Telangana

Mahbubnagar

CC/08/43

Manikyala Sujatha W/o late Manikyala Ramulu O/c House hold - Complainant(s)

Versus

M/s Bajaj Allianz General Insurance Company Ltd., Hyderabad. - Opp.Party(s)

Sri G. Surender Reddy

30 Sep 2008

ORDER

BEFORE THE DISTRICT CONSUMER FORUM AT MAHABUBNAGAR

Monday the 29^th day of September, 2008

 

                                                               Present:- Sri M. Rama Rao, B.A.,LL.B., President

                                                                    Sri P.Venkateshwar Rao, B.Com. LL.B., Member

                                                        Smt. B.Vijaya Kumari, M.Sc. B.Ed., C.C.P., Member    

 

                                                                                                                         C.C.No. 43  Of 2008

 

Between:-

Manikyala Sujatha, W/o late Manikyala Ramulu, aged 32 years, Household, R/o 3-71, Dhanwada village and Mandal,

Mahabubnagar  Dist.

                                                                                  … Complainant

 

And

M/s Bajaj Allianz General Insurance company Limited,through its Manager, r/o 2^nd floor, Far East Plaza, 3-6-111/8, Street 18 main Road, Himayatnagar, Hyderabad -29.                                                                             

                                                                                        … Opposite party

This C.C. coming on before us for final hearing on 26.09.2008 in the presence of Sri G. Surender Reddy, Advocate, Mahabubnagar for the complainant and of Sri G. Parandhamulu Goud, Advocate, Mahabubnagar for the opposite party and having stoodover for consideration till this day, this Forum delivered the following: 

                                                                                          O R D E R

                                                                                      (Sri P.Venkateshwar Rao, Member)           

1.      This is a complaint filed on behalf of the complainant under section 12 of Consumer Protection Act, 1986 seeking a direction to the opposite party to pay Rs.1,00,000/- towards  Policy amount together with interest @ 18% p.a. from the date of claim and to pay Rs.50,000/- towards costs and damages for causing mental agony.  

2.  The complaint averments are as follows:- The husband of the complainant  purchased Bajaj CT 100 bearing No.AP 22 K 3932 in the year 2005.  The complainant insured the said vehicle with the opposite party.  In the said policy the complainant has paid additional premium for coverage of risk of Personal Accident for the sum of Rs.1,00,000/-.  The husband of the complainant died in the road accident on  18-10-2007 at 7.00 P.M. near Kollampally village gate.  Being a nominee the complainant submitted claim to OP, but the opposite party not responded.  Hence there is a deficiency of service on the part of OP.  As such the complainant is entitled for Rs.1,00,000/- in terms of the policy together with interest @ 18% p.a. apart from Rs.50,000/- towards cost and damages for causing mental agony.  Hence the complaint.

3.    The opposite party filed counter with the following averments:- It is true that the husband of the complainant obtained policy and the same was in force as on the date of alleged accident.  But the policy did not cover the Personal Accident risk coverage.  The unfortunate accident took place due to own negligence of the insured as he was driving the vehicle in drunken condition and without having any valid and effective driving license to drive such vehicle, which is a clear violation of the terms and conditions of the policy.  As such the complainant is not entitled for any amount under the policy and the complaint is liable to be dismissed.

4.  The complainant filed her affidavit and got marked Exs.A-1 to A-16 on her behalf.

5.  The opposite party filed his affidavit and got marked Ex.B-1 on his behalf. 

6.    The opposite party filed his written arguments.

7.  The point that arises for consideration is whether the complainant is   entitled for the reliefs as prayed for?

8.  There is no dispute with regard to the issuance of policy and its subsistence as on the date of accident and the death of insured in the said accident.  According to the opposite party the policy will not cover the risk of personal accident of insured.  The contention of the complainant is that the opposite party collected “extra premium” for coverage of personal accident risk, as such the complainant is entitled for the amount.   

       The policy issued by the opposite party is marked as Ex.B-1 and  Ex.A-1.   Ex.A-1 reveals that the opposite party has collected premium of Rs.50/- towards compulsory personal accident risk coverage apart from the premium for insuring the vehicle. This policy also reveals that in case of accident it covers the accidental risk to the sum of Rs.1,00,000/- to the vehicle and also to the insured.  Therefore we hold that in terms of the policy the opposite party is liable to pay an amount of Rs.1,00,000/- in case of accidental death of the insured.   It is not in dispute that the insured has died in a road accident on 18.10.2007.    Therefore we hold that being a nominee, of the insured, the complainant is entitled for the sum of Rs.1,00,000/- under the policy.     

9.   The another contention of the opposite party is that the insured not possessing the valid and effective driving license at the time of accident.   He relied upon the decision of the Hon’ble National Commission reported in 2005 (1) TAC 254 and 2004 (2) ALD (Cons.) 21 (NC).   The learned counsel for the complainant argued that the insured not died on account of  his negligence or rash driving while driving his motor cycle at the time of accident.  He died due to hit given by the lorry bearing No.AP 16 U 7259 which was coming in the opposite direction.  Therefore the offending vehicle is the lorry as such there is no violation of terms of the policy with regard to the driving license.  The complainant relied upon Ex.A-1 to prove his contention and also relied upon the decision of the Hon’ble High Court of Karnataka reported in 2006 (2) An.W.R. 483 (Karn.) wherein it is held that “the insurance company cannot repudiate the claim of the wife of the deceased insured for non production of her husband’s driving license because it may not be within her knowledge”,  and he further relied on the decision of the Hon’ble High Court of Madras reported in 2006 (2) An.W.R.485 (Mad.).   

          Ex.A-2 FIR reveals that the insured died on the spot in the road accident due to hit given by the lorry as the driver of the said lorry was driving it in rash and negligence manner at the time of accident.  In view of the Ex.A-2 we hold that the offending vehicle is the lorry bearing No.AP 16 U 7259 and there was no negligence of insured in any manner.   Further the decision of the Hon’ble Karnataka High Court stated supra is quite applicable to this case as the facts and circumstances of the case on hand are similar to that case.  However, in our opinion the decision of the Hon’ble Madras High Court and the decisions of the Hon’ble National Commission stated supra which are relied by the complainant and also by OP are not applicable to this case as the facts of those cases are different with the facts of the case on hand.    In view of the above discussion and in light of the judgment of the Hon’ble Karnataka High Court, we hold that the contention of OP that the insured did not possesse valid and effective driving license holds no water. 

10.  The another contention of the opposite party is that the insured drove the vehicle in drunken condition.  The opposite party has not filed any material to prove this contention.  The PME report filed by the complainant which is marked as Ex.A-4 does not reveal anything about alcohol in the abdomen.  Therefore we hold that the insured has not driven the vehicle in drunken condition. The opposite party did not file any evidence before this Forum in support of his contention raised for repudiating the claim.  Therefore we hold that the opposite party is not justified in repudiating the claim and repudiation is arbitrary without any valid reason.  Thus we hold that repudiating the claim on whimsy grounds amounts to deficiency of service.  As such the opposite party is liable to pay the sum assured to the complainant under the policy. 

11.  The contention of the complainant is that inspite of several reminders the opposite party neither settled nor repudiated the claim.  As such she has suffered with much mental agony.  Therefore she is entitled for the damages to the tune of Rs.50,000/-.  The letter addressed by the complainant is marked as Exs.A-7 to A-10 and the acknowledgements of the said reminders are marked as Exs.A11 to A-14 respectively.  It is clear from the above documents the complainant has informed the opposite party about the death of the insured on 1-11-2007 under  Ex.A-7 and further reminded the opposite party severally to settle the claim vide Exs.A-8 to A-10.  In view of the decision of the Hon’ble NC, in the case of United India Insurance Co.  Ltd., V. M/s MKJ Corporation, National Commission and State Commission on Consumer Cases,1986-1999, page 4781, two months is reasonable time for the Insurance Company to take decision, whether the claim requires to be settled or rejected in accordance with the policy.  But in the instant case, the opposite party neither settled nor repudiated the claim and also not given even reply to the reminders.  Therefore we hold that the complainant has made all his efforts before filing the complaint but failed to get response from the opposite party.  Therefore, the opposite party is liable to pay the policy amount of Rs.1,00,000/- together with interest @ 9% p.a.  from 01-01-2008  i.e.,  after two months of the intimation of the death vide Ex.A-7 till the payment.  The opposite parties negligently delayed in deciding the claim as such in our opinion, the opposite party caused much inconvenience and sufferance to the complainant.  Therefore the opposite party is liable to pay Rs.2,000/- towards compensation.  Further the acts of the opposite party led the complainant to approach the Forum by spending Court fee and Advocate fee.  Therefore, we hold that the opposite party is also liable to pay Rs.1,000/- towards costs of the proceedings.

12.   In the result, the complaint is allowed.  The opposite party is directed to pay the policy amount of Rs.1,00,000/- together with interest @ 9% p.a. from 01-01-2008 till the payment and also Rs.2,000/- towards compensation and Rs.1,000/- towards costs to the complainant within one month from the date of receipt of this order.     

       

          Typed to dictation, corrected and pronounced by us in the open   

    Forum on this the 29^th day of September, 2008.

 

 

MEMBER                        MEMBER                                PRESIDENT

 

 

Appendix of evidence

Witness examined

 

For complainant: Nil                                                    For opposite party:  Nil

 

Exhibits marked for Complainant:-  

 

Ex.A-1:        Certificate cum Policy Schedule, dt.4.12.2006.

Ex.A-2:        Xerox copy of FIR, dt.19.10.2007.

Ex.A-3:        Xerox copy of Panchanama Report.  

Ex.A-4:        Xerox copy of PME Report, dt.19.10.2007.

Ex.A-5:        Xerox copy of RC.

Ex.A-6:        Postal Receipt.

Ex.A-7:        Letter to OP, dt.1.11.2007.

Ex.A-8:        Letter to OP, dt.14.11.2007.

Ex.A-9:        Letter to OP, dt.26.12.2007.

Ex.A-10:      Letter to OP, dt. 21.01.2008.

Ex.A-11:      Postal acknowledgement.

Ex.A-12:      Postal acknowledgement.

Ex.A-13:      Speed post customer receipt, dt.28.12.2007.

Ex.A-14:      Postal acknowledgement.

Ex.A-15:      Postal Receipt.

Ex.A-16:      Postal Receipt.

 

Exhibits marked for OP:-

 

Ex.B-1:   Certificate cum Policy Schedule, dt.31.12.2006.

 

By the Forum:

     - Nil -

   

   PRESIDENT

 

Copy to:-

 

1. Sri G. Surender Reddy, Advocate, Mahabubnagar for the complainant.
2. Sri G. Parandhamulu Goud, Advocate, Mahabubnagar for the opposite party.