BEFORE THE MANDYA DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MANDYA PRESENT: 1. SIDDEGOWDA, B.Sc., LLB., President, 2. M.N.MANOHARA, B.A.,LLB., Member, 3. A.P.MAHADEVAMMA, B.Sc., LLB., Member, ORDER Complaint No.MDF/C.C.No.31/2010 Order dated this the 29th day of June 2010 COMPLAINANT/S Smt Soubhagya W/o Sri Chikkanna, R/o 7th Cross, Mahadeshwara Temple Road, Halahalli, Mandya-571401. (By Sri.T.S.Gururaja., Advocate) -Vs- OPPOSITE PARTY/S 1. Metro Marketing Solutions (India) Pvt., Ltd., # 826, IInd Floor, 5th Main, Vijayanagara, Bangalore-40.(Absent) 2. Sri Jayaramu H.N. C/o Sillegowda, Mandya Range-Agent, R/o Behind Govternment School, Hosahalli, Mandya City. 3. The Oriental Insurance Company Ltd., Mandya Branch, M.H.Boraiah Building, V.V.Road, Mandya-01. (By Sri.S.P.Krishna.,Advocate for OP.2 & Sri.G.K.Puttaswamy., Advocate for OP.3) Date of complaint 08.03.2010 Date of service of notice to Ops 22.03.2010 Date of order 29.06.2010 Total Period 3 Months 7 days Result The complaint is allowed partly, directing the 1st Opposite party to pay Rs.1,48,000/- to the Complainant with interest at 9% p.a. from 19.01.2009 till payment with cost of Rs.2,000/-. The complaint against 2nd & 3rd Opposite party is dismissed. Send the copy of the order to 1st Opposite party to comply the order within six weeks. Sri.Siddegowda, President 1. This complaint is filed under section 12 of the Consumer Protection Act, 1986 against the Opposite parties claiming insurance amount of Rs.3,00,000/- and compensation of Rs.2,00,000/- particularly against the 3rd Opposite party Insurance Company. 2. The case of the Complainant is that at the instance of 2nd Opposite party, the agent of 1st Opposite party Company for the purpose of promotion of its activities approached C.Mahesh, the son of the Complainant and C.Mahesh obtained 3 membership cards of 1st Opposite party on purchase of articles by remitting an amount of Rs.2,989/- each on 05.02.2008 and 12.02.2008. On purchase of articles, the policy of insurance covering accidental death will be issued to the member. So, the 1st Opposite party has issued insurance policy bonds in favour of C.Mahesh, valid from 10.03.2008 to 09.03.2009 issued by 3rd Opposite party. But, the insurance policy bond issued against the card No.0502080951 has not been given to Complainant son by 1st Opposite party in spite of several requests. The sum assured payable to the insured is Rs.1,00,000/- per each insurance policy bond. On 24.08.2008, the son of the Complainant had been to a pond near TATA Mines situated at Doddakhane Village, Mysore District to take bath and he took his last breath. In this regard, the Mysore South Police have registered a case in UDR No.31/2008 dated 23.08.2008. Inquest and post mortem were also done by the concerned police. The agent of 1st Opposite party is her son close friend. During the free days of her son work, he used to assist the said agent for the promotion of business of 1st Opposite party. The Managerial Personnel of the 1st Opposite party have felt sad on the death of C.Mahesh and as a mark of his services to 1st Opposite party, the 1st Opposite party has paid Rs.1,52,000/- as monetary assistance. The 1st Opposite party has taken all the insurance policy bonds and filled up the claim form from the Complainant and assured to get Rs.3,00,000/- in total from 3rd Opposite party. In spite of repeated requests and demands, 1st & 3rd Opposite party have not come forward to settle the claim of Rs.3,00,000/- to the Complainant. Thus, the Opposite parties 1 to 3 have committed deficiency in service. On these grounds, the complaint is filed. 3. The notices were served on Opposite parties 1 to 3. The 1st Opposite party has remained exparte. 4. The 2nd Opposite party has filed version admitting that he is the agent of 1st Opposite party for promotion of activities in Mandya District and approached the son of the Complainant and solicited his membership at the 1st Opposite party. But, he has disputed the other averments made in the complaint and sought for dismissal of the complaint. 5. The 3rd Opposite party has filed version admitting that it is doing the marketing business in different fields. The deceased C.Mahesh had been issued two identity cards of 1st Opposite party and 3rd Opposite party had issued individual personal accident policies bearing No.421900/48/2008/400 for Rs.1,00,000/- each sum assured, covering the risk from 10.03.2008 to 09.03.2008. It is not known to 3rd Opposite party that the 1st Opposite party had issued identity card bearing No.0502080951, 3rd Opposite party has not issued any individual personal accident policy to this identity card. Basing upon the police report, the death of C.Mahesh is admitted. To promote the business of attracting the customers by introducing scheme of offering free group personal accident benefit policy, 1st Oppsite party approached 3rd Opposite party with an idea of purchasing 1000 un-named GPA policy for Rs.10/- crores sum assured, in order to give free gift package of one personal accident policy for Rs.1,00,000/- each to the purchasers of the articles for a worth of Rs.2,989/- each. The 3rd Opposite party has issued one policy in favour of 1st Opposite party covering 1000 un-named persons and sum assured is Rs.1,00,000/- for each policy and the risk was covered from 10.03.2008 to 09.03.2009 and 3rd Opposite party has issued individual policy furnishing the ID number and certificate number and name to the members and the name C.Mahesh is in the list at Sl.No.309 and 311. After receipt of the information of death of C.Mahesh and claim papers from 1st Opposite party, the 3rd Opposite party settled the policy claim of Rs.2,00,000/- in favour of 1st Opposite party, as the 1st Opposite party was the insured and obtained the discharge voucher on 19.01.2009 from the 1st Opposite party. Hence, there is no deficiency in service committed by 3rd Opposite party. It appears that the 1st Opposite party has not settled the entire policy claim of Rs.2,00,000/- to the Complainant for the reasons best known to 1st Opposite party. As per the complaint, the 1st Opposite party has paid only Rs.1,52,000/- and the Complainant has mistaken it as the monetary assistance given by the 1st Opposite party. Therefore, the complaint is not maintainable against the 3rd Opposite party and is liable to be dismissed. 6. During trial, the Complainant has filed affidavit and produced the documents Ex.C.1 to C.13. On behalf of the 3rd Opposite party, one witness is examined and Ex.R.1 to R.5 are produced. 7. We have heard the both sides. 8. Now the points that arise for our considerations are:- 1. Whether the 1st Opposite party has failed to get insurance coverage of Rs.1,00,000/- against the identity membership card No.0502080951? 2. Whether the 3rd Opposite party has committed deficiency in service in not settling the claim of insurance in fevour of the Complainant? 3. Whether the 1st Opposite parties has committed deficiency in service? 4. Whether the Complainant is entitled to the insurance amount of Rs.3,00,000/- and compensation? 9. Our findings and reasons are as here under:- 10. POINTS NO.1 TO 4:- The undisputed facts borne out from the materials and documents on record are that C.Mahesh, the son of the Complainant was issued membership card Ex.C.6, C.7 and C.8, on purchase of articles worth of Rs.2,989/- each under Ex.C.9, C.10 and C.11 from 1st Opposite party and 1st Opposite party as per the assurance at the time of purchase of articles, obtained GPA un-named policy for 1000 members for a sum of Rs.10/- crores as per Ex.R.1 insurance certificate and then furnished the list of those 1000 members as per Ex.R.2 and we find the name of C.Mahesh son of the Complainant at Sl.No.309 and 311 and the Complainant is the nominee and 3rd Opposite party has issued individual personal accident policy schedule in favour of C.Mahesh as per Ex.R.4 & R.5. The un-natural death of C.Mahesh by insured is not disputed by the Opposite parties and Ex.C.1 FIR, UDR Ex.C.2, inquest report Ex.C.3 and PM report Ex.C.4 clearly proves that the death was due to drowning in water and so it is an accidental death and Ex.C.5 is the death certificate. 11. Admittedly, the Complainant through 1st Opposite party claimed the insurance amount from 3rd Opposite party. But, according to the Complainant, her son had obtained 3 membership cards, but 1st Opposite party has obtained only two insurance policy and hence it has committed deficiency in service in not obtaining another policy for membership card Ex.C.8. The 1st Opposite party has remained exparte. As per the policy documents produced by 3rd Opposite party, 1st Opposite party has furnished the name of C.Mahesh for two policies for Rs.1,00,000/- each and accordingly, the 3rd Opposite party has issued two GPA individual policy schedule and not three. So, we cannot attribute any deficiency in service against the 3rd Opposite party in not issuing 3rd policy in favour of C.Mahesh and 1st Opposite party has committed deficiency in service in not obtaining 3rd policy in respect of membership card Ex.C.8 as per promise given for the promotion of business. 12. As per the GPA policy, C.Mahesh the son of the Complainant is covered for two insurance for Rs.1,00,000/- for each policy, obtained by the 1st Opposite party from 3rd Opposite party. Now, after the death of C.Mahesh, the insurance claim was made by the Complainant and according to the 3rd Opposite party, it has settled insurance claim of Rs.2,00,000/- in respect of two individual policies of C.Mahesh and has obtained discharge voucher from 1st Opposite party. The 3rd Opposite party has produced the discharge voucher Ex.R.3. The 1st Opposite party has not disputed the same. Therefore, it is proved by 3rd Opposite party that it has settled the claim for two policies of C.Mahesh of Rs.1,00,000/- each. 13. Now, the contention of the Complainant is that the 3rd Opposite party should have settled the insurance claim in favour of the Complainant and not in favour of the 1st Opposite party. Though, from one angle it is correct that the 3rd Opposite party should have settled the insurance claim in favour of the Complainant in view of the individual policy schedule with a details in respect of C.Mahesh. But, in another angle it has to be accepted as correct in settling the claim in favour of 1st Opposite party, because it has obtained the policy for 1000 members un-named and later furnished the list of members and as the 1st Opposite party is the insured, 3rd Opposite party has paid the amount of Rs.2,00,000/- to 1st Opposite party and obtained the discharge voucher Ex.R.3. 14. Admittedly, the Complainant has received Rs.1,52,000/- from 1st Opposite party. According to the Complainant, the 1st Opposite party has paid this amount as monetary assistance as a mark of the services of C.Mahesh to 1st Opposite party, as was assisting 2nd Opposite party agent for the promotion of business of 1st Opposite party in free time, but there are no documents at all. Further, the Complainant has admitted her son was working in Kadakola Factory and admittedly, the Office of 1st Opposite party is in Bangalore and 2nd Opposite party is not examined to prove that the deceased C.Mahesh was assisting 2nd Opposite party for the promotion of business of 1st Opposite party and it cannot be accepted that as a compensation, 1st Opposite party has paid Rs.1,52,000/- and as contended by 3rd Opposite party, the 1st Opposite party has paid Rs.1,52,000/- out of insurance amount of Rs.2,00,000/- and the Complainant has mistaken it as monetary assistance. So, the 1st Opposite party which has received the insurance amount of Rs.2,00,000/- has committed deficiency in service in not paying the full amount of Rs.2,00,000/-, but only paid partly and holding Rs.48,000/-. Further, as contended by the Complainant, if the 1st Opposite party had obtained the insurance for Rs.1,00,000/- for another membership card Ex.C.8, the Complainant would have been entitled for insurance amount of Rs.1,00,000/- on the death of her son C.Mahesh, since she is the mother and nominee. Therefore, the 1st Opposite party has committed deficiency in service in not paying the full amount of insurance and not obtaining another policy of Rs.1,00,000/- and hence, the 1st Opposite party is liable to pay the balance amount of Rs.48,000/- received from 3rd Opposite party and Rs.1,00,000/- for another insurance policy, which is not obtained from 3rd Opposite party as per the promise given. Therefore, in the result, we proceed to pass the following order; ORDER The complaint is allowed partly, directing the 1st Opposite party to pay Rs.1,48,000/- to the Complainant with interest at 9% p.a. from 19.01.2009 till payment with cost of Rs.2,000/-. The complaint against 2nd & 3rd Opposite party is dismissed. Send the copy of the order to 1st Opposite party to comply the order within six weeks. (Dictated to the Stenographer, transcribed, corrected and then pronounced in the open Forum this the 29th day of June 2010). (PRESIDENT) (MEMBER) (MEMBER)
