BEFORE A.P STATE CONSUMER DISPUTES REDRESSAL COMMISSION AT HYDERABAD
F.A.No.544 OF 2009 AGAINST C.C.NO.778 OF 2006 DISTRICT FORUM-II VISAKHAPATNAM
Between:
Uppalapati Satyavathi W/o late Trinadh Raju
aged 38 years R/o D.No.6-57-4/1,
Shramika Nagar, Chinagantyada, Visakhapatnam
Appellant/complainant
A N D
1. Andhra Bank rep. by Manager
Gajuwaka Branch, Visakhapatnam-26
2. M/s United India Insurance Co. Ltd.,
rep. by its Manager, Posnett Bhavan
Tilak Road, Hyderabad-001
3. United India Insurance Co.Ltd.,
rep. by its Deputy Manager, Regional Office
Near PEN School, Dabagardens
Visakhapatnam
Respondents/opposite parties
Counsel for the Appellant Smt N(P) Anjana Devi
Counsel for the Respondent M/s K.Sridhar Rao(R1)
M/s S.Shravan Kumar(R2&3)
QUORUM: SRI R.LAKSHMINARASIMHA RAO, HON’BLE MEMBER
AND
SRI THOTA ASHOK KUMAR, HON’BLE MEMBER
TUESDAY THE TWENTIETH DAY OF NOVEMBER
TWO THOUSAND TWELVE
Oral Order (As per Sri R.Lakshminarasimha Rao, Hon’ble Member)
***
1. The complainant has filed appeal contending that the District Forum has not considered her claim that the respondents had not settled the claim even after receiving final opinion and that the respondents had not chosen to adduce evidence as also that the non-settlement of claim by the respondents no.2 and 3 amounts to deficiency in service.
2. The appellant’s husband during his life time operated S.B.A/c with the respondent bank under Abhaya Gold Savings Scheme which covers an accident risk for `one lakh to the account holder in view of an agreement entered into, between the first respondent bank and the second respondent insurance company. Her husband, the owner of tanker bearing registration No.AP31T 4478 and he left in his lorry for Visakhapatnam on 13.7.2005 and when the lorry reached Jangareddygudem on the intervening night of 13/14.7.2005 some unknown offenders attacked the appellant’s husband and the cleaner, Kanchi Ashok Kumar. The offenders robbed them. The appellants husband succumbed to the injuries and died at the spot. The lorry was traced on outskirts of Chinna Tirupathi.
3. On filing of complaint by the cleaner of the lorry, the policy registered case in Cr.No.69 of 2005 on 14.7.2005 and the appellant intimated the death of her husband in the month of September 2005 to the respondents and lodged claim with them as also got issued notice dated 14.11.2005 for which the first respondent-bank had sent reply stating that she had not submitted relevant papers. Thus, the appellant submitted claim form with relevant document on 18.1.2006 to the second respondent insurance company.
4. The claim was resisted by the first respondent-bank on the premise that the job of the first respondent is to forward the claim putforth by the nominee of the deceased account holder to the second respondent insurance company and it had forwarded the claim submitted by the appellant and that there was no negligence on its part nor was there any deficiency in service. It is contended that the first respondent-bank forwarded the claim form on 20.2.2006 to the second respondent-insurance company with its recommendation to settle the claim.
5. The second and third respondents contended that the appellant is not a consumer nor the dispute a consumer dispute. The contract is between the first respondent-bank and the second respondent insurance company and not with the husband of the appellant. The appellant has not submitted the document like FIR, Account opening form and other relevant documents for processing of the claim. The respondents’ no.2 and 3 had issued repeated reminders for submission of the documents. The liability of the respondents’ no.2 and 3 crops up in the event of accidental death of the appellant’s husband which was not established.
6. The appellant filed her affidavit and the documents Exs.A1 to A15. On behalf of the respondents Exs.B1 to B3 are marked.
7. The District Forum dismissed the complaint on the premise that the respondents no.2 and 3 had not repudiated the claim and the claim has been pending with them for the reason that the forensic science laboratory report and the final report pertaining to the cause of death of the appellant’s husband was not furnished to them by the appellant.
8. The counsel for the respondent no.1 bank has filed written submissions.
9. The point for consideration is whether the order of the District Forum suffers from misappreciation of facts or law?
10. The appellant’s husband holding account bearing No.ABG17643 with the first respondent bank and coverage of accident risk on him by virtue of the insurance policy issued by the respondents no.2 and 3 basing on the agreement entered into, between the respondent no.1 bank and the respondents no.2 and 3 are not disputed. The appellant’s husband died on 13.7.2005. After the death of her husband the appellant lodged claim which was processed by the first respondent bank and the respondents’ no.2 and 3 kept the claim pending on the premise that the appellant had not submitted final report and the report of forensic science laboratory showing the cause of death of her husband.
11. The learned counsel for the appellant has contended that the appellant had submitted all the documents sought for by the respondents’ no.2 and 3 whereas the contention of the respondents’ no.2 and 3 is that they issued several reminders for submission of the relevant documents and the claim was pending on account of failure of the appellant in submitting the documents. The final opinion filed along with the appeal would show that the cause of death of the appellant’s husband is due to cardiorespiratory complication and due to respiratory obstruction as also due to cerebrovascular hemorrhage and due to hypoveolaemia.
12. The copies of FIR, Inquest report and report of postmortem examination combined with the final report would amply establish that the appellant’s husband died in the accident when he was proceeding in the insured lorry from Visakhapatnam to Hyderabad and when some unknown offenders attacked him at Jangareddygudem on 13.7.2005 as a result of the injuries sustained by him, he died at the spot. As such, the respondents’ no.2 and 3 ought to have settled the claim which however they had not done on the premise that the appellant had not produced the documents sought for. It is not the case of the respondents’ no.2 and 3 that the appellant’s husband died due to any cause other than the accident reported by the appellant. The respondents had not appointed any investigator to know the cause of the death in the circumstances they suspected the death of the appellant’s husband for the reasons other than the accident.
13. The respondents’ no.2 and 3 failed to settle the claim for no reasonable cause and deprived the appellant for the amount she is legitimately entitled to and the failure of the respondent’s no.2 and 3 constitute deficiency in service on their part for not making settlement of the claim. As such the finding of the District Forum in this regard is liable to be set aside and insofar as the finding returned by the District Forum in regard to the prompt steps taken by the first respondent bank in processing the claim does not need intervention. The appellant is held entitled to the amount covered under the insurance policy along with interest @ 9% per annum.
14. In the result the appeal is allowed setting aside the order of the District Forum. The respondents no.2 and 3/opposite parties no.2 and 3 directed to pay a sum of `1,00,000/- with interest @ 9% per annum from the date of filing of the complaint till payment together with costs of `5,000/-. The complaint against the respondent no.1/opposite party no.1 is dismissed without costs. Time for compliance four weeks.
MEMBER
MEMBER
Dt.20.11.2012
KMK*
