BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION:HYDERABAD.
FA.No.415 OF 2006 AGAINST C.D.NO.173 OF 2003
Between:
B.Shivappa, S/o.B.Chennaiah,
Aged 43 years, Indian, Govt. Service,
R/o.H.No.1-10-5/16/N, S.S.Gutta,
Mahaboobnagar.
1. The New India Assurance Co. Ltd.,
Howrah
Dobson Lane, 2nd West Bengal), rep. by
2. The New India Assurance Co. Ltd., rep.
Kurnool.
Counsel for the Appellant
Counsel for the Respondents:
TUESDAY, THE SECOND DAY OF DECEMBER,
TWO THOUSAND EIGHT
Oral Order :
The brief facts as set out in the complaint are that the brother of the complainant, B.Chinna Swamy, obtained Janata Personal Accident Insurance Policy from opposite party No.1 through opposite party No.2 bearing No.4751220001605 for Rs. 10.00 lakhs on31-12-1998 30-12-2001. 14-7-2000, the insured died as he fell from the staircase in his own house at Ippatoor village, Nawabpet Mandal, Mahaboobnagar. 15-9-200014-7-2000 18-12-2000, the Village Sarpanch of Ippatoor village also gave a certificate declaring that the insured died on14-7-20004-12-2000 15-7-2000 21-12-2000 21-12-2000, the complainant got issued a legal notice to opposite parties, i.e. the Regional Manager at Secunderabad and others to settle his claim. They also informed that they are not liable to pay the claim amount as the insured died due to cardiac failure. 27-12-2000, opposite party No.1 sent a claim form asking the complainant to produce the death certificate, post mortem report and police investigation report. 17-3-2001, opposite party No.2 gave a reply through their advocate stating that they are not liable to pay the claim amount. 28-3-2001, the complainant gave a rejoinder notice to both the opposite parties clarifying his stand.
Opposite party No.2 filed counter which was adopted by opposite party No.1. He is a general surgeon and not a cardiologist to give any such opinion and the certificate issued by Sarpanch and the affidavits given in support of the alleged accidental death of the insured and panchanama are created for claiming the amount. 21-12-200024-7-2001 They further submitted that in the absence of FIR. PM report and Police final investigation report, the claim cannot be considered as the same is mentioned in the policy conditions. 21-12-200015-8-2000, the complainant approached him with original policy and asked him to help in the matter and it can be seen in whose presence and at whose instance the documents were prepared. 15-7-2000 They therefore submitted that the complainant is not entitled for any reliefs and that there is no deficiency in service on their behalf and justified their repudiation.
Based on the evidence adduced i.e. Exs.A1 to A12 and the pleadings put forward, the District Forum dismissed the complaint.
Aggrieved by the said order, the complainant preferred this appeal.
The learned counsel for the appellant/complainant submitted that the insured fell from a stair case and died and hence the question of getting a F.I.R. or post mortem does not arise. DistrictHeadquartersHospital, Mahabubnagar in which he stated that the insured died due to head injury sustained on account of fall from stair case and therefore the repudiation is arbitrary and unreasonable.
We have perused the material on record. 31-12-1998 14-7-2000 21-12-200021-12-2000. On 2-1-2001, opposite party No.2 gave a reply stating that they did not receive death intimation and copies of F.I.R. and post mortem report.
The learned counsel for the respondents/opposite parties contended that when the insured admittedly died on14-7-2000, the claim was made five months thereafter at a belated stage and only then the complainant had secured the certificates of the doctor. judgement of the National Commission in
“Merely because the claim is not made within the stipulated period,
it is not void”.
14-7-2000
When it is opposite party’s contention that this certificate was taken on 15-9-2000 which is two months after the date of death and therefore cannot be relied upon, the burden of proof shifts to the opposite parties to prove that the certificate issued vide Ex.A12 is not genuine.
Dated 02-12-2008.
