BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION:HYDERABAD.
FA.NO.1699 OF 2005 AGAINST C.D.NO.10/2004 District Forum, PRAKASAM AT ONGOLE.
Between:
Chilipi Lakshmi Kanthamma, W/o.Chilipi
Ramana Reddy, R/o.Chandrapadu Village,
Chimakurthy Mandal, Prakasam District. ..Appellant/
Complainant
And
1. M/s. United India Insurance Co. Ltd.,
Rep. by the Divisional Manager,
Divisional Office No.4, Church Buildings,
Tilak Road, Hyderabad-500 001.
2. M/s.United India Insurance Co. Ltd.,
Rep. by its Branch Manager, Branch Office,
Birudaraju Towers, GNT Road, Ongole.
3. The Branch Manager, Andhra Bank,
Doddavaram Branch, Doddavaram,
Maddipadu Mandal, Prakasam District.
4. M/s. National Insurance Company Limited,
Rep. by its Manager, Ongole (added as
Per orders in IA 157/04 dated 6-8-2004). Respondents/
Opp.parties
Counsel for the Appellant : M/s.Y.V.Ravi Prasad
Counsel for the Respondent: R1 and R2 served.
Mr.Rupendra Mahendra-R3
Mr.Kota Subba Rao-R4
QUORUM:THE HON’BLE SRI JUSTICE D.APPA RAO, PRESIDENT.
SMT.M.SHREESHA, MEMBER.
AND
SRI G.BHOOPATHI REDDY, MEMBER
WEDNESDAY, THE THIRTEENTH DAY OF AUGUST
TWO THOUSAND EIGHT
Oral Order : (Per Sri G.Bhoopathi Reddy, Hon’ble Member)
***
This is an appeal filed by the appellant/complainant under Section 15 of Consumer Protection Act, 1986 to set aside the dismissal order passed by the District Forum, Prakasam at Ongole in C.D.No.10/2004 dated 16-12-2004.
The brief facts of the complaint are that the complainant’s husband by name, Chilipi Ramanareddy opened an S.B. account in 3rd opposite party bank under SB account No.3515 and was operating the same along with his son, Chilipi Srinivasa Reddy as joint account. Under the scheme, the account holder is provided with “Accident insurance cover”. The complainant submitted that unfortunately the account holder, Chilipi Ramana Reddy, husband of the complainant, died on 30-1-12003 due to snake bite and the dead body was cremated. The complainant submits that she has no knowledge about legal formalities and therefore did not give police report or made any inquest on the dead body of her husband. The complainant thereafter approached 3rd opposite party and informed the death of her husband and requested to send the claim form to 1st opposite party or 2nd opposite party, who is competent to settle the claim and pay the insurance claim under policy No.666/44/115/6. The 3rd opposite party sent the claim forms to 2nd opposite party for settlement of complainant’s claim under the said policy with opposite party No.1. The complainant also sent a letter dated 27-8-2003 to 2nd opposite party requesting to settle the claim along with the certificate issued by Panchayat Sarpanch, Chandrapadu and MPTC of Chandrapadu. The complainant submitted that 2nd opposite party sent its persons to the village of the complainant and made enquiries regarding the death of her husband but inspite of repeated requests failed to settle the claim. Hence the complainant got issued a registered notice to the opposite parties 1 to 3 on 22-9-2003 demanding to settle the claim but opposite parties sent replies with false allegations to evade the claim. Again 6-10-2003, 2nd opposite party sent a letter to the complainant requesting her to send F.I.R. and inquest report, post mortem report which are not available with the complainant and on 9-10-2003, 3rd opposite party also sent a letter to the same effect. Hence the complaint for a direction to opposite parties 1,2 & 4 to settle the claim of the complainant and direct them to pay the amount of Rs.1,00,000/- under Abhaya Gold Savings Scheme with interest at 12% p.a. from the date of filing of complaint and also costs.
Opposite parties 1 and 2 filed counter contending that the complainant is not a ‘consumer’ within the meaning of Consumer Protection Act, 1986. They submitted under Abhaya Gold Savings Bank, account holders were covered under group personal accident policy with M/s.IFFCO-TOKIA General Insurance Company Ltd., for the period of 01-11-2001 to 31-10-2002 and for the period of 01-11-2002 to 31-10-2003 they were covered by National Insurance Company Ltd., They further submitted that at the time of alleged accident, the deceased was not covered by opposite parties 1 & 2 but was covered by National Insurance Company and the complainant has to make it as proper party and prayed for dismissal of the complaint.
Opposite party No.3 filed counter contending that it is true that the complainant’s husband, Mr.Chilipi Ramana Reddy, opened SB account No.3515 with them and it is not Abhaya Gold Account which is covered under insurance scheme to pay for the death of snake bite. Opposite party No.3 further submitted that the complainant did not submit proper person certificate, FIR, inquest report and postmortem report and submitted that there is abnormal delay in submitting report to 2nd opposite party and prayed to dismiss the complaint.
Opposite party No.4 filed counter mainly stating that they were added as party in I.A.No.157/2004 on 6-8-2004 and submitted that the complainant has to submit necessary documents, after following due procedure and that they would settle the claim basing on the genuineness of the documents and version of the complainant. Opposite party No.4 further submitted that no claim was made by the complainant or by 3rd respondent before them and as per their knowledge the SB account holder is not eligible and entitled for claiming compensation for accidental death and prayed to dismiss the complaint.
The District Forum based on the evidence adduced i.e. Exs.A1 to A11 and B1 and the pleadings put forward, dismissed the complaint.
Aggrieved by the said order, the unsuccessful complainant preferred this appeal.
The point for determination in this appeal is whether the appellant is entitled for the insurance claim amount as per Abhaya Gold Savings Scheme and whether the order passed by the District Forum is sustainable?
The appellant submits that the District Forum has not properly appreciated the evidence on record. The order of the District Forum is illegal, erroneous, arbitrary and contrary to the principles of natural justice. The death of the deceased is accidental and the death was on account of snake bite and as per Abhaya Gold Savings Scheme, the appellant is entitled to the death claim. The District Forum has failed to consider Ex.A3, certificate issued by MPTC & Gram Panchayat Sarpanch. The District Forum ought to have seen that M.R.O. V.A.O. or village secretary are neither the persons competent to speak about the cause of death nor are persons having knowledge about the cause of death of the appellant’s husband. The order passed by the District Forum may be set aside and the appeal be allowed.
There is no dispute that the appellant is the nominee of her husband, who has filed a claim before the Branch Manager, Andhra Bank who in turn sent the documents to insurance company. The appellant submits that on account of snake bite the deceased died. After the death of the deceased, the complainant being the wife of the deceased had claimed the amount and submitted claim to Andhra Bank and they in turn submitted to the insurance company and the insurance company did not settle the claim. The appellant submits that non settlement of the claim by the insurance company is not sustainable. Ex.A9 is the letter of United India Insurance Company dated 6-10-2003 which discloses that on 10-6-2003 insurance claim is received from the Branch Manager, Andhra Bank and requested to send death certificate, F.I.R., Post Mortem Report, K.C.C.-cum-pass book. It was also further mentioned that if the documents are not sent within 15 days, the claim will be treated as “No claim” and also asked reasons for the delay in preferring the claim. There is no dispute with regard to the death of the deceased on account of snake bite. The appellant submits that the District Forum has not properly appreciated the documentary evidence i.e. Ex.A3 to prove that the death of deceased was due to snake bite. The District Forum has not relied on the said certificate issued by the Sarpanch of the Village. A perusal of the said certificate discloses that on 30-1-2003 at 5.00 p.m. on account of snake bite the deceased died. Ex.A2 dated 28-8-2003 notice was issued to the Branch Manage of United India Insurance Company Limited. In the said notice it was mentioned that the complainant’s husband died on 30-1-2003 by snake bite and that she sent the claim application through the Branch Manager, Andhra Bank and requested to settle the claim and pay Rs.1,00,000/- with interest at 12% p.a. The said notice was received by the insurance company. Ex.A5 is the office copy of legal notice and Ex.A6 is the reply given by United Insurance Company to the notice issued on behalf of the complainant. No enquiry was conducted by the company as to the cause of the death. The appellant submits that the District Forum held that the M.R.O., V.A.O. and Village Secretary are the proper persons to speak about the cause of death and they have not given any certificate. There is no doubt that the complainant has not obtained any certificate from them. No rule or authority was shown that they are competent persons to give certificate. The complainant has filed a certificate, Ex.A2 of the Sarpanch of the Village. The said certificate discloses that on account of snake bite the deceased died. We do not see any reason to suspect the bonafides of the certificate The question of giving any police complaint will not arise, as it is not a crime, that could be reported. Therefore, issuing of F.I.R. and post mortem report does not arise.
On 6-10-2003, opposite party No.2 sent a letter to the complainant asking her to enclose F.I.R., inquest report and post mortem report. These are routine without anything to do with the case. Even if a report is given, police will not register the case. As per Ex.A1, pass book, on 24-11-2000 the balance was Rs.167/-, on 2-2-2000 the balance was Rs.178/-. Not maintaining a minimum balance is not a fundamental breach and cannot come in the way for settling the claim. The complainant is a poor widow and she cannot be denied the claim amount. As per the conditions in Ex.A1, the death due to snake bite also covers the policy. Therefore, the account holder is entitled to Rs.1,00,000/-. Therefore, the order of the District Forum is set aside and the complaint is allowed directing respondent No.4, insurance company, to pay the insurance amount of Rs.1,00,000/- along with interest at 9% p.a. from the date of complaint together with costs of Rs.5,000/-. Respondent No.3, Branch Manager of Andhra Bank is only a facilitator and respondent Nos. 1 and 2, United India Insurance company are also not necessary parties and the complaint against them is dismissed. Respondent No.4 is directed to comply with this order within six weeks from the date of order.
In the result the appeal is allowed and the order of the District Forum is set aside by directing respondent No.4, insurance company, to pay the insurance amount of Rs.1,00,000/- along with interest at 9% p.a. from the date of complaint together with costs of Rs.5,000/-. Respondent No.3, Branch Manager of Andhra Bank is only a facilitator and respondent Nos. 1 and 2, United India Insurance company are also not necessary parties and the complaint against them is dismissed. Respondent No.4 is directed to comply with this order within six weeks from the date of order.
PRESIDENT. LADY MEMBER. MALE MEMBER.
JM Dated 21-8-2008
