Before the District Forum: Kurnool
Present: Sri K.V.H. Prasad, B.A., LL.B., President
And
Smt C.Preethi, M.A., LL.B., Member
Friday the 26th day of November, 2004
C.D.No.180/2003
M. Venkatalakshmamma,
W/o. Late Moolinti Krishna Murthy,
Gargeyapuram (V),
Kurnool (M),
Kurnool Dist. . . . Complainant represented by his counsel
Sri P. Madhusudhana Reddy.
-Vs-
1.M/s Oriental Insurance Company Ltd,
Rep. by its Divisional manager,
Kurnool. . . . Opposite party No.1 represented by his
2.The President,
The Gargeyapuram primary
agricultural co-operative credit society,
Kurnool Dist. . . . Opposite party
3.The General Manager
The Kurnool Dist. Co. Operative
Central Bank Ltd,
Kurnool. . . . Opposite party
O R D E R
(As per Smt C. Preethi, Member)
1. This CD complaint of the complainant is filed under section 12 of C.P. Act, 1986, seeking a direction on the opposite parties to pay G.P.A insured amount with 24% interest per annum from the date of filing of the claim petition i.e 3.6.2002 and any other relief or reliefs which the complainant is entitled in the circumstances of the case.
2. The gist of the complaint of the complainant is that the complainant’s husband by name Moolinti Krishna Murthy has insured his life with opposite party No.1 under G.P.A policy bearing No. 42/2003/14. The said M. Krishna Murthy on 31.3.2002 at about 6.00 P.M, while going to bath room, when there is heavy down pour of rain compounded with thunder storm fell down and sustained injuries to his head and died on the spot and burial was performed the next day. After burial the complainant came to know through opposite party No.2 that her husband has insured his life under the above said policy and the dependents are entitled to receive the insured G.P.A amount, provided the complainant producing P.M report etc. Thereafter, the complainant lodged a complaint before the Talug Police Station, Kurnool and registered a case as Cr No.89/2002 under section 174 Cr P.C. The deceased dead body was exhumed and inquest was held followed by post mortem in which it was stated clearly that the cause of death of the deceased Moolinti Krishna Murthy was “Due to Head Injury”. The complainant intimated the death of the deceased and submitted claim form to the opposite party No.1 on 3.6.2002 and the opposite party No.1 repudiated the claim on the ground that the there is delay of 64 days in intimating the death of deceased which is in violation of policy condition No.1. The complainant submits that as she is illiterate and poor helpless lady aged 48 years was an aware of the facts, so could not intimate that opposite party No.1 within the stipulated time of death of the deceased, which cannot be termed as such grave violation of policy condition No.1. The opposite party No.1 in not paying the G.P.A insured amount to the complainant is amounting to deficiency of service, hence the complainant approached this Forum seeking redressal for the above said grievance.
3. The complainant in support of her case filed the following documents Viz (1) office copy of FIR No.89/02 dt 12.5.2002 of Taluq Police Station Kurnool (2) Office copy of inquest report dt 21.5.2002 and (3) postmortem report No. 342/02 dt 21.5.2002 issued by Kurnool Medical College, Forensic Medical Department besides to her sworn affidavit in reiteration of her complaint avernments and the above documents are marked as Ex A.1 to A.3 for its appreciation in this case.
4. In pursuance to the notice of this Forum as this case of the complainant the opposite party No.1 appeared through its standing counsel and contested the case by filing denial written version and alleging the case of the complainant as not maintainable either in law or on facts and the opposite parties 2&3 remained exparte through out the case proceeding.
5. The written version of opposite party No.1 submits that it repudiated the claim of the complainant as the death of the complainant’s husband occurred on 31.3.2002 and the complainant informed the police on 12.5.2002 by lodging an FIR with a request to exhume and carry out P.M on the body of the deceased. As the death intimation along with the claim form was submitted on 3.6.2002 as such there is delay of 64 days in intimating the claim which is clear violation of policy condition No.1. Which reads as claim must be made within one calendar month after event which may give rise to claim under the policy and further the unreasonable delay of 64 days gives rise to reasonable, legitimate, suspicion and apparently fraudulent on the face of the case which itself is in violation of policy condition No.3 and further no corroborative evidence in support of the case is placed. In these circumstances the repudiation by opposite party No.1 is justified and the opposite party No.1 is not liable to pay the benefits under the G.P.A policy to the complainant and seeks for the dismissal of complaint with costs.
6. In support of it’s the opposite party No.1 filed the following documents Viz (1) policy conditions besides to its sworn affidavit in support of its case and the above documents are marked as Ex B.1 for its appreciation in this case
7. Hence the point for consideration is whether the complainant has made out any deficiency of the opposite parties towards him and thereby his entitleness to the reliefs sought?:-
8. There is no dispute as to the disceased M. Krishna Murthy covered under the G.P.A policy of opposite party No.1 bearing No.43/2003/14. There is no dispute as to the complainant is entitled to the insured amount under the above said policy. There is no dispute that the deceased died on 31.3.2002 and the death information and claim form was submitted on 3.6.2002 to the opposite party No.1.
9. The only dispute is regarding the delay in informing the death of deceased and submitting claim form. The complainant’s counsel argues that the complainant being aged about 48 years and illiterate poor women un aware of the facts of informing the opposite party No.1 within the stipulated time. On the other side the counsel for opposite parties argues that the belatedness of the complainant in informing the opposite party No.1 about the death of deceased and submitting claim form after 64 days from the date of death of deceased is clear violation of condition No.1 of the said policy and apparently fraudulent on the face of the case which is in violation condition No.5.
10. There is no dispute that the complainant gave a complaint to the policy on 12.5.2002 by lodging an FIR with a request to exhume the dead body of her husband and thereafter inquest and P.M were conducted on the said dead body. The Ex A.1 is the attested Xerox copy of FIR, Ex A.2 is the attested Xerox copy of inquest report conducted on the dead body of complainant’s husband and Ex A.3 is the attested Xerox copy of P.M report of the deceased M. Krishna Murthy. The Ex A.3 envisages the cause of death of the deceased M.Krishna Murthy as “Due to Head Injury”,. The only attack made by the opposite party No.1 as against complainant in the lengthy written version filed by the opposite party No.1 was that the complainant was not entitled for any amount under the policy as she intimated the death of her husband belatedly i.e after 64 days of demise of the insured, which is in violation of policy conditions No.5. The above condition No.5 in Ex B.1 envisages that upon the happening policy of any event which may give rise to a claim under the policy insured shall forth with give notice thereof to the company. Unless reasonable cause is shown the insured should within one calendar month after the event which may give rise to claim under the policy, give written notice to the company with full particulars of the claim.
11. The said condition doesn’t envisage the forfeiture of the insured amount of the deceased, on failure of the dependent/nominee not informing the death of insured to the insurance company within the stipulated time. Further the condition No.1 envisages unless reasonable cause is shown the injured should in variable inform the Insurance Company within one month after the event. From the above it appears that when reasonable cause is shown, claim can be made to the Insurance Company for payment of Insured amount even after stipulated time i.e one month. In the present case the complainant being aged 48 years old women poor and illiterate and un aware of the facts could not made the claim within the stipulated time, which does not appear to be such a grave violation of condition that the complainant should in all events be denied of insured amount of her husband M. Krishna Murthy.
12. In support of her case the complainant relied on the following decision between LIC of India Vs Rajendra Singh Gaur, reported in IV (2004) CPJ (53), when in, it was held that repudiation of claim by LIC on the ground that intimation of death was delayed, the complainant contended that he was aged 80 years old and not able to intimate earlier and he completed all formalities, hence held repudiation of claim is unjustified and illegal and LIC is liable to pay to the complainant the policy amount.
13. In the above said case policy holder died on 29.11.1994 and intimation of death was given by nominee to the Insurance Company in June 2003, the complainant alleged that he was more than 80 years of age and could not intimate earlier and completed all formalities. The complaint was allowed on the ground that policy stood in tact for more than 10 years and the complainant was nominee under the policy and the complainant alone is entitled to the policy amount as nominee.
14. Following the above mentioned decision, in the present case the intimation was given after 64 days delay and the reasons averrned by the complainant in her complaint avernments that she is aged 48 years, poor and illiterate and un aware of facts could not intimate in time, but completed all formalities as required by the opposite party No.1 for settling her claim, as such the complainant is showing reasonable cause of the delay in intimating late the death of her husband M. Krishna Murthy and there appears no fraudulent suspicion on the face of the case in violation of policy condition No.5. Hence, the complainants approach to this Forum seeking redressal is justified. The opposite party No.1 by its doscile conduct should not have repudiated the claim of the complainant, there appears every deficiency of service on part of the opposite party No.1 towards the complainant.
15. The opposite party except alleging delay of 64 days in intimating the death of the deceased did not substantiate their bonafidies and malafidies of the complainant by substantiating the same by any accepting corroborative material.
16. To conclude, from the above discussion and following the afore mentioned decision, the complainant is certainly remaining entitled to get the insured amount under the above said policy covering the risk of her husband M.Krishna Murthy and the opposite party No.1 is liable to pay the same as there is deficiency in service on the part of the opposite party No.1 in not paying the said amount. As no cause of action was made against opposite party No.2&3case against them is dismissed.
17. In the result, the complaint is allowed, directing the opposite party No.1 to pay insured amount of the deceased M. Krishna Murthy covered under policy No.42/2003/14 to the complainant with 9% interest per annum from 3.6.2002 till realization along with Rs.5, 000/- as compensation and the opposite partNo.1is directed to pay the supra awarded amount within one month of the receipt of this order.
Dictated to the Stenographer, Typed to dictation corrected by us pronounced in the Open Court this the 26th day of November 2004.
Sd/- Sd/-
MEMBER PRESIDENT
