BEFORE THE A.P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION

AT HYDERABAD.

F.A. 641/2008 against C.C.  75/2007, Dist. Forum, Nalgonda.

Between:

Kodadala Srinu, S/o. Papaiah

Age: 35 years

R/o. Indugula Village

Thipparthty Mandal

Nalgonda Dist.                                            ***                         Appellant/

                                                                                                Complainant. 

.                                                                  And

1)  The L.I.C. of India

Suryapet Branch

Nalgonda Dist.

Rep. by its Branch Manager.  

2)  The Senior Divisional Manager

The L.I.C. of India

Divisional Office,

Lower Tank Bund Road

Behind NTR Stadium

Hyderabad-500 070.                                   ***                         Respondents/      

                                                                                                Opposite Parties

Counsel for the Appellant:                          M/s. V. Gourisankara Rao.

Counsel for the Resps:                                M/s.  Srinivasn S. Rajan

CORAM:

                         HON’BLE SRI JUSTICE D. APPA RAO, PRESIDENT     

                                                             &

  SMT. M. SHREESHA, MEMBER

TUESDAY, THIS THE FIFTH DAY OF OCTOBER TWO THOUSAND TEN

Oral Order: (Per Hon’ble Justice D. Appa Rao, President)

                                                          *****

1)                This is an appeal preferred by the unsuccessful complainant against the order of the Dist. Forum in dismissing his complaint. 

2)                The case of the complainant in brief is that  his wife Smt. Kodadala Ramana  had taken an insurance policy  from the respondent insurance company for a sum of Rs. 50,000/- covering the period from 27.5.2004  to 27.5.2019 keeping her husband as her nominee.     While so, on 5.10.2004 while she was  preparing the food  on a kerosene stove,  accidentally,  her saree caught fire, as a result of which  she  had sustained severe burn injuries, admitted in the Government Area Hospital at Suryapet where she succumbed  to injuries  on 6.10.2004 while undergoing treatment.    On  a report the police registered a case in Crime No. 97/2004 u/s 174 Cr.P.C. and conducted panchanama followed by  post-mortem examination.  When he submitted the claim it was repudiated on the ground that  clause 4(b) of the policy stipulates that  if the accident had not taken place in public place  the policy  would  not cover.   The said repudiation was unjust and therefore   he claimed Rs. 50,000/- covered under the policy  with interest @ 18% p.a., together with compensation of Rs.  40,000/- towards mental agony and costs.

3)                The insurance company resisted the case.    While  admitting issuance of policy however it alleged that clause-4(B)  of the policy stipulates that “in the event of death of the life assured occurring as a result of  intentional self injury, suicide, attempted suicide, accident other than  an accident in a public place or murder at any  time on or after the date  on which the risk has commenced but before expiry of three years  from the date of policy, the  liability of the insurance company shall be limited to the sum equal to the total amounts of premiums exclusive of extra premium if any paid  under the policy without interest.”    Therefore it was not liable  to pay the amount covered under the policy and prayed for dismissal of the complaint with costs. 

4)                The complainant in proof of his case filed his affidavit evidence and got Exs. A1 to A10 marked while the insurance company filed the affidavit evidence of its  Administrative Officer and got Exs. B1 to B4 marked.

5)                The Dist. Forum after considering the evidence placed on record opined that  Clause-4(B) of the policy excludes  payment of amount unless the accident was in public place and therefore repudiation was just, consequently  dismissed the complaint, however, with a direction to the insurance company to pay whatever premiums that were paid.

6)                Aggrieved by the said decision, the complainant preferred the appeal contending that the Dist. Forum did not appreciate either facts or law in correct perspective.    It ought to have seen that  Clause-4B  of policy  was  unilateral, unreasonable and un-conscionable, and therefore prayed that the complaint be allowed.

7)                The point that arises for consideration is whether the order of the Dist. Forum is vitiated by mis-appreciation of fact or law?

8)                It is an undisputed fact that the complainant’s wife  was covered by  LIC policy for a sum of Rs. 50,000/- covering the period from 27.5.2004  to 27.5.2019  evidenced under policy Ex. B3.    It is also not in dispute that  she died on 6.10.2004  while preparing food when her saree caught fire, sustained injuries, admitted in  Government Area Hospital at Suryapet  where  she succumbed to injuries  while undergoing treatment vide post-mortem examination report Ex A5.    The police in fact registered a case in Crime No. 97/2004 u/s 174  Cr.P.C.  in FIR Ex. A3 followed by inquest evidenced under Ex. A4.    There was no suspicion or foul play in regard to her death.   When the claim was made  it was repudiated on the ground that clause-4B  attracts whereby  her death being inside the house and not a public place  not covered by terms of the policy.   

9)                It may be stated herein  that Clause-4B does  not form  part of terms of the policy    A file slip was pasted to the policy.  No signature whatsoever  of the assured was taken to prove that it forms  part of original  terms of the agreement.     Since the insurance company could not show that existence of clause-4(B)  at the time when the assured had taken the policy,  it would in no way  bind  the assured and consequently the complainant.   The insurance company if really intends that  clause-4(B) to be introduced as one of the terms,  being not part of the original policy,   it ought to have taken  the signature of the assured indicating that the said term was part and parcel of he

contract whereby   they would not be liable to pay the amount covered under the policy in case of accident.    The insurance company did not file the affidavit of the agent who had obtained the proposal or that of   Mr. Budde Krishna Murthy, LIC Chairman Club Member  who has attested her signature  to state that  originally clause-4B  was part and parcel of the policy conditions and the said fact was intimated to her.    The insurance company cannot repudiate the claim by inserting some term  contrary to the original terms of the policy by pasting a slip.    Since it is not  part and parcel of the terms of the policy the insurance company is liable to pay the amount covered under the policy.    The Dist. Forum did not appreciate the facts in correct perspective.

10)              In the result the appeal is allowed setting aside the order of the Dist. Forum, consequently the complaint is allowed in part.  The insurance company is directed to pay Rs. 50,000/- to the complainant with interest @ 9% p.a.,  from the date of repudiation viz., 7.7.2007  till the date of realization together with costs of Rs. 2,000/-.  Time for compliance four weeks.

1)      _______________________________

PRESIDENT                 

2)      ________________________________

 MEMBER           

   Dt.   05. 10. 2010

*pnr

“UP LOAD – O.K.”