence, the point for consideration is whether the complainant has made out the alleged deficiencies of the opposite parties and there by the liability of the opposite parties to the complainant‘s claim.
6. The Ex.A1 – is an acknowledgement slip dated.17.11.1998 issued for Sanchayani Savings and Investments (I) Limited, Culcutta(OP.2) by its in charge sun Branch at Kurnool(i.e OP.No.1) as to receipt of an application for sum assured of Rs.1.lakh along with a cheque for Rs.383/- from E.Venkateswra Goud of kurnool. As per the terms and conditions printed in the said ExA1. the risk commence from the first day of the third month subject to encashment of cheque and the maximum sum of assured insurance is Rs.1.lakh on single life and it as a facility offered to the members and faild workers of Sanchayani Savings Investment and their family members for availing the coverage in package form and its co-ordination with New India Assurance in the matters of Insurance coverage and claim processing without any guarantee from its side towards any liability for assured sum as the liability is solely of on said Insurance Company subject to exclusions of said policy on contingency of claim arising upon death, permanent total disability and loss of limbs of insured person. The said Ex.A1 and its bonafidies being not disputed by the opposite parties side, the Ex.A1 stands proved in favour of the complainant.
7. The Ex.A2 issued by the New India Assurance Company Limited, Howrah through its D.O/B.O Kurnool vide serial Number.8113/600199800379, says that it was issued in the name of Sanchayani Savings and Investments (I) Limited for the risk period expiring on 2.12.2013 vide policy No.4751220001513 covering the risk of accidental death/loss of limbs / permanent total disablement , for a capital sum insured of Rs.1.lakh to Ediga Venkateswara Goud and the nominee of said policy is his wife and the benefits there under are subjected to important terms, conditions and exclusions and definitions printed in over leaf of said Ex.A2. The issual of said policy is not disputed by the contesting opposite party as its complaint is only as to non compliance of certain requirements by the complainant i.e. non submission of claim form along with require documents, for entertaining the claim. Therefore the there appears any difficulty in holding the Ex.A2 in favour of the complainant as for as its issual for the benefit of complainant ‘s husband as member of Sanchayani Savings and Investments (I) Ltd., and as to the terms and conditions it is subjected for its acting upon in the contingency of claim arising there under.
8. The conditions printed in overleaf of the Ex.A2 mandates the claimant to give the intimation of the event giving rise to the claim forthwith in writing and for the reasonable cause if any it could be with in One calendar month. The complainant except saying that it has given intimation and complied the formalities in submission of claim as required does not specify with any detail particulars as to the date of intimation and date of submission of the claim form , to contradict the opposite parties version of belated intimation of death of the policy holder vide ex.B1 dated 26.10.2007 and non submission of claim form at all with all its requisites for entertaining the claim in spite of the requisition of the opposite party to that effect vide Ex.B2 dated.31.12.2007. In the absence of any such required cogent material there appears violation by the complainant the terms and conditions pertaining to the period of intimation of the event giving the raise to the claim and also the claim procedures envisaged in Ex.A2 and sought under Ex.B2. Neither the notice in Ex.A3 dated.17.1.2008, except demanding for making arrangement for the payment of insurance amount, nor the sworn affidavit of the complainant furnishes any such details as to the actual date of intimation and submission of claim form or any proof as to its submissions to the opposite party.
9. Mearly because the Ex.A3 envisages the demise of the member of the Insured covered under Ex.A2 the opposite party would not be liable to make the payment of the assured amount under Ex.A1as it would be payable on due processing of the claim when submitted with relevant material for its adjudication.
10. As there is any cogent material from the complainant side as to the fact of intimation of event giving rise to the claim under Ex.A1 within stipulated time and as to the fact of submission of claim form by the complainant with are relevant and requisition material for entertaining any claim of complainant under Ex.A1, there appears any deficiency on the part of the opposite party No.3 to make it liable to the complainant ‘s claim.
11. As per the stipulation mentioned in Ex.A1 the liability of the opposite party No.1 and 2 being limited only to co-ordinate the processing the claim with insurance Company and provides any guarantee for liability for assured amount under said policy making it further know that the liability if any under the said policy shall be exclusively of insurance company only and any overt and deficient acts on the part of the opposite parties 1 and 2 being alleged constituting any deficiencies of them towards the complainant , there appears any bonafidies in the complainant ‘s case to proceed against them and to hold any of the liability to complainant claim. Consequently for want of proper cause of action the case of complainant is dismissed against the OP’s1and 2.
12. When there is any material, as discussed above as to the factum of giving due intimation of the event giving rise to the claim with in stipulated time and as to the submission claim form with all its requisites for its adjudication, there appears any deficiencies of the opposite parties 3 to 5 insurance agencies concerned under said Ex.A2, to constitute any deficiencies on their part to hold their liability to the complainant claim.
13. Consequently, there being any merit and force in the cause of action and contentions of the complainant as to the alleged deficiencies of the opposite parties and there by any of their liability to the complainants claims, the case of the complainant is dismissed against the all opposite parties without costs.
Typed to dictation, corrected and pronounced on this 26th day of May, 2009.
Sd/- Sd/- Sd/-
LADY MEMBER 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. Acknowledgment slip issued by OP2.
Ex.A2. Policy NO.4751220001513.
Ex.A3. Death Certificate dt.15-10-2007 issued by Tasildar,
Dhaaroor (M).
Ex.A4. Office copy of legal notice dt.17-1-2008 along with postal
acks. & receipts by OP 3&4.
.
Ex.A5. Family members certificate dt.29-1-2008 issued by Tasildar,
Kallur (M) Kurnool District.
List of exhibits marked for the opposite parties:
Ex.B1. Xerox copy of letter dt. 26-10-2007.
Ex.B2. Reply dt.31-12-2007 of OP3 to Ex.B1.
Sd/- Sd/- Sd/-
LADY MEMBER 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 :
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