BEFORE THE DISTRICT CONSUMER FORUM AT NALGONDA
PRESENT: SRI D.SINGARA CHARY, B.A., LL.B.,
PRESIDENT.
SRI K.VINODH REDDY, B.Sc.,
MALE MEMBER.
SMT.CH.A.LATHA KUMARI, M.A.,M.Sc.,LL.M.,
FEMALE MEMBER.
. . .
MONDAY, THE SEVENTH DAY OF JANUARY, 2013
CONSUMER COMPLAINT No. 45 OF 2012
Date of filing: 23-08-2012
Date of Disposal:07-01-2013
Between:
1. Nadimpally Mangamma W/o Late Yadaiah, Aged: 40 years,
Occ: Coolie,
2. Nadimpally Pushpalatha D/o Late Yadaiah, Age: 21 years,
Occ: Nil,
3. Nadimpally Shiva Prasad S/o Late Yadaiah, Age: 20 years,
Occ: Nil,
All are R/o H.No.3-8, Narkatpally Village and Mandal,
Nalgonda District.
…Complainants.
AND
1. M/s Sanghamithra Co-operative Urban Bank Limited, Prakasham
Bazar, Nalgonda. Represented by its Managing Director.
2. Oriental Insurance Company Limited, Service Centre, 6-1-349,
Adjacent to Naivedyam Hotel, Padma Rao Nagar, Secunderabad.
Represented by its Manager.
…Opposite Parties.
This complaint coming on before us for final disposal on this day, in the presence of Sri G.Prakash, Advocate for the Complainants, and Sri G.V.S.Chalapathi Rao, Advocate for the Opposite Party No.2, and the Opposite Party No.1 having been set exparte, and on perusing the material papers on record, and having stood over for consideration till this day, the Forum passed the following:
ORDER OF THE FORUM DELIVERED
BY D.SINGARA CHARY, PRESIDENT
1. The Complainant No.1, the wife and the Complainants No.2 and 3, the children of late Nadimpally Yadaiah have filed this complaint
Contd…2
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Under Section 12 of Consumer Protection Act to direct the Opposite Parties to pay a sum of Rs.25,000/- towards sum assured with interest @ 24% p.a. and to pay a sum of Rs.10,000/- towards compensation for mental agony and Rs.10,000/- towards incidental expenses and costs.
2. The facts leading to the filing of this complaint are as follows:
Late Nadimpally Yadaiah was the account holder of the Opposite Party No.1 bank and OP-1 bank paid consolidated premium after collecting amounts from its customers, including the deceased Yadaiah towards Janatha Personal Accident. On 26-09-2010 in the night, the deceased who was rickshaw puller in Vijayawada and who was living in hill area, fell accidentally and later on died in Government Hospital, Vijayawada while undergoing treatment. The Complainant No.1 submitted all the required documents, but the Opposite Party No.2 repudiated the claim by a letter dated 21-12-2011 on the ground that the deceased was in intoxicated condition at the time of his death. The repudiation is illegal.
3. The Opposite Party No.1 remained exparte.
4. The Opposite Party No.2 filed a written version contending that the Complainants are not consumers and as such this Forum has no jurisdiction. However, OP-2 admitted the issuance of the Janatha Personal Accident Policy, but stated that according to the terms and conditions, the sum assured is not payable if the insured while under
Contd…3
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the influence of intoxicating drugs or liquor dies. The deceased was under the influence of alcohol as certified by the Station House Officer, Machavaram, Vijayawada in Krishna District. Therefore, the repudiation was on justifiable grounds. It is also stated that the claim should have been made within one month after the event and as there is delay in lodging claim by 26 days, the amount is not payable.
5. The parties filed their respective proof affidavits. While the Complainants marked Exs.A-1 to A-13, the Opposite Party No.2 marked Ex.B-1.
6. The point for consideration is:
Whether the repudiation of the claim by the Opposite Party No.2
is justified?
7. POINT:
The Opposite Party No.2 admitted issuance of the policy and the coverage of personal accident of the deceased, but stated that the deceased was under the influence of alcohol and was in intoxicating condition and according to the terms and conditions under Ex.B-1, the amount is not payable.
8. There is no dispute that the deceased had accidental fall when he went to answer calls of nature in his house which is located on a hillock and suffered severe injuries and ultimately died in the Government Hospital, Vijayawada. The Opposite Party No.2 relying on
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Ex.A-2 intimation of accidents and injuries, given by the Government Hospital to the Police and it is stated therein that the deceased had fallen from height near a hill region at his house due to drunken state at 8-00 p.m. on 26-09-2010 and that the patient was in serious condition. After the death of the deceased, the police held inquest under Ex.A-4. It is, however, stated therein that while the deceased was passing urine, he fell down accidentally since it was dark at that place. It is nowhere stated therein that the deceased was under the influence of alcohol at the time of his accidental fall. After the inquest the dead body was subjected to post mortem and Ex.A-5 is the Post Mortem Report. In the column relating to abdomen in the post mortem report, it is shown that the stomach was empty. Thus, the post mortem report also does not indicate that there was liquor in the stomach of the deceased. Both the inquest and post mortem report if read together, the possible conclusion is that the deceased fell down from a height of 10 feet in the hillock area due to darkness and slip of leg. In the circumstances, Ex.A-3 wherein it is stated that the deceased was in drunken state, cannot be given any weight. Even in Ex.A-3 it is only stated that the deceased was in drunken state but, it is not stated therein that he was under the influence of alcohol. There is lot of difference between drunken state and under the influence of alcohol. We are very much sure that the deceased was not even under drunken state, in the light of Exs.A-4 and A-5. The above differentiation between being drunken state and under the influence of alcohol is only resorted to explain the words drunken state in Ex.A-3.
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There is no basis for the author of Ex.A-3 to state that the deceased
was in drunken state more particularly in the light of Exs.A-4 and A-5. The affidavit of the author of Ex.A-3 is not filed. Therefore, it is not established that the deceased was under drunken state, leave alone that he was under the influence of intoxication. When it is held that the deceased was not under the drunken state, the Opposite Party No.2 is bound to pay the amount.
9. The alleged delay of 26 days in lodging the claim is no ground to reject the claim since the fixation of one month time is only intended to settle the claim early and not to punish the legal heirs of the deceased, who were already under the grief.
10. Since the Opposite Party No.2 repudiated the claim and as the deceased paid premium for the coverage of his accidental death, the Complainants are consumers within the meaning of Section 2(d) of the Consumer Protection Act.
11. In view of the above facts and circumstances, the repudiation of the claim is not justified and consequently we hold that the Opposite Party No.2 is liable to pay a sum of Rs.25,000/- to the Complainants being the sum assured for Janatha Personal Accident Policy of the deceased.
12. The Opposite Party No.1 is only a service provider and as such the claim against it is liable to be dismissed.
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In the result, the complaint is allowed and the Opposite Party No.2 alone is directed to deposit in this Forum a sum of Rs.25,000/- (Rupees Twenty five thousand only) towards sum assured and a sum of Rs.2,000/- (Rupees Two thousand only) towards deficiency of services with interest @ 9% p.a. from the date of the complaint till realization and costs of Rs.2,000/- (Rupees Two thousand only) within one month from today. The claim against the Opposite Party No.1 is dismissed without costs.
Dictated to Steno-Typist, transcribed by him, corrected and pronounced by us in the open Forum on this 7th day of January, 2013.
FEMALE MEMBER MALE MEMBER PRESIDENT
APPENDIX OF EVIDENCE
WITNESSES EXAMINED
For Complainants: For Opposite Parties:
Affidavit of the Complainant No.1. Sri Dr.Nagabhushanam,
Divisional Manager of Opposite
Party No.2 Insurance Company
filed his affidavit on behalf of
Opposite Party No.2.
EXHIBITS MARKED
For Complainants:
Ex.A-1 Dt. Pass Book issued by Opposite Party No.1.
Ex.A-2 Dt.27-09-2010 Xerox copy of F.I.R. in Cr.No.400/2010 of
PS.Machavaram.
Ex.A-3 Dt.27-09-2010 Xerox copies of Intimation of Accidents and
Injuries to Police.
Ex.A-4 Dt.27-09-2010 Xerox copy of Inquest Report.
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Ex.A-5 Dt.27-09-2010 Xerox copy of Post Mortem Report.
Ex.A-6 Dt.27-10-2010 Certificate of Death, issued by Municipal
Corporation, Vijayawada.
Ex.A-7 Dt.05-12-2007 Xerox copy of Aarogyasri Health Card.
Ex.A-8 Dt.03-12-2010 Xerox copy of letter addressed by the
Opp.Party No.1 to Opp.Party No.2 Company.
Ex.A-9 Dt.21-12-2011 Letter (Repudiation Letter) addressed by the
Opposite Party No.2 tothe Complainant No.1.
Ex.A-10 Dt.17-04-2012 O/c of legal notice issued by the counsel for
the Complainants to the Opposite Parties.
Ex.A-11 Dt.17-04-2012 Courier Receipt.
Ex.A-12 Dt.17-04-2012 Courier Receipt.
Ex.A-13 Dt.18-04-2012 Reply Notice given by Opposite Party No.2.
For Opposite Party No.2:
Ex.B-1 Dt. Terms and Conditions of Janatha
Personal Accident Insurance Policy.
PRESIDENT
DISTRICT CONSUMER FORUM
NALGONDA
TO
1). Sri G.Prakash,
Advocate for the Complainants.
2). Sri G.V.S.Chalapathi Rao,
Advocate for the Opp.Party No.2.
3). The Opposite Party No.1.
